From my perspective as an experienced mental health and substance use clinician and someone with lived experience and in recovery, I find it important to reach out to others who have lived and living experience, especially those who view themselves as in recovery.
I posted on social media a bit ago about harm reduction. I stated that HR was not meant to directly treat addiction but rather was meant to provide ways to actually reduce harm and save lives. A person, stating they were in recovery, commented that harm reduction doesn’t work because a person has to want to recover. I have read and heard this belief from far too many people who are in recovery. Now I congratulate that person and all those in recovery for their personal success. I encourage all people who see themselves in “recovery” from “addiction/alcoholism” to open their minds and hearts more as I assume their program encourages them to do. Remember, “progress not perfection”.
In fact, the Big Book, the essential textbook, or even bible if you will, of the AA 12 step program is replete with encouragement to explore the unknown, other paths, to have the willingness to do whatever it takes to recover.
I am certainly not here to disparage the 12 step program. I am a member of AA and benefit greatly from much of the program. I also benefit greatly from many other forms of approaches to addiction as I learned and practiced them throughout my career. I find that there is great overlap and value between all approaches. As we all know (or at least I hope we know) is that there is no one magic approach to manage addiction and recovery. And as I would say in my practice, “any door is the right door”. So embracing any and all approaches is crucial if one is interested in recovery.
One of the most important approaches in my practice and in the field, was harm reduction. Because it worked. It played a crucial role in peoples’ lives whether or not they were seeking abstinence from substances and relief from the symptoms of addiction.
So again, harm reduction does not mean a person is ready to recover from addiction to a substance (as we currently and traditionally define that). Harm reduction is used to help give people some alternatives and strategies to stay healthier and alive. It can also mean abstinence, by the way, but does not require it. It is not solely meant to be a “treatment” for abstinence but rather an option throughout recovery when abstinence might not be an option for whatever reason. Moments or periods of non abstinence is a solid reality for virtually everyone who has made any progress in recovery.
Currently recovery has been understood through an abstinence only lens. What the current crisis has forced us to do is expand our understanding that recovery is far more than abstinence from a substance. It is any action that assists in improving health for an individual. Just as it is with any health issue. So to say harm reduction doesn’t work and is not a part of recovery is completely inaccurate.
Harm reduction works. It decreases the spread of diseases. It decreases risk of infections and other health problems. It can decrease risk to the heart, lungs, skin and so on depending on the strategy. It helps provide a door and a road to abstinence with respect and dignity to the person. So it helps to improve mental health. It recognizes that recovery is different for everyone. It does not demand abstinence but recognizes that abstinence is an effective form of harm reduction.
Harm Reduction also decreases harm to the community through all of the above. It helps decrease criminal behaviours which benefits the individual and the community. When health is improving, cost to the community decreases via reduced hospital visits. Decreased crime reduces costs in the justice system. When harm reduction is recognized and practiced as a crucial part of any type of recovery, families and friends can benefit from expanded support and knowledge. This, based in evidence and not the traditional moral, guilt and shame based judgments and myths that we have all been indoctrinated with. The un truths that truly enable people to remain in unhealthy behaviours. Harm reduction helps improve lives regardless if abstinence from substances is considered or not.
There are still people in recovery and treatment centres that are claiming that harm reduction enables addiction and thus it does not work. The Last Door in Vancouver is one of those centres which is actively and publicly campaigning against harm reduction. They are in line with a demographic of people, some in recovery, who are actively campaigning against harm reduction on all levels including the political level.
I can’t emphasize enough the danger in this campaign to separate and eliminate harm reduction from the public and the recovery continuum. Alberta is the prime example of the deadly failure of this type of policy. It claims success in reducing overdose deaths. It shut down crucial harm reduction programs across the province in favour of abstinence only recovery based programs. They added more beds. And campaigned hard, yelling out their success. Yet accidental drug poisoning deaths continue to rise. In fact, I would say that their approach has drastically and tragically failed. It is a deadly approach that has denied harm reduction to all those who are not in abstinence only programs, and to those who actually are not in need of said programs.
Yes, they exist. Not everyone who uses substances become addicted (only 10-20% at most). So those programs are irrelevant to the general public and do not even touch the tainted supply of illicit substances.
My hope is that we can clearly see how narrow this perspective is. Not only that but how mortally dangerous it is. Being a treatment centre, the Last Door and any treatment centre that does not recognize the importance of harm reduction should know better and be better. If you really want to help all people who wish it, you need to have that willingness to know more and not remain stagnant in beliefs created out of a time when science was not even a part of the treatment process.
Again, having developed, facilitated and participated in various forms of treatment, our view of treatment must evolve to include “progress not perfection” a mantra in 12 step programs and the Big Book. As I said above, recovery must include much more than abstinence only. It must include any action that improves physical and mental health. We go around telling each other recovery is a process not a place. Well, this is what that actually looks like.
So please. If you are in recovery, don’t remain stagnant in outdated and traditional beliefs even though they may be helpful to you personally. Remember progress is movement. Perfection is an illusion and a disguise for stagnation. Many of the traditional ways can work well, as can virtually all approaches “if you work them”. But we are now in a newer, much more evolved state of crisis which demands we take a humanistic and compassionate approach to the well being of individuals balanced with the well being of our communities. Harm reduction is a crucial part of that shift we must take. Harm reduction is a crucial and necessary part of overall recovery and is not the demonic beast some make it out to be. Harm reduction works. If you don’t believe me, ask someone who is including it in their life. Ask someone who’s life has been saved because of it.
