No drugs What are drug users looking for in treatment; abstinence or harm reduction?

Within the UK and in many other countries two of the most significant issues with regard to the development of health and social care services for drug users has been the growth of the consumer perspective and the philosophy of harm reduction.

These researchers looked at drug users’ aspirations from treatment and consider whether drug users are looking to treatment to reduce their risk behavior or to become abstinent from their drug use.

They interviewed 1007 drug users starting a new episode of drug treatment in Scotland. Participants were recruited from a total of 33 drug treatment agencies located in rural, urban and inner-city areas across Scotland.

There was widespread support for abstinence as a goal of treatment with 56.6% of drug users questioned identifying ‘abstinence’ as the only change they hoped to achieve on the basis of attending the drug treatment agency.

By contrast relatively small proportions of drug users questioned identified harm reduction changes in terms of their aspiration from treatment, 7.1% cited ‘reduced drug use’, and 7.4% cited ‘stabilization’ only.

Less than 1% of respondents identified ‘safer drug use’ or ‘another goal’, whilst just over 4% reported having ‘no goals’.

Drug users desires;

  • Abstinence – 56.6%
  • Reduce drug use – 7.1%
  • Stabilization – 7.4%
  • Safer drug use or other goal Less than 1%
  • No goals – 4%

The prioritization of abstinence over harm reduction in drug users treatment aspirations was consistent across treatment setting (prison, residential and community) gender, treatment type (with the exception of those receiving methadone) and severity of dependence.

Neil McKeganey, Z Morris, Joanne Neale & Michele Robertson. What are drug users looking for when they contact drug services: abstinence or harm reduction? Drugs: Education, Prevention & Policy, Volume 11, Number 5 / October 2004, Pages: 423 – 435

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