Andrew Tatarsky Ph.D.

Beyond Disease

They Didn't Have to Die

Harm reduction saves lives: Our loved ones would still be with us

Posted Sep 15, 2019

Andrew Tatarsky
Source: Andrew Tatarsky

We didn't have to lose Jimi, Amy, Heath, Cory, Philip Seymour Hoffman, Mac Miller, Michael, Whitney, Chris Farley, River Phoenix, Janice, John Belushi, Jim Morrison, Prince and hundreds of thousands of loved ones lost to accidental unnecessary overdose just in the last few years!

Addiction and overdose are among America's worst humanitarian crises 

America has 20 million people with serious substance use disorders and  80 million with problematic substance use,  which has significant negative public health consequences not only for the people who use drugs but their families and their communities. Lethal overdose from all drugs has been rising over the last 30 years and is, therefore, not just due to the recent overprescribing of opioids.

Yet our government spends two cents on the dollar on failed abstinence-based prevention and treatment programs that most problem drug users don't want. The abstinence-only approach simply does not meet most problem drug users where they are: concerned about their use yet not ready to stop for a variety of complex personal and social reasons that often must be addressed before they are ready to tackle their drug use directly.

Harm-reduction strategies meet people wherever they are ready to begin their positive change journeys 

What if everyone was taught personal harm-reduction practices in primary school to help them to live their healthiest, most meaningful and satisfying lives as they define them? These would include:

  • honest education about the risks of drugs and other risky behaviors
  • self-management skills to identify and manage difficult emotions that often drive people to do risky things, including mindfulness, breathing techniques for managing stress, and skills for managing difficult relationships and other life challenges
  • healthy alternatives for caring for oneself in challenging moments
  • assertiveness skills for saying no in the face of peer pressure
  • and more

What if harm-reduction therapy was available to everyone who needs and wants it regardless of their ability to pay? Harm-reduction therapy:

  • recognizes that people engage in risky and addictive behavior for many personal and social reasons that often must be addressed before people are willing and able to give addictive behaviors up; such reasons may include coping with emotional and physical pain, belonging and connecting, finding pleasure in a life with few opportunities for positive experiences.
  • accepts people while they are engaging in risky substance use and other problematic behaviors so they can begin their positive change journeys on their terms, where they are, in any stage of change and around all positive change goals: safer use, reduced use, or abstinence.
  • "meets people where they are" with compassion, respect, empathy and acceptance so they feel safe and understood and are more willing to engage in an alliance as an empowered member of a therapeutic team.
  • embraces ambivalence about change as a universal human experience and invites both the part of the person that wants to change and the part that does not into the dialogue so that new solutions to the dilemma can be considered.
  • "any positive change" is celebrated as the way most change happens. Small changes can lead to quantum change. Just showing up and hanging in, not giving up, makes quantum change possible.
  • helps people discover and create their ideal relationship to drugs and other risky and addictive behavior whether safer use or abstinence.
  • is inherently empowering, as it puts the client/person in the driver seat of their positive change process.
  • is radically committed to not imposing the helper's values, wishes and agenda on the client, so the client can discover their truth, what goals and approach to change best suits them as a unique, complex person in unique social circumstance.
  • it works! 

We have the ideas and strategies to solve our addiction and overdose crises.

We need our leaders to support a COMPLETE overhaul of how people who use drugs are treated in America!

  • We must transform or culture of ignorance, stigma and punishment to one of compassionate pragmatism
  • We must decriminalize and eventually move toward regulated legalization. Drug use is a health and human rights issue not a criminal one. The criminalization of drugs was driven by racism and politics and has not protected vulnerable people who use drugs. The war on drugs has benefited government, the criminal justice system, the abstinence-only treatment industry and drug cartels, not the people who are struggling with drugs. 
  • We must shift our support to honest education and a continuum of care wrapped in harm-reduction principles to solve our addiction crisis.
  • We must unite as a strong, vocal movement of Americans who care about the suffering people we love and demand this change!

Join the global harm-reduction movement and be part of the solution.

#harmreduction #anypostivechange #supportdontpunish

For more information on harm reduction, see: The Challenge of Harm Reduction: Changing Attitudes Toward Addiction Treatment


Tatarsky, A. & Kellogg, S.H. Integrative Harm Reduction Psychotherapy: A Case of Substance Use, Multiple Trauma, and Suicidality. Journal of Clinical Psychology: In Session, Vol. 66 (10), pp.123-135.

Tatarsky, A. & Marlatt, G.A. (2010). State of the Art in Harm Reduction Psychotherapy: An Emerging Treatment for Substance Misuse. Journal of Clinical Psychology: In Session, Vol. 66 (10), pp.117-122.

Tatarsky, A. Harm reduction psychotherapy: Extending the reach of traditional substance use treatment. (2003). Journal of Substance Abuse Treatment. Vol. 25, pp. 249-256.

Tatarsky, A. (1998). An integrative approach to harm reduction psychotherapy: A case of problem drinking secondary to depression. In Session: Psychotherapy in Practice. Vol. 4/ 2, pp. 16-29.