M3D1: Harm Reduction or Disease Prevention Make the Case

An active discussion is the key to an interesting and engaging online course. As in the first two modules, we will go through the questions as a group, one question at a time. As you join in the discussion, read what has already been posted and then add substantively to what has been written.  Time goes by quickly, so be sure to post early in the week by Wednesday latest.

This week, we are going to look at some of the similarities and differences between the disease model and the harm reduction model. Well explore the benefits and costs of each model and propose ways to improve access to treatments that fit people where they are at in readiness for change.  We will apply what we are learning to the Sheffs experiences.

1. First, in your opinion: The harm reduction model, which we will learn about this week, allows people to continue to use a substance upon which they may be dependent, while they work toward recovery.  Thinking about what we have learned over the past several weeks together, do you believe the harm reduction approach is helpful or harmful? Do you think that certain people, groups, or circumstances may do better with this gradual approach, or conversely with a tough stop now approach? How so?

While you engage with your classmates and me on the opinion-based question, please complete your readings. After completing the reading, lets move into the readings-application portion of our discussion about models of disease and of harm reduction.

Now applying this weeks learning materials:  Lets imagine that we as a class are asked to present an in-depth analysis to the practitioners in a rural comprehensive health clinic of the two main treatment models (disease model or harm reduction) for substance abuse and addiction.

2. First, lets gather some background information together, using our readings. How can the harm reduction model assist an individual to address their abuse issues? How about the disease model? As you engage in conversation about which elements you would want to share with the clinic practitioners, consider differences and similarities between the two models in terms of goals, action steps toward sobriety, and how these two models may work with people across different groups (e.g. gender, generation, culture, etc.), as well as varying stages of readiness for change. 

3. Now that you have spent several days discussing the hallmarks of each model, which approach do you feel would be more beneficial than the other for the patients and for community interventions in general.  How about for certain groups within the community?  Is there room for both?  As you engage in conversation, be sure to talk about what you would say to convince the practitioners. 

4. Lets now turn to our case studies found in our Scheff texts.  Read the following quote and discuss the question following it:

..in mortal combat with addiction, a parent wishes for a catastrophe to befall his son. I wish for a catastrophe, but one that is contained. It must be harsh enough to bring him to his knees, to humble him, but mild enough so he can, with heroic effort and the good that I know is inside him, recover, because anything short of that will not be enough for him to save himself. I wish for a near miss for Nic. (The book name: David Sheff, Beautiful Boy.)

What do you think Nics father is experiencing as he sees the impact of addiction on his son and his family? How does his thinking relate to the concept of harm reduction? 

Note: We will be discussing each question together as a group, one at a time. As you create your posts, remember that the goal is an informed, dynamic conversation. Be creative in your headings and responsive to others who have posted before you. As you create responses to others, create new and descriptive titles to your post. Dont simply put “re:” or type in a person’s name that is already clear from the thread. Instead, if you type a full sentence or long enough phrase that the point of your post will be clear. This tip for using the subject line effectively will make navigating all discussion threads easy and meaningful. There is no right or wrong response, but you should demonstrate an ability to relate the module materials to the discussion questions in an articulate, well-reasoned manner.

This discussion will be graded using a rubric. Please review this rubric prior to beginning the discussion. You can view the rubric on the Course Rubrics page within the Start Here module. All discussions combined are worth 40% of your final course grade.

Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click on “Reply.” Then copy/paste the text into the message field, and click Post Reply. 

To respond to a peer, click Reply beneath her or his post and continue as with an initial post.

Reading material:
https://www.carnevaleassociates.com/our-work/overview.html/article/2013/04/26/the-affordable-care-act-shaping-substance-abuse-treatment

https://harmreduction.org/about-us/principles-of-harm-reduction/

https://www.ncbi.nlm.nih.gov/books/NBK64815/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1002402/pdf/westjmed00117-0040.pdf

https://youtu.be/xy1TS_cGaPE

https://vlib.excelsior.edu/login?url=https://fod.infobase.com/PortalPlaylists.aspx?wID=103647&xtid=154763

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