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People who say that those who die of drug overdose bring it on themselves clearly don’t understand how addiction works.
Consider alcohol addiction. Plenty of people drink alcohol. They have a drink after work, or go for drinks with their friends, or have a beer when they’re watching the game or grilling steaks. Yet very few people ever develop an alcohol addiction.
And honestly, no matter how many people do develop an alcohol addiction, we as a society don’t see alcohol drinking as immoral.
Despite the fact that a risk exists for people to develop an alcohol addiction, as a society, we don’t oppose public alcohol consumption. We allow for establishments where people can drink freely without judgement. We accept alcohol drinking amongst friends at a backyard BBQ. We even permit public drinking at concerts and hockey games.
Because we know that most people will never develop an addiction.
But we don’t give drug consumption the same consideration.
A 2011 study, for example, examined 20 drug-use studies (with at least 500 participants each) and estimated based on the data that the prevalence of 12-month illicit drug abuse/dependence (this includes marijuana, mind you) in the general US adult population was about 5%. That’s less than cigarette addiction, less than alcohol addiction, even less than shopping addiction.
That means that 95% of the population that uses drugs never develops a dependence. And that means that the vast majority of the people who use drugs are people we never see using drugs. They may even be people we personally know, who hold down jobs, and volunteer, and manage their families, and participate in all sorts of mundane, everyday activities. Yet we have no idea they use drugs.
And despite the fact that they keep choosing to consume drugs, they never develop an addiction.
That’s because addiction has nothing to do with choice. Lots of people choose to drink alcohol but never develop a dependence to it. Just like lots of people choose to consume drugs but never develop a dependence to it.
Certainly, everyone who takes their first hit chooses to do so, just like everyone who takes their first drink chooses to do so. But no one knows if that first hit or first drink will lead to dependence. And by the time addiction takes hold, it’s too late; they’re already addicted.
Addiction isn’t something you can switch on and off at will. Emptying the liquor cabinet of someone who’s addicted to alcohol won’t stop that person from being addicted to alcohol. Stopping the supply of clean needles to someone who’s addicted to drugs won’t stop that person from being addicted to drugs. The addiction will still exist, and the addiction will drive them to find a way to feed the cravings. That’s not something they get to control.
Harm reduction isn’t enabling. Addicted people are going to be addicted no matter what we do. If we don’t provide clean needles to people addicted to heroin, they’ll still inject heroin. If we don’t provide supervised consumption sites to reverse overdoses, they’ll still overdose. If we stop them from smoking crack in the neighbourhood parks, they’ll still smoke crack.
Harm reduction is about reducing risk: risk of disease transmission, risk of death, risk of danger to the public. Harm reduction keeps them safe until they’re ready for recovery, as well as being the best path to recovery.
Harm reduction isn’t about eliminating addiction. It’s about reducing harm.
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