harm reduction

Discuss the concept of harm reduction and compare it to the notion of zero tolerance

Harm reduction is a set of strategies aimed at educating the community to abstain from engaging in risky behavior in order to eliminate harm. Abstinence is considered the highest form of harm reduction. The concept of harm reduction promotes individual right to health as well as believing that people are capable of protecting themselves, loved ones and their communities. It is acknowledged in harm reduction that many individuals will use drugs so that they can cope with effects of violence in the families, sexual abuse or racism. According to Kleinig (2008) harm reduction also refers to public policy and usually involves use of public funds and so those spending the resources should be held accountable. Since of its practice in the public domain, it is open to public scrutiny and practices may range from education to legally mandated conduct. Its main aim is to reduce harm caused by certain practices which vary with the practice. Subjects of harm may be specified or general harm to the individual engaging in risky or harmful behavior, harm to others who are either directly or indirectly affected by those engaging in risky activity or social costs which is determined by the loss of productivity for the people harmed or social expenditure incurred during treatment of such individuals. Behavior practices involved in harm reduction are often not socially acceptable but in most cases when harm reduction practices are introduced, the results are opposite of the desired effects since the person engaging in such activities feels less vulnerable therefore increasing the risk activity.

The harm reduction measures take a value-neutral form to both the drug user and drug use. For example, distributing needles and syringes reduce the possibility of drug users becoming infected with HIV due to needle sharing. The policies usually make no judgment on the means or the end beyond those concerning the how effective it will be to secure the end. They thrive in the fact that they are working and not merely on the fact that they will work. However, not all methods that promise reduction of harm are applicable because the people are involved and the side effects of the policies have to be looked at. Those who support condom distribution to teenagers argue that the harm caused by the unwanted pregnancies and STDs is less compared to engaging in premarital sex or the erosion of the parental authority. Others find that the harm to civil liberties that are involved in drug use criminalization is harmful than those resulting from engaging in them.

Among the policies that have been effected by Australia is one on reducing demand, supply and harm. Supply reduction is aimed at disrupting the supply and production of illicit drugs while at the same time controlling use of the licit substances like alcohol. The strategies for demand reduction aim to reduce the uptake of the harmful drugs including treatment and abstinence strategies while the harm reduction strategies involve reduction of drug related harm to individuals and communities involving programs like safe injecting sites and needle and syringe programs aimed at preventing disease spread or death occurrence due to overdose (Kellehear  & Rumbold, 1998). One of the ways in which the government of Australia has sought harm reduction of drug use is by prohibiting the sale or transportation of recreational drugs. According to Wodak and Moore (2002) the government policies on controlling drug supply has failed in its attempts of harm reduction. This is largely because when there is demand for a drug that is not available legally it is a guarantee that there will be emergence of other sources which might not even be legal. Over the years, the government policies have been based on increasing the penalties for drug trafficking while increasing funding to the law enforcers so that they can curb the threat of drug traffickers. In the event of drug addicts, law enforcers can do nothing to reduce drug trafficking. Recently the world has marked developments in global trade where it is easy to move products and services from one country to another. The revolution in technology has created new and innovative way in which both legal and illegal commodities can be transported. Drug traffickers would do anything to ensure that the drug reaches the market because it is a guarantee that its price will increase several hundred folds in transition from the producer or farmer to the consumer bringing in a lot of money to the dealers. This is among the many reasons why drug trafficking cannot be stopped by enforcing laws on prohibition. Profits driving this industry have been largely ignored by the Australian Government in developing policies on drugs. Efforts for harm reduction have been initiated through education but even this method offers little or no change. Commitment to zero tolerance in any government only serves to do more harm than good. The zero tolerance policy increases the prices of drug s artificially which lead to increase in crime, violence and corruption. The government policies should come to terms with the fact that drug markets cannot be eliminated but they can be managed in ways to cause less harm to the society.

Harm reduction policies have been involved with things like needle and syringe programs, random breath testing of drivers, prescription heroin, use of nicotine patches and ban on public place smoking. The phrase is however also used in aims of reducing risks associated with other behaviors that are not socially acceptable like prostitution or adolescent sex. This has been marked by increased condom distribution in public places that include schools and specialized shelters for the homeless as harm reduction strategies (Ritter & Cameron, 2005).

