Mission Moment: Why Harm Reduction?

Transcript

Cindy: I’ve been using for over 30 some years off and on, and it’s been pretty hard to try to get off of it. I’m trying to get off, trying with the suboxone, but I don’t have an appetite with it. I, you know, I can’t eat. I’m losing so much weight. And the only way i can eat is… is… use.

Dr. Clifasefi: Harm reduction is exactly what it sounds like, it’s about reducing harm and there are many different ways to do that. I would say, you know, not everyone is ready, willing, or able to stop using substances, so our job as harm reductionists is really to work with the individual wherever they are on that spectrum of of change to really try and identify ways that reduce the harm that they might be experiencing as a result of their substance use, and then working with them to try and figure out how to minimize that harm and and improve the quality of their lives.

Jean: I really can’t think of a day in my work that harm reduction doesn’t come into play and specifically my work with harm reduction in the context of Plymouth is around substance use. Recognizing that trying to force people to stop or force people into treatment is not an effective way to get anybody to quit using substances and also creates a space where they’re not using safely. They’re sharing pipes, they’re sharing needles, they’re not talking or being as open and truthful about what’s going on with them because they feel like they’re being judged, and so harm reduction is fostering a space where people have access to use substances as safely as possible.

Cindy: Try to understand that, hey, I have this problem, you know, and I’m using, but don’t try to be judgmental, you know? Because that’ll– to me, it would make me want to use more. Down deep, I know it’s not good for me, but… But that’s all I know. I’m 56 years old and I’ve been using since I was in my 20s. Everybody’s different, you know, reason why they’re using. Me using? That helps me, you know. I just got into a big accident in January. I was shot three times on Third Avenue. Still recovering from it. I was in that coma for two months, yeah… That’s a hard thing for me to even talk about, because I was shot pretty big, you know, and I don’t remember too much of it, but I still feel the, the making the shots sometimes.

Jean: A lot of people use substances in order to sort of deal with or maybe even mask some of the trauma that they’ve been through, it’s self-medicating and again this is something that we see in all parts of society.  I don’t think it’s… Really, it’s definitely a normal part of our society to see people have a hard day and go home and have a beer. You know, when you’re looking at somebody who has had really extensive childhood trauma, or, you know, just the trauma of having been chronically homeless, it’s really not a surprise that substance use ends up becoming a really soothing and comforting coping mechanism. Without properly dealing with some of the trauma and, and why that you started in the first place it’s really difficult to deal with one without understanding and dealing with the other.

Dr. Clifasefi: In this way, we really see this model as giving individuals autonomy and self-determination in their own lives. They get to set the agenda and our job is to walk with them and help them achieve the things that they want to see along the way.

Jean: Wonderful example of somebody, pretty much everyday user, and it was kind of impacting their ability to do other things or meet goals that they had. And this person is now actually working full-time through a program at another housing agency has stopped using substances. That person’s growth and story has been really inspiring and one of the things that I’m most grateful for being able to witness in this job.

Dr. Clifasefi: If we can really figure out the way, a way to minimize the harm of whatever the substance the person is using and maximize the quality of life for people, like, shouldn’t that be the goal?

Cindy: I like being in Plymouth Housing because they don’t try to judge you about it. You guys are my guardians, you know, watched over me. People don’t understand why I say it, you know, you guys are like family.