How Does Harm Reduction Therapy Work?

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When it comes to addiction recovery treatment, it is important to remember there is no one type of treatment or therapy that is going to be successful for everyone. For a rehabilitation program to be able to offer its clients the most effective treatment, it needs to provide a variety of options that can be tailored to the needs of a given individual.

For many people struggling with a substance use disorder, total abstinence from drugs or alcohol can seem like an impossible goal, which can keep them from seeking out professional addiction treatment services.

This is where the concept of harm reduction therapy comes in. The term harm reduction, as it relates to addiction treatment, actually refers to two separate approaches.

The first is the idea of lessening the usage of drugs or alcohol rather than aiming for immediate abstinence. The second is that if addiction treatment is not an option, then at least find a way to reduce the level of social, economic, and personal harm that substance abuse causes. Common examples of this include needle exchange programs and the efforts to make overdose-reversal drug Narcan more widely available.

But does harm reduction work in curtailing substance abuse?

What Is Harm Reduction Therapy?

Harm reduction therapy is typically more focused on the first idea, which is getting someone to lessen their usage of whatever substance they are dependent on.

Perhaps the biggest misconception surrounding harm reduction therapy is that it supports or encourages the continued abuse of a substance. This is not the case, as the overall goal of harm reduction therapy is still eventual abstinence, just on more of a sliding scale.

Harm reduction therapy acts as another option for an addiction treatment professional to have in their toolbox to more effectively treat a wider range of clients. As previously mentioned, total abstinence all at once is not going to work for everyone who is addicted to drugs or alcohol, and can even act as a deterrent that keeps them from entering a recovery program.

Lessening Usage Over Time

The biggest distinction between harm reduction therapy and abstinence-based treatments is how therapeutic progress is measured. For example, if someone was struggling with alcohol addiction and having at least eight drinks a day, and after a month of treatment reported that they were having three drinks a day, this would be counted as a failure.

However, under the principles of harm reduction therapy, this would be viewed as successful progress, as the person has at least been able to reduce their alcohol intake and is clearly taking steps in the right direction.

While the end goal is still abstinence, harm reduction therapy can make the process of achieving sobriety less intimidating, breaking it down into more manageable milestones and helping to build up the confidence of the person in treatment.

In contrast, if someone who was dependent on drugs or alcohol tried to quit all at once and then relapsed, the potential feelings of defeat and shame could make them feel like any further attempts at recovery would be pointless and end in failure.

Replacement Therapy

Apart from just encouraging those in treatment to use less, another common harm reduction strategy in addiction treatment, particularly when it comes to treating opioid dependence, is medication-assisted treatment (MAT) in the form of substance replacement therapy.

MAT basically uses the same logic as using a nicotine patch or gum to quit smoking cigarettes. To successfully get people in treatment to stop using heroin or prescription opioids, they will instead be given administrations of buprenorphine or Suboxone to block cravings and wean them off their dependence.

Buprenorphine is what is known as a partial opioid agonist, so it is much weaker than heroin or other opioids and able to help with cravings and withdrawal without providing a euphoric high. Suboxone is a drug that is a mix of buprenorphine and naloxone, an opioid blocker that is the primary ingredient in Narcan.

As with the other methods of harm reduction therapy, the goal of harm reduction strategies like Suboxone maintenance is eventual abstinence. Once someone has been fully weaned off their opioid of abuse, the next step is to then slowly taper down Suboxone usage. It is a longer overall process but has been proven in clinical case studies to provide positive outcomes in terms of people staying in treatment longer and avoiding relapse in the future.   

The Controversy Behind Addiction and Harm Reduction

Not everyone is in agreement, however, that addiction and harm reduction strategies are a useful combination. In fact, many people even view it as the opposite, something that is actively harmful to people with substance use disorders.

Many people worry that harm reduction therapy could be interpreted as a “free pass” of sorts to continue engaging in substance abuse. In the case of treatments like buprenorphine or Suboxone maintenance therapy, there also is the fear that it is just replacing one opioid with another rather than solving dependency.

It is true that medication-assisted treatment on its own is not going to be enough for someone to truly recover from their addiction, and it is critical that it is paired with evidence-based behavioral therapy for it to be effective.

In a similar vein outside of addiction rehabilitation treatment, the harm reduction strategy of having law enforcement and other emergency responders carry Narcan to save people from fatal overdoses has been met with significant criticism, too.

Many law enforcement officials have expressed frustration about having to use Narcan over and over to revive the same people, and that having an “overdose safety net” might make those dependent on opioids feel less pressured to stop using or even reduce their use.

Part of this problem is, again, that Narcan is not a solution on its own. It works as a form of harm reduction in that it saves lives, but it is not a form of therapy, and it does not do anything to address addictive behaviors. For that, addiction rehabilitation services must be sought out.

Of course, just as abstinence-based treatment is not universally effective, harm reduction therapy is not going to be a viable option for everyone. Some people dealing with severe substance use disorders cannot control how much they use and are then unable to actively lessen their use over time.

But for those who are good candidates for harm reduction therapy, it can mean the difference between eventual sobriety and no treatment at all.

Looking for Help with Substance Abuse Recovery?

If you or a loved one is struggling with a substance use disorder and searching for help, New Perspectives can help you take the crucial first steps toward recovery by combining medication-assisted treatment and traditional therapies to guide you through the withdrawal process.

Our skilled and experienced clinicians and staff work to provide the highest quality professional addiction recovery treatment services. Call us today at 855-463-0793 to speak to one of our specialists about finding the treatment program that’s right for you or your loved one. You can alsocontact us online for more information.



Megan Hesse
Content Writer

Megan Hesse is a digital content writer, copywriter, and former teacher, with a Master of Fine Arts from Florida Atlantic University. Her daily goal at Delphi is creating content that's well-researched as well as compelling and engaging.

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