This ground-breaking volume provides readers with both an overview of harm reduction therapy and a series of ten case studies, treated by different therapists, that vividly illustrate this treatment approach with a wide variety of clients. Harm reduction is a framework for helping drug and alcohol users who cannot or will not stop completely—the majority of users—reduce the harmful consequences of use. Harm reduction accepts that abstinence may be the best outcome for many but relaxes the emphasis on abstinence as the only acceptable goal and criterion of success. Instead, smaller incremental changes in the direction of reduced harmfulness of drug use are accepted. This book will show how these simple changes in emphasis and expectation have dramatic implications for improving the effectiveness of psychotherapy in many ways. From the Foreword by Alan Marlatt, Ph.D.: “This ground-breaking volume provides readers with both an overview of harm reduction therapy and a series of ten case studies, treated by different therapists, that vividly illustrate this treatment approach with a wide variety of clients. In his introduction, Andrew Tatarsky describes harm reduction as a new paradigm for treating drug and alcohol problems. Some would say that harm reduction embraces a paradigm shift in addiction treatment, as it has moved the field beyond the traditional abstinence-only focus typically associated with the disease model and the ideology of the twelve-step approach. Others may conclude that the move toward harm reduction represents an integration of what Dr. Tatarsky describes as the “basic principles of good clinical practice” into the treatment of addictive behaviors. “Changing addiction behavior is often a complex and complicated process for both client and therapist. What seems to work best is the development of a strong therapeutic alliance, the right fit between the client and treatment provider. The role of the harm reduction therapist is closer to that of a guide, someone who can provide support an

Twelve-step programs that insist on abstinence are beneficial to many--but what about the millions of Americans who try to quit and fail, just want to cut down, or wish to work toward sobriety gradually? This groundbreaking book presents the Harm Reduction approach, a powerful alternative to traditional treatment that helps users set and meet their own goals for gaining control over drinking and drugs. The expert, empathic authors guide readers to figure out which aspects of their own habits may be harmful, what they would like to change, and how to put their intentions into action while also dealing with problems that stand in the way, such as depression, stress, and relationship conflicts. Based on solid science and 40+ years of combined clinical experience, the book is packed with self-discovery tools, fact sheets, and personal accounts. It puts the reader in the driver's seat with a new and empowering roadmap for change. Winner--American Journal of Nursing Book of the Year Award

All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.

Harm Reduction is a philosophy of public health intended as a progressive alternative to the prohibition of certain potentially dangerous lifestyle choices. Recognising that certain people always have and always will engage in behaviours which carry risks, the aim of harm reduction is to mitigate the potential dangers and health risks associated with those behaviours. Harm Reduction in Substance Use and High-Risk Behaviour offers a comprehensive exploration of the policy, practice and evidence base of harm reduction. Starting with a history of harm reduction, the book addresses key ethical and legal issues central to the debates and developments in the field. It discusses the full range of psychoactive substances, behaviours and communities with chapters on injecting, dance drugs, stimulant use, tobacco harm reduction, alcohol use and sex work. Written by an international team of contributors, this text provides an essential panorama of harm reduction in the 21st century for educators and researchers in addiction and public health, postgraduate students and policy makers.

"Just say no" just doesn't work for everyone. If you've tried to quit and failed, simply want to cut down, or wish to work toward sobriety gradually, join the many thousands of readers who have turned to this empathic, science-based resource--now thoroughly revised. A powerful alternative to abstinence-only treatments, harm reduction helps you set and meet your own goals for gaining control over alcohol and drugs. Step by step, the expert authors guide you to determine: *Which aspects of your habits may be harmful. *How to protect your safety and make informed choices. *What changes you would like to make. *How to put your intentions into action. *When it's time to seek help--and where to turn. Updated to reflect a decade's worth of research, the fully revised second edition is even more practical. It features additional vivid stories and concrete examples, engaging graphics, new worksheets (which you can download and print for repeated use), "Self-Reflection" boxes, and more. Mental health professionals, see also the authors' Practicing Harm Reduction Psychotherapy, Second Edition.

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.