Dr. Jeanne Spencer Limiting harms of addictive behavior

Dr Jeanne Spencer, The Tribune-Democrat, Johnstown, Pa.
·4 min read

Mar. 6—Most persons suffering from addiction are well aware that stopping the use of the addictive substance is in their best interest. Many have tried to quit before. Often multiple times.

Something within either the person or their environment keeps them coming back to the addictive behavior.

Efforts to stop the addictive behavior are very important but until the person is able to quit, harm reduction is a concept for this stopping may not be possible.

The National Harm Reduction Coalition defines central principles of harm reduction. These include that illicit drug use exists and it is better to try to reduce the harmful effects than to ignore them, that substance abuse exists on a continuum and some types of use are riskier than others.

They encourage seeking to improve the quality of life for all, including those abusing substances, and that people with a substance use disorder should be encouraged to help themselves and others to reduce the harm of this use. It is also important to recognize that social inequalities including race and socioeconomic factors play a large role in a person's susceptibility to substance abuse and their ability to limit its harms.

Examples of harms that might be reduced through this approach include limiting transmission of infection, decreasing overdose deaths or limiting other heath harms such as liver disease.

Medication-assisted treatment such as methadone or buprenorphine has been shown to reduce the risk of overdose and this treatment often allows patients to end addictive behavior and become more productive.

Some practical examples — a person who is abusing alcohol might not be able to quit drinking but they may be

able to stop drinking and driving.

While not an option for everyone — some people may be able to use the substance in smaller quantities or less often. Maybe they can limit use to weekends.

If a person is abusing injection opiates, they might be able to use clean needles, clean their injection site and dispose of needles safely. In order to avoid overdose they could avoid using alone and have the antidote Narcan (naloxone) available.

Narcan is a brand name for naloxone. It is a medication that reverses the action of opiates by blocking the opiate receptor. If it is given to someone who has taken an opiate overdose, it often quickly revives the person. It can be administered by injection or in the nose.

The Cambria County Drug Coalition offers frequent free trainings on the use of this medication. To schedule and receive a supply of Narcan call the Coalition at 814-619-4505.

Online trainings are also available at: https://www.ddap.pa.gov/overdose/Pages/Naloxone_Reversal.aspx.

Anyone who is around persons who are abusing opiates should participate in the training and have Narcan readily available. In Pennsylvania, we have a standing prescription for Narcan, it is often available at the pharmacy without cost.

Sadly, sometimes Narcan gets bad press. People say that having it available enables opiate abuse. Some say that people can continue to abuse opiates if they have been saved with naloxone. I would hope that we would want to save someone's son, daughter, or neighbor.

Naloxone administration results in painful withdrawal so persons abusing opiates are unlikely to abuse them more and then anticipate naloxone rescue. Friends and loved ones can use the concept of harm reduction in other ways to help the person with an addiction.

For example, we can invite the person with an addiction to participate in sober activities or help them find employment. We can offer rides to appointments or an encouraging word for steps in the right direction.

Often when we use this supportive approach it is easier to be heard. Persons with addiction are so accustomed to being chastised and put down that when they hear someone trying to reach them where they are, they can listen much easier. In the end, this may make it easier for them to enter recovery. But even if it doesn't, it will keep them safer and prevent some of the harmful effects of substance abuse.

It will take a continued effort of many in our community to limit the effects of substance abuse. The Cambria County Drug Coalition is working hard to bring people from throughout the county together to find solutions to the problems. Every life matters every time ... If you or someone you know needs help with a substance use disorder — there is help. Treatment is available by calling 800-GET-Help in Pennsylvania.