Harm Reduction Vs Recovery – Smackdown or Summer of Love?

This article has been written in response to a comment posted by the Phatpooch blog  on a previous article I posted: “A case against the argument that harm reduction strategies are costly and encourage people to use drugs”  You can see there comment here . I have been very ambivalent about approving Phatpooch’s comment as it introduced no evidence to the debate and I found some of the assertions in the slideshow to be a little offensive, however the comment did get me thinking about the dichotomy of recovery and harm reduction and whether it really is necessary.  In the interests of being fair I have approved Phatpooch’s comment but I also invite you to read my response below.

What do you see in the picture? An older man contemplating life? A homeless man quite probably alcohol dependent? It  fascinates me the number of perspectives that the same situation or event can elicit from different people.

Drug use in our community is no different.  While human beings have been getting stoned since the stone age the variety of perspectives have been far ranging  (for a few examples of some of the perspectives on drugs and drug problems check out Scary Cars and Harm Reduction ).

Of course humans being humans, these range of  perspectives on drug use has been cause for some contention .  Some will invest a lot of time and energy into these contentions and this is not an altogether bad thing.  By questioning and debating we continue to keep drug use on the public agenda and we continue to refine our shared understanding of drug use and drug problems within our communities.  There comes a point however when we can become so intractable in our views that we cease to hear what others with different perspectives have to say.  This is where learning ceases and wasted opportunities arise (for the sake of a catchy title lets refer to this as ‘Harm Reduction vs Recovery Smackdown’).

For harm reduction workers who perceive drugs and drug use through a particular philosophical lens this can be a trap particularly when working with clients who view there substance use issues through the lens of ‘opposite absolutes’.  I use the term opposite absolutes rather than recovery as I do not believe that that harm reduction and recovery are mutually exclusive.  I guess I am more of a Summer of Love rather than a Smackdown kind of guy when considering the two philosophies in parallel.

I have had the pleasure of knowing many people in recovery, some of whom believe that harm reduction exacerbates drug problems by  encouraging drug use, others who acknowledge that part of the reason that they have been able to make significant change to there drug using behaviour (including achieving abstinence) has been in part due to harm reduction interventions.  Let’s face it there is only two ways of becoming abstinent: doing it while your alive or dying.  If by providing harm reduction interventions we keep the possibility afloat that people may live long enough to abstain from drugs then this is obviously better than the alternative.

It does need to be acknowledged however that some people may never need, want or obtain abstinence and recovery oriented workers will need to meet people where they are at, in much the same way that harm reduction workers need to be able to meet substance users who view their substance use as an absolute.

Recovery oriented treatment options should be made available to those who want it and harm reduction information should be provided those who are abstinent from drugs, after all today’s abstinence maybe the precursor for tomorrows relapse.

Most of all I think we need to move away from the dichotomy of Harm Reduction vs. Recovery in our thinking and focus on how we can draw the best from both perspectives to be able to offer substance users the best services that meet them where they are at, at this point in time.

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Comments
One Response to “Harm Reduction Vs Recovery – Smackdown or Summer of Love?”
  1. Interesting piece – I agree that the dichotomy needs to be challenged. I worked for a short time in an office where a lot of people were former drug users, and we would always celebrate their recovery ‘anniversaries’. They were working directly with people who were in rehabilitation camps as well as people who were still using (those visiting drop-in-centres), and in this way they were acting as role models, offering support and advice. It would have been incredibly difficult for them to admit it if they started using drugs again, and they may have felt that they had ‘failed’, as the emphasis of the process was on complete recovery and they were held up as those who had succeeded. Furthermore, it would have put their jobs at risk, which would have further encouraged people to hide their use. Perhaps less of an emphasis on abstinence would be beneficial in this instance, but given the political nature of the issue (in this particular country), this is not really possible.

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