Harm Reduction vs. Abstinence in Substance Abuse Treatment

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When it comes to treatment for substance use disorders, there are two main schools of thought that treatment providers subscribe to, abstinence or harm reduction. When choosing a treatment provider, clients and their families may ask, “Which approach is better?” That’s a difficult question to answer because each philosophy has its own benefits.

Because of this, it’s important to be well-informed on both philosophies before making a decision as to which approach fits you. Learn more about the harm reduction model and abstinence model in substance abuse treatment.

Abstinence-Based Approach

Abstinence is the most traditional form of addiction treatment. An abstinence-based approach means that clients must completely abstain from drugs and alcohol. Practitioners believe that people with substance use disorders cannot successfully moderate their use in a way that does not lead to addiction and negative consequences.

There is some wisdom in this approach. Using substances lowers a person’s inhibitions and impairs their ability to make good judgments. For example, a person in recovery for opioid use disorder who continues to drink alcohol may be at risk of relapsing due to lowered inhibitions and poor judgment while under the influence of alcohol.

In addition, people who don’t practice an abstinence approach to recovery may develop an addiction to another substance. For example, a person with an opioid use disorder who has committed to abstaining from opioids may develop an alcohol use disorder if they do not commit to complete abstinence.

Harm Reduction Model of Treatment

The harm reduction model prioritizes reducing the negative consequences of a person’s substance use over complete abstinence. This model recognizes that drug use is complex, and abstinence may not work for everyone. Harm reduction aims to reduce harmful consequences like:

  • Risk of death
  • Medical complications
  • Financial consequences
  • Legal consequences
  • Relationship strain

Some people with substance use disorders struggle to identify their drinking or drug use as a problem. However, they may be able to admit that they are having some medical, financial, or relational issues in their lives.

In the beginning stages of treatment, therapists can address other issues in their clients’ lives, and eventually encourage them to face their substance use once the therapeutic alliance has been established.

Similarly, some people with substance use disorders are not willing to completely stop using drugs and alcohol but are willing to practice moderation. In these cases, clients may be more successful working with a harm reduction provider.

Only you know which treatment philosophy is best for you. Educate yourself on the risks and benefits of abstinence and harm reduction approaches. There are resources available to you to help you choose your treatment approach and facility. If you are struggling with a substance use disorder and would like to explore the possibility of getting help, contact Pyramid Healthcare. There is no obligation to enter treatment.

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