Historically, substance use treatment has largely focused on achieving abstinence from all substances. However, recent shifts emphasize individualized goals and holistic treatment noting that abstinence is not, and does not need to be, the goal of treatment for everyone. Using data from the 2021 National Survey on Drug Use and Health, Jason Snyder, director of the substance use disorder treatment division of RCPA, examines how individuals may perceive what it means to be in recovery and how providers can respond to these perspectives. Namely, Snyder demonstrates that this survey underscores that one need to not be abstinent to be in recovery. Of the nearly 21 million individuals identifying as in recovery or having recovered from a substance use problems, the majority report having used a substance in the past year. Opening the scope of what recovery is always treatment programs to redefine progress and work collaboratively with clients and communities to set individual substance use goals. For example, medicated assisted therapy for opioid use disorders (MOUD) can be a life-saving intervention that minimizes risk of overdose. However, as Snyder notes, rigid definitions of treatment and abstinence may have compelled individuals to forego this option. Similarly, harm reduction is a rapidly expanding area of both research and practice that does not require abstinence, but rather focuses on mitigating potential harms associated with use (e.g., clean syringe programs, drug testing stations). In addition to expanding substance-related treatment goals, Snyder argues that moving away from an abstinence-only mindset allows for broadening the scope of intervention to include other mental and physical health needs such as housing, wellness, and physical health. Moving forward, Snyder writes that it will take a concerted, multisystem effort to effect meaningful, sustainable change as to how addiction treatment systems are structured, but the payoff will be well worth the effort.
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