Why Treatment Fails, Part 2 of 4 by David Gerber

There has been a seismic shift in the philosophy of substance use disorder treatment. In large part due to the opiate epidemic across the country, many treatment providers have abandoned the idea of “getting people sober” and instead are focused on preventing overdose. The word sobriety is being abandoned and replaced with phrases like “harm reduction” and “improved quality of life.” The treatment community has punted on the notion that we can actually help people live alcohol and drug free lives.

Instead of believing that we can help people regain control of their lives through abstinence from substances, we applaud harm reduction. On its face harm reduction seems like a good thing. Less harm is better, right? The premise is to keep people alive until they arrive at the conclusion (or not), that they eventually will want to give up alcohol and drugs altogether. Unfortunately, many will die anyway, as this model frequently delays the inevitable. Keep in mind that anyone who is using an illicit substance runs the risk of that substance being laced with dangerous drugs like fentanyl.

Fentanyl is being placed in every illegal drug from marijuana to heroin. The user, with the tacit approval of harm reduction folks may overdose even in a harm reduction model. The facts are that overdose numbers are increasing, not decreasing as the harm reduction model is taking a firm hold in the treatment community. Government agencies are removing the word “sobriety” from regulations, guidance, and standards. Unmotivated users take advantage of harm reduction to continue dangerous patterns of use. With Sober at Home, users are encouraged and provided with information to help them find their way to living a sober life.