Approaches in Addiction Treatment

Treatment for substance misuse employs both abstinence and harm reduction models. The selection between these approaches hinges on the practitioner’s evaluation and assessment and the individual’s personal goals.

Ultimately, the decision on the treatment approach lies with the individual experiencing a substance use disorder, whether it involves drugs, medication, or alcohol. In order to make a well-informed decision, it’s essential to determine the most suitable approach. Keep reading to gain further insight.

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What is the Harm Reduction Model

The Harm Reduction model’s main concern is reducing substance use’s negative or harmful effects (or, in some cases, reducing risky behaviours). It starts with assessing the harm to the person if they were to cut off all substances completely. Here, the focus is on reducing the harmful consequences, such as:

  • Medical complications
  • Legal consequences
  • Relationship consequences
  • Personal financial hardships
  • Risk of death
  • Social and economic consequences, etc.

Such programs include treatments like needle exchange, methadone, suboxone, and other substitution programs. This model considers the practitioner’s assessment of the client and addresses the issues mentioned above before addressing the substance use issue. The person may not be able to tackle their drug or alcohol problem until managing the current obvious situation.

The fundamental principle of harm reduction is to prioritize the health and safety of individuals, even if they continue to engage in behaviours that carry inherent risks. Many individuals coping with substance use disorder may be unable to remain abstinent from their substance of choice.

It includes a series of programs, services and practices. It provides users with medical and social services options to “meet them where they are.” As a result, those who engage in this programs are more likely to follow up on treatment. These types of programs have decreased the rate of death by overdoses. It also reduces the spread of blood-borne diseases like HIV/AIDS and Hepatitis C.

A Bit of History the Harm Reduction Approach

Canada’s Harm reduction programs began gaining traction in the 1980s and 1990s. The model’s principles and initiatives started in the country in response to the rising HIV/AIDS epidemic among intravenous drug users. 

Vancouver, British Columbia, played a significant role in pioneering this model, notably with the establishment of Insite, North America’s first supervised injection site, in 2003.

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Abstinence-Based Treatment Model

The abstinence-based treatment model addresses substance use disorders with the primary goal of complete and sustained abstinence from substances. This approach is grounded in the belief that the most effective way to overcome addiction is to completely refrain from using mind-altering substances.

Another aspect of the abstinence-based treatment model is that a person can develop other addictions if there is no abstinence. An individual can begin a new dependency on other drugs as a substitution. It isn’t uncommon to see an individual on methadone use cocaine and then cocaine becoming a problem. In our practice, we’ve seen people rid themselves of a substance use problem only to have a new problem with another one.

The abstinence approach is still widely used to address any dependency. Practitioners prefer this approach because it is successful for most. We advise that before deciding on a program method, see your clinical practitioner for a complete assessment.

Some History of Abstinence-Based Treatment

Abstinence-based programs have a long history that dates back to the late 19th century.

The temperance movement was active during the 19th and early 20th centuries. They believed that alcohol use was a major contributor to numerous societal problems. The movement advocated for either moderation or complete abstinence from alcohol. The movement played a pivotal role in influencing the legal prohibition of alcohol in various regions of Canada.

The most well-known abstinence-based program for addiction is Alcoholics Anonymous (AA), founded in 1935. AA introduced the concept of a 12-step program to achieve and maintain sobriety through abstinence. Facilities around the world use this method. It is the most popular rehabilitation program used today.

Harm Reduction Model and Abstinence-based Treatment in One Facility

A single addiction treatment facility or program can use both the harm reduction model and abstinence-based methods as part of their treatment. Canada has adopted a comprehensive and client-centred approach to addiction treatment, recognizing that different individuals have varying needs and preferences regarding their recovery journey.

This integrated approach aims to provide continued care that meets individuals where they are in their recovery journey. It respects the principles of autonomy and self-determination, allowing clients to choose the best approach for their needs and values.


It’s important to note that the effectiveness of abstinence-based programs or harm reduction models varies from person to person, and there is no one-size-fits-all approach to addiction treatment. The treatment choice should be tailored to an individual’s specific needs and circumstances, focusing on achieving the best possible outcome for their recovery.

Picture of Marc J. Bernard

Marc J. Bernard

Substance Use Disorder & Recovery Professional,
Referral & Consultation Counsellor

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1 888-488-8434
Speak to a live agent

Or Contact us through
our form here.


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