At its core, harm reduction is an evidence-based client-centered approach that aims to meet people where they are at with their substance of choice. Harm reduction acknowledges that each person is different and thus each approach should reflect that difference, and be tailored to each individual. In other words, harm reduction recognizes that each individual has a different starting point for exploring their substance use. Overall, harm reduction encourages individuals
to explore the connection between their substance use and their well-being. Any reduction inharm is seen as a positive change.
Abstinence is not required, nor is it forced on individuals. Harm reduction consists of a spectrum of goals to work towards because there is more than one path to recovery.
Spectrum of Harm Reduction:
● Substance Use Management (SUM)
○ SUM acknowledges that some individuals are not ready to stop using. Instead,
SUM explores: safer use, controlled use, planned use, and reducing use.
Ultimately, SUM focuses on reducing the negative consequences of substance
use. For example, using clean needles, preventing an overdose, or limiting the
amount of alcohol an individual consumes in one evening.
● Targeted Abstinence
○ Some individuals use multiple substances (meth and alcohol, cocaine and
alcohol), but would like to explore their relationship with one substance at a time
or would like to be abstinent from one substance instead of all substances.
● Total Abstinence
○ Many people assume that harm reduction does not include abstinence and
encourages illicit substance use. In reality, harm reduction does include total
abstinence because harm reduction does not presume a specific outcome.
How is Harm Reduction used in therapy?
According to harm reduction, individuals who use substances should be treated with dignity and respect and have the opportunity to select the best treatment that will allow them to make more informed decisions about their needs and what will be the most effective for them, while also reducing harm. Harm reduction requires a collaborative effort by both the individual and their therapist.