Weave harm reduction in
Despite my focus on recovery I have a strong harm reduction ethos at my core. Sure, I challenge services to be recovery-orientated, but I firmly believe that the reverse needs to be true. Rehabs and other services with a recovery goal ought to have harm reduction practices woven into their fabric. If they don’t they could be short-changing clients.
How can a rehab or a community recovery treatment service be more harm reductionist? Well, for opiate dependent clients a good start would be teaching and training on loss of tolerance, the risk of relapse and subsequent overdose. The harm can be reduced by using less, not injecting, not mixing substances and not using alone.
Training on recognition of overdose and basic life support could be given. Why not embrace the Take Home Naloxone programme? There is evidence that this saves lives. What if families were also involved in this?
Then there is being honest with patients about relapse which though not inevitable is still fairly common. Few folk have a straight line to recovery. Recovery-oriented services need to have a firm understanding that his does not represent failure and have an early intervention programme for lapse or relapse. If the client is too chaotic then good connections to other services are essential to get them back into treatment and reduce risk.
Screening for BBVs
Recovery services can offer screening for blood-borne viruses (BBV) or have simple referral pathways for this to be done. Immunisation against hepatitis A and B and advice to injectors on reducing risk ought to be standard. It is important to make sure referral to specialist services happens if virus infections are found.
Recovery outreach & support
There are other ways for recovery to get into bed with harm reduction. In some areas trained peer supporters who have gone through rehab or other community-based recovery services work in traditionally harm-reduction areas like needle exchange or methadone clinics. They can be trained to give harm reduction advice and simultaneously be signposts to recovery and offer to take clients to mutual aid meetings or recovery cafes etc. where they will meet other recovering people.
Join the dots
Harm reduction and recovery don’t have to be polar opposites; blackand white thinking has a lot to answer for. We need to get the best out of both approaches. My advice is to pop the two of them in a blender and offer the smoothie that results to all clients in all services.
[This blog was first posted in April 2014]