In 2021, there were 107,622 overdose deaths in the United States. This was a 15 percent increase from the number of deaths that occurred in 2020.

Overdose deaths are preventable; however, the increased incidence is very concerning. So what’s the solution?

Some people claim that the best solution is abstinence, and that’s true. However, how do you keep individuals who are actively using safe? More and more people are becoming supporters of harm reduction.

Is one better? Or should both options get used? Keep reading to learn more about harm reduction vs. abstinence.

What Is Abstinence?

Abstinence from drugs and alcohol means that you don’t use them. But for some individuals, that’s easier said than done. For years, abstinence has been preached, and the rate of addiction is only increasing.

Abstinence is more complicated than it seems, even with the social programs implemented over the years. Let’s take a look at one of the more well-known ones, “Just Say No.”

Just Say No

Just say no. During the 80s and 90s, this ideal was preached to kids around the United States. The program was spearheaded by First Lady Nancy Reagan.

It was part of the War on Drugs movement, and the goal was to teach children to just say no to drugs. Not doing drugs, drinking, or abstaining from drugs is a great choice. However, these programs have been mostly ineffective.

“Just say no” caused an increase in public concern, which can be clearly seen in the numbers. In 1985, between two and six percent of Americans saw drug abuse as the number one problem in the United States.

That number increased to 64 percent in 1989. This social program did bring awareness to a growing issue; however, when it came to encouraging the next generation to abstain, it failed.

This social movement looked at sending people to schools to educate children, and they largely used scare tactics. That made programs like “Just Say No” and “DARE” ineffective because they didn’t teach children the social skills they need to say no.

Effective abstinence programs go beyond scare tactics. They’re comprehensive, interactive, and long-term. They help children recognize that they can say no, and it’s okay to do so.

Just Stop Using Drugs

But what about people who begin using? Many people say, just stop. However, with addiction, it’s not that simple.

If you have a friend or family member who is addicted, it might be difficult to understand why they don’t just stop. You see the negative consequences, and you don’t understand why they can’t just walk away. Understanding addiction is a challenge if you’ve never struggled with it.

However, just stopping isn’t as easy as it sounds. With addiction, when you stop using, your body craves the substance. Without it, your body will begin to go through withdrawals.

For many, there’s a need to undergo a medical detox to get the drug out of their system. However, even after detoxing, just stopping isn’t as simple as that.

You need to address the reason the person began to use it in the first place. Without doing that, the person will continue to go back to old patterns of behavior.

What Is Harm Reduction?

Using drugs is dangerous. There is no way around that. Even if you survive an overdose, it has lasting effects.

In addition, when using drugs, you put yourself at risk of other diseases. Many addicts share needles and other drug paraphernalia, which increases the risk of diseases like HIV.

Harm reduction programs attempt to reduce the negative impact of drug use. This could be providing a safe space with clean needles and other supplies for people to go to and use.

It can also include providing clean needles.

The Controversy Surrounding Harm Reduction

Harm reduction is a controversial subject in the United States. While other countries have adopted harm reduction, in some ways, the US is lagging behind with that.

Critics of harm reduction argue that it doesn’t do enough to address the root causes of drug addiction and that it ultimately enables people to keep using drugs.

Supporters of harm reduction argue that it is a pragmatic approach that recognizes that some people will continue to use drugs regardless of the risks. They argue that by reducing the harms associated with drug use, we can save lives and make our communities safer.

The Similarities and Differences Between Harm Reduction and Abstinence

Harm reduction and abstinence are two different approaches to dealing with substance use. They both have their own strengths and weaknesses, and there is no one-size-fits-all solution.

Harm reduction is all about reducing the harmful consequences of substance use without necessarily requiring abstinence. This can involve strategies like education (teaching people about the risks of drug use), harm reduction services (like needle exchange programs and medication-assisted treatment), and legal reforms (like decriminalizing possession of small amounts of drugs).

Abstinence, on the other hand, is complete avoidance of all drug use. This approach is often taken by people who are in recovery from addiction, as it eliminates the risk of relapse. However, it can also be very difficult to stick to, especially if someone is surrounded by triggers or temptation.

There are many similarities between these two approaches. Both seek to improve the health and well-being of those who use drugs. And both recognize that complete abstinence is not always possible or desirable.

However, there are also some important differences. Harm reduction accepts that people will continue to use drugs, even if it’s not ideal.

It seeks to make drug use safer rather than eliminating it altogether. Abstinence, on the other hand, attempts to stop all drug use completely.

Both harm reduction and abstinence have their pros and cons, and there is no one-size-fits-all solution. The most important thing is to find an approach that works for you and that you can stick to in the long term.

The Benefits of Harm Reduction

The debate between harm reduction and abstinence is one that has been around for years. Each approach has its own merits, but what are the benefits of harm reduction? Here are a few key points:

  1. It acknowledges that people will use substances and aims to reduce the harmful consequences of that use
  2. It is more realistic and, therefore, more effective than abstinence-only approaches
  3. It does not demonize drug users or judge them for their choices
  4. It can be tailored to the individual, making it more likely to be successful
  5. It can help people to reduce their drug use, even if they don’t completely stop

Harm reduction is a pragmatic approach that offers real benefits for both individuals and society as a whole. If you’re struggling with substance abuse, it may be worth considering this approach as an alternative to complete abstinence.

The Benefits of Abstinence

There are many benefits to abstaining from all substances, including alcohol, drugs, and cigarettes. When you’re in recovery, abstinence can help you stay focused on your goals and avoid any potential relapse triggers. Additionally, it can provide a sense of structure and routine in your life, which can be helpful in early recovery.

