Sussman Steve, Sinclair Deborah L, Clifasefi Seema L, Collins Susan E
University of Southern California, USA.
Ghent University, Belgium.
Eval Health Prof. 2024 Mar;47(1):75-80. doi: 10.1177/01632787241227225. Epub 2024 Jan 21.
"Substitute addiction" refers to the process of achieving abstinence or resolution of one addictive behavior and subsequently engaging in one or more additional addictive behaviors in its place. Substitute addiction, a concept in the abstinence-based recovery field for decades, is viewed as a cause for concern because resolving one addictive behavior might not fully remove harm or ensure recovery. Conversely, "harm-reduction treatment" refers to a counseling orientation that focuses on helping service users reduce substance-related harm and improve their quality of life without necessarily requiring abstinence or use reduction. Harm-reduction treatment assesses a constellation of addictive behaviors in the larger context of a person's life to holistically reduce harm in that constellation. In this commentary, we define and compare both constructs and point out their implications for addictions treatment.
“替代成瘾”是指戒除或解决一种成瘾行为，随后又代之以从事一种或多种其他成瘾行为的过程。替代成瘾这一概念在基于戒除的康复领域已存在数十年，因其被视为一个令人担忧的问题，因为解决一种成瘾行为可能无法完全消除危害或确保康复。相反，“减少伤害治疗”是一种咨询导向，侧重于帮助服务使用者减少与物质相关的伤害，并改善他们的生活质量，而不一定要求戒除或减少使用。减少伤害治疗在一个人的生活大背景下评估一系列成瘾行为，以全面减少该系列行为中的伤害。在本评论中，我们对这两种概念进行定义和比较，并指出它们对成瘾治疗的影响。
