harm reduction and abstinence model

The recovery process is different for everyone, and treatment must be constructed on an individual basis with the core tenets being safety and connection.

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An abstinence program wrapped inside a harm-reduction model

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At Red Door Life we employ the harm reduction model when the more commonly accepted abstinence model fails. We are an abstinence program wrapped inside a harm-reduction model. Abstinence has long been enforced in mainstream treatment models as the only path to recovery. However, according to the National Institute on Drug Abuse in 2022, the relapse rate for those struggling with substance abuse issues ranges from 40%- 60%. We have to look deeper and be realistic about the efficacy of the abstinence model and also the hidden danger it creates.

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ATTACHMENT-BASED HEALING IN ACTION

One of our core principles is supporting our members through an attachment-focused approach. This means remaining connected with compassionate support through all the twists and setbacks no matter what. When a suffering person who is dysregulated and impacted by neurobiology that is injured by substance abuse and trauma is met where they are at- wherever that may be, with consistent love, compassion, nonjudgement, and steady reliable support, over time this unconditional stable attachment and changes them and they begin to be able to make better choices for themselves of their own free will. They begin to evolve. They begin to transform. 

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To be perfectly clear: There is no illicit substance abuse tolerated on our properties. The only substance use we permit on our properties are doctor-prescribed medications which are carefully monitored and administered by qualified professionals.

 

The harm reduction model is used as a pathway to abstinence. It is a means of supporting and caring for those who are not ready yet for sobriety instead of leaving them alone and in danger. Often people are not willing to go to treatment because they can't break away from their lives, can we support them in a way that works for them until they are ready?  Or, when someone is ready to give up one substance but not others, can we support them through this first major step as we guide them towards full sobriety?

 

This is especially important when dealing with high acuity patients who may have multiple co-occurring conditions, be at a high risk of complications, or experience an acute flare-up of a preexisting chronic condition. If a patient is high acuity, that means that their condition is severe and imminently dangerous. 

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The DANGER OF black & WHITE treatment: ABSTINENCE OR ABANDONMENT

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Typically, in residential substance abuse treatment things are black and white. There is only one model of care offered: abstinence. One must conform or be disconnected from the help they desperately need. Along with this comes the loss of privileges and many harsh and punitive rules that one must abide by, forfeiting their autonomy and sense of control over their lives. As long as one can conform, they can stay in the program. When they fail- as is unfortunately often characteristic of chronic relapse disorders, they are cast out.

 

While the abstinence model sounds safe on the front end, it actually creates several critical safety issues. First, it puts the client in extreme danger as they are now cut off from the team of people they had come to rely on for monitoring and support. Second, it is also a little-known fact that once you has been sober for a time, you are much more susceptible to overdose or worse, overdose death.

 

Finally, the abstinence model creates danger when trauma and especially attachment wounding are at the root of substance abuse issues. Relapse leaves you in a fragile, disoriented state and may activate deeper level attachment wounds. This all comes together to exacerbate the relapse and create extra layers of extreme risk.

 

One of the biggest contributing factors to relapse and relapse death is disconnection. A person entering relapse may not honest about their urges and intent and may disappear, leaving loved ones and those working to support their recovery powerless to help until they resurface or something terrible happens.

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One of the factors that correlates to positive recovery outcomes is honesty. As our members learn to be honest and that they will not be cast out by bringing their urges and relapses out of the shadows and into the light it undoes the aloneness and strengthens the bonds that are critical for healing. It lessens shame and the need to sneak and hide which always amplifies the substance abuse.

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COMPASSIONATE GROWTH MINDSET

At Red Door Life, we see recovery holistically and realistically. Relapse doesn't just suddenly happen, there are many triggers and a whole cascade of feelings and behaviors that result in the decision to use again. We also help you process a relapse to help you gain insight, understand yourself better, and learn how to take care of yourself in stronger ways. We help coach you into healthier thinking and behaviors as we remind you of your value, your bright future, the importance of your life, and those who love you.

 

By learning what triggers exist for you personally and having the support to begin bringing this into the light in a supportive environment, you can develop the ability to head off the spiral.  This inspires a compassionate growth mindset rather than a shame spiral that comes from judging our mistakes harshly.

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SAFETY FOR ALL

The concept of harm reduction may sound shocking to those outside the direct circle of addiction, but we believe in meeting our members where they are at- and if they are not ready for abstinence, we work with them to reduce the risk of harm- and hopefully, reduce the severity of the using.

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One of the key concerns with employing both the abstinence and harm reduction model is balancing the protection of the individual who is relapsing and also protecting the residential community they are a part of. We do this through the use of certified companions who stay off-site around the clock with the client who is going through relapse.

 

This helps the client stay in contact with the rest of their multidisciplinary team (therapist, psychiatrist, medical doctors, client advocate, etc.). They are helped to find safe temporary housing offsite. They are helped to stay connected to family and loved ones, who are informed rather than completely in the dark as to what is happening. The client is watched over and guarded against overdose and accidental suicide. This gives them the best possible chance in the worst-case scenario.

 

Our sober companions and recovery partners also work to keep the client re-engaging with the reasons they came into treatment in the first place even if they cannot act on them in the moment. There is constant encouragement to stop using as soon as possible and make choices that value their life and future. In the worst situations, they are helped to stay as safe as possible and make the best decisions possible.

 

They are helped to develop the resilience to try again…. and come back to residential treatment and all that is offered at Red Door Life. As they have remained in connection to their path and support, they have a direct and easy path back. This lessens the damage and danger.

 

At Red Door Life, we firmly believe that no matter where one is in their journey to recovery, they are worthy of care and support. We are continually honored to see how our innovative, evidence-based methods save and transform lives.

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