Harm Reduction 101. Senior Vice President of Outpatient Services at The Bridge, Inc. Naomi Weinstein, MPH

Transcription

1 Harm Reduction 101 Jenna Tine, LCSW Senior Vice President of Outpatient Services at The Bridge, Inc. Naomi Weinstein, MPH Vice President of Innovations at ICL (a MCTAC/CTAC partner) September 27th, 2018

2 Agenda Welcome! Poll questions what do you think? What is harm reduction Why harm reduction Required mindset Harm reduction strategies

3 Poll question Ideally, I would like all my clients who are drug users to strive for abstinence. Agree Disagree

4 Poll question Promoting safer use of drugs encourages drug use. Agree Disagree

5 Common scenarios He was sober for a while, but he seems to have started using again. She denies she has a problem with alcohol. He gets very aggressive whenever he has been smoking K2. I spoke with him about his marijuana use, but he doesn t want to stop. She keeps showing up intoxicated to group.

6 Traditional responses Convince her it s a problem and she needs to stop now. Strongly encourage him to go to treatment, although he says he doesn t want to stop. Applaud her when she says she is willing to go into a treatment program. And if these don t work, either keep trying to get them clean, or just let them do what they do.

7 What is Harm Reduction? Harm reduction is a set of strategies designed to reduce the negative consequences associated with risky behaviors, including substance abuse. Harm reduction is based on a firm belief in and respect for people who engage in risky behavior.

8 Harm reduction embraces all possible responses to risk behavior, from total abstinence to safer continued use.

9 It s not just for drugs Substance abuse is not the only risky behavior that can be addressed through harm reduction approaches Unprotected or otherwise risky sex Tobacco use Gambling Screen time

10 Why Harm Reduction?

11 Substance use Normal Social Fun

12 And when it crosses the line Normal Social Fun Morally bad Weak Wrong priorities

13 And when it crosses the line Normal Social Fun Morally bad Weak Wrong priorities Stigma

14 Let s Chat What kinds of stigma do people experience?

15 Let s Chat How do people behave or feel in response to this stigma?

16 Let s Chat How do people behave or feel in response to this stigma? Angry/feel disrespected Don t want to trust/engage Continue risky behavior

17 Harm reduction approaches point toward an alternate set of outcomes.

18 Harm Reduction Mindset People know themselves best. Safety is more important than abstinence. Drugs serve a purpose for most people, and may make some people s lives better or easier. Some ways of using drugs are safer than other ways. People are more likely to connect when they feel liked and respected. It is essential to be open to a full range of outcomes, including abstinence.

19 Professionals need to be very aware of their own biases and judgments, and how these may be communicated to people receiving services.

20 Focusing on Risk and Safety

21 Continuum of use Abstinence/no use Continuum of use frequency Experimental Occasional/casual Regular Heavy

22 Focus on risk instead No risk Continuum of risky behavior Minimal risk Some risk Heavy risk Very risky use

23 Types of risks Health Family/relationships Legal Economic Housing Spiritual/sense of self

24 At the core of Harm Reduction approaches are Safety Strategies

25 Harm Reduction Approach Traditional Approach Convince her the drinking is a problem and she needs to stop now. Strongly encourage him to go to treatment, although he says he doesn t want to stop. Applaud her when she says she is willing to go into a treatment program. And if these don t work, keep trying to get him clean, or just let him do what he does. Harm Reduction Approach Explore the ways alcohol helps her, any risks she faces, skills that might be helpful, and what she can do to reduce risk. Talk with him about risks that concern him, such as possible arrest or overdose, and what he can do to stay safe. Be a champion of abstinence based programs, if that is what she wants. If she changes her mind, support her in that decision and talk about other ways to reduce harm. Focus on connection and trust, respect, and what can be done to promote safety and well-being.

26 Harm reduction opportunities Engagement Safety strategies

27 Harm reduction opportunities Safety strategies Engagement Assessment

28 Harm Reduction Strategies Safety strategies Engagement Assessment Treatment planning (person-centered)

29 Harm Reduction Strategies Safety strategies Engagement Assessment Treatment planning (person-centered) Service delivery (person-centered)

30 Harm Reduction Strategies Safety strategies Engagement Assessment Treatment planning (person-centered) Service delivery (personcentered) Motivational interviewing

31 Harm reduction programs are examples of harm reduction principles in action

32 How can you apply harm reduction strategies in your work? Questions?

33 Upcoming CTAC Events Harm Reduction October 11, 2018 from 12p-1p More in-depth discussion about using harm reduction approaches with people, especially those not interested in reducing their use The Neurobiology of Resilience - A short video by Dr. James Rodriguez to be released in October, 2018

34 Contact Us Please contact us with any questions and/or concerns!