Harm Reduction Model for Substance

Harm Reduction Model for Substance Abuse -- Pros and Cons

The Harm Reduction Model (HRM) is one of the more liberal approaches to substance abuse intervention and treatment. Instead of requiring complete cessation of substance abuse and absolute sobriety, the HRM allows the drug user to continue using drugs but in a safer and less socially detrimental manner. Cessation of drug use is frequently incorporated as a goal within HRM treatment, but the principal difference between the HRM and traditional substance abuse treatment is that complete cessation is merely an ancillary objective in the former instead of the primary focus as in the latter. The same concept has also been applied much more generally to many other forms of behavior, such as smoking, alcoholism, prostitution, and precocious or unsafe sexual behavior. On balance, the HRM approach in connection with substance abuse seems to have established a record of relative effectiveness; on the other hand, it is still opposed by some, mainly on the fundamental objection to permitting continuation of illicit activity on principle.

In Support of the Harm Reduction Model

Some of the most effective examples of the use of the HRM approach to reducing undesirable behavior (in general) include the dramatic reduction in new HIV / AIDS infection rates in New York City through public service information campaigns about safe sex, counseling centers, and the distribution of free condoms (Brocato & Wagner, 2003; Denning, 2000). More specifically with respect to substance abuse, the crossover information resulting from the close connection between HIV / AIDS prevention programs and heroin addiction programs in New York further illustrated the potential value of the HRM approach in the simultaneous reduction of HIV / AIDS infection through needle sharing as a function of free needle exchange programs (Denning, 2000).

Various formal peer reviewed clinical studies conducted both by public and private sector researchers have documented very similar benefits in several European nations achieved through the HRM strategy instead of strict enforcement under the penal laws of those countries (Brocato & Wagner, 2003; Ghetti, 2004; Tuukka, 2004). Specifically, Britain, Germany, the Netherlands, and Switzerland have all experienced success through the implementation of HRM drug abuse treatment and rehabilitation programs. Some of those programs rely on the traditional substitution of methadone to treat heroin addiction, but others have demonstrated better success with certain patients through supplying maintenance doses of heroin (Brocato & Wagner, 2003; Ghetti, 2004; Tuukka, 2004).

In theory, the main concept of HRM does not reject the position that absolute cessation of illicit drug use (and of other harmful behaviors) is always desirable (Brocato & Wagner, 2003; Ghetti, 2004; Tuukka, 2004). However, the HRM concept recognizes that (1) cessation may not necessarily always be achievable and (2) many of the worst consequences of substance abuse (and of other harmful behaviors) is only indirectly related to the substance abuse problem rather than directly attributable to it (Brocato & Wagner, 2003; Ghetti, 2004). Therefore, HRM is designed to help those who would likely not succeed in traditional treatment methodologies as well as to address the indirect harms associated with the behavior targeted for intervention (Brocato & Wagner, 2003).

In that respect, existing HRM-based drug treatment programs have confirmed the social benefit and individual welfare achievable through the more tolerant form of intervention. Universally, the literature documents the extent to which social problems such as petty crime and personal harm such as disease transmission and other types of intravenous infection have been substantially reduced through the HRM approach to drug abuse.

In Opposition to the Harm Reduction Model