Harm Reduction vs Sobriety: Why Harm Reduction?

Written By: Connor Freeh, Clinical Trainee at ACS, Adolescent Substance Addiction Treatment Program

WHY HARM REDUCTION?Harm reduction is concerned with keeping people alive. Sobriety is included under the umbrella of harm reduction and for some, is ultimately the goal. Harm reduction understands that substance use is sometimes a long and difficult path to recovery with several routes including prevention, intervention, reduction, and eventual recovery. Harm reduction acknowledges substance use, and takes steps to take safer and more appropriate means with possible usage. This can include everything from seatbelts, sunscreen, a designated driver, test trips, syringe exchange, and methadone. Young adults are generally more receptive to the harm reduction approach, which is less rigid and more understanding than sobriety. These factors have helped to propel harm reduction as the new gold standard of intervention.

Why sobriety doesn’t always work?

Drug Abuse Resistance Education Program (D.A.R.E.) has been a long-reported unsuccessful failure that has resulted in 600-750 million dollars provided per year between 1983 and 2009. This large amount of money has done little to curtail the growing trends of drug use amongst youth. This has led to new treatment directions evolving to provide care for individuals in need. Adopting alternative means can provide an easier approach for youth who are having difficulty addressing their relationship with substances.

How to have the conversation?

            It is always important to empathize with the point of view of the person you are speaking with, especially in the case of your child. The pressure of peers, relationships, and alternative influences has a greater influence than your own parental judgment. This is a factor that evolves and continues to change as your child matures. It is important to remember that we are not condoning drug use, but encourage them not to use, stop, or cut back. Understand their perspective and remember what it was like to be their age. There are many factors that influence their choices and their appearance amongst their peers. This can help bridge the gap and provide an outlet for them to discuss their concerns.

Additionally, speaking with your child about prioritizing their safety and the consequences of their actions can help to provide several protective factors and an outlet for help. This can include information about DUIs, possible repercussions at school, inability to apply for colleges, being sent to jail or a juvenile detention center, as well as accidents and overdoses.

Where to look for more information.

Research is continuing to develop on the use of substances, substance abuse treatment, and addiction with young adults, especially in the case of harm reduction. The Standard Research Helpern-Felscher Lab has continued to provide cutting-edge research while providing resources for harm reduction. Their resources include information and tool kits for high school students that cover substances, including tobacco and cannabis. Additional information is provided on different classes of drugs, including alcohol, opioids, and psychedelics, for adolescents and caregivers.

Harm reduction includes sobriety.

            Harm Reduction includes sobriety and does not approve of underage drug use or judge teens who use drugs. Harm reduction continues to adapt to the needs of complex substance abuse treatment, but is ultimately concerned with prioritizing safety and saving lives.

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References

Bagot, K. S., & Kaminer, Y. (2020). Abstinence vs harm reduction for youth with substance use disorders: “You can’t always get what you want.” Adolescent Psychiatry, 10(3), 236–239. https://doi.org/10.2174/2210676610666200327164503

Helpern-Felscher REACH Lab. (n.d.). Safety First. Stanford Medicine. https://med.stanford.edu/halpern-felsher-reach-lab/preventions-interventions/Safety-First.html

Kimmel, S. D., Gaeta, J. M., Hadland, S. E., Hallett, E., & Marshall, B. D. L. (2021). Principles of harm reduction for young people who use drugs. Pediatrics, 147(Supplement 2), S240–S248. https://doi.org/10.1542/peds.2020-023523G

Slemon, A., Jenkins, E. K., Haines-Saah, R. J., Daly, Z., & Jiao, S. (2019). “You can’t chain a dog to a porch”: A multisite qualitative analysis of youth narratives of parental approaches to substance use. Harm Reduction Journal, 16(1), N.PAG-N.PAG. https://doi.org/10.1186/s12954-019-0297-3

Stowe, M.-J., Feher, O., Vas, B., Kayastha, S., & Greer, A. (2022). The challenges, opportunities and strategies of engaging young people who use drugs in harm reduction: Insights from young people with lived and living experience. Harm Reduction Journal, 19(1), 1–6. https://doi.org/10.1186/s12954-022-00663-z

Winer, J. M., Yule, A. M., Hadland, S. E., & Bagley, S. M. (2022). Addressing adolescent substance use with a public health prevention framework: The case for harm reduction. Annals of Medicine, 54(1), 2123–2136. https://doi.org/10.1080/07853890.2022.2104922