A Little Bit Better. Harm Reduction During the Coronavirus Crisis - המרכז הישראלי להתמכרויות - ICA

A Little Bit Better. Harm Reduction During the Coronavirus Crisis

Hadar Peled

Even optimists would agree that the current coronavirus crisis poses real challenges for all of us, and requires us to adapt to abnormal and complex circumstances. For some people, this experience brings feelings of extreme uncertainty and loss of control. The desire, then, to regain a sense of control and certainty is perfectly natural and healthy. However, setting strict rules for how to live can cause frustration and stress, and may ultimately make coping with this crisis period even more difficult.

Now more than ever, it is important to distinguish between the things we can change and what is outside of our control. Given these abnormal times, such an examination demands forgiving and non-judgmental eyes. It requires us to set realistic and flexible goals and to accept our current emotional state, so that we can make informed decisions and achieve a new balance. Doing so can help prevent future damage to our lives, and increases the likelihood of a smooth return to normal life.

It’s Better to be Smart than Right

Take, for example, the issue of screens: obviously, screen use during this period has increased considerably for both children and adults. The struggle to limit screen use is hard enough during normal times, and only harder nowadays. So how do we reduce the harm that may be caused by heavy screen use?

First, we must replace the focus on control with a focus on communication, and ask ourselves: What type of “harm” are we most concerned about? Is it the duration of use, or the content being consumed? Is the hardest part the constant fighting over screen use and the unpleasant atmosphere that this creates? We must decide, from a forgiving place, whether we want to be more flexible about screen time and maybe focus more on controlling content. Or, perhaps, during this period when the entire family must spend long days together at home, harm reduction means maintaining a peaceful atmosphere, and not turning screen use into another battleground.

There is no one right answer. Making the best choice for you and your family requires honest reflection and flexibility. At a time when screens allow many of us to keep up with work, school, social connections, and even sports and fitness, we may find that screens do not necessarily, in and of themselves, cause harm.

The Harm Reduction Approach to Addiction

The harm reduction approach is practical in that it recognizes that there is no one solution that is right for everyone, and no uniform benchmark for “success” or “failure.” It offers a way to mitigate the damage caused by a certain behavior, even if the behavior does not completely stop. For example, wearing a seat belt does not prevent car accidents, but it can certainly reduce the damage caused by an accident. Around the world the best minds are currently trying to develop a coronavirus vaccine that will eradicate the disease, but until that happens, we are busy trying to reduce the negative effects of the disease on our health, economic and social systems. In other words, even when there is no perfect solution to a problem, the goal is to start moving in the right direction.

The current crisis-induced quarantine, home isolation, lack of routine, and lack of outside stimuli can cause great distress for those suffering from addiction. People suffering from addiction, whether they normally abstain from use or are dealing with an active addiction, can find themselves at risk of exacerbating their condition, or forced into an unplanned—and perhaps undesired—withdrawal.

It is important for people to examine and define the negative consequences of their substance or behavioral addictions for themselves, and then, in accordance with their determinations, think of ways to reduce the damage caused by their addictions. We must also consider whether a call for total abstinence during this period will produce the desired results or only make things worse. If the latter, then it may be best to focus only on harm reduction during this time.

For example, we may find that one of the negative consequences of home quarantine is that children can be exposed to the substance use of one or both parents. In such a scenario, harm reduction would include reducing this exposure, by encouraging the parents to not use in front of their children. If the issue is high levels of anxiety, then it is important to find alternative ways of providing meaning, comfort and stress relief, rather than resorting to substance use.

If early morning substance use is preventing an individual from being able to function at home with their family, and causing frustration and conflict, then delaying use to later in the day may help. Maybe family members can decide together on a schedule of use that is less disruptive to family life, or maybe they can be encouraged to show more patience and tolerance, instead of trying to change the pattern of use.

The harm reduction approach allows people to find solutions that are tailored to their unique circumstances, and, as a result, may provide more effective means of coping. It offers hope that we may come out of this ordeal a little stronger and a little wiser, and—despite the social distancing and isolation—a little more loving and close.