Recently I attended an inservice on harm reduction.  If you are not familiar with this philosophy, it means changing behavior in a healthier direction without demanding abstinence from the harmful behavior.


Needle exchange programs are one easy to understand example.  Injection drug addicts who are not willing/able to quit may be perfectly willing to use clean needles if they are available.  By making a small change in their behavior (not sharing needles) you have reduced their chances of contracting HIV. 


The benefit to the drug user is clear.  Abstaining from drug use would be better, but at least you are reducing the harm they are doing.  There’s a big public health benefit too.  It costs hundreds of thousands of dollars to care for one AIDS patient over the duration of their life.  And an uninfected junkie is a junkie who will not pass the virus on to sexual partners or other drug users. 


The instructor at the inservice showed us this astonishing slide, demonstrating the many ways we kill ourselves:


behavior graph



Note that the deadliest behaviors are the legal ones.  The circumspect “microbial agents” includes AIDS.  It causes less than a quarter as many deaths as tobacco does.


You can practice harm reduction for yourself.  If you can’t quit smoking, cut down your intake.  If you just HAVE to have ice cream, get a single scoop. 


Thankfully, caffeine is not on the chart.




12 thoughts on “

  1. Four basic food groups:  caffeine, nicotine, chocolate and alcohol.  I smoke, but I smoke one to four a day.  Can’t afford much more than that, and in a way I’m glad that the government of the US is going to raise the cost of cigarettes by 61¢ per pack and take the extra money they get and put it towards uninsured kids’ health care.  Smoking is a luxury.  I don’t enjoy it when I smoke a lot anyway.  Yeah, behavior.  My doctor has a jar on his desk that says “ashes of problem patients.”

  2. People are indeed crazy. Why the death wish? Sounds like a good research topic to me!I thought I’d mention it took me a few updates to finish the last post – did you get to see all of it?

  3. I was suspect of the tobacco numbers – these sorts of things are often “padded” – but even if you only include deaths from cancers and conditions with a strong causal link with smoking you come up with a number just shy of 300,000.  Upsetting.  (CDC has a neat little webapp that breaks it all down.  webapp here)
    The other interest tidbit is the breakdown of the “firearms” category – over half of the 30,000 deaths are chalked up as suicide, the other half are homicides except for 675 accidental deaths and 300 “law enforcement intervention-related” deaths. 
    But I wonder if illicit drug-related deaths are so inconsequential compared to alcohol/tobacco because of the relative numbers of users?  I would suspect that a heroin addict would be more likely to die of heroin overdose than an alcoholic would of cirrhosis.  But maybe not.
    RYC:  Your hubby’s gadget is too big for my tastes – my little nano is the size of a credit card.  Not exactly direct competition.

  4. Well said.  I’ve known people in the needle exchange program, and they face a lot of opposition.  Your points are absolutely valid.

  5. OK Ok.  I admit it.  I will never smoke again.  Oh wait, I never have smoked.  Damn it’s the weight thing and the diabetes.  That’s right.  OK Ok, I admit it.  I will do better on my diet and excersise routine!

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s