When dealing with cases of drug and alcohol addiction recovery, there are two main strategies that are used. It seems to be an age-old battle between harm reduction and abstinence. While both models have their pros and cons, it’s important to be informed and knowledgeable before treatment.

To truly understand their differences, we must take a look at their statistics and their overall ideas first. At Rock Recovery Center, we’ve laid out some of the major differences between the two models just for you. Regardless of the method, it’s important to get treatment if you or someone you know is struggling with addiction. Let Rock Recovery be your guiding light towards a better future. 

A Look at the Abstinence Approach

To understand both of these methods, let’s take a look at them separately. Abstinence-based treatment is centered around the idea that an addict must completely abstain from drugs and alcohol. The abstinence approach is based on the idea that the person cannot control their use in a healthy way (that won’t lead to abuse or addiction).

When someone is addicted to a substance, their judgments and inhibitions are impaired. A person’s life can become completely consumed by addiction, so an abstinence approach makes sense. In some cases, people in recovery might turn to alcohol which can just as easily lead to a relapse. 

It’s also common for people who don’t practice abstinence to become addicted to another drug. By remaining completely clean from all drugs, the abstinence approach is much more reliable when it comes to long-term recovery. Overall, the abstinence approach is widely accepted by the medical community. 

Abstinence-Based Treatment Ideals

There are a set of pillars that the abstinence approach follows. These are important to keep in mind during the process of recovery. A few ideas that abstinence-based treatment follows closely are:

  • Alcoholism is considered a chronic and serious disease 
  • Residential treatment is not the only option that defines successful treatment 
  • Alcoholics and addicts tend to abuse a wide variety of mood-shifting drugs; this should be addressed during the recovery process
  • The idea that alcoholism (or drug addiction) may not be curable, but it’s manageable
  • Individual or group sessions with professionals should be utilized during treatment, along with sharing and bonding with others in the same situation
  • Holistic addiction treatment is something that should be used when possible (holistic treatment helps physical, social, mental, and spiritual aspects
  • Respect and motivation should be present throughout the recovery process

Twelve-step programs like Alcoholics Anonymous (AA) are typically used for cases of alcohol addiction. Some people criticize the use of a 12-step program as the only real way to measure a successful recovery. However, this is typically not the case, as abstinence uses a number of different treatment options. 

A Look at the Harm Reduction Approach

The harm reduction approach is different from the abstinence approach in many ways. The main goal of harm reduction is to reduce the negative consequences that come with substance use. It seeks to soften these negative effects as opposed to encouraging complete abstinence. 

The harm reduction approach helps reduce the multitude of effects that alcoholism and addiction can have on a person. Some of these areas include the following:

  • Medical issues and complications
  • Legal problems
  • Relationship troubles
  • Risk of death
  • Financial issues 

The harm reduction approach is able to put some ease into the consequences. In many cases of addiction or alcoholism, some people may struggle to see they have a problem at all. However, what they can admit is the issues they may be having financially, medically, or socially in their lives. 

Harm Reduction Approach Ideals

The harm reduction approach looks at addiction in a completely different light. While many may not agree with its sentiment, it is worth looking at its ideals (along with the abstinence approach). Some of the main pillars of the harm reduction approach include the following:

  • Harm reduction looks to ease the consequences as opposed to stopping altogether
  • It follows the idea that people may be willing to practice moderation instead of stopping altogether
  • Harm reduction is best for those who are willing to face the consequences and work around them
  • This approach uses therapy to address these issues 
  • A strong relationship is emphasized during the harm reduction approach
  • Focus on self-accountability and consequences

Overall, harm reduction has lost its credibility over the years for several reasons. It focuses more on the consequences rather than encouraging full abstinence. It’s also worth noting that harm reduction is only effective when these consequences have not caused severe damage. Cases of financial, employment, or social ruin don’t work as well with harm reduction. 

The Success Rates: Harm Reduction Vs. Abstinence

Many people instinctively turn to the numbers for success rate statistics. Unfortunately, finding accurate and reliable statistics can be close to impossible. Much of the data for both these approaches rely on honest self-reporting data from patients. Certain relapses or slip-ups may not be accounted for because of social stigma or other factors. 

When you look at a group like Alcoholics Anonymous, the success rate seems to vary immensely; their success rate being anywhere from 10 to 70%. This is not to say that AA is not a credible form of treatment that has undoubtedly saved the lives of many. It can be tough to truly pinpoint accurate information stating one approach is more successful than the other. 

Some surveys and studies have been conducted in the past to determine more statistics on the success rate. In terms of abstinence, there are some indicators that show certain rates of relapse. It seems as though the longer you are clean of drugs or alcohol the lower your chance of relapse begins. 

  • Those who were abstinent for less than a year had an 80% chance of relapse
  • Those who were abstinent for at least 3 years had a 34% chance of relapse
  • Those who were abstinent for 5 years had just a 14% chance of relapse

Criticism of Abstinence-Based Treatment

There are a number of critiques for both the abstinence and harm reduction approach. It’s important to keep in mind that there is no set-in-stone right way to get treatment. Additionally, some people might experience treatment in a different way that other people might. 

One of the main criticisms of abstinence-based treatment is its reliance on a rigid 12-step program. Typically, these programs also focus on faith-based treatment, which is something some people are not comfortable with. Low success rates are also cited but this must be taken with a grain of salt. 

Another area of criticism is the lack of problem drinkers that are helped. Abstinence-based treatment supposedly only focuses on those who have become dependent on alcohol. Problem drinking is different from full dependency on alcohol (which is what it eventually becomes). Once again, it should be reiterated that certain treatment approaches may work better than others for you or a loved one. 

Criticisms of the Harm Reduction Approach

One of the glaring issues and criticisms of harm reduction is that addicts are allowed to continue using or drinking. The harm reduction approach is criticized for enabling this behavior. Others see it as an excuse to relapse. 

In some cases of harm reduction treatment, a person may be dishonest about how much they’ve actually been drinking or using. This can cause a number of issues that go against the overall goal of the treatment method.

Another glaring issue is harm reduction’s view towards illicit substance use, like heroin or cocaine. It can be complicated to tell someone to use less of such an addictive and dangerous substance. Binge drinking can cause its fair share of dangers but using heroin or cocaine excessively can be potentially fatal. 

Harm Reduction vs. Abstinence: Which is Better?

It’s tough to give a blanket answer for which one is better. As with many treatment options, they both have their pros and cons. At the end of the day, the answer falls on preference and your own thoughts. 

Harm reduction gives the person more room and freedom, while abstinence focuses more on the root of the issue for long-term recovery. Over the years, abstinence-based treatment has become more prominent in most rehab centers. It’s more effective to work toward sobriety and long-term recovery. Using individual and group therapy to help with addiction are common factors in both approaches. 

Let Rock Recovery Help You Today

Addiction can be a crippling condition that can destroy multiple aspects of your life. If you or a loved one is struggling with addiction, now is the time to get help. With a variety of therapy and treatment options, Rock Recovery will be by your side the entire way. Contact us today to learn more about our recovery process and drug addiction resources.

Schedule appointment

Thank you for your message. It has been sent.
There was an error trying to send your message. Please try again later.

Tom Conrad

Vestibulum ante ipsum

Vestibulum ac diam sit amet quam vehicula elementum sed sit amet dui. Donec rutrum congue leo eget malesuada vestibulum.

Learn more about us