What is Harm Minimisation?

Harm minimisation refers to strategies aimed at reducing the harm associated with behaviours detrimental to health and wellbeing. Australia has had a long commitment to harm minimisation and has used this approach in relation to:

• Drink driving (e.g. seat belts, speed limits, education campaigns “don’t drink and drive” “alcohol: think again”);
• Gambling (e.g. restrictions on advertising, age restrictions);
• Health (reducing the transmission of blood-borne viruses or other viruses in our community through, for example, needle and syringe programs; wearing masks; vaccines);
• Obesity (education promoting healthy eating habits).

In the alcohol and other drugs area (AOD), the harm minimisation approach considers the health, social, and economic consequences of drug use on individuals, families, and communities. It acknowledges that drug use occurs across a continuum, ranging from occasional use to dependent use. It recognises that a range of harms are associated with different types and patterns of drug use, including consuming alcohol, such as problems of intoxication or “drunkenness” like accidents, road crashes, and aggression; regular or longer-term use, e.g. health, social and financial problems or dependent use, often described as addiction. Responding to these harms requires a multifaceted response. While not condoning AOD use, it recognises that abstinence is not for everyone, nor is it possible.

The 3 Pillars of Harm Minimisation

These pillars are:

1. Demand reduction
2. Supply reduction
3. Harm reduction

• Demand reduction strategies focus on decreasing the desire to use AOD. Strategies include the provision of education and information about the harms associated with AOD, social media campaigns, and warnings on alcohol about the dangers of use when pregnant.
• Supply reduction strategies focus on ways to reduce availability and accessibility, such as legal age restrictions for purchasing cigarettes or alcohol, limiting opening hours of hotels and liquor stores, or banning substances like heroin.
• Harm reduction strategies include providing treatment, health services, and support programs for individuals, families, and communities.

Understanding the Drug Use Experience

The harm minimisation approach recognises that no single factor is sufficient for understanding the complexity of drug use or the problems that may arise. People drink or use other drugs within a social context, and therefore, what may be relatively trouble-free use in one setting may be quite problematic in another setting.

Harm minimisation strategies also address the use of illegal drugs, aiming to reduce the associated health and social consequences.

AOD use emerges out of a balance between the costs and benefits to the user, which will often determine how much, how often, and with whom an individual will use. No drug use behaviour is intrinsically “good” or “bad”. The balance is a function of the interaction of:

• The drug: includes its dosage, purity, route of administration, price, availability, ease of use, form of the drug, pharmacological properties etc.
• The individual: includes gender, age, health, expectations, tolerance, beliefs, attitudes, mental health problems, history of trauma etc.
• The environment: the influence of the setting, including where, when, who with, how, laws, customs, religion, time of day, media, peer influence, promotion, and advertising.

Harm reduction approaches aim to reduce the negative consequences associated with drug use, including illicit drug use, such as overdose, blood-borne virus transmission, and other health problems.

What Can You Expect from Holyoake?

Holyoake provides a range of harm reduction strategies, including peer-based support, group work programs, family work, psycho-social education, brief interventions, as well as more intensive counselling and suicide prevention.

How Can Counselling Help Me?

Counsellors at Holyoake work from a trauma-informed perspective to assist you in reducing the harm of your AOD use. Counsellors, working together with you in an equal partnership, will determine the best course of action based on the nature, complexity, and severity of the problems you are experiencing. They will provide support for any of your physical and mental health needs and collaborate with other agencies to ensure you have access to housing, education, vocational, and employment support. Counsellors will help you to develop and enhance significant relationships and connections to the community.

Counsellors will support you in identifying personal, drug-related, or environmental factors that can lead to relapse. They will work empathically and non-judgementally with you to help you maintain your positive changes and remain focused on your goals. A key objective is improvement to the quality of your life after you have made any changes.

Frequently Asked Questions

References

Helfgott, S. & Allsop, S. (2009) Models of Addiction. In S. Helfgott & S. Allsop (Eds) Helping change: The drug and alcohol counsellors training program. Perth. WA. Drug and Alcohol Office.

National Drug Strategy 2017-2026. Commonwealth of Australia, Department of Health.

Stone, J., Marsh, A., Dale, A., Willis, L., O’Toole, S., Helfgott, S., Bennetts, A., Cleary, L., Ditchburn, S., Jacobson, H., Rea, R., Aitken, D., Lowery, M., Oh, G., Stark, R.,& Stevens, C. (2019). Counselling Guidelines: Alcohol and other drug issues (4th ed.). Perth, Western Australia: Mental Health Commission.

Zinberg, N.E. (1984). Drug, set and setting. The basis for controlled intoxicant use. New Haven, Yale University Press.