Abstinence vs. Harm Reduction

Published: 2021-10-07 15:10:19
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Category: Abstinence

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Also, critics of the harm reduction policy claim that as drugs are legalized, so will the rates of drug addiction. In the article “In Support of the United Nations Drug Conventions: The Arguments Against Illicit Drug Legalization and Harm Reduction,” David G. Evans expresses his opposing view of harm reduction and states reasons why legalizing drugs for the harm reduction policy will increase drug use, drug problems, drug-related crimes, and drug markets. One main argument Evans claims is that “illicit drugs are addictive and dangerous” (Evans 2009: 9).
Therefore, legalizing these threatening drugs could increase the chances of abuse. Evans asserts that from the past, America has learned that sanctioning drugs for harm reduction and establishing lenient laws to regulate substance abuse will increase drug abuse and there is less drug abuse when there is strong drug control. For instance, the 1914 Harrison Act “contributed to a significant decline in narcotic addiction in the United States” (Evans 2009: 10).
Evans concludes that treatment programs that aim for abstinence could improve in various ways but he believes that “the best goal for those addicted to drugs which is abstinence” (Evans 2009: 48). All in all, Evans claims that reducing the harm won’t help prevent or eliminate the issues of drug abuse, “only treatment and recovery will save the addict” (Evans 2009: 45). On the other hand, the alternative approach to abstinence is harm reduction. The concept first arose in the 1980s presenting a way to deal with drug problems more humanely and effectively (Reinarm and Levine 1997).
Although people want a “drug-free America” or a “crime-free America,” we know that the use of drugs and crime will always exist. Therefore, harm reduction attempts to reduce the harm in these issues instead of struggling to eliminate drugs and crime. In “Real Opposition, Real Alternatives,” Reinarm and Levine stress that abstinence is not the only goal of drug policies. Although critics of harm reduction claim it condones the use substance abuse, harm reduction doesn’t “treat drug abuse as harmless” (Schmidt and Williams 1999: 68).
It is just an alternative perspective to drug abuse because the American society’s prohibitionist ideologies pushed people to believe that abstinence was the only way to solving the problems of drug abuse. For example, Benedikt Fischer talks about the benefits of the adoption of harm reduction in Germany, in his article “Drugs, Communities, and Harm Reduction in Germany: The New Relevance of Public Health Principles in Local Responses. ” Similar to America, Germany dealt with drug issues by applying the idea of abstinence.
However, in the early 1980s, they have “modified their approach to drug controls from a strategy of repression and stigmatization of drug users to a policy of what is currently discussed under the umbrella of harm reduction” (Fischer 1995: 393). After employing the harm reduction approach, registered drug users, deaths related to drugs, and drug-related crime has declined significantly. Although drug abuse and drug-related issues exist, one of the main goals of harm reduction was accomplished; reducing the harm and risk of drugs.
Fischer concluded that “one is especially startled by how these relatively dramatic changes and results could be accomplished in a political-ideological environment of a nation and culture characterized by a strong sense of prohibition and repression” (Fischer 1995: 406). Therefore, due to the similar past policies on drugs, America will experience beneficial changes if it were to adopt the harm reduction method when approaching drug issues.
Moreover, in the article “Hungry for the next fix: Behind the relentless, misguided search for a medical cure for addiction,” the author, Stephen Peele, discusses America’s belief of drug abuse as an “illness” that could be cured but presents his argument against this idea. Firstly, Alan Leshner, the director of the National Institute on Drug Abuse (NIDA), and Enoch Gordis, head of National Institute on Alcohol Abuse and Alcoholism (NIAAA) argue that drug addiction is a “medical illness” and “a biological problem with a pharmaceutical solution” (Peele 2002: 1).
However, Peele critiques Leshner/NIDA, Gordis/NIAAA, and Alcohol Anonymous’ pseudoscientific moralism that supports abstinence in solving drug abuse. Peele evaluated this idea of curing addiction by presenting a study of naltrexone that is supposed to treat dependence on alcohol and heroin. The study consisted of some alcoholics who received the treatment of naltrexone and some who received a sugar pill (placebo). This experiment found that “the reduction was about the same for men who took the fake pills as it was for those who were given naltrexone” (Peele 2002: 4).
Most of the untreated alcoholics reduced their drinking without any withdrawals. Therefore, this study showed that this “treatment” did not cure addiction but when men reduced their harm of drinking, it was more successful. Peele concluded, “We will never eliminate drinking and drug use. But we might be bale to reduce the harm they sometimes cause if we could eliminate the pseudoscientific moralism dispensed by the likes of Leshner and Gordis” (Peele 2002: 6). Finally, in “Harm reduction: a new perspective on substance abuse services,” Samuel A.
MacMaster proposes the combination of the traditional abstinence and harm reduction perspective to approaching drug abusers. Also, the author claims that abstinence may not be for all substance users while certain individuals could overcome his or her addiction with abstinence-based treatment programs. Basically, “it is important to provide services relevant to the individual’s needs” (MacMaster 2004: 3). Conversely, harm reduction interventions could be most successful for individuals who are at the beginning stage of drug abuse or those who only experienced minimal damaging consequences.
Each side brings upon reasonable arguments to the table but “harm reduction interventions have been found effective” (MacMaster 2004: 7) especially through the clean needle exchange programs (preventing HIV/AIDS). MacMaster ends the article by suggesting the incorporating of harm reduction and abstinence to provide a basis for approaching drug abuse problems. In conclusion, when compared to abstinence, I believe the harm reduction strategy is a better approach to the drug-related concerns in America.
Some abstinence-based treatment programs label addicted individuals as failures if they can’t fully abstain (such as when one relapses during treatment). According to the sociological labeling theory, when individuals are labeled as certain characteristics by the society, he or she will accept it as their label. Instead of only focusing on the idea of complete abstinence, I believe that efforts of reducing the harms of drugs will be more beneficial to the society and drug addicted individuals. Also, just like Mr. MacMaster suggested, incorporating the two different ideas will be efficient.

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