The concept of zero tolerance is however different from that of harm reduction. Zero tolerance is aimed at completely cutting off the supply of drugs using law enforcement procedures. The concept of zero tolerance was first applied in the United States where drug users instead of suppliers were targeted by law enforcers. The aim of this tactic was to get to the root cause of the problem through imposing strict enforcement and harsh sentences to reduce the demand of the drugs. The zero tolerance policy equates all illicit drugs and all forms of use as undesirable to the society because they cause harm. This does not distinguish between occasional drug use and problem drug use as they both are undesirable. Countries that have generally managed to effectively manage zero tolerance are Sweden and China where individuals in possession of drugs and drug users are subject to strict law penalties including life imprisonment. Harm reduction policies are aimed at not stopping the use of drugs but managing the problems the drugs cause in an amicable way.

Many governments in the world are adopting the harm minimization policies while at the same time running zero tolerance policing. This has been the case in Australia as prohibition of drug use is one of the many zero tolerance strategies that can be exercised. According to research done by Australian researchers, the government aim at cracking down on minor drug users and not the producers shows that the government has been unable to penetrate the upper levels of the drug market because they only target the lower levels (Hulse, White & Cape, 2002). Research done in Sydney’s Cabramatta indicates that zero tolerance policy of heroine use has improved the quality of life in that place due to curtailed open-air drug markets in the location. Zero tolerance policy is a however expensive method of dealing with drug users as one will have to consider what to do with those arrested due to congestion of prisons. Police legitimacy in areas exercising ZT can be compromised because the drug problems serve to widen the gap between the police and the public and it may result to riots and police assault on individuals arrested while high on drugs because it will be impossible to remember the incident. Among the strategies that would be employed for ZT would be use of hidden cameras in the streets which would impose on civil liberties while more duties will be delegated to the police officers who will be involved in patrols instead of attending to other works. ZT policy can cause more harm than good to the community given that in research done in Cabramatta, dealers in the streets have resulted to storing heroine caps in the nose or mouth which puts the individual at risk of overdose because they have to swallow the drug if they encounter police. Alternatives to ZT policy is harm reduction policies. The HM policies are however at logger heads with law enforcers because the law does not recognize drug use while harm reduction is aimed at reducing the effects of the use of drugs through provision of better and safe ways for drug use. The common phrase used in Australia is-do not use drugs but be safe if you do- which is a difficult phrase to understand for law enforcers. HM involves using a problem-solving approach instead of prioritizing the law enforcement in eradicating problems caused by the drug markets. Sydney and NSW have opened safe injecting houses where drug users are allowed to go and inject themselves under supervision while using safe ways. Such means would help keep drug use from public eye so that the police can deal with the upper level marketers of drugs and the street peddlers easily through keeping use of drugs above ground (Dixon &Coffin, 1999). The dealers who supply to customers in their houses with an additional safety package and information are left alone while those who sell in public like to tourists are subject to being arrested.

In conclusion, the drug use in the society is increasing by day and there is need for the government to redesign its policies to meet the current global and technological advances. The harm reduction policy is successful in many places though it is socially unacceptable in many practices because it is seen as a way of increasing drug use if the user will access and use it safely. The zero tolerance policies are not applicable everywhere because they are expensive and they have only led to more innovative ways of drug peddling. It is therefore important for the government to balance the two policies to maximize the effects instead of relying on one kind of policy.

References

Dixon, D. and Coffin, P. 1999. Zero tolerance policing of illegal drug markets. Drug & Alcohol Review, Vol. 18 no. 4, p477-486, DOI: 10.1080/09595239996338

Kellehear H. M., A. and Rumbold G.(Eds.) 1998  Drug Use in Australia; A Harm minimisation Approach, Oxford University press, Melbourne

Hulse G., White J. and Cape G. 2002. Management of alcohol and drug problems Oxford University Press, Melbourne

Kleinig, J. 2008. The Ethics of Harm Reduction. Substance Use & Misuse, Vol. 43 no. 1, p1-16, DOI: 10.1080/10826080701690680

Ritter, A and Cameron, J .2005. “Monograph No. 06: A systematic review of harm reduction”. DPMP Monograph Series. Fitzroy: Turning Point Alcohol and Drug Centre.

Wodak A and Moore T. 2002, Modernising Australia’s Drug Policy. UNSW Press

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