Harm Reduction
Abstinence
Motivational interviewing
Development of discrepancy
Rolling with resistance
Support self-efficacy
Avoidance of argument
In this paper we lay bear the differences that exist between harm reduction approach and the abstinence model of managing drug (opiate) addiction. We do this by a thorough analysis of the processes involved in each approach and then a systematic review of their applications. A comparison as well as contrasting of the approaches is then carried out. A recommendation on how to best apply the two techniques for optimal outcome is then provided.
The treatment of drug addiction has been indicated to be a tough journey that requires several intervention techniques. Two main interventions have been proposed and even applied in efforts to assist drug addiction patients. The two techniques, harm reduction and the abstinence have been indicated and argued to be two different roads which lead to the same destination (Mckeganey,2005). The World Health Organization indicated that both techniques can be integrated into an effective program for treating drug abusers with WHO (2006,p.13) suggesting that harm reduction is an integral step in the journey towards abstinence.
Harm reduction
Peterson et al. (2006) argued that while the abstinence-based intervention approach to opiate use generally demands a total cessation from the use of all non-prescribed drugs as a prerequisite for a successful addiction treatment, the harm reduction technique places an emphasis on the improvement of health as well as social outcomes and begins with the addicts position in regard to drug usage (Lenton,1998).
Both strategies need to be optimized in regards to service delivery as well as their operations. The abstinence-based programs are noted by Rachlis et al. (2009,p.2) to be ideally high-threshold in regard to the eligibility criteria as well as the extent of 'readiness' necessary for individuals to enroll (Peterson et al.,2006; Lenton,1998).
The low threshold services such as the needle exchange programmes (NEPs) are noted to have very minimal requirements in regard to involvement. They also place the IDU in direct contact with a series of care at a time when the patients may not be eligible to engaged in programmes that are abstinence-based (Marlatt,1996).
The harm reduction techniques involves a series of strategies that range from the promotion of safe as well as managed drug use to complete abstinence (Peterson et al.,2006). The proponents of harm reduction as well as its guidelines indicate that the strategies aim at reducing the rather high risks of transmission of diseases and should therefore be treated as culturally appropriate and then subsequently implemented in healthcare settings such as hospitals (Marlatt,1996). Existing evidence indeed suggests that drug use is active in hospitals and this is associated with abandoning AMA (Hurley and Jolly,1997).
In regard to the specific strategies, the methadone maintenance treatment (MMT) is closely associated with a general reduction in the necessity of hospitalization and has been shown to lead to a general improvement in the level of access to healthcare.
The needle exchange programmes (NEPs) aims at the reduction of the level of disease transmission through the reduction of the syringe sharing rate as well as the length and number of time that the used syringes stay in circulation (Dolan et al.,2004). The introduction of Supervised Injecting Facilities (SIFs) have been noted to successfully lead to a general reduction in the risk of contracting HIV as well as other harms amongst the IDUs. In the initial phases of implementing Supervised Injecting Facilities (SIFs) in the U.S., IDU were given access to sterile syringes, referral to addiction treatment, emergency care as well as primary care services (Kerr et al.,2005).The use of Supervised Injecting Facilities (SIFs) has been associated with a general increase in the level of safer injecting practices (Wood et al.,2005a;2006), a rapid entry into the various detox programs (Wood et al.,2006) as well as a general increase in the level of acceptance of addiction treatment (Wood at al,2005b).
Ideally, the concept of harm reduction denotes the use of policies as well as programmes that are aimed at the reduction of the harm that is closely associated with the use of drugs.The main feature of the harm reduction technique is their focus on the ultimate protection from and prevention of various drug-related harm as opposed to the complete prevention of drug use. Newcombe (1992) reiterated the argument that the concept of harm reduction makes a distinction of harm at various different levels' individual, societal and community as well as different types; social, economic and health.
Abstinence
The abstinence...
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