Many people use drugs and alcohol despite its negative effects, some may avoid seeking treatment has their goal is not to achieve abstinence. Social workers may lose the client’s interest in treatment if they are more focused on total abstinence and fail to respect and empathize with the client’s definition of the problem. When using the harm reduction approach the social worker should focus on strategies to reduce risk, harm and improve quality of life.

Harm reduction model is used to assist individuals who do not wish to stop or unable to stop using drugs, from those who use recreationally to those who are dependent on legal or illegal substances. The focus is to reduce the negative consequences associated with the use of drugs and alcohol such as reducing the risk of contracting infectious diseases, preventing death from overdose, and reducing social and economic consequences.

Examples of harm reduction approach include:

• Needle exchange program- prevents contraction of infection diseases (HIV, Hepatitis), reduce drug overdose by providing clean needles and syringes to IV drug users.
• Medication-assisted treatment (for opioid addiction)- methadone, buprenorphine, and naltrexone.
• Naloxone distribution program (for opioid addiction) – reduce the risk of drug overdose.
• Nicotine replacement products – eliminate the risk associated with nicotine use. Products include gum, patches, tablets, and inhalers.
• Providing education about the risks of drinking and driving – practicing healthier habits, reducing alcohol intake.

The approach provides the rights of people who use drugs instead of condemning them. Interventions are pertaining to the client’s identified goals and needs rather than achieving abstinence.

Question

A social worker is employed by a facility that uses harm reduction in its approach to substance abuse. The social worker meets with a twenty-two-year-old man court-ordered to treatment after assaulting a man in a bar. The man says, “I know when I drink I tend to get into fights, but I’m not interested in going on the wagon.” In which of the following ways is the social worker MOST likely to respond?

• A. “Unless you agree to stop drinking, I can’t help you.”
• B. “Let’s see if you can confine your drinking to when you’re at home.”
• C. “We’ll aim for abstinence, but one step at a time.”
• D. “We need to focus on managing your anger.”

Answer: The focus of the question is the treatment approach that the social worker is using and the client’s wishes, as the client has no intention to stop drinking alcohol. The correct response is B. It is important for the social worker to respect the client’s decision and assist the client in reducing future risk and harm.