Harm Reduction




What does that even mean?


That’s the common response I receive from almost everyone, whether it be friends, family, or clients. This is usually followed by confusion in regards to its application to alcohol and drug use. 


The definition of Harm Reduction is to reduce harm, period.


Does this mean I tell others they have permission to keep using?  Well, Yes and No.


Let's face it, adults do not need permission to use. And if people are using, shouldn’t we offer them ways of doing things to cause less harm?


The use of alcohol is promoted constantly, virtually everywhere. In Connecticut there are signs on their liquor store doors reminding you to "think ahead" since they are closed on Sundays. Never mind permission to use, we are encouraging it, of course "Responsibly." Isn't becoming of legal drinking age a rite of passage? The final induction into adulthood? We are a culture, a society that enjoys our vices. Well, is there anything wrong with that?  And here I go back to the Yes and No.

There is very little in life that is black or white, all or nothing.


Rather, the older we become, the clearer it is that life is made of up of shades of grey.

“Old school” substance abuse counseling and theory is all or nothing.

That’s what we are taught.  The only option, if you have crossed that invisible (and undefinable) line, is to stop using.  This approach, stemming from a medical model of substance dependence (Alcoholism and Addiction are not actual diagnoses), states that abstinence is your only choice and only hope. 

Estimated success rates with this approach are 7%.

This is not to say this approach doesn't work. It can. And when it does, the results are amazing.  I have seen miracles happen with with abstinence and the use of 12-step programs.

But, here are some of the problems with the abstinence-only model:

  • 93% of people seeking help do not succeed with abstinence-only treatment; we are individuals, what works for one person, most likely needs modification for someone else;

  • Change is a process, this is extensively focused on with regards to relapse, as we know relapse doesn't happen impulsively.  

  • Most people are more successful when they believe in themselves, whatever their goal ; and some just never want to stop using and that is their choice, not anyone else's to make.


Harm Reduction is not permission.

It is, instead, the recognition that people use drugs and alcohol.

It is understanding that change takes time.

It acknowledges that we all have the power of choice

and can decide how we want to live our lives.

It is also compassion rather than condemnation.

Harm Reduction is not a new concept. We all practice it in some way every day, such as using your seatbelt, wearing a condom, or putting an oven mitt on before you grab something hot.  


Harm Reduction is a compassionate approach to educating and motivating those who want and need help modifying their use of alcohol and/or drugs.  And it works.

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