#03 - Dr. Andrew Tatarsky: Abstinence Only Doesn't Work

Dr. Tatarsky is internationally recognized for his work in the treatment of problematic substance use and other risky behaviors. For the last 35 years he’s worked as a counselor, psychologist, program director, trainer, advocate and author, with a focus on harm reduction psychotherapy.When it comes to therapy for people suffering from substance use disorder, the focus is generally not on harm reduction but on complete abstinence. That’s where this discussion kicks off – talking about the standard practices in the psychotherapy field for addiction.The belief that people cannot benefit from psychotherapy until they are sober or they’ve stopped using is very common in the field.Dr. Tatarsky’s approach has been the opposite. He speaks to how the harm reduction approach in psychotherapy disproves the idea that one must be abstinent before they can benefit from therapy, and not only that, how traditional models of drug and alcohol treatment can often create further harm for people suffering from addiction. He has a name for this: treatment trauma.He also discusses the origins of harm reduction psychotherapy, his early involvement in the field, and how it has affected substance use disorder treatment on a broader level.Amanda asks Dr. Tatarsky some questions critics of harm reduction might have: if the goal of harm reduction therapy is not abstinence, what is it? What are the challenges of a harm reduction approach?Dr. Tatarsky shares about his work in New York City, the recent implementation of harm reduction measures in the state of New York, and finally, if a harm reduction approach and ibogaine treatment can be complimentary.Why it’s important:Dr. Tatarsky brings up valid points that challenge standard psychotherapy models for substance use disorder, which are not only ineffective but dehumanizing. Through the harm reduction model, clients are offered a holistic approach to healing rooted in empathy, one that humanizes them and often leads to improved quality of life. Looking at drug treatment more broadly and ibogaine more specifically through his lens might challenge some of the preconceived notions you have about substance use disorder and drug treatment, in a good way.Relevant links: Dr. Andrew Tatarsky’s website The Center for Optimal Living website Dr. Andrew Tatarsky’s book, Harm Reduction Psychotherapy: A New Treatment for Drug and Alcohol Problems Integrative Harm Reduction Psychotherapy: A Case of Substance Use, Multiple Trauma, and Suicidality by Andrew Tatarsky and Scott Kellog The Challenge of Harm Reduction: Changing Attitudes Toward Addiction Treatment by Dr. Andrew Tatarsky Dr. Andrew Tatarsky on Twitter