The term harm reduction refers to a public health strategy to reduce negative consequences resulting from activities such as illicit substance use and addiction. Whereas abstinence from dangerous drugs may be ideal, it’s not always realistic to expect abstinence from every addict at every stage of their addiction. Whether it’s handing out clean hypodermic needles or fentanyl test strips, administering opioids, naloxone training for overdoses, or decriminalizing substances, harm reduction looks to meet addicts where they live, rather than sweep them under the rug with an idealized version of how they should behave.
“Cars are dangerous. You put on a seatbelt — that reduces the harm,” journalist Maia Szalavitz told Dr. Josh King on the Beyond Addition Show. “We don’t put spikes on the dashboard to get people to not have accidents. We recognize that crashes are going to happen sometimes.”
The spikes on the dashboard are symbolic of Prohibition, which has done little to prevent substance use and addiction or reduce the availability of illegal drugs. Harm reduction, on the other hand, has shown progress as a more realistic approach. Harm reduction treats addiction as a health issue rather than a crime or moral failing.
In 2001, Portugal decriminalized possession of small amounts of any substance, and implemented a public health program of harm reduction. Drug users are not charged and prosecuted, but given an addiction assessment and treatment options. This harm reduction policy ushered in a dramatic improvement in Portugal’s public health and drug problems overall.
the number of heroin users in Portugal has dropped from about 100,000 before the law to just 25,000 today. Portugal now has the lowest drug-related death rate in Western Europe, with a mortality rate a tenth of Britain’s and a fiftieth of the United States’. The number of HIV diagnoses caused by injection drug use has plummeted by more than 90 percent.https://www.apa.org/monitor/2018/10/portugal-opioid
In Portugal and in the US, many addicts receive either methadone or Suboxone to treat addiction. These programs are designed to reduce harm. An addict on a minimal dose of pure opioids taken under medical supervision is safer than an addict buying unknown substances of unknown strength and possibly using dirty IV needles.
However, in these types of harm reduction programs, the patient remains addicted to opioids. And in a recent turn of events, MDs have been prescribing Suboxone to counter kratom addiction.
Kratom has shown to be an effective harm reduction tool, perhaps more effective than Suboxone or methadone, which in and of themselves can lead to miserable addictions.
Consumer testimony and studies in mice have shown kratom to be an effective tool to combat opioid physical dependency and withdrawal symptoms. Sociological studies have shown illicit drug users, after beginning kratom, engage in fewer HIV risk behaviors like using heroin or methamphetamine, using IV drugs and dirty needles, and having sex with sex workers (Swogger 2019). In another study, long-term kratom consumers in Malaysia, even those with a dependence, were found to have no impairment in social functioning (Singh 2015).
In most consumers, kratom is considered to be less addictive, easier to control, and easier to taper from and quit than opioids. Hundreds of individuals have posted to KratomScience.com detailing their experience in breaking opioid or alcohol addiction with the help of kratom.
Addiction, perhaps more than any other disease, stems from trauma and often takes years and years to heal. Chronic pain sometimes never goes away. Realistically, all people cannot be expected to be sober all the time when substances exist that remove deep psychological and physical pain. Kratom may buy opioid addicts and alcoholics the time they need to work through their issues without killing themselves. Even those who take large amounts of kratom can be productive, employed, able to maintain relationships, and generally happy. Most people who use kratom already use it as a harm reduction tool.