Theory of Change #3: Reduce the Harm

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"Reduce the Harm"

Q: What is Harm Reduction anyways?

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), Harm reduction is an evidence-based approach that is critical to engaging with people who use drugs and equipping them with life-saving tools and information to create positive change in their lives and potentially save their lives. It incorporates community-driven public health strategies — including prevention, risk reduction, and health promotion — to empower people with the choice to live healthy, self-directed, and purpose-filled lives. Harm reduction centers an individual's lived and living experience, especially those in underserved communities, in these strategies and the practices that flow from them.

Harm reduction emphasizes engaging directly with people to prevent overdose and infectious disease transmission; improve physical, mental, and social wellbeing; and offer low barrier options for accessing health care services, including substance use and mental health disorder treatment.

Q: How does Harm Reduction work at AHCH?

At AHCH, Harm Reduction is so much more than syringe services and overdose prevention. It is the foundation of AHCH’s philosophies of care and woven into every program, service, and interaction. AHCH’s Harm Reduction Outreach program (HRO) is a vital component in our mix of services.  AHCH was an early adopter of the harm reduction model, integrating it into services from their inception. Today the AHCH Harm Reduction program collaborates with the New Mexico Department of Health to serve nearly 5,000 individuals, reducing overdose deaths and the risk of transmissible disease through outreach, awareness, and education. 
Our Harm Reduction team provides syringe services, naloxone (Narcan) training, fentanyl test strips, education about the risks of using, resource navigation and general safe use supplies. But they also will routinely have water, food, hygiene kits, and survival materials to reduce the harms of exposure on the street. Often by the end of an outreach session, our HRO team will have gone through almost all of the food, water, and supplies they brought with them. For a lot of our clients, the HRO team was the first point of contact they had with AHCH's health care network. 

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Q: So, is Harm Reduction just overdose education and giving out safe-use supplies?

Not at all, like we mentioned earlier, all of our programs provide services through a harm reduction lens. The reality is after clients leave AHCH, they return to harmful situations or environments. Without intervention, that harm will continue to persist and affect their health outcomes. Our Harm Reductionists often follow up with vulnerable clients multiple times a week to check on their wellbeing and continue to follow up with managing their crises or the harm of homelessness.
    Our Harm Reductionists aren't just trained to educate people on safe use and overdose prevention, they are also an empathetic shoulder, client advocates, crisis responders, or guerilla survivalists. They outreach over 20 hours a week to reach some of the most isolated communities. Last year we served over 5,000 individuals!
   To help people become healthy and avoid infectious diseases and overdose, these services are vital to reduce the harms of homelessness that cause them to get sick in the first place. To this end, AHCH is continually innovating new ways to direct people to care and services as well as mitigate the harm and consequences of homelessness.

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Q: If people are still using, there is still harm being done. Wouldn't true "Harm Reduction" mandate treatment to cure them?

Central to the Harm Reduction model is understanding an individual's right to choice, dignity, and consent. We understand that the people we serve are consenting adults who make their own choices, including the choice to engage in risky behaviors or the choice to pursue treatment. We also recognize that the experience of homelessness is inherently traumatic and harmful, and to provide health care means to reduce harm and provide safer choices for high-risk behaviors. When we engage clients at all stages of change, even while they are using, we are laying down the groundwork for trust and future engagement, especially when they choose to pursue treatment. When clients do choose to pursue treatment, we have several options at AHCH for counseling as well as medication assisted treatment to help treat substance-use and opioid-use disorders. 

Q: Where do you provide Harm Reduction Outreach (HRO) services?

Our Harm Reduction team delivers low-barrier care 5 days a week, rain or shine, to people experiencing homelessness via roving outreaches to encampments and other client-occupied public spaces all throughout Albuquerque. Our outreach teams also meet clients on a weekly and rotating basis across seven site-based locations, including the West Side Emergency Housing Center, also known as the WEHC or Westside Shelter. 

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Q: Who is on the Harm Reduction team?

I'm so glad you asked! Here are our HRO team members!

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