Understanding Addiction: Harm Reduction vs Abstinence.

My colleague, Caroline, has worked in a variety of fields including addiction and mental health services, community outreach, homeless shelters, and an inpatient rehabilitation centre for adults struggling with addiction and concurrent mental health disorders.

Her passion for social work stems from her desire to help others recognize their resilience regardless of their past or present challenges, and to help clients develop and strengthen their relationship with themselves.

Addiction is a polarizing topic in today's society and is a subject close to Caroline's heart.

~ Laura

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Caroline's hope for treating addiction...

I have been connected with many people in my life who have struggled with addiction and I understand the repercussions it has on the people who love a person who struggles.

Something I have been thinking a lot about lately is how the dichotomy of abstinence versus harm reduction has left many of us misunderstanding not only addiction but how to help those who struggle.

As a part of my masters field work, I have been asked to research the harm reduction approach to addiction versus abstinence. What the general public understands about addiction is that either you use or you don’t. Either you’re an addict or you’re in recovery. This is very challenging to understand both as a social worker and as a human being. How can it be so black and white? I have come to learn that in fact, it isn’t.

The harm reduction model can be traced back to the 1920s with the Rollerstone Committee which consisted of well-respected physicians from England suggesting it could be beneficial to maintain a person on their substance(s) to help them lead a more productive life. Harm reduction has been understood by most to be a needle exchange program or methadone maintenance (which it is) but nothing more. The trouble with this misunderstanding is the discrimination that accompanies harm reduction in other contexts, such as those who would like to reduce their use and learn healthier ways of coping, or who are in a place where they aren’t even sure if there is a problem.

I want to shed more light on the opportunities that harm reduction can bring to those who have a difficult time with the abstinence route to recovery.

The harm reduction model meets the person where they are and considers the person-in-environment context, meaning the holistic and bio-psycho-social approach to recovery. This is also a model that is connected to the stages of change which plays an important and impactful role in a person’s life both in active addiction and in recovery.

I am an advocate for both the harm reduction model and for abstinence. I believe the person who struggles is the expert in their life and helping a person recognize their strengths and goals while allowing them autonomy in their journey through addiction will empower them and help affect change.

To reduce harm is to improve one’s quality of life. My hope is to create a conversation and reduce stigma to the best of my ability.

~ Caroline, clinical therapist

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