Eng102 final project 2
- 1. Burgess G. Brown A Second Look
- 2. Harm Reduction has a functional place in the continuum of care based on: The historic ineffectiveness of abstinence-based treatment The benefits garnered from utilizing the Harm Reduction model of treatment The needs of the consumers who choose the Harm Reduction model of treatment
- 3. I know what you are thinking… “No! Harm Reduction does NOT have a place in the continuum of care!” I had these same thoughts. As a Professional Addiction Therapist, my life’s work has focused on trying to help substance abuser end their destructive relationship with substances and create lives worth living. Sometimes I am successful and my efforts worthwhile. But there are too many times when I am unable, despite my best efforts, to initiate anything that even remotely resembles a positive outcome. The futility of my labor leaves me wondering if there may be another option to help. Hence, my willingness to re-examine the Harm Reduction Model. I have compared the traditional abstinence-based model of treatment with the Harm Reduction model to see if there is any merit to this model which I share in the following.
- 4. Harm Reduction Harm Reduction proposes individuals who abuse substances can improve their quality of life if they are given access to certain specific services irrespective of whether or not they continue to use substances. Abstinence-based Abstinence-based treatment postulates that individuals’ must discontinue use of all mind-altering substances in order to improve their lives. The methodology to treating individuals who struggle with substance abuse varies between the two approaches.
- 5. Harm Reduction Harm Reduction allows recipients to define treatment goals based on improving their quality of life. Harm reduction accepts each individual is capable and responsible for choosing their own path. Harm Reduction does not attempt to manipulate or coerce participants into abstinence. Individuals may choose abstinence for a particular substance, continue to use all substances, or choose to not use any substances at all. Abstinence-based Abstinence-based treatment defines abstinence as the irrefutable main goal and those unwilling to work toward that goal are deemed inappropriate for treatment.
- 6. Harm Reduction Counseling and education Needle exchange Free kits Condoms HIV testing Safe rooms to use Opiate replacement (Methadone, Suboxone, Subutex) Referrals for social services, treatment, vocational rehabilitation, employment and housing (Einstein, 2007). Abstinence-based Counseling and education Condoms HIV testing Medications including use of benzodiazepines, Suboxone and Subutex for detoxification, and craving reducing medications such as Vivitrol and Topamax Referrals for social services, treatment, vocational rehabilitation, employment and housing
- 7. Harm Reduction Reduced transmission of HIV/AIDS and Hepatitis C Improved public health Lowered crime rates Connecting substance abusers with needed referrals Improved self-efficacy which enables individuals to manage their own lives, make better life choices, and meet their own goals. Positively affects the number of deaths associated with substance abuse. Abstinence-based Reduced transmission of HIV/AIDS and Hepatitis C Improved public health Lowered crime rates Connecting substance abusers with needed referrals Improved self-efficacy which enables individuals to manage their own lives, make better life choices, and meet their own goals. Positively affects the number of deaths associated with substance abuse.
- 8. Harm Reduction Meets all clients where they are Does not attempt to apply judgments or moral directives Allows clients to define whether they are capable of moderating their own use Enables clients to seek whatever changes they feel are necessary at any time they feel they are ready Abstinence-based In order to be allowed in treatment, the client must verbalize a willingness to abstain from all mind-altering substances Clients who do not maintain sobriety are labeled “resistant” and are most often discharged from treatment
- 9. Harm Reduction Harm Reduction may reduce some of the unintended effects of using such as • Contracting communicable diseases • Engaging in criminal behavior • Having criminal charges and the attending consequences • Interpersonal issues • Unemployment • Homelessness (Kleinig 2008) Abstinence-based Abstinence completely eliminates all future unintended effects of substance abuse Abstinence improves many of the past consequences of use
- 10. Harm Reduction Harm reduction offers substance users who may be marginalized an opportunity to begin to reengage in their communities (Einstein 2007) Abstinence-based Abstinence-based treatment encourages participation in society especially with others in recovery for support
- 11. Harm Reduction Needed services for both models of treatment include medical personnel, treatment providers, housing options, financial assistance, and employment. Abstinence-based (Einstein, 2007) These social services are typically extremely limited. If there is a lack of available services, neither program can meet its function.
- 12. Harm Reduction and Abstinence-based treatment share many of the same modalities, services, benefits, and even some goals. The major differences is in the demand for abstinence. This difference however is vast. While the abstinence-based providers minimizes the efforts of Harm Reduction, they must admit their own inadequacies in providing services that meet their goals across the board. It is in those moments when the reduction of harm seems more beneficial then no improvement at all.
- 13. Einstein, S. "Harm And Risk Reduction: History, Theories, Issues, And Implications." Substance Use & Misuse 42.2-3 (2007): 257-265. Academic Search Premier. Web. 14 Nov. 2014. Kleinig, John. "The Ethics Of Harm Reduction." Substance Use & Misuse 43.1 (2008): 1-16. Academic Search Premier. Web. 12 Nov. 2014.