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Harm Reduction for Alcohol and Drug Addiction


The only real way to overcome the problems associated with alcohol and drug addiction is for the person to choose complete abstinence. So long as people continue to use these substances, they are going to suffer. The reality is though that many people are just not willing to break away from addiction at this point in their life. If these individuals are allowed to continue just as they are, there is a good chance that they could be dead before they ever become ready to quit. It would be considered unethical to just sit back and watch these people slowly kill themselves, so this is why harm reduction programmes have been created.

What is Harm Reduction?

Harm reduction is an approach that is based on the idea that an all or nothing approach to recovery is not going to work for everyone. Some people will just not consider giving up alcohol or drugs at this point in their life. Harm reduction works on the assumption that some improvement will be better than no improvement. The hope is that by helping the individual improve their current circumstances, it will help them reach a stage where they are ready to break away from addiction for good. In other words, another way to look at harm reduction is to see it as the first step towards permanent abstinence.

Is Harm Reduction a Type of Enabling?

It is commonly believed that in order for people to be able to break away from their addiction problems they will need to hit some type of rock bottom. The fear is that by offering a harm reduction approach it will be preventing people from hitting rock bottom. While this type of concern is understandable, it may be considered unwarranted for a number of reasons. The reality is that if those individuals who are not ready to quit are not helped, there is a real possibility they may end up dead. There can be no recovery for dead people. Another thing to keep in mind is that rock bottom is not about how much people lose – it is about the person concluding that they have already lost enough. This means that there is no reason why this person cannot benefit from harm reduction and still hit their rock bottom.

Benefits of Harm Reduction Programmes

Harm reduction programmes can be beneficial in a number of different ways:

  • These approaches can help to keep the individual alive until they are ready to choose permanent abstinence.
  • The fact that the person’s circumstances improve can put them in a better position for quitting addiction.
  • Harm reduction is all about encouraging the person to make small positive changes to their life, and this can encourage them to make further positive changes later on – a type of snowball effect.
  • It can mean that when the individual does become ready for sobriety, they will not be dealing with chronic disease and infirmity.
  • It can make life much easier for the loved ones of the person who is trapped in addiction.
  • It can make society safer because the person will be better able to control their addiction.
  • It can help the individual move away from the criminal underworld – it can mean they no longer need to negotiate with dealers.
  • These programmes may help to reduce the spread of HIV and other infectious diseases.
  • It may reduce the incidence of drunk driving and therefore save innocent lives.
  • It can help the individual rebuild their self-esteem and confidence, making things much easier for them when they do decide to break away from addiction for good.

The Different Types of Harm Reduction Programmes

There are many different types of harm reduction programme. The aim of all of these approaches is to counter some of the negative effects of alcohol or drug addiction. It would not be possible to remove all of these negative effects when the person continues to abuse these substances, but it is possible to make life for the individual slightly better. Here are just some of the most common harm reduction programmes around today.

  • Methadone maintenance programmes – this is where the individual replaces heroin with methadone.
  • Moderation management – this is a programme that attempts to help people moderate their alcohol intake.
  • Dieticians can provide substance abusers with nutritional supplements to help them avoid the worst effects of malnutrition.
  • Needle exchange programmes – to reduce people’s risk of being infected by HIV and hepatitis.
  • Safe injection sites – places where people can go to inject drugs safely.
  • Heroin maintenance programmes – the aim is to help the person taper off heroin over time.
  • There are safer drinking programmes to help people drink more sensibly.
  • Wet shelters are places where alcoholics can go and drink in a safe environment – if people are inebriated, they will usually be refused entry to other shelters.
  • Safe sex programmes and free condoms
  • Decriminalisation of soft drugs might be considered a type of harm reduction effort.
  • Some parts of the world offer free ride home programmes for people who have been drinking – this is to discourage drink driving.
  • Nicotine replacement therapy
  • Health promotion programmes will try to help the individual to live a healthier life even though they continue to use alcohol or drugs.

Harm Reduction or Permanent Abstinence

The only way to break away from the negative effects of alcohol or drug abuse is to choose complete abstinence. This means that everything should be done to encourage people to end the substance abuse for good. The purpose of harm reduction is to just buy the individual a bit more time so that they can reach a point where they are ready to quit forever. It would be unhelpful to promote harm reduction as a long-term alternative to abstinence, as it is only used as a last resort.

Harm Reduction to Prepare People for Rehab

The hope is that a harm reduction programme will allow the individual to reach a stage where they are ready to break away from addiction for good. In many instances, the best way for the person to take the next step will be for them to enter rehab. This will mean that they will be supported as they take their first tentative steps into recovery. It will also mean that they will be given the tools they need in order to begin building a much better life without addiction.

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