I've been trying to establish a personal position on harm reduction theory for a while. I go back and forth. Many times those who espouse a harm reduction philosophy in the field of substance abuse treatment are seen as far more compassionate and tolerant. They often are, but this is an entirely different issue. Harm reduction theory basically asserts that the goal of treatment is not necessarily the cessation of illicit drug use, but rather reducing the harm associated with drug use and the improvement of quality of life (which is rather subjective, as a Christian I most likely have a different opinion on what a "quality life" would look like for a recovering addict). Harm reduction measures presume that the present user is going to continue his or her drug use, and that this must be accepted as fact and all must be done to ensure this behavior is "safe" or "safer".
Harm reduction theory has been known to produce impressive outcomes in practice. And there are many benefits to the approach. One of the things I like most about harm reduction is that it aims to preserve the dignity of the addict by providing them with options and allowing them to be active in their treatment. I do firmly believe that no human being can overcome the power addiction without admitting that addiction has power over them. Addicts must take ownership of their lives and work towards health. In some twisted way, harm reduction does promote patient dignity.
Here's the problem with harm reduction: it is in stark contrast to the nature of the Gospel message. Because of Christ's work on the cross and God's masterful plan of redemption through that work, no human being is beyond redemption. Harm reduction theory negates this fact by declaring that full recovery is just not possible with some people. Yes, some people struggle their whole lives with addiction and are never freed from the vicious cycle of drug abuse. But that doesn't mean that it wasn't possible for them to find freedom in Christ.
Now I do think that harm reduction has produced some viable treatment modalities; methadone maintenance treatment is one of them. Many addicts are frozen by their fear of physical withdrawal symptoms and therefore are unable to quit their drug use. Heroin withdrawal is especially heinous. Think of the most awful case of the flu you've ever had, magnify it by 20x and you can begin to comprehend heroin withdrawal. Obviously, no can truly comprehend it unless they've experienced it. Upon withdrawal, the user feels restless and irritable and loses their appetite. As withdrawal peaks, the user suffers diarrhea, shivering, sweating, general malaise, abdominal cramps, muscle pains, and an increased sensitivity to pain. If flu symptoms were the only aspect of withdrawal, treatment of heroin addiction would be more manageable. Unfortunately, this is not the case and there is a symptom that is more intangible and longer-lasting. Withdrawal brings about dysphoria (the just-feeling-lousy feeling), which is quite possibly the reverse of opiate-induced euphoria. That was kind of a tangent which was too in-depth. But you get the idea: opiate withdrawal sucks and wreaks havoc on your body physically. Methadone is a synthetic opioid that is given to addicts to replace heroin. Although most patient's don't experience a high (they're much too opiate tolerant), methadone serves as a replacement on the neuronal receptors that would be receiving heroin thus masking withdrawal symptoms.
Methadone can help addicts in their transition to recovery and abstinence. But methadone becomes an issue when drug users are enrolled in methadone maintenance treatment for their entire lives. To me, this isn't recovery. Full recovery is experiencing freedom from all pharmacological crutches, both illegal and legal. Sure, if a patient is undergoing controlled methadone maintenance treatment they are no longer involved in illicit drug use, turning tricks, prostituting, and engaging in various other avenues of criminal exploration. But they are by no means healthy, functional adults. And that should be the goal. There are so many facets of addiction. Physical, mental, emotional, and by far the most neglected: spiritual! Addicts can experience full recovery through Christ.
Maybe someday I'll start a faith-based methadone clinic. SIGH. That would be so awesome.
Grace and peace.
Hillary
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