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“A very good introductory guide through the often difficult and controversial terrain of harm reduction.”

—Drug and Alcohol Review


“An extremely important and valuable work....The real impact of this seminal volume is that it makes the case for harm reduction as a powerful model for both treatment and public policy innovations.”

—Psychiatric Services


“This realistic, pragmatic approach to managing high-risk behaviors is solidly based on research evidence and clear logic.”

—Choice


“Harm reduction is a pragmatic approach that meets people 'where they are at.' This excellent book brings together researchers and practitioners who have made significant contributions to the growth and acceptance of harm reduction as an integral, viable, and effective approach to minimizing the negative consequences of high-risk behaviors. The second edition provides an updated, expanded review of the current status of harm reduction approaches, their applications, and the evidence that supports them. It is a valuable resource for practitioners and researchers and an essential text for graduate students in addictive behaviors, psychology, and public health.”

—Dennis M. Donovan, PhD, Director, Alcohol and Drug Abuse Institute, University of Washington School of Medicine


“Marlatt and his colleagues have compiled what is certain to be the gold-standard reference, covering the history, evolution, and applications of harm reduction strategies in clinical practice, as well as controversies surrounding harm reduction. Harm reduction is founded on the idea that people are more likely to change risk behaviors when the approaches supporting these changes are intimately client centered—even when such approaches conflict with social mores. The book shows how compassion and safety considerations create a fulcrum for balancing complex clinical decision making that both reduces harm and engages individuals in effective treatment.”

—Hilary S. Connery, MD, PhD, Department of Psychiatry, Harvard Medical School; Division of Alcohol and Drug Abuse, McLean Hospital


“The original book was a revelation to me; the second edition makes another leap forward. Harm Reduction should be required reading for anyone who wants to understand behavior change. Both professionals and students will benefit from the up-to-date research reviews and practical applications for a variety of high-risk behaviors. Harm reduction principles and strategies offer a crucial counterpoint to the disease model and abstinence-only orientations. The material in this book provides a blueprint for enabling individual and social change.”

—Jan W. Murdoch, PhD, Department of Psychology, Clemson University


“This eloquent, compassionate book outlines pragmatic ways to identify and reduce high-risk behaviors associated with use of a broad spectrum of drugs, including alcohol, amphetamines, cannabis, cocaine, heroin, and tobacco, as well as high-risk sexual behaviors. Tailored strategies designed to meet the needs of diverse cultures and communities are described. This important book is essential reading for workers in the field, and should be compulsory reading for policymakers.”

—Frank Ryan, CPsychol, AFBPsS, Honorary Senior Lecturer, Centre for Mental Health Research, Imperial College London, United Kingdom

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Table of Contents

I. Overview of Harm Reduction

1. Current Status, Historical Highlights, and Basic Principles of Harm Reduction, Susan E. Collins, Seema L. Clifasefi, Diane E. Logan, Laura S. Samples, Julian M. Somers, and G. Alan Marlatt

2. Harm Reduction Psychotherapy, Andrew Tatarsky and Scott Kellogg

II. Areas of Concentration in Harm Reduction

3. Harm Reduction for Alcohol Problems, Mary E. Larimer, Tiara M. Dillworth, Clayton Neighbors, Melissa A. Lewis, Heidi D. Montoya, and Diane E. Logan

4. Tobacco: Untapped Potential for Harm Reduction, Carl V. Phillips, Karyn K. Heavner, Paul L. Bergen, and Catherine M. Nissen

5. Harm Reduction and Cannabis, Roger A. Roffman and Robert S. Stephens

6. Reducing Harm Associated with Illicit Drug Use: Opiates, Amphetamines, Cocaine, Steroids, and Other Substances, Jason R. Kilmer, Jessica M. Cronce, Scott B. Hunt, and Christine M. Lee

7. Harm Reduction for High-Risk Sexual Behavior and HIV, Michele Peake Andrasik and Ty W. Lostutter

8. Redefining the Treatment of Dual Disorders, Patt Denning

III. Harm Reduction and Special Populations

9. The Need for Culturally Competent Harm Reduction and Relapse Prevention Interventions for African Americans, Michele Peake Andrasik, Briana Woods, and William H. George

10. Harm Reduction among Hispanic and Latino Populations, Arthur W. Blume and Michelle R. Resor

11. Harm Reduction for Asian American and Pacific Islander Populations, Karen Chan Osilla, Eunice C. Wong, and Nolan Zane

12. Adolescent Alcohol-Related Harm Reduction: Realities, Innovations, and Challenges, Adrian Kelly

IV. The Role of Harm Reduction in U.S. Drug Control Policy

13. Harm Reduction and Public Policy, Justin Walthers, Kenneth R. Weingardt, Katie Witkiewitz, and G. Alan Marlatt

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About the Editors

G. Alan Marlatt, PhD, until his death in 2011, was Director of the Addictive Behaviors Research Center and Professor of Psychology at the University of Washington. For over 30 years, Dr. Marlatt conducted pioneering work on understanding and preventing relapse in substance abuse treatment and was a leading proponent of the harm reduction approach to treating addictive behaviors.

