Drug and Addiction: the harm reduction approach

This article was exclusively written for The European Sting by Ms. Rawshan Saiyara Nawal, a Bangladeshi undergraduate medical student from the University of Dhaka. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Merriam Webster defines drugs as “a substance (as cocaine) that may harm or addict a user.” In general use, drug addiction is a neuropsychological disorder typified by constant use of a drug, despite its ample harm and other negative costs. World Health Organization – WHO observes that psychoactive drugs are substances that, when taken in or administered into one’s system, affect mental processes, e.g. perception, consciousness, cognition or mood and emotions. It defines those to a broader category that also include alcohol and nicotine. On the other hand, Harm reduction refers to policies, programmes and practices that target to reduce negative health, social and legal effects related to drug use, drug policies and drug laws. Harm reduction is based on justice and human rights. It concentrates attention on constructive change and on working with people without judgment, coercion, discrimination, or requiring abstinence from using drugs as a requirement for availing support.

Global Health Estimates focused that 180 thousand deaths were directly linked to drug use disorders in 2019. World drug report recently observed that 0.5 million deaths are attributable to illicit drug use annually. The report also discloses that 35 million people are estimated to be suffering from drug use disorders. Thus drug addiction is a serious global issue to be addressed.

Globally – manufacturing, supply, trading or non-medical use of many psychoactive drugs is limited or restricted by law. Those have some extent of control of availability, depending on their threats to health and therapeutic utility, and are classified according to a steps of agenda at both national and international levels.

At the global level, there are international drug conventions on psychoactive drugs. Single Convention on Narcotic Drugs, 1961, aimed to fight drug abuse by coordinated international action – firstly, through containing the possession, use, trading and production of drugs, and secondly, combating drug trafficking. Convention on Psychotropic Substances, 1971 establishes an international control system for psychotropic substances, responding to the spectrum of drugs, introducing controls over a number of synthetic drugs. United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1988 provides wide-ranging measures against drug trafficking, including provisions against money laundering and the diversion of precursor chemicals.

Harm reduction approach includes a range of health and social services and practices that address illicit and licit drugs. These include, but are not contained to, drug consumption rooms, needle and syringe programmes, non-abstinence-based housing and employment initiatives, drug checking, overdose prevention and reversal, psychosocial support, and the provision of information on safer drug use.

There is no globally accepted definition of harm reduction. Every country has its own drug policy, incorporating some extent of international conventions. Existing national laws and international conventions may address drug addiction challenges better through harm reduction approaches. It is not only an approach to follow, but in a greater understanding, it is also a movement for social justice based on a belief in, and respect for, the rights of people who use drugs.

About the author

Rawshan Saiyara Nawal is a Bangladeshi undergraduate medical student. She is currently studying at Shaheed  Suhrawardy Medical College under University of Dhaka.Nawal, the young girl, has multi-faceted qualities with outstanding performance in academic and extracurricular activities. She attained merit scholarships in all the public exams. She also received best performance awards in district and divisional levels in cultural, writing and debating competitions. She is an activist in students’ humanitarian activity. Serving humanity is her goal.