The practice of helping addicts live a healthier life, reducing harm to the commumity

According to Peele (2002) (http://www.peele.net/lib/smart.html) the US is the only country in the Western world not to embrace harm reduction as a treatment goal. My review of literature (in re to addiction only) seems to point to increasing mention of the philosophy but little directive action. The majority of treatment programs remain total abstinence as does the direction of counseling efforts.

In whispered terms, in professional journals, there are efforts to promote the harm reduction approach in the US but in public recommendations, in the popular media, total abstinence is still the pronouncement and official policy in practice.

Total abstinence as the only remedy for addiction and as public health policy has a long history in the US growing from the efforts of the American Temperance Society, 1826, reinforced by Prohibition 1919-1933, promoted by Alcoholics Anonymous (1935-present) and medical practice and recommendations (1938-present). During later times, 1916 forward, the ideas systematically developed for alcohol were applied to other substances. So harm reduction as a treatment goal for addiction of any type isn't likely to become socially or therapeutically integrated for at least another generation or two, if at all.