Harm reduction can be defined as any effort that attempts to minimize the negative consequences associated with substance use (either to the individual, their families, their communities, or society as a whole) without requiring the cessation of such use.
Harm reduction provides an alternative to the moralistic and medical models of drug and alcohol treatment, acknowledging that some individuals may be unable or unwilling to refrain from use.
Harm reduction has been gaining popularity in Mombasa as an alternative to traditional means of dealing with substance abuse. Research indicates that harm reduction strategies such as needle exchange and methadone maintenance are associated with reductions in: drug use, disease, crime, unsafe injection behaviors, drug related deaths, and improvements in employment and interpersonal relationships among IV drug users.
There is strong empirical evidence demonstrating the effectiveness of harm reduction necessary to promote its acceptance. Despite the evidence, however, efforts to implement harm reduction strategies have met with resistance from some health care professionals, especially when dealing with individuals who are considered dependent on rather than just using drugs or alcohol. Reasons for this resistance are varied and multifaceted. One difficulty may be the lack of consensus regarding what harm reduction is, exactly.
Stigma and structural violence
Stigma and discrimination are well-documented barriers to health seeking behavior, engagement in care and adherence to treatment across a range of health conditions. “Negative attitudes and beliefs about certain groups of people. It is the prejudice that comes with labelling and stereotyping an individual as part of a group that is believed to be socially unacceptable.” It leads to status loss and discrimination all occurring in the context of power. Stigma can manifest through health (e.g. disease specific) and non-health (e.g. poverty, gender identity, sexual orientation, migrant status) differences, whether real or perceived. Discrimination is the unfair and unjust action towards an individual or group on the basis of real or perceived status or attributes, a medical condition (e.g. HIV), socioeconomic status, gender, race, sexual identity or age.