Harm Reduction Approaches CSD 5970

Review (Disease Model) Chronic Progressive Incurable Loss of control “An illness which only a spiritual experience will conquer”. Alcoholics anonymous

Review Where did these beliefs come from?

Review of Popular Treatment Approaches Minnesota model 12-step facilitation (Nowinski) Addiction counseling (Mercer) CENAPS relapse prevention (Gorski) Living in balance (Hoffman)

Review of Popular Treatment Approaches Dual disorders model (Daley) Solution focused (Scott Miller) Motivational interviewing (William Miller)

Harm Reduction Approaches Bartender Training Methadone Maintenance Narcotic Antagonist Programs Needle Exchange New Year’s Eve Taxi Programs There are hundreds more.

Principles & Assumptions There has never been and never will be a drug-free society.

Principles and Assumptions A pragmatic approach – it is not what’s nice it is what works. Measures outcomes in terms of death rates, disease and crime rather that changes in drug use. Incarceration and interdiction are failed approaches.

Principles and Assumptions The interventions strategy should reflect the relative harmfulness of the drug. Lessen the harm caused by drugs through education, treatment, and prevention. Prohibition causes harm – black markets result in crime, exploitation, unnecessary deaths, and disease.

Principles and Assumptions Harm reduction seeks to restore human dignity and self-determination.

Principles and Assumptions “If tobacco suddenly were unavailable and was as expensive as heroin and cocaine, I think you would find that the behavior of some tobacco addicts would be very much like the behavior of some addicts of heroin and cocaine”. C. Everett Coop

Questions On what points do harm reduction proponents and abstinence-based treatment proponents agree?

Questions What are the key areas of disagreement?

Questions Can these two approaches be effectively integrated? Is a “unified theory” possible

Exercise Develop a harm reduction policy.