Harm reduction paradigm in the face of psychoactive substance use and dependence: psychotherapeutic implications

Abstract

The harm reduction paradigm is a health approach that prioritizes reducing the negative consequences of substance use over the requirement of total abstinence. It is based on the recognition that substance use is a complex and persistent phenomenon in society. The objective of the study was to determine the importance of the harm reduction paradigm in the face of psychoactive substance use and dependence, focusing on its psychotherapeutic implications. Methodologically, the study constitutes a documentary exploration; for this purpose, doctoral and master's theses, original articles, and review articles were considered. The search was carried out in the Scielo, MEDLINE, Dialnet, Scopus, Psicodoc, PsycArticles, Google Scholar databases and main postgraduate repositories. The results highlight that the harm reduction approach is a psychotherapeutic perspective applied in developed countries regarding the use of psychoactive substances, where a culture of consumption exists and a series of erroneous criteria about them have been destigmatized. These countries have evolved in terms of human rights and addiction interventions, as drug use becomes entirely an individual responsibility and not that of the State. It is concluded that public health policies with a modern contextual approach within the field of addictions to psychoactive substances are based on harm reduction, since the complexity of their treatment indicates that it is the most viable option for the individual and society. Furthermore, it is consolidated on solid parameters of human rights, ethics, and bioethics.