Overlooked Aspects of Harm Reduction

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 bit…

These three points are related:

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…

Reduce the Wait Time = Reduce the Harm

…the rudeness of the staff,

Reduce 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 the Harm

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.

I 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 again. 

Mind 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. 

The 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!" 

Mind 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 alarm! 

So 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... 

My 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 helped.