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Challenges to Implementing the Harm Reduction Approach

NCJ Number
Journal of Social Work Practice in the Addictions Volume: 8 Issue: 3 Dated: 2008 Pages: 380-408
Michael A. Mancini; Donald M. Linhorst; Francie Broderick; Scott Bayliff
Date Published
29 pages
This evaluation attempts to understand the challenges of implementing a harm reduction approach in programs serving people with dual diagnosis and the implications this has for program administrators, staff, and clients.
The mental health practitioners who participated in this study revealed a complex array of competing and contradictory attitudes about the harm reduction approach. While many practitioners revealed positive attitudes toward harm reduction, many others held reservations about the benefits of harm reduction and some voiced opposition to using the approach. These findings hold important systemic and programmatic implications for administrators and supervisors of community mental health and social service programs considering harm reduction. Harm reduction started in the Netherlands as a response to the rising prevalence of hepatitis and HIV among IV drug users. Through assertive street outreach efforts, the program provided clean needles, bleaching kits, educational pamphlets containing information regarding safe sexual and drug use practices, and opportunities to engage in low-threshold treatment programs, in which abstinence is a goal. Although accepted elsewhere, harm reduction represents a controversial approach in the United States due to a long policy history of drug prohibition that has largely viewed drug use as a moral and legal issue rather than a health issue. The purpose of this evaluation was to identify the attitudes and perceptions staff had of the harm reduction approach just prior to the start of CJ’s Place (housing program serving people with histories of psychiatric illness, substance use disorders, and homelessness) to facilitate its effective implementation. Tables, references