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What are drug addicts looking for in treatment; abstinence or harm reduction?

In this research we looked at drug users’ aspirations from treatment and consider whether addicts are looking to treatment to ‘reduce’ their risk behavior or to become ‘abstinent’ from their drug use.

The research is based on interviews using a core schedule with 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.

Our research has identified 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 user’s desires;

• Abstinence – 56.6%
• Reduce drug use – 7.1%
• Stabilization – 7.4%
• Safer drug use or other goal (Grouped) – 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, Zoë 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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