Traditional Approaches to Addictions Aren’t Working. It’s Time to Take a Different Approach – The Emily Dahl Foundation

Traditional Approaches to Addictions Aren’t Working. It’s Time to Take a Different Approach

After many years of lobbying, the world has been warming up to legalizing needle exchanges, letting some alcoholics drink in moderation rather than face abstinence, allowing heroin addicts to get methadone treatment, and loosening drug laws. 

However, things just keep getting worse. 

There are many that believed years ago and continue to believe today that harm reduction strategies simply do not work and are basically a refusal to face the problem. 

In March 1996 Dr. Gabriel Nahas warned that harm reduction strategies would not work. Not many listened. 

Gabriel Georges Nahas (March 4, 1920 – June 28, 2012) was an anesthesiologist known for his advocacy against marijuana use and for the illegality of drugs. He worked at Walter Reed Medical Center Columbia University and later New York University.

"It is a cop-out, a refusal to face the problem," says Dr. Gabriel Nahas, a professor of anesthesiology at New York University (NYU) and a consultant to the United Nations Commission on Narcotics. "Under a general harm reduction policy, you have an increased acceptance of the use of other drugs such as heroin and cocaine."

Here is what Abraham Michael Rosenthal stated in the same year.  Rosenthal (May 2, 1922 – May 10, 2006) was an American journalist who served as The New York Times executive editor from 1977 to 1988. Previously he was the newspaper's city editor and managing editor. Near the end of his tenure as executive editor, he became a columnist (1987–1999). Later, he had a column for the New York Daily News (1999–2004).

"It is time to state the truth, the legalization movement is cruel because it would create more addicts, more abused children, more victims of muggings and robbery, millions every single year. It is selfish because it would move the burden of fighting drugs from the totality of society to neighborhoods that already suffer most. It is both cruel and selfish because it glides over the ruined lives of those who abuse drugs, legally or not," he stated.

But, slowly, harm reduction--which European countries have used for years--has edged onto the stage as an alternative solution to devastating social and health problems facing the U.S. and Canada, even as a response to the spread of AIDS.

So, what is harm reduction and why does it inflame passions so readily?

The argument is that it is humane because you have to meet people on their own terms rather than confronting them on yours. You want to encourage them to give up a behavior, but if a person can't, you don't want to reject them and keep them from treatment. Traditional treatment programs for substance abuse are confrontational. Without abstinence, people are kicked out of treatment. That's an inhumane way to deal with problems. It's considered pragmatic because harm reduction accepts substance use as a fact of life and recognizes its role as a way of coping with the consequences of social problems. It does not try to remove a person's primary coping mechanisms until others are in place. 

What bothers many opponents of harm reduction is how it deals with abstinence. While staying "clean and sober" is a goal, harm reduction doesn't insist on abstinence or make it a condition for treatment.

Not all substance abusers can give up their addiction's cold turkey. So, advocates believe, for example, that it is far better to help a problem drinker to cut back on the quantity of alcohol he consumes than it is to deny him treatment altogether.

Let's use the analogy of a thermometer. When an activity gets "too hot" or dangerous, counselors seek to bring the temperature down by reducing the harmful consequences of the behavior a step at a time. If there is a raging 104-degree fever, at first you try to bring it down a degree or two rather than all the way back to 98.6.

The idea is to reduce harm by degrees and just a few can make a big difference. 

Others, however, doubt moderation will work. To ask a recovered addict to engage in `responsible heroin shooting' or a compulsive gambler to play for just small amounts is to ignore the whole psychology and physiology of addiction.  Intuition should lead you to the conclusion that this simply will not work and is more likely to make matters worse. 

The solution?  A society that encourages mindfulness and compassion. 

Success in meditation and mindfulness is most often hard and slow to achieve; patience, and more patience, is needed. 

Drugs offer instant escape from this world of time, care, toil, problem, and suffering makes a better appeal to the ill-informed. 

It follows that the same crowd that relies on short term solutions will suggest short term solutions. 

In time, the world will learn that mind-tearing by drugs is not the same as mind-stretching by philosophy and mindfulness. 

The Emily Dahl Foundation 
August 17, 2022