Sherry Gaba LCSW, Psychotherapist, Life and Recovery Coach on Celebrity Rehab on VH1 and Author of “The Law of Sobriety” which uses the law of attraction to recover from any addiction. Please download your copy of “Eliminate Limiting Beliefs”, from Sherry’s, Enrich Your Life series. Contact Sherry at sherry@sgabatherapy.com for webinars, teleseminars, coaching packages and speaking engagements

harmreductionHarm reduction, used as a method to work with addicted individuals, is a controversial topic. Harm reduction refers to incorporating strategies to provide safer use of drugs. The concept is that by engaging in safer drug use, the clinician is meeting the drug user where they are in their recovery process.   Harm reduction theories are backed with fundamental practices.

Harm reduction can be effective in reducing harsh consequences that accompany drug use. The philosophy of harm reduction believes that addicts are going to do what they want to do; therefore by providing access to safer methods of achieving their goal (using their drug of choice), we are eliminating health epidemics. An example of harm reduction is offering clean needles to IV drug users.    Due to the various interpretations of harm reduction, there is no one method that is utilized universally, however, certain practices tend to be followed.

The use of drugs is seen as a consequence of complex human behavior. Drugs are seen on a scale of certain substances being “safer” than others. Rather then condemn the use of drugs, why not provide a safer environment for them?

Providing access to safer practices, regarding drug use, harm reduction is seen as a logical method to monitoring drug use. An example is providing methadone as a treatment for heroin addiction. Methadone can relieve the addict of the need to use heroin and the practice of ingesting methadone is considered “safer” due to how it is taken into the body and how it is regulated by clinics.  In addition, there are some individuals that “abuse” alcohol that are not “dependent” upon it.  Perhaps their bottom is not low enough for them to quit drinking. Should I turn them away because they won’t remain sober.  I think not and I won’t turn them away.  I always encourage 12 step meetings and sobriety, but I will always meet them where they are or I might never see them again.  My feeling is I am planting a seed,  and if I don’t support them in the beginning, they may never come back, and I lose the opportunity to help them find their way through the recovery process.

Rather than focus on abstinence or cessation, harm reduction theorists base their idea on the notion that drug users are not always going to choose to quit. The core belief regarding harm reduction is remaining impartial. No judgment should be passed. The hard truths of motivating factors that may foster drug use: abuse, poverty, racism, social isolation and traumatic events are accepted without prejudice. Harm reduction supporters also believe that they are not adding to the drug epidemic. They realize the severity of the impact that result from abusing addictive substances. This theory is in opposition to the traditional treatment plans in the professional addiction field.

Traditional Approach

There are addiction professionals that do not adhere to the principles of harm reduction. They do not accept a client taking one drug over their drug of choice as a feasible or healthy alternative to abstaining. These clinicians tend to agree that working a solid treatment plan, created with structure and strict guidance,  may prove more effective for long-term optimal health. These treatment plans can include: inpatient treatment, outpatient treatment, attending 12-step meetings, counseling and talk therapy. The addicted individual is taught how to function in the world as a sober individual; they are not supported in using a “safer” drug rather then a “harder” drug.

Harm reduction and traditional treatment have differing philosophies. While success rates are difficult to determine, due to the varying degrees of measurable variables, there are strong cases that support each side. The important element to remember is that all addicted individuals are unique and what works for one addict may not work for another.  Taking each individual on a case-by-case basis can ensure better results based on the individuals life circumstances and history of drug addiction and/or drug abuse.

While harm reduction remains to be a controversial subject, there are strong arguments for its effectiveness in reducing the rates of disease transmission in the IV drug using community. Above all, the afflicted individual must accept the treatment plan. The only treatment plans that works involve the addicted client to be willing to engage fully.

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