A Harm Reduction Approach to Treating Alcoholism and Addiction is Flawed

A Harm Reduction Approach to Treating Alcoholism and Addiction is Flawed


Harm reduction is a philosophy of treatment that seeks to reduce harm caused by addiction instead of directly treating the addiction itself.

For example, with a harm reduction approach, the solution to intravenous Heroin use would be a Methadone maintenance program, or possibly a needle exchange program, instead of a push for abstinence and a program of recovery to maintain sobriety. These strategies are designed to reduce harm while still medicating the drug addict, instead of trying to encourage abstinence.

But harm reduction goes far beyond this example. The idea can be applied to the fight to legalize Marijuana, or even to the idea of trying to get alcoholics to somehow drink in a safer, less dangerous manner.

A flaw in harm reduction thinking

The biggest problem with the harm reduction approach is that it tends to automatically concede defeat in terms of achieving real recovery. In almost all cases, harm reduction is a compromise, a way to try and patch up the real addiction and gloss over it, instead of trying to really treat the addiction on a deep level.

If an addict comes into treatment and is subjected to a harm reduction approach, they will likely find themselves stuck in one of these compromising situations. Because they will likely still be self medicating, they will cut off their capacity to make any real growth. Instead of learning how to successfully deal with new situations in sobriety, they will continue to self medicate any real problem or situation that gets thrown at them. The harm reduction approach becomes a crutch that prevents real growth.

Another reason that harm reduction typically fails

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Harm reduction will generally fail to boost a person’s self esteem, because there is no real program of recovery, only an attempt to modify behavior. One inherent flaw in the harm reduction philosophy is that many addicts and alcoholics are driven by a subtle need to harm themselves.

This need to harm ourselves is driven by poor self esteem, and is also well documented in traditional recovery texts (for example, in NA they talk about our tendency towards self-sabotage).

There is also a phenomenon where recovering addicts and alcoholics might find themselves abusing other substances or acting out their addictions in other ways (such as other drugs, sex, gambling, food, and so on). This idea of “cross addiction” is a strike against a harm reduction approach, as it just goes to show that the idea of “self sabotage” can be very real in the recovering addict. In other words, if we treat one aspect of our addiction with a harm reduction approach, some addicts will simply find other ways to “harm” themselves.

Addiction is either on/off

Any recovering drug addict or alcoholic who has experienced real recovery can tell you: addiction is either on or off. There really is no in-between. Either you are clean and sober, or you are off to the races.

Just imagine how ridiculous it is for a chronic alcoholic to try and control their drinking. That’s the whole point, that an alcoholic can not control it. Yet this is the only real goal of a harm reduction approach, to somehow control and mitigate the harmful effects.  A quick look at the Binge Drinking Statistics will tell you as much.

Nearly every addict and alcoholic has struggled with trying to control their intake. Once you realize that this is not working, at some point you will want to consider complete abstinence as the foundation for your solution. A crushing decision, yes, but one that is necessary for the true addict or alcoholic to eventually make. Making this decision is the point of surrender, the beginning of freedom.


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