Abstinence can also have physical benefits. For example, if you’re recovering from alcohol addiction, complete abstinence will allow your liver to heal and improve your overall health. If you’re quitting smoking, abstinence will help your lungs recover and reduce your risk of developing cancer.

Lastly, abstinence can have psychological benefits. When you’re not using substances, you’re more likely to be clear-headed.

Challenges of Harm Reduction

Harm reduction is not without its challenges. One of the biggest challenges is that it can be difficult to get people on board with the idea. There is a lot of stigma surrounding drug use, and many people believe that the only way to deal with it is through abstinence.

This can make it hard to convince people to try harm-reduction strategies, even if they are proven to be effective.

Another challenge is that harm reduction can be seen as a way to enable drug use rather than discourage it. This can be a tough sell for many people, especially those who have been personally affected by addiction. It’s important to remember, though, that harm reduction is not about condoning drug use; it’s about making it safer for those who do choose to use drugs.

Finally, harm reduction strategies can be expensive and time-consuming to implement. This can be a deterrent for many organizations that may not have the resources to devote to such programs. It’s important to remember, though, that the long-term benefits of harm reduction can far outweigh the initial costs.

Challenges of Abstinence

There are many challenges that come with abstinence from substances or behaviors. For some people, it may be difficult to give up a substance or behavior completely. They may have grown accustomed to using the substance or participating in the behavior on a regular basis.

Abstinence can also be challenging because it requires changing one’s lifestyle and routine. This can be difficult to do, especially if the person is used to using the substance or participating in the behavior on a regular basis.

Additionally, abstinence can be challenging because it requires willpower and self-control. Some people may find it difficult to stick to an abstinence plan, especially if they are dealing with cravings or temptations.

How Does Medication-Assisted Treatment Factor In?

Medication-assisted treatment (MAT) can help someone with an addiction abstain from using their drug of choice. Some would say that MAT is a harm reduction model.

However, depending on the medication used, it can be an abstinence model.

Abstinence With MAT

MAT helps encourage abstinence from a chosen drug. There are two medications we want to touch on under the abstinence model.


This medication is intended for people with opioid and alcohol addictions. Before they can begin taking it, they must detox and abstain from opioids for a period of around seven to ten days.

This drug works to reduce opioid and alcohol cravings by binding to and blocking receptors. If the person does use while taking Naltrexone, the sedative and euphoric effects are blocked.


The next medication we’ll touch on is Antabuse. This medication is intended for people struggling with alcohol addiction.

When taking Antabuse, if the person consumes alcohol, the Antabuse prevents the body from fully breaking down the alcohol.

It gets broken down into acetaldehyde which is toxic and makes the person sick. Because of this, when someone drinks while taking Antabuse, they can experience chest pain, vomiting, nausea, headaches, and difficulty breathing.

The goal of this medication is to deter people from drinking.

Harm Reduction

There are some medications in this type of treatment that fall more on the side of harm reduction. These drugs vary a bit, but there are a couple we want to touch on here as well.


Naloxone is different from the other medications we have discussed or will discuss. This medication helps reverse the effects of an opioid overdose.

It does this by blocking opioid receptors. Naloxone can be given as a shot or nasal spray. Many states have begun programs training caregivers and police officers in the use of this drug.

The goal of it is to keep the person alive.

Methadone and Buprenorphine

These two drugs are slightly different, but they’re also very similar. Both are opioids, and the goal is to replace the painkillers or heroin the person was previously taking.

People taking methadone generally need to go to a clinic every day to get their dose because there’s still a potential for abuse. However, using these medications can help prevent the person from entering withdrawal and reduce cravings.

These drugs are both good for long-term maintenance, and some people choose to remain on them indefinitely.

Why Harm Reduction and Abstinence Can Coexist

Recovery exists on a spectrum. There’s no right way to battle addiction. Abstinence and harm reduction can coexist, and viewing these approaches as one or the other can be more harmful than helpful.

For many people in recovery, the thought of harm reduction can be controversial.

However, the reality is that harm reduction and abstinence can coexist. In fact, for many people, harm reduction can be a stepping stone to abstinence.

Harm reduction is all about making choices that will minimize the negative consequences of substance use. It’s about being honest with yourself about your drug use and taking steps to reduce the risks. This might mean using drugs less often, choosing safer methods of use, or avoiding certain situations where you know you’re more likely to use.

For some people, harm reduction can lead to abstinence. As they learn to make healthier choices and reduce the risks associated with their drug use, they may find that they no longer want to use drugs at all. Or they may decide that they’re ready to give up drugs for good.

Either way, harm reduction is a positive step forward. It’s an acknowledgment that you’re not ready or willing to abstain from drugs right now, but you are ready to begin making healthier choices.

How to Choose the Right Approach for You

There are many different approaches to addiction recovery, and two of the most popular are harm reduction and abstinence. Both of these methods have their own advantages and disadvantages.

So, which one is better? The answer depends on your individual situation. If you’re struggling with a severe addiction, then abstinence may be the best option for you.

However, if you’re able to manage your drug use and you’re not ready or able to give up completely, then harm reduction may be a better fit. Ultimately, it’s important to have these conversations with a healthcare provider.

They can help you connect with the services you need to begin your path to wellness.

Harm Reduction vs. Abstinence: It’s Not Either/Or

When it comes to harm reduction vs. abstinence, it’s not an either/or situation. Both models have their benefits and challenges. However, when you’re looking at opioid treatment possibilities, the most important thing is to get the help you need.

Do you or a loved one need help to beat addiction? Contact us today and let us help you get connected to the services you need.