• All titles by G. Alan Marlatt

Mary E. Larimer, PhD, is Professor of Psychiatry and Behavioral Sciences and Adjunct Professor of Psychology at the University of Washington, where she is also Associate Director of the Addictive Behaviors Research Center and Director of the Center for the Study of Health and Risk Behaviors.

Katie Witkiewitz, PhD, is Associate Professor of Psychology at the University of New Mexico, with a joint appointment at the Center on Alcoholism, Substance Abuse, and Addictions.

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Contributors

Michele Peake Andrasik, PhD, Fred Hutchinson Cancer Research Center and Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington

Paul L. Bergen, MSc, Populi Health Institute, Edmonton, Alberta, Canada

Arthur W. Blume, PhD, Department of Psychology, Washington State University, Vancouver, Washington

Seema L. Clifasefi, PhD, Addictive Behaviors Research Center, University of Washington, Seattle, Washington

Susan E. Collins, PhD, Center for Healthcare Improvement for Addictions, Mental Illness and

Medically Vulnerable Populations, Department of Psychiatry and Behavioral Sciences, Harborview Medical Center, University of Washington, Seattle, Washington

Jessica M. Cronce, PhD, Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington

Patt Denning, PhD, Harm Reduction Therapy Center, San Francisco, California

Tiara M. Dillworth, PhD, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington

William H. George, PhD, Department of Psychology, University of Washington, Seattle, Washington

Karyn K. Heavner, PhD, Populi Health Institute, Malvern, Pennsylvania

Scott B. Hunt, MA, Fielding Graduate University, Seattle, Washington

Scott Kellogg, PhD, Schema Therapy Institute and Department of Psychology, New York University, New York, New York

Adrian Kelly, PhD, Centre for Youth Substance Abuse Research, School of Social Science, University of Queensland, Brisbane, Queensland, Australia; Mental Health Centre, Royal Brisbane Hospital, Herston, Queensland, Australia

Jason R. Kilmer, PhD, Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington

Mary E. Larimer, PhD, Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington

Christine M. Lee, PhD, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington

Melissa A. Lewis, PhD, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington

Diane E. Logan, MS, Addictive Behaviors Research Center and Department of Psychology, University of Washington, Seattle, Washington

Ty W. Lostutter, PhD, Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington

G. Alan Marlatt, PhD (deceased), Department of Psychology, University of Washington, Seattle, Washington

Heidi D. Montoya, PhD, Department of Veterans Affairs, Puget Sound Health Care System, Seattle, Washington

Clayton Neighbors, PhD, Department of Psychology, University of Houston, Houston, Texas

Catherine M. Nissen, BSc, Populi Health Institute, Edmonton, Alberta, Canada

Karen Chan Osilla, PhD, RAND Corporation, Santa Monica, California

Carl V. Phillips, PhD, Populi Health Institute, Wayne, Pennsylvania

Michelle R. Resor, BA, Department of Psychology, University of North Carolina at Charlotte, Charlotte, North Carolina

Roger A. Roffman, DSW, School of Social Work, University of Washington, Seattle, Washington

Laura S. Samples, BS, Department of Psychology, Washington State University, Vancouver, Washington

Julian M. Somers, PhD, RPsych, Faculty of Health Sciences, Simon Fraser University, Burnaby British Columbia, Canada

Robert S. Stephens, PhD, Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia

Andrew Tatarsky, PhD, Center for Integrative Psychotherapy for Substance Misuse, New York, New York

Justin Walthers, BS, Department of Psychology, Washington State University, Vancouver, Washington

Kenneth R. Weingardt, PhD, Center for Health Care Evaluation, VA Palo Alto Health Care System, Menlo Park, California

Katie Witkiewitz, PhD, Department of Psychology, Washington State University, Vancouver, Washington

Eunice C. Wong, PhD, RAND Corporation, Santa Monica, California

Briana Woods, PhD, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina

Nolan Zane, PhD, Department of Psychology, University of California, Davis, California

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Audience

Clinical psychologists, social workers, substance abuse counselors, psychiatrists, and other clinicians who treat clients with addiction and substance use problems.

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Course Use

May serve as a supplemental text in advanced undergraduate- and graduate-level courses.

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Previous editions published by Guilford:

First Edition, © 1998
ISBN: 9781572308251

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New to this edition:

• Reflects significant advances in research and clinical practice, as well as increasing professional acceptance of the harm reduction model.
• Chapters on the current status of the field, applications to psychotherapy, and treatment of dual disorders.
• Chapters on additional populations (adolescent drinkers and Hispanic/Latino and Asian American substance users) and an additional substance (cannabis).