Substance abuse can be very destructive to the life of the addict and those around them. The ideal solution would be complete abstinence from these substances. However, the addict often doesn’t want to choose this path. If the only options available are programs aimed at quitting, these people will be left to fend for themselves. If addiction is a disease, it is unethical to simply criminalize addicts and leave them to their own devices. This is not only bad for them but also bad for society as whole. The usual path of untreated addiction leads towards death. Harm reduction is an alternative approach to dealing with addicts. The aim is to minimize the negative impact of drug use, even when the individual is not prepared to consider complete abstinence.
Harm minimization is based on the belief that some improvement is better than no improvement. It means accepting that alcohol and drug abuse is a reality within society that shows no signs of going away. Simply condemning the addict as a bad person or insisting that they give up their substance abuse is not an effective approach. A wiser course of action will be to minimize the damage caused by such behavior.
The philosophy of harm reduction accepts that there is not yet one solution that suits every addict. Rehabs and 12 Step groups may work well for some people, but these approaches are clearly not working for everyone. Addiction is a complex phenomenon that is unlikely to be solved by any one approach. Insisting on a one size fits all approach can be highly damaging. If society continues to use the same approach to addiction as used in the past, improvements will not be made.
Harm reduction works on the assumption that it is possible to make alcohol or drug abuse less damaging to the individual. It is impossible to remove all the ill-effects of such abuse, but they can be minimized. For example, heroin maintenance programs remove the addict from the criminality and dangerous contexts, and it means they are no longer at the mercy of immoral people. Needle exchange programs can reduce their risk of developing HIV.
Harm reduction programs can include such provisions as:
* Needle Exchange programs
* Methadone maintenance programs
* Heroin maintenance programs
* Safe injection sties
* Decriminalization of soft drugs
* Moderation Management for alcohol abusers
* Wet shelters where alcoholics are allowed to drink
* Free ride home programs for people who have been drinking
* Nicotine alternatives to tobacco
* Safer drinking programs for alcoholics
* Provision of nutritional supplements to substance abusers
The principle of harm reduction is not limited to dealing with substance abuse. Programs also exist for dealing with other problems such as:
* Safer sex programs
* Legalized prostitution
* Harm minimization for self harm
*Free condoms to reduce the risk of HIV transmission
The aim of harm reduction is not to replace abstinence. If the addict is willing to give up the abuse altogether then this will be the best possible situation. These programs are for those who will not consider quitting but are at risk of the many negative consequences of their addiction. If this type of individual is able to improve their circumstances then they may become more willing to consider completely giving up the abuse in the future.
The main criticism of harm reduction is the claim that it may encourage people to engage in dangerous behavior. Addicts may be less likely to quit the substance abuse because they are now spared some of the negative effects associated with such abuse. There is also the concern that harm minimization could encourage more people to experiment with drugs. These criticisms of harm reduction are not supported by empirical evidence. A good example of this can be seen in Switzerland where a heroin maintenance program has led to a decrease in such abuse.
There is a widely held view that in order for an addict to become ready for recovery, they need to hit rock bottom. The worry then would be that harm minimization could prevent them from reaching such a point. The problem with this way of thinking is that in a lot of cases the rock bottom for the individual will be death. It is arguably better to encourage the individual to improve their current life circumstances rather than allowing them to deteriorate in the hope that this will cure them.
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