Smart Substance Use: Harm Reduction Strategies

One of the big side effects of the pandemic is that people are drinking (or smoking or sniffing or taking pills) more than ever before. A recent study found that people have increased their alcohol use by about 32%. Whatever your vice, you are probably doing it more often.

It makes a lot of sense when you think about it. We’re all stuck at home, stressed out, and alienated from our coping mechanisms like socializing and entertainment. It’s too easy to reach for another glass of wine or another joint in order to cope.

And I’m not here to tell you that it’s wrong. The use of mind-altering substances is one of the most normal things in the world. Human beings have been indulging and escaping via substances since the beginning of time. In fact, I believe (and this is controversial) that the use of substances can be a normal part of healthy coping - the keyword here is part, which I’ll talk about more later.

HOWEVER, AS WE ALL KNOW, IT IS VERY EASY FOR THE USE OF SUBSTANCES TO GET OUT OF CONTROL AND WREAK HAVOC ON YOUR LIFE. THAT IS WHERE HARM REDUCTION CAN BE HELPFUL. HARM REDUCTION IS A SET OF PRACTICAL STRATEGIES AND IDEAS AIMED AT REDUCING THE NEGATIVE CONSEQUENCES OF SUBSTANCE USE. IT IS THE ANTITHESIS OF THE SOBRIETY MOVEMENT, THAT WHILE HELPFUL FOR MANY, DOES NOT WORK FOR MANY OTHERS.

You’ve probably heard of harm reduction strategies or programs before. The best known examples are needle exchange programs where intravenous drug users can trade out their old, used needles for new ones that reduce the spread of HIV and hepatitis. This hasn’t picked up a lot of steam in the US but is used effectively in countries like Canada and Portugal.

Harm reduction is normally used for high risk populations like IV drug users or the chronically homeless but harm reduction strategies can be used by anyone who is looking to use in responsible and non-harmful ways. Here’s a few practices that you can try below:

1. INCREASE MINDFULNESS OF YOUR PATTERNS.

First, we need to get a better understanding of our own patterns with substances by reflecting on the following questions:

• What do I like to use?

• When and how often do I use it? Is this ideal for me?

• When am I more likely to overindulge or use too often?

• How do I feel after using? Better or worse? Does this change with how much or how often I use?

• Is my substance use causing any negative consequences for me at work, home, with friends, or on my body or mind?

Understanding our own patterns of use better and how they interact with our emotions, energy, and health will give us lots of great information and insight.

The point initially is not to change anything but just to better understand what is already there.

2. .GIVE YOURSELF MORE COMPASSION AND LESS JUDGMENT.

As we raise mindfulness of our patterns, chances are we won’t like everything we see. This is a very common experience but can be discouraging if you’re not expecting it.

The goal here is to hold what you find with compassion, kindness, and even some humor. Remember, we all have things about ourselves that we don’t like and we all have ingrained, sub/unconscious patterns that we replicate.

It’s also important to keep in mind that self-shame and judgment are ineffective. They don’t make it more likely that you will do better in the future, in fact they make it less likely, and they distract you from the real work, changing the stuff you don’t like.

3. REPLACE SUBSTANCE USE WITH OTHER COPING ALTERNATIVES.

Now that we’ve identified some patterns we’d like to work on and gotten past shame (at least for now, it’ll probably come back again), we can start to actually make some changes.

You can start wherever you like but I often recommend simply adding new, healthy coping alternatives to your routine. This can include walking, yoga, meditation, exercise, painting, playing the piano, really whatever helps you to feel centered and happy. The goal is to add more tools to your coping toolbox.

One thing I’ve noticed over my career in substance use is that folks who struggle with substances often rely way too heavily on those substances to cope. They essentially put all of their coping eggs in one basket. Folks who have a lot of coping alternatives, on the other hand, often struggle less with issues like overindulgence or their use getting out of control and hurting them in other areas of their life.

4. IDENTIFY THE NEGATIVE IMPACT OF YOUR SUBSTANCE USE AND MAKE A PLAN TO MITIGATE.

Another great place to start making changes is to target any negative impact that your substance use is having. For example, maybe I notice that one of my patterns is to drink too much wine on Friday and Saturday night which leaves me hungover and fatigued for most of the weekend so I’m not getting anything done around the house and am grumpy with my husband. Maybe my plan would be to limit my drinks or add glasses of water between drinks, or add another fun, relaxing activity like dancing to my night. Maybe I would meditate before I start drinking to build mindfulness so I’m not drinking on autopilot. The options are really limitless - you just want to find a plan that works for you and that’s going to address any harm your substance use is causing.

5. MAKE SURE YOU ARE USING IN A SAFE ENVIRONMENT AND WITH SAFE PEOPLE.

When you do decide to use, a great general harm reduction strategy is to make sure you are using in a safe environment and with safe people. Make sure you have any water or food that you might need. If you’re using heavier drugs, you might even make a quick plan on what to do if someone overindulges or gets sick. If you’re going to need transportation at some point, make sure the driver is sober, call an Uber or Lyft, or just stay the night where you are if you can. Whatever you do just make sure you are in a place where you can relax and enjoy your experience instead of dealing with any unexpected legal or health consequences.

6. FIND A THERAPIST WHO USES HARM REDUCTION.

Sometimes we need professional support to better mitigate our use. A good indication that professional support is needed is if your use is making it hard to fulfill your responsibilities at work, home, or with the people you love.

A lot of people avoid seeking therapy for their use because they’re not ready to get sober and the good news is you don’t have to. Older models of substance abuse treatment did emphasize sobriety and a lot still do but there are also a lot of therapists who work from a harm reduction model. If that’s something that would be helpful for you, it’s important to ask potential therapists about their understanding and use of harm reduction before deciding to work with them.

THE GOOD NEWS IS, IF YOU’VE FOUND YOURSELF STRUGGLING WITH YOUR SUBSTANCE USE, YOU’RE NOT ALONE, AND THERE’S SOME PRETTY EASY AND PAINLESS CHANGES YOU CAN MAKE TO SEE SOME BIG RESULTS AND MAKE SURE THAT WHEN YOU DO USE IT’S A SAFE AND FUN EXPERIENCE FOR EVERYONE INVOLVED.

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