new behaviors

Reducing Harms Associated with Substance Abuse

Bryan Vasquez, CATC III, Certified Addiction CounselorLeave a comment

For many who have been using alcohol or drugs problematically, the advice given from loved ones and many mental health professionals is they must remain abstinent from all mind-altering substances and any deviation from complete abstinence is a cause for major concern. This approach to substance abuse follows an all-or-nothing model that does not consider all the gray areas between severe problematic addiction and complete abstinence, and can often have devastating consequences when a slip, or a lapse, occurs.

Harm reduction is about reducing the harms associated with substance abuse. It can be applied to any circumstance where there is less harm, or the potential occurrence of harm, due to specific interventions or actions to reduce, substitute, or replace the use of a harmful substance. In the case of alcohol, if someone were drinking a fifth of vodka a day, and is now drinking a bottle of wine, the harm would be reduced because a bottle of wine has much less alcohol content.  If someone has been using heroin and now strictly uses cannabis, they will have reduced the harm of a potential lethal overdose. 

Harm reduction can come in many forms and will be greatly needed during a time when addiction is expected to climb 100% over the next two years (CCAPP, 2020). For opioid use disorder, there are two main medications, Naltrexone and Buprenorphine, both of which can come in oral or subcutaneous once-monthly injections. Naltrexone can also be used for those who are wishing to stop drinking or reduce their alcohol intake as it helps with cravings and reduces the euphoric effects of alcohol. Often times, people may not want to use medications to help them cut back, taper or assist them in maintaining their abstinence, but harm reduction approaches have been shown to be highly effective when compared with total days sober, and not just total days abstinent (Peele, 2020).  

When working with clients, my goal is to always help them find ways to reduce the harm, or the potential for harm, caused by their problematic use.  Expecting or demanding complete abstinence, when that is not the goal or desire for someone only sets them up for guilt, shame, and a potential self-fulling prophecy if a slip occurs, giving them the opportunity to tell themselves, “See, I knew I would fail at this.” Following a harm reduction model for those who are seeking it or require it based on medical necessity helps individuals build the self-efficacy and belief that they have power to change their behaviors and live a balanced life, free from the grasp of addiction.  

If you or a loved one have been told abstinence is the ONLY WAY, give Realize Recovery a call today and we can discuss options and provide education on the evidenced based treatments that have been proven to work. 

Peele, S. (2020, March 19). So Alcoholics Anonymous Is “Proven” to Work After All? Not So Fast. Retrieved October 12, 2020, from https://filtermag.org/alcoholics-anonymous-cochrane/

The Disease of Addiction Thrives on Isolation (Rep.). (2020, May 12). Retrieved https://www.ccapp.us/application/files/9715/8932/2072/Addiction_Thrives_on_Isolation.pdf

Habits: Friend or Foe?

Bryan Vasquez, CATC III, Certified Addiction CounselorLeave a comment
Habits compel us to act against our better judgment. When changing them, it can seem like the whole world is challenging our intentions.

Changing habits is not easy.  It can seem like as soon as we decide to change a behavior, the whole world conspires to challenge and thwart our courageous intentions.  Habits compel us to act against our better judgment and reason, despite our desire to act differently.  Therefore, habits can be our best friend or our worst enemy, depending on their nature. 

Habits are formed through the continued repetition of a certain thought or action. The behavior or thought then becomes automatic and requires little thought or conscious effort to engage in that activity.  Habits and feelings are closely tied together because there is a sense of normalcy that can be comforting and predictable, while change often feels extremely uncomfortable.  Anytime we want to make a change in our lives, we often must learn to act differently then we feel.  This can be a powerful statement to remind ourselves on a regular basis when working on changing a pernicious habit.  

In the process of early recovery, there are often urges and cravings that can feel compelling and strong.  You may want to have a drink or use your go-to substance to feel differently and avoid the discomfort of feeling uncomfortable.

Unfortunately, I have not heard of, nor know of anyone who has ceased problematic substance use without having to sit with discomfort to a greater or lesser degree.  The more we can get comfortable being uncomfortable, the more we build the habit of acting on our best judgement because we know it is in our best interest long-term.  We began to no longer do what feels good only in the moment yet causes long term suffering, both in our lives, and the people most important to us.  You are probably already practicing this in your life to some extent, and if you have a desire to change problematic substance use, you can start taking positive action right now!  

Forming helpful new behaviors is like building a muscle, the more we work at it the stronger and easier healthy behaviors are to establish.  Keep in mind we must often first establish a new habit before we begin to experience the benefits of this new behavior.  We cannot go to the gym for a few days and expect our body to look and feel the way we want it to or eat healthy for one week and presume we are good to go.  By taking small steps in the right direction to establish a firm habit of exercising regularly, or eating healthier, we create a new lifestyle that can continue to compel us to carry on that helpful habit, even when we feel like acting differently!  By practicing this in your life regularly it will assist your recovery efforts by training you to confidently know that you can do what you set your mind to regardless of how you feel.  

I suggest trying the following formula to make positive habit change a daily routine in your life.  

  • Choose one action you can perform daily that feels uncomfortable doing, but you know will be beneficial for you. 
  • Identify the time of day, specific place to engage in this action, and amount of time you will spend doing it
  • Make this extremely manageable, an action and length of time you are 99% confident you can achieve daily.  
  • Set reminders on your phone or use post-it notes to help you remember your new action
  • Take action today and start engaging even if you feel uncomfortable.  Reminding yourself that you are comfortable, being uncomfortable!

Example:  New behavior is to exercise for at least 5 minuets every day.  I can perform 20 push-ups, 20 squats, and a minute or two of planks.  I will do this each morning as soon as I get out of bed.