Academic journal article The International Journal of Behavioral Consultation and Therapy

Using Mindfulness in a Harm Reduction Approach to Substance Abuse Treatment: A Literature Review

Academic journal article The International Journal of Behavioral Consultation and Therapy

Using Mindfulness in a Harm Reduction Approach to Substance Abuse Treatment: A Literature Review

Article excerpt

ADDICTED PEOPLE ARE A vulnerable population. They face many psychological and emotional problems which have a negative impact on their quality of life. In addition to the psychological and emotional problems, there is also an adverse impact to the health and well-being of addicted individuals, which have a significant effect on the social and economic influence on a global level (Nooripour, 2014).

The outbreak of the human immunodeficiency virus (HIV), in the early 1980s, rapidly spread from the homosexual community to the heterosexual population through the shared use of needles and syringes during intravenous drug use. The result of HIV became Acquired Immunodeficiency Syndrome (AIDS) and spread throughout the world. Lee, Engstrom, and Petersen (2011) reported that this pandemic disease gave birth to the idea that in order to decrease the spread of HIV/AIDS, a new alternative to assist in the treatment of people who suffer from drug use was developed. This new form of treatment was known as harm reduction (Lee et al., 2011). Harm reduction was an intervention designed to reduce the problematic effects of addictive behavior (Logan & Marlatt, 2010). In an attempt to reduce the blood-borne diseases associated with HIV and hepatitis, harm reduction was a supporter of the needle exchange program that provided substance abusers with new needles, education on safe use, sharing needles, safe injection sites, and allowed them the ability to inject themselves in the presence of medical personnel (Logan & Marlatt, 2010).

The harm reduction concept

Marlatt's Buddhists beliefs had a profound influence on his research in addictive behavior. Buddha teaches that enlightenment should be sought by seeking the middle way, which is analogous with harm reduction. Marlatt believed that a middle path between the extremes of asceticism and gluttonous self-indulgence led to moderation in behavior. Moderation in behavior became the principal focus of his research related to the understanding and intervening in addictive behaviors (Blume, 2012).

The "compassionate pragmatism", as Dr. Marlatt called it, of harm reduction provides an important public health alternative to moral and disease model of substance abuse (Lee et al., 2011). Lee et al. argued that harm reduction opened the eyes of public health to multifaceted programs and policies that reduced harm associated with drug use. Harm reduction focused on meeting people "where they were at", and identifying client-driven individualized goals. Although open to abstinence, advocates for harm reduction recognized that (1) this goal may not be the most appropriate goal for every client, and (2) emphasizing abstinence as a goal may prevent some of the clients from seeking help or staying in the program (Lee et al., 2011).

Realizing that any and all positive changes regarding substance abuse were valuable, addressing substance abuse would be just one part of helping clients make positive changes in their lives (Lee et al., 2011). Programs that were effective in helping people change were needed in order for this change to take place. Positive indications of effective programs are improved individual, and community well-being (i.e. reduced needle sharing, discarding needles in public areas, reduction in deaths from overdoses, increased enrollment in detoxification and treatment centers) (Logan & Marlatt, 2010). By reducing the harmful effects of substance abuse, communities are able to see a reduction in the need for medical care due to drug overdoses, reduction in the number of arrests and court costs, and increase in participation in tax payer contributions, due to an increase in an employed population Larimer, Malone, Garner, Atkins, Burlingham, Lonezak, ... Marlatt, G. A. (2009).

Recognizing that substance use had become a problematic coping strategy of disadvantaged neighborhoods was a step toward helping make a positive change and this would call for an alternative coping mechanism (Lee et al. …

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