The issue of drug addiction and the focus on harm reduction approach

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This article was exclusively written for The European Sting by Ms. UWASE Sandrine, a medical student from the University of Rwanda, Rwanda. 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.


[1]Addiction is defined as a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences. After many criminal and societal sanctions, we come up with, people still use drugs, and far too many still die.  Making drugs illegal has nothing to do with stopping people from using them. Judging, and criticizing drug users increases the stigma and self-hatred. Not only are they caught up in a hopeless cycle of incarceration, violence, poverty, marginalization, and discrimination that have been created by our drug laws, but they are also at the peak of getting infected by HIV and other transmittable diseases.

[2]According to WHO, People who inject drugs are at an increased risk of HIV, Tuberculosis, and Viral Hepatitis B and C, in addition to an overdose. Globally, around 11 million people inject drugs. [3]Approximately 1.4 million of these people are living with HIV [4]while 39.4% have viremic HCV infection, in this way recommends a package of harm reduction interventions that will reduce the overall overdose deaths and transmission of such diseases.

Harm Reduction stands in stark contrast to a punitive approach to problematic drug use.it is based on minimizing negative consequences and promoting optimal health and social inclusion. It includes strategies like needle exchange programs that reduce the risk of acquiring HIV, supervised injection and consumption sites, and overdose prevention sites. Saying such programs are an endorsement for drugs is like saying a hospital is an endorsement for sickness or a chemotherapy clinic is an endorsement for cancer. These all are places you go to treat an illness and addiction is an illness and an effective proven treatment for it is Harm Reduction. 

  Withdrawal management can also be viewed as a harm reduction strategy. Decades of experience and evidence prove that getting antidote naloxone in the hands of people who use drugs is the most effective way to prevent an overdose and so are substitution treatments like methadone which is widely prescribed to heroin users.

Psychosocial, community-based support can also help individuals overcome social barriers and create solutions that work best for their community. The offering of immunity for drug law violations, as another strategy, will encourage drug users to get life-saving help.

These strategies for drug use can improve health, bring connections, and greatly reduce suffering and death. We, the world, are stuck in the idea that the only option for drug users is to stop using drugs. Offering them a clean needle and a safe place to inject and dispose of is the first step to treatment and recovery.

Harm Reduction is claimed to give the wrong message to our children about drug users, but as I recall, these drug users are our children. I consider harm reduction as a step to the abstinence approach. People who use drugs are the experts of their own experience and we should provide every opportunity for those suffering to experience the miracle of recovery. Handcuffs won’t solve the drug crisis. so, why won’t harm reduction approaches take off?

REFERENCES

1. “Drug Misuse and Addiction.” National Institutes of Health. U.S. Department of Health and Human Services, July 13, 2020.

2. “People Who Inject Drugs.” World Health Organization. World Health Organization. Accessed June 25, 2022. https://www.who.int/teams/global-hiv-hepatitis-and-stis-programmes/populations/people-who-inject-drugs.

3. “Executive Summary.” World Drug Report, 2020, 10–24. https://doi.org/10.18356/ceb25f4c-en.

4. Des Jarlais, Don C. “Commentary on GrebelyEt Al. (2019): Ending HCV Epidemics among People Who Inject Drugs.” Addiction 114, no. 1 (2018): 167–68. https://doi.org/10.1111/add.14427.

5. “The Harm Reduction Model of Drug Addiction Treatment: Mark Tyndall.” YouTube, May 9, 2018. https://youtu.be/cfzkBGgxXGE.

About the author

UWASE Sandrine is a medical student from the University of Rwanda, Rwanda. She is affiliated with MEDSAR Rwanda (IFMSA NMO) in the Standing committee on Public Health. Sandrine is more engaged in youth empowerment and interested in equitable healthcare. She is highly an advocate for quality health care for all and is involved and an enthusiast in research.

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