Question

"Harm reduction" is the basic objective of many treatments for substance use disorders. These treatments can take many forms, including the controversial use of psychoactive drugs that are either agonistic or antagonistic to the drug "of choice" (the drug on which the patient has become dependent).

a. Give one example of the use of medication assisted therapy (MAT) in the treatment of opioid dependency.

b. Give one example of a "harm reduction" protocol for treating opioid dependency that does not use agonist or antagonist drugs, but relies on behavior modification. .

c. Give an example of a "harm reduction" protocol used to treat nicotine dependency.

d. Give an example of a "harm reduction" protocol used to prevent alcohol abuse.

Answer 1

Answer-

a. Medication-assisted treatment (MAT) is the use of medications in combination with counseling and behavioral therapies, which is effective in the treatment of opioid use disorders (OUD) and can help some people to sustain recovery. Opioid

Buprenorphine, methadone, and naltrexone are used to treat opioid use disorders to short-acting opioids such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone. These MAT medications are safe to use for months, years, or even a lifetime. As with any medication, consult your doctor before discontinuing use.

b. Naltrexone, acamprosate, and disulfiram are effective for reducing alcohol use. The most effective pharmacotherapies for opiate use disorders are agonist therapies, including methadone and buprenorphine.

c. Harm reduction as applied to illicit drugs of dependence has included many different strategies, some of which readily apply to smoking and some of which do not (for example, destigmatising use).

d. Harm reduction approaches to alcohol problems have endured a controversial history in both the research literature and the popular media. Although several studies have demonstrated that controlled drinking is possible and that moderation-based treatments may be preferred over abstinence-only approaches, the public and institutional views of alcohol treatment still support zero-tolerance. After describing the problems with zero-tolerance and the benefits of moderate drinking, the research literature describing prevention and intervention approaches consistent with a harm reduction philosophy are presented. Literature is reviewed on universal prevention programs for young adolescents, selective and indicated prevention for college students, moderation-based self-help approaches, prevention and interventions in primary care settings, pharmacological treatments, and psychosocial approaches with moderation goals. Overall, empirical studies have demonstrated that harm reduction approaches to alcohol problems are at least as effective as abstinence-oriented approaches at reducing alcohol consumption and alcohol-related consequences. Based on these findings, we discuss the importance of individualizing alcohol prevention and intervention to accommodate the preferences and needs of the targeted person or population. In recognizing the multifaceted nature of behavior change, harm reduction efforts seek to meet the individual where he or she is at and assist that person in the direction of positive behavior change, whether that change involves abstinence, moderate drinking, or the reduction of alcohol-related harm. The limitations of harm reduction and recommendations for future research are discussed.