#4 - Dr. Andrew Tatarsky: Why Drug Abstinence Only Doesn't Work

December 14, 2022

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.

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.

Show notes

About the podcast

At our core, all humans are affected by trauma—it’s what we do with that trauma that can reshape our lives. In Root Medicine, author and journalist Amanda Siebert is joined by psychedelic researchers, trauma and addiction specialists, practitioners, patients, and parents as they unpack their understanding of and experiences with ibogaine, a potent drug derived from the West African shrub, iboga. It may be best known for its ability to interrupt opiate addiction, but there’s more to it than that: ibogaine can help us get to the root of our trauma so we can truly heal. As mental healthcare is slowly reshaped by psychedelic medicines, join Siebert for powerful conversations that provide listeners with knowledge for their own healing journey, and practitioners with cutting-edge information on the safe and effective use of ibogaine for trauma and addiction.

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