By Almas Shamim

I have lost count of the number of times I have heard and read the harmful nature of drug addiction and the havoc it can wreck in an individual’s life. ‘Don’t do drugs’, ‘Say no to drugs’ are words that are very commonly used. Yet, the fact remains that people of widely ranging age groups have been reported to be using addictive substances/’drugs’.

In such a situation, does it really help if we simply put out messages for adolescents and young adults to abstain from drugs? The situation is very similar to asking adolescents and older adults to abstain from sex. In both circumstances, while some do succeed in abstaining, others go ahead to exert their autonomy and indulge in sex or/and drugs. What, then, becomes of the latter group?

They are ostracized by the society for being addicted to drugs and signed off as failures who couldn’t ‘abstain’ from these ‘evils’. The heightened stigma pushes this group further away from the mainstream, to a risky life of no return. The very society which, more often than not, influences people into the habit of drug use- refuses to show ownership of these members once they have been consumed by their habit. And even here, like in all other aspects of life, the poor fare worse than the rich.

The real danger of such an attitude towards drug use is that it presents life as a black or white situation- where you are either a clean, sober, healthy person or a poor, wretched, drug addict with innumerable diseases. Such an attitude forces people who use drugs down a pre-determined path towards poor physical, mental and social health.

This need not be the case.

The key to a healthy society is not ‘abstinence’, for the simple reason that it does not necessarily work. The key is ‘Harm Reduction’. Harm reduction is an umbrella term given to the many small steps that can be taken for people who use drugs, so that their life can be supported and improved. To begin with there should be sufficient knowledge amongst people on the various side effects that the various ‘substances’ can cause, the interaction these substances will have with any other medications they are taking and the safe range of dose and frequency of the drug use that will not cause any harm to the user. A special concern of IV drug users is that they tend to share their syringes- this can lead to the spread of transmissible diseases such as HIV, Hepatitis B and C among others. Access to new and disposable syringes can go a long way in the control of spreading these infections in this vulnerable population. Collection of used syringes, provision of clean cotton swabs and maybe even drug use booths can help in reducing the severe harm that is associated with drug use. All this can be accompanied by an Opioid Substitution Therapy (OST) which will help the user to find a substitute to the used ‘substance’ if he/ she is motivated to quit drug use.

It is extremely important for us to realize that ‘Harm Reduction’ and providing syringes to drug users is not a method to promote drug use. On the contrary, it is to support them who either choose not to abstain or are unable to abstain from drug use, but have a right to good health and inclusion in the society.

India’s “National AIDS Control Organization” has also been actively involved in ‘Harm Reduction’ and recognizes it as a major step in the prevention of HIV infection.

To know more on harm reduction, do visit these sites:

Almas Shamim is a public health specialist with a great interest in sexual and reproductive health and rights, and feminism among Muslim women. She currently works for an international humanitarian aid organization in New Delhi