An Argument for Harm Reduction to Address Collegiate Drinking

Harm Reduction (HR) and its utility as an approach to address substance use is nothing if not controversial. Although most are aware of HR as regards Methadone maintenance or Needle Exchange, but there is more to this behavioral and public policy objective than these two strategies.

In brief, HR is about considering ways to engage individuals committed to a particular pattern of behavior so as to reduce the likelihood of their doing harm to themselves and/or the community in which they reside and operate.  For a brief overview of HR as it applies to collegiate drinking, visit this article that you may find useful as regards justifying HR techniques and strategies when looking to approach a high-risk community (an indicated population) in a pre-contemplative (not ready) stage of readiness to change.  Visit http://peele.net/lib/reducing.html and scroll down to, Is Harm Reduction a Viable Policy for American Collegiate Drinking?

In brief, our biggest challenge in addressing the concerns related to HR is that arguments against such policies tend to be grounded in moral and/or legal principles while the rationale for HR is steeped in public health and quality of life issues.  Until and unless both sides of the HR debate can find a common ground where they can talk about the issue in neutral terms, there will always be more heat than light generated by this debate.

It seems to me that our challenge is to level the proverbial playing field.  Those advocating HR as one strategy in a comprehensive plan to address collegiate drinking will never trump the moral and legal rhetoric directed against HR with a logic-based appeal that addresses the quality of life of those who choose to use.  You and I can likely appreciate this logic and as the result embrace it, but for those who see drug use as “illegal” and those who use drugs as “criminals”—or its first cousin, “if drugs are bad then those who use them are bad people”—HR is tantamount to “giving in,” “permitting use,” “the first step to legalization,” and/or “pushing current non-users towards use.”

An alternative in this debate is to shift the focus for HR away from the reduction of harm for the user and direct it instead onto the reduction of harm for the community in which the user uses.  In the case of the Greeks, a high-risk community of drinkers on college and university campuses, for example, it is improving the quality of life for the community in which the Greeks live (this is where programs like the Good Neighbor Project at Clarion University in Clarion, PA can be useful – see http://www.clarion.edu/267773/) or reducing costs to the university related to violence and vandalism.  If a case can be made to lower high-risk Greek drinking, its related behaviors, and its negative impact on quality of life issues in general, especially if those quality of life issues affect student decisions to transfer before graduation, then one can argue for HR not so much to benefit to “miscreant drinkers,” but the individual “well-behaved student” in the general university community.

Put another way, if there are “indicated populations” that already manifest indications of problems related to drinking on campus, then the university community as a whole--and not just the errant consumers--is the most likely benefactor of the HR efforts targeting those communities.

What do you think?

Dr. Robert