Abstinence vs harm reduction
Addiction A recent report by the Government’s expert committee on drugs concluded that many who experience periods of dependence on drugs and alcohol do eventually overcome it. But for some, it is a long-term battle requiring long-term support.
Most people will also have a range of problems that pre-date their drug use, and have suffered ‘collateral damage’ as a result of their addiction — for example, health and mental health problems, exclusion from employment, relationship breakdown and homelessness.
The big debate
How we should treat people with a drug or alcohol dependency is an issue which attracts a lot of political and media heat, but less light. In some quarters of the drug and alcohol sector, an unhealthy split has developed in recent years between two philosophies — abstinence and harm reduction.
Abstinence-based treatment refers to programmes that focus on helping individuals to stop using drugs or alcohol for the rest of their lives; you may be aware of 12-step or AA programmes which are abstinence-based. Some believe that abstinence is the only way that anyone can truly recover from dependency.
By contrast, those in favour of a harm reduction approach believe we should primarily aim to reduce the health, social and economic harms associated with the use of substances. In the UK, needle exchange programmes, which were established in the 1980s, have done much to reduce the spread of blood-borne viruses such as HIV and hepatitis among people who inject drugs. The prescription of opiate substitution medication, such as methadone, has helped to stabilise the lives of many thousands of people addicted to heroin, many of whom go on to become drug-free.
A joint approach
DrugScope believes that abstinence and harm reduction approaches should both form part of the treatment journey. There are many routes into drug and alcohol dependency, and many routes out. A balanced treatment system is the only way to maximise the numbers of people willing to engage with the treatment and rehabilitation process.
What it means to be ‘in recovery’ from addiction will mean different things to different people, too. Coming forward for treatment is a big step and, for those people who make it, there has to be something to look forward to; jobs, training, a decent place to live, a rebuilding of relationships. Society as a whole has a critical role to play in this. DrugScope and our members are working to help bring down the barriers of stigma that many face. People cannot start to rebuild their lives if there is no way back into society.
Marcus Roberts, CEO, DrugScope