Harm Reduction Model
Many therapists consider harm reduction model as a legitimate substitute for abstinence-based therapies for dually diagnosed persons. However, there are few studies on various recovery strategies impact frontline practice when addressing alcoholism and substance abuse, especially among young people. Harm reduction refers to an approach directed to groups or individuals to reduce the harms related to various behaviors. Regarding substance abuse and alcoholism, harm reduction model allows people to have a continuous drug and substance usage as they continue with their recovery sessions. That is because the objective of this approach is to reduce severe consequences and end the addiction gradually. It focuses on the measurement of economic, social and health outcomes and not determining the frequency of alcohol consumption or level of substance abuse. Unlike total abstinence, harm reduction model allows slow but complete recovery for addicts without fear of withdrawals or a relapse.
Harm reduction approach has transformed over time since its first use in the 80s. It is now a recommendable alternative to abstinence-based intervention for people struggling with alcohol and substance abuse. In the 1980s, therapists noted that abstinence was not an ideal objective for most addicts. Additionally, programs requiring complete abstinence excluded people whose interest was minimizing but not stopping the substance use. Studies indicate that harm reduction significantly reduces mortality and morbidity related to risky lifestyles and behaviors. As aforementioned, harm reduction is a model incorporating policies, practices as well as programs aimed at reducing adverse legal, social and health effects related to alcoholism, drug laws and policies. It is based on human rights and justice through a focus on positive changes and working with individuals without condemnation, discrimination, or coercion. Also, this approach does not require addicts to eliminate alcohol or drug usage as a condition for support.
Unlike the abstinence approach, harm reduction model is inclusive and encompasses several social and health practices and services relevant to legal and illicit drugs. They include needle and syringe exchange initiatives, drug usage rooms, employment programs, overdose reversal and prevention, non-abstinence houses, psychosocial support and education on safe drug use practices. Such strategies are evidence-based, cost-effective and produce a positive impact on community health and individual. Several principles guide the harm reduction approach, and the first one is respecting the individual rights of addicts. The primary objective of the harm reduction model is protecting human rights and improving community health. Treating individuals struggling with alcohol and substance abuse addiction, together with their families and society with dignity and compassion, is integral to this recovery model. Alcohol or substance does not forfeit a person’s human rights. Addicts remain entitled to the liberty of quality healthcare, life, social services, and privacy. Additionally, they enjoy freedom from cruelty, degrading and inhuman treatment, and arbitrary detention, among other rights.
The second principle of harm reduction model is evidence-based practices. The practices and policies forming the basis for harm reduction are based on adequate evidence which suggests that interventions are cost-effective, safe, practical, useful and feasible in different social, economic and cultural settings. Majority of harm reduction strategies are cheap and easy to enforce in addition to having a positive effect on the community and personal health. Third, harm reduction intervention is committed to social justice and partnering with different networks of individuals using alcohol and drugs. The basis of harm reduction is ending discrimination and ensuring every person is included in the social and health services they require. People often face discrimination due to their alcohol and substance abuse behaviors, gender, sexual orientation, race, socioeconomic status and choice of work. However, harm reduction approach ensures that everyone can access relevant services without fear of unnecessary hindrances such as discriminatory and burdensome regulations.
Moreover, the purposeful inclusion of people using illicit drugs and alcohol in designing, enacting and assessing policies and programs that serve them is crucial integral to harm reduction. The last principle of harm reduction intervention is avoiding stigma. People implementing harm reduction interventions accept individuals who use alcohol and drugs and remain dedicated to meeting them in their locations without any prejudice. These practitioners use language and terminologies that convey respect and avoid words that instill stigma or create division between harmful and useful drugs. Stigmatizing words and language perpetuate negative stereotypes and create barriers to social and health services. Harm reduction model has several goals that guide practitioners. The primary basis of harm reduction recognizes that several people across the world are either unwilling or unable to stop alcohol consumption and substance abuse.
The first aim of harm reduction is keeping people alive and encouraging them to live positively. Preserving the lives as well as protecting the wellbeing of addicts is an urgent priority. Harm reduction interventions are accommodative and not coercive and seek to promote positive changes in an individual’s life regardless of how much that transformation can be. By recognizing that few people who use alcohol or drugs experience problematic usage, this approach also helps individuals maximize the potential benefit they acquire from drugs or alcohol. Secondly, harm reduction seeks to minimize the harmful effects of drug policies and laws. The objective of this intervention is to advance law enforcement approaches as well as the drug laws and policies to reduce their detrimental impact on the wellbeing and health of addicts and their families.
Several policies create and worsen the potential risks and harmful effects of alcohol use and substance abuse. That includes criminalizing drug addicts and alcoholics, corrupt and abusive policing services, arbitrary detention disguised as rehabilitation, and the denial of harm reduction interventions and medical services. These individuals also face discrimination based on their gender, race, socioeconomic status, class and drug or alcohol use. As a result, the harm reduction approach challenges both national and international policies and laws that contribute to drug-linked dangers. Third, harm reduction provides alternatives to strategies aimed at preventing or ending alcohol and substance abuse. Addicts should receive high-quality therapy and care programs like interventions involving the cessation of alcohol consumption and drug use and other evidence-based prevention measures. An individual should not be forced to enter treatment; instead it should be based on their terms.
Most people using alcohol and drugs do not require treatment, and those facing problems related to these habits may be unable or unwilling to join abstinence-alone therapy for several reasons. While alcohol and drug abstinence could be the objective for different people using drugs, seeking treatment should be a personal choice and not coerced or imposed, or deemed as the only alternative. Harm reduction is an ideal strategy for drinkers and drug users who feel the need to curb their drinking or drug use. That is because the approach is not only inexpensive but also less invasive and intensive, plus it does not prohibit social drinking. However, it is worth noting that such a practice requires discipline, accountability and self-control, something not common among regular drinkers and drug users. Additionally, unlike abstinence-oriented method, harm reduction is not focused on faith-linked addiction therapy. That makes it fitting for people who are both religious and non-religious. Overall, harm reduction is an effective intervention practice for alcoholics and drug addicts that allows them to make gradual improvement and enhances their eventual social integration without fear of stigma or discrimination.