Harm reduction interventions and abstinence-based models are part of a broad continuum of health care that needn't be framed in opposition to one another. The path to wellness varies for people experiencing dependence or substance-use disorder. Some people may decide to reduce or moderate their use so that it no longer negatively impacts their health or their lives. Others may prefer to pursue total cessation of substance use.

People may pursue abstinence on a short-term or long-term basis. For many people, returning to substance use is a normal part of the journey to attain abstinence. Some people who choose abstinence will return to use many times before they are able to reach their goal.

Research shows that periods of voluntary or involuntary abstinence can increase risk of greater harm for people who use opioids. Some high-risk situations include:

  • Discharge from hospital

  • Release from incarceration

  • Withdrawal management without follow-up healthcare assessment and treatment

  • Discharge from residential addiction treatment

  • Illnesses where opioid consumption is reduced

References
i. Changing the Narrative, Health in Justice Action Lab, Northeastern University School of Law
ii. Abstinence & Harm Reduction, Alberta Health Services