I was recently an attendee at the Southern Maine Harm Reduction Conference. The Harm Reduction Coalition defines harm reduction as a “set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.” A prominent idea came to my mind as I was observing the various speakers and break out sessions: how polarized thinking impedes our ability to tackle the opioid crisis in this country.

Coming from a clinical social work background, we understand polarized or “black and white thinking” as our tendency to simplify our lives by categorizing things as either all good or all bad; therefore, dissipating any grey area. Black and white thinking is a common unhelpful thought pattern that clinicians particularly see when treating individuals with depression and borderline personality disorder.

That distorted thinking is evident when we label people who use substances as “all bad” and view their decisions as moral failings due to inherent weakness. Placing this immense amount of responsibility on the individual not only elucidates things, but reduces anxiety that arises when we cannot or do not want to identify other contributing factors and solutions to the problem.

The reasons that drug use has become so prevalent in this country is complex and suggests macro-societal issues, including social inequality, mental illness, and the overprescribing of pain medication among many other influences.

Polarized thinking is also apparent when we ignore that drug use is a spectrum of behaviors from severe abuse to total abstinence, and decide that the only person worth treating is the one who is sober. Consequently, we fail to meet people where they are at in their use by providing safer ways to use drugs. This action is alienating, keeps individuals in their cycle of addiction, and exposes them to transmittable diseases or at worst, an untimely death.

It is imperative that we challenge our distorted thinking in relation to substance use and the people it affects. Helping people heal from their addiction requires compassion, unconditional love, destigmatization, and the reduction of shame through harm reduction approaches.

Anmarie Reed is a licensed clinical social worker who provides counseling services in Lewiston to children, adolescents and adults in a private practice setting. She graduated from Columbia University in 2013 with a master’s degree in social work where she focused on clinical social work and contemporary social issues, including substance use and social inequalities.

Anmarie Reed

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