When we think of 'harm
reduction' three aspects top the list: distribution of Narcan, safe injection
sites, and needle exchange. All three are
very worthwhile pursuits.
There are several aspects of
Harm Reduction that tend to get overlooked.
Let's look at this partial list
of overlooked aspects that 'Dakota'provided to me one day not too long ago when I asked her why she doesn’t go
to detox even though she's very clearly stated that she is sick of this lifestyle…
"The long wait time, the need to get high before
going in, the need to hide enough drug to inject during a quick trip to the
bathroom while waiting too many hours for a bed, the rudeness of the staff, the
strong possibility that at the end of those hours being told that there are no
beds available in the entire city and to come back the next day."
Let's break this quote down a
These three points are
The long wait time, the need to get high before going in ( a side
effect of expecting a long wait time and wanting to avoid dope sickness), the
need to hide enough drug to inject during a quick trip to the bathroom while
waiting too many hours for a bed…
the Wait Time = Reduce the Harm
…the rudeness of the staff,
the Rudeness = Reduce the Harm
Remind staff to
demonstrate the dignity and respect that is owed to any patient with Substance
Use Disorder who is seeking treatment.
…being told (after many hours) that there are no beds available in
the entire city and to come back the next day."
Increase Bed Availability = Reduce the Harm
Here are a few other overlooked
aspects of Harm Reduction:
Discipline or remove from employment any nursing/medical staff member who tells a Substance Use Disorder patient in their care to "Get out…" -
Discipline or Remove = Reduce
When a Substance Use Disorder patient needs hospitalization for any condition, provide the best available and prompt detox comfort care while tending to the specifics of the medical situation that made hospitalization necessary.
Provide Prompt Comfort Care in the Hospital = Reduce the Harm
When a patient with Substance Use Disorder has been admitted to a detox facility, provide prompt and complete detox comfort care.
Provide Prompt Comfort Care in
the Detox Facility = Reduce the Harm
Provide Rehab services in the jails so patients with Substance Use Disorder do not find this to be a time of 'mental rot.'
Turn Jail Time into Rehab Time
= Reduce the Harm
I leave this testimony with you
from the blog: As I write this, one of my Medicaid-reliant loved ones from the streets sits in a crisis center awaiting a bed for detox.
have personally been to several crisis centers in Philadelphia. A few months
ago, I went to one and sat for about 13 hours in a waiting room so very sick
shaking and sweating and vomiting everywhere and all for them to come out and
tell me that there were no beds and said to come back the next day to try
you I was very very sick and when they told me that, I asked them what should I
do as I was laying on their bathroom floor vomiting everywhere and it looked
like someone had sprayed a hose on me because I was dripping wet. My clothes
were soaked and I was flopping on the floor like a fish out of water.
doctor said to me "I don't know what to do." She said she cannot give
me anything because I am not admitted and there are no beds. So they asked me
where would I like to go to because they will call a cab for me. As I was
waiting for the cab, security and a nurse came outside to me and asked me what
I was doing and I said "You told me you are calling a cab." The nurse
said, "We did not call one and you have to get off of the property!"
you, I had no money and I was so sick so I ended up walking to the EL. The SEPTA
personnel told me I cannot go through without money and I told them that I just
came from the hospital. I showed them paperwork and they still said
"No" so I ended up jumping the train and the SEPTA personnel hit the
thank God the train came before any cops got there so I was fine. As I was on
the train I dropped to the floor and had a seizure. When I woke up people were
standing around me and they were waiting for the ambulance but I jumped up and
said no and got back on the next train and got off at Somerset station and had
to find a way to get well...
experience that day with the crisis center made me so sick to my stomach
thinking that I really wanted to get clean and I really wanted help and nobody