In the world of addiction and recovery, the initial mindset was typically centered around removing all substances from the addicted individual. This is done in hopes of promoting a sober lifestyle designed to last as long as possible. This is typically achieved through a mixture of personal accountability, substance use testing (breathalyzers and drug tests), and spirituality.
But as our understanding of this disease slowly grows, fatalities do so at an ever-growing rate. For this reason, experts have developed concepts designed to meet in the middle in order to make the most successful impression possible. Today, Clearbrook’s Pennsylvania Rehab examines the debate of harm reduction vs. abstinence.
Meaning of Abstinence
Abstinence is the term used to describe the process of avoiding any and all addictive substances. The medical understanding of addiction is constantly evolving as substance abuse rages through countless American communities. Alcoholics Anonymous was founded in 1935, while the development of the “Big Book” of recovery spread the concept that alcoholism was, in fact, a disease.
At this time, the only options for individuals struggling with a drinking problem were incarceration or a mental institution (which wasn’t that much better than the former.) It was thanks to AA that the concept of abstinence treatment gained support in the medical community.
Most addiction centers in the United States center their approach around the Minnesota Model. Key tenants of this model include:
- Addiction (particularly alcoholism) is a diagnosable disease
- It cannot be cured, only treated
- Addiction is multiphasic and affects the individual’s body, mind, and spirit
These are facts that our Northeast addictions treatment center takes very seriously within our own programs and services; however, a more recent concept has begun to grow in popularity within the realm of addiction treatment.
History of Harm Reduction
American history is a rich and unique tapestry of different experiences and perspectives. The concept of Harm reduction has roots in a variety of revolutionary movements taking place in the 1960s, 1970s, and 1980s.
These movements include:
- The Young Lords’ acupuncture program in the South Bronx designed to provide relief for heroin users
- Feminist Activism of the 1970s paved the way for women’s health
- Activist responses to the AIDS epidemic of the 1980s
Advocates have since developed the practice of harm reduction with the intention of understanding the deep struggles that run beneath the surface of the addicted and finding new ways to treat them in the hopes of preserving life, dignity, and understanding.
Harm Reduction Principles
This model consolidates a variety of strategies that include safer use, managed use, meeting people who struggle with addiction “where they’re at,” and addressing the conditions of the abuse combined with the use itself.1 It even incorporates aspects of abstinence and depends on a case-by-case basis of what works for each user.
Some of the most poignant principles of this model include:
- Doesn’t minimize the real harm and danger surrounding illicit drug use
- Recognizes the realities of social isolation, past trauma, and poverty that can affect a person’s vulnerability to drug-related harm
- Bases quality of life in both the individual and community as the criteria for successful policies, instead of only cessation of all drug use
A modern-day example of harm reduction is the use of fentanyl test strips that have been distributed amongst communities with a high rate of substance abuse. This is due to the presence of fentanyl in illicit substances, which has resulted in a slew of accidental overdoses in recent years.
There is still a substantial amount of work to do in researching the benefits and downfalls of this model’s evolution, but perhaps we can still learn something from it.
So Which Is Better?
As understanding and research continue to evolve, perhaps the emphasis shouldn’t be placed on deciphering superiority in harm reduction vs. abstinence, but rather on what we can take from each concept to most effectively treat the ones that need help the most.
It is clear that the impact of addiction is not going away anytime soon. Clearbrook takes pride in the knowledge that every individual will have different needs, and everyone’s journey through addiction will be different.
If you are currently struggling with an addiction, our detox in PA is an excellent option for those in need of guidance through the withdrawal process. Once this concludes, treatment can begin to help you get back to the life you deserve.
- Principles of Harm Reduction – National Harm Reduction Coalition