“Abstinence Vs. Harm Reduction”
“Drug policy regarding the control of the traditional illicit substances (opiates, cocaine, cannabis) is currently moving through upbeat times in almost all Western countries. Prohibition on the basis of repressive law enforcement not only seems to fail on a large scale, but also to create vast additional costs, problems, and harm for drug consumers, who often find themselves in extreme social, economic, and health conditions” (Fischer 1995: 389).
Western countries struggle with the control of drug abuse. America, for example, has been failing with eliminating or reducing the chronic issues of drug abuse and crimes associated with drugs. America’s goal around these problems consistently has been complete abstinence. By providing drug treatment programs, the drug use and abuse is approached with “solutions” that could heal drug-addicted individuals. However, other countries such as Europe and Germany developed an alternative approach called harm reduction. This practice is “aimed at reducing the harms related to drug use --- including the harms caused by harsh drug laws --- without attempting to eliminate drug use per se” (Reinarman and Levine 1997: 345). The harm reduction tactic has shown more success than abstinence in Europe and Germany; America could follow their footsteps. In this essay, I will be discussing the two opposing approaches of abstinence and harm reduction, then explain why I believe harm reduction is the most effective way to provide drug treatment in America.
“Complete abstinence from nonmedical drugs has been the goal of most substance abuse treatment in the United States” (MacMaster 2004: 1). With the passing of Harrison Act in 1914, the United States of America begin its regulation on drug use. Policies regarding drug use incorporated the idea of abstinence and prohibition. Then, “the Anti-Drug Abuse Act of 1988 mandates abstinence-based drug policy” (MacMaster 2004: 2) that promotes a drug free America. Also, critics of the harm reduction policy claim that as drugs are legalized, so will the rates of drug addiction. In the article “In Support of the United Nations Drug Conventions: The Arguments Against Illicit Drug Legalization and Harm Reduction,” David G. Evans expresses his opposing view of harm reduction and states reasons why legalizing drugs for the harm reduction policy will increase drug use, drug problems, drug-related crimes, and drug markets. One main argument Evans claims is that “illicit drugs are addictive and dangerous” (Evans 2009: 9). Therefore, legalizing these threatening drugs could increase the chances of abuse. Evans asserts that from the past, America has learned that sanctioning drugs for harm reduction and establishing lenient laws to regulate substance abuse will increase drug abuse and there is less drug abuse when there is strong drug control. For instance, the 1914 Harrison Act “contributed to a significant decline in narcotic addiction in the United States” (Evans 2009: 10). Evans concludes that treatment programs that aim for abstinence could improve in various ways but he believes that “the best goal for those addicted to drugs which is abstinence” (Evans 2009: 48). All in all, Evans claims that reducing the harm won’t help prevent or eliminate the issues of drug abuse, “only treatment and recovery will save the addict” (Evans 2009: 45).
On the other hand, the alternative approach to abstinence is harm reduction. The concept first arose in the 1980s presenting a way to deal with drug problems more humanely and effectively (Reinarm and Levine 1997). Although people want a “drug-free America” or a “crime-free America,” we know that the use of drugs and crime will always exist. Therefore, harm reduction attempts to reduce the harm in these issues instead of struggling to eliminate drugs and crime. In “Real Opposition, Real Alternatives,” Reinarm and Levine stress that abstinence is not the only goal of drug policies....
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2. Fischer, Benedikt. "Drugs, Communites, and Harm Reduction in Germany: The New Relevance of Public Health Principles in Local Responses." Journal of Public Health Policy 16.4 (1995): 389-411. JSTOR. Web. 29 Nov. 2010. <http://www.jstor.org.offcampus.lib.washington.edu/stable/3342618?&Search=yes&term=harm&term=reduction&list=hide&searchUri=/action/doBasicSearch%3FQuery%3Dharm%2Breduction%26gw%3Djtx%26acc%3Don%26prq%3Ddrug%2Btreatment%2Bprograms%26hp%3D25%26wc%3Don&item=22&ttl=30218&returnArticleService=showFullText>.
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