Since it has become evident that the homeless population experiences an increased prevalence of communicable diseases in comparison to the general population, it is necessary to identify various approaches we can take to reduce their susceptibility. One such approach is harm reduction, which is built on the principle of respecting individuals’ decision to utilize substances (Collins et al., 2015). It is an approach used to minimize or reduce the potential negative consequences that may be caused due to drug use/abuse (Collins et al., 2015). Several individuals experiencing homelessness have a history of mental illness or are suffering from substance addictions which increases their likelihood to utilize needles (Bonar & Rosenberg, 2010).
As mentioned earlier, HIV/AIDs can be transmitted through bodily fluids, including reusing needles or needlestick injuries. By providing users with kits containing sterile needles, they will be able to reduce their needle re-usage or refrain from sharing needles with others (Collins et al., 2015). This evidently reduces the risk of transmitting and contracting HIV/AIDs. Also, since HIV is commonly transmitted through unsafe sexual intercourse, it is important to provide condoms and as well as education on safe sex in order to prevent these risky behaviors from occurring (Bonar & Rosenberg, 2010). This encourages and supports individuals experiencing homelessness to gain a sense of control over their health and to reduce the risks they encounter on the streets (Stamler & Yui, 2012).
Alcohol addictions create difficulties in sustaining employment, finances and creates barriers in one’s social relationships (McNeil et al., 2012). Several individuals experiencing homelessness suffer from alcohol addictions, which can also be targeted by strategies of harm reduction. There are specific low-barrier shelter programs which allow individuals to drink in moderation under supervision (McNeil et al., 2012). It helps to prevent individuals from experiencing withdrawal symptoms that they would with sudden drinking cessation (McNeil et al., 2012).
As a student nurse, I understand that harm reduction can be a controversial topic. However, from a nursing standpoint, I would support this practice using the ethical principle of beneficence. This principle supports the notion of promoting good to the public, which is a nurse’s duty (Bonar & Rosenberg, 2010). I believe that harm reduction is a successful and beneficial approach to reducing the transmission of communicable diseases among the homeless population.
If you are interested in learning more about low barrier shelter programs in Canada, check out the link provided below. It will provide a great overview of the shelter!
To learn about the Annex Harm Reduction Program that is currently being implemented in Toronto, check out the provided link. It provides a summary of a day in the program.
A Day in the Life: The Seaton House Annex Program – Housing & Homelessness Services (n.d.) Housing & Homelessness Services – City of Toronto. Retrieved from http://www1.toronto.ca/wps/portal/contentonly?vgnextoid=ac2baf2c85006410VgnVCM 0000071d60f89RCRD
Bonar, E. E., & Rosenberg, H. (2010). Substance abuse professionals’ attitudes regarding harm reduction versus traditional interventions for injecting drug users. Addiction Research & Theory, 18(6), 692-707. doi:10.3109/16066359.2010.483310
Collins, S. E., Duncan, M. H., Smart, B. F., Saxon, A. J., Malone, D. K., Jackson, T. R., & Ries, R. K. (2015). Extended-release naltrexone and harm reduction counseling for chronically homeless people with alcohol dependence.Substance Abuse, 36(1), 21-33. doi:10.1080/08897077.2014.904838
Collins, S. E., Grazioli, V. S., Torres, N. I., Taylor, E. M., Jones, C. B., Hoffman, G. E.. . Dean, P. E. (2015). Qualitatively and quantitatively evaluating harm-reduction goal setting among chronically homeless individuals with alcohol dependence. Addictive Behaviors, 45, 184-190. doi:10.1016/j.addbeh.2015.02.001
McNeil, R., Guirguis-Younger, M., Dilley, L. B., Aubry, T. D., Turnbull, J., & Hwang, S. W. (2012). Harm reduction services as a point-of-entry to and source of end-of-life care and support for homeless and marginally housed persons who use alcohol and/or illicit drugs: A qualitative analysis. BMC Public Health, 12, 312. doi:http://dx.doi.org/10.1186/1471 2458-12-312
The Editor (2014, June 2). Low barrier vs high barrier shelters – why is Abbotsford different? Abbotsford Today. Retrieved from http://www.abbotsfordtoday.ca/low-barrier-vs-high barrier-shelters-why-is-abbotsford-different/