The following is a true story: A short time ago I was under a tremendous amount of situational stress involving leaving an old job and starting a new venture. Not only was I leaving an old job behind, this new venture also entailed leaving many close old friends behind. I was depressed and stressed from all sides from emotional to financial. I needed someone to talk to so I sought out a mental health professional.
I filled out an intake questionnaire which asked if I had any problems with drugs or alcohol. Since I currently had no problems with drugs or alcohol, I truthfully answered “No”. Then it came time for my intake interview and the interviewer asked if I had ever been in a chemical dependency treatment program. I truthfully replied yes that I had checked myself into such a program many years before. I was then asked if I had been perfectly abstinent from alcohol and all other recreational drugs (except for nicotine and caffeine) for the past six months. I truthfully replied that I was not totally abstinent from alcohol because I was drinking within NIAAA approved guidelines for moderate drinking.
I was told by the intake person that I would not be allowed any mental health services until I had been totally abstinent for all addicting drugs (except for caffeine and nicotine) for six months and that I would have to enroll in their chemical dependency treatment program for six months before I would be allowed access to any mental health services to deal with my stress and depression.
I tried to explain that my previous experience with chemical dependency treatment had been damaging and had caused me to drink more and that it had taken me two years to recover from the treatment and establish a non-problematic relationship with alcohol. I was still refused necessary mental health treatment unless I was willing to undergo a chemical dependency treatment which was not only unnecessary but which was in violation of my religious beliefs and which had proved harmful in the past.
It is a total outrage and morally reprehensible to deny client needed mental health services which might save their lives simply because the client’s goal vis a vis alcohol or drug use might be moderation or harm reduction rather than total abstinence. It is a violation of the most basic principles of humanistic psychotherapy for the therapists to force their goals and beliefs and values on the clients against the clients’ wills.
The time has come to eliminate discrimination against clients who are successfully pursuing treatment goals of moderation or harm reduction. The evidence from the NIAAA itself shows that people are just as likely to resolve and alcohol problem with a goal of moderation as with a goal of abstinence and that most problems with drugs or alcohol are resolved successfully without recourse to any sort of formal chemical dependency treatment at all.
People like Patt Denning and Andrew Tatarsky have clearly demonstrated that drug and alcohol users respond to psychotherapy even while they are still actively using drugs and alcohol and that giving them access to mental health treatment while actively using can actually help them to resolve drug or alcohol problems successfully via harm reduction, moderation or abstinence.
The time has come for the Department of Health and Mental Hygiene of the City of New York and the New York State Office of Alcoholism and Substance Abuse to insure that no active user of drugs or alcohol is refused access to mental health services for refusing to undergo chemical dependency treatment. Let us put an end to this sort of discrimination once and for all.
Copyright © 2009, The HAMS Harm Reduction Network