What is the role of harm reduction when drug users say they want abstinence?

Neale, J., Nettleton, S. and Pickering, L. (2011) What is the role of harm reduction when drug users say they want abstinence? International Journal of Drug Policy, 22(3), pp. 189-193. (doi:10.1016/j.drugpo.2010.09.007)

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Publisher's URL: http://dx.doi.org/10.1016/j.drugpo.2010.09.007

Abstract

Quantitative survey data indicate that most drug users starting treatment want abstinence rather than harm reduction (McKeganey et al., 2004). This finding has been seized upon by those seeking ‘evidence’ that abstinence is the bedrock of recovery and harm reduction is a negative and oppositional philosophy. However, all research involves questions of meaning, definition and value and an alternative research paradigm and different study design can provide important additional insights into treatment aspirations, including the desire for abstinence. Qualitative interviews conducted with 30 recovering heroin users (15 males and 15 females) in Southern England in 2009 confirm that those starting treatment often report a desire for abstinence. Nonetheless, drug users are frequently uncertain about their ability to achieve this and can have very different and inconsistent understandings of what being abstinent means. We suggest that the work of the critical theorist [Habermas, 1970] and [Habermas, 1991] could improve our understanding of abstinence and is consistent with recent efforts to achieve a working definition of recovery. Importantly, our qualitative data also reveal that drug users have treatment aspirations that extend far beyond their drug consumption. They additionally want to improve relationships, engage in meaningful activities, acquire material possessions, and achieve better mental and physical health. Moreover, these broader life goals are often inextricably linked to their drug taking. From this, we conclude that both abstinence and harm reduction discourses should more routinely prioritise the many diverse ‘wellness’ goals that so clearly motivate treatment clients. The harm reduction field will then likely find that it has more in common with abstinence-oriented services and the broader recovery agenda than it might otherwise have imagined.

Item Type:Articles
Keywords:Abstinence, harm reduction, recovery, evidence, quantitative methods, qualitative methods
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Pickering, Dr Lucy
Authors: Neale, J., Nettleton, S., and Pickering, L.
Subjects:H Social Sciences > HV Social pathology. Social and public welfare
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Social Scientists working in Health and Wellbeing
College of Social Sciences > School of Social and Political Sciences > Sociology Anthropology and Applied Social Sciences
Journal Name:International Journal of Drug Policy
Publisher:Elsevier BV
ISSN:0955-3959
ISSN (Online):1873-4758

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