Harm Reduction Nursing - Identifying Relevant Harm Reduction Goals for Persons Who Use Drugs


Harm reduction is not new to nursing. A harm reduction perspective is key in positioning nurses in a compassionate, relational space that breaks down stigma related to substance use. 


Reducing Stigma of Drug Use 

The central principle of harm reduction is the recognition that some substance use within any society is normal, meaning there will always be some people using some substances for various purposes.  This goal is relevant to individuals using drugs because currently many cultures and societies view substance use, especially use of illegal substances or misuse of prescription substances, as morally wrong and stigmatize those individuals who choose to engage in their use.  The goal of reducing stigma involves actively countering social exclusion and stigma of substance use and substance users.  Further, work towards this goal places an emphasis on promoting and supporting community mobilization, as seen in organizations like VANDU. The individual drug user is able to become part of a community that plays an important role in turning drug use and substance use issues into a public health issue.  


Autonomy for Persons Using Drugs

With the normalization of some substance use there also comes the understanding that using substances is a personal choice (though substance dependence and addiction may not be). This goal also entails individuals taking responsibility for their choices within the spectrum of options that are available.  


Flexibility and Maximization of Intervention Options 

Harm reduction philosophy is designed to offer a wide range of options. Harm reduction strategies are creative, innovative and meant to be accessible for those at all levels of drug use meaning individuals who use substances can be met where they are at with respect to their substance use and also to the Stages of Change if they are having substance use issues.  


Evidence-Based Strategies

Some of the strategies that are used to reduce drug use, such as those that focus on reducing drug use through criminalization of individuals who use drugs, are not subject to evaluation for their effectiveness in meeting the desired goal. Harm reduction strategies are strategies that demonstrate effectiveness in reducing the harms of drug use as seen in evaluation. The strategies that are used clearly state the target goals and the desired effect. This aligns with the goal of the substance user because resources such as money, staff, time and education are directed at strategies that are shown to have a beneficial outcome for substances users. 


Health Promotion 

One of the central principles of harm reduction is a focus on reducing the harms of drug use without requiring the reduction of drug use.  The goal of health promotion is evidenced in the recognition that harms of drug use can be reduced. For example, implementation of a needle distribution program helps reduce transfer of blood borne diseases because of accessibility and education about using sterile needles; however users are not required to reduce the number of times or amount of injection drugs they are using. Those who have substance use issues may have had poor experiences with the health care system.This goal also relates to promoting the right in Canada that everyone has equitable access to healthcare access and  a right to health. 





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