The Challenges of Non-Abstinence-Based Drug Treatment: A Harm Reductionist Speaks
This week Professional Voices features an interview with Dr. Tom Horvath, a leader in the progressive treatment of addictive disorders and a contributor to The Fix. Hovarth Practical Recovery,SMART Recovery. The interview highlights some of the challenges faced by clinicians who don't demand abstinence as a prerequisite, or even a goal, of treatment.
Richard Juman: In thinking about taking a harm reduction approach in working with people with alcohol and substance use disorders, one of the aspects to consider is that it really takes some courage to work in this way. On an important level, it seems that an abstinence model is much easier on the clinician. For example, if a patient overdoses or gets into a car accident after drinking, the abstinence-based therapist is "off the hook" because his position was that the client should not have been using at all. On the other hand, if as a therapist you are accepting of ongoing drinking or substance use, then you are putting yourself at risk, perhaps not legally, but as a clinician and a human being, if there is a negative outcome. Do you agree?