by Patt Denning, Jeannie Little and Adina Glickman
Guilford Press, 2003
Review by Fred Ashmore on Feb 23rd 2005
This is a terrific book. Recovering from alcohol
and drug habits isn't a fun subject, but it's an interesting one. People's reasons
for starting with a substance are as varied as people are. What this book
showed me is that the habit is just one aspect of a person's life. To
understand it or offer help, you'd best try to see the whole picture and focus
on what you want to achieve.
The title phrase "Harm Reduction
Guide" is central to what Over the Influence is trying to do (my opinion)
which is to help people with a problem. In contrast to the widely adopted
advise that complete abstinence is the only way to start recovery, that you have
to hit rock bottom before you can start recovery Over the Influence is
about learning how to reduce the damage that a habit does. Sure, this may work
out as complete abstinence in due time, but the important thing for many, many
users is to improve life. Now, if possible.
The authors describe themselves as
"therapists who have worked with hundreds of people who use drugs -- both
the legal ones and the illegal ones." It shines through. If I was in a
severe fix with a drug habit, these are people who would listen, would not
judge (in the censorious sense) and who would have sensible ideas on what I
could try to improve my position.
I very much appreciated the respectful tone.
The message seems to be, "You have a problem with a substance related
habit? Here are some facts we know, this is how we see their meaning, here are
some options that you might like to think about in relation to your
situation." I have read a good number of self-help books, and many of
them try to achieve this tone. Few manage it.
OK, enough lavish praise (I suspect that I'll
break out again before the end of this review, though). What is the book
content? Here are the chapter titles.
What is Harm Reduction,
1. Addiction: is it all or
2. So if we're not addicts,
what's the harm?
3. How much is too much?
4. To change or not to
5. How do I know exactly
what my problem is?
What are these drugs,
anyway? (factual information on the main groups of drugs)
6. Practicing harm
reduction: substance use management
7. Practicing harm
reduction: how to take care of yourself while still using
8. Finding the right help
9. Is harm reduction workin?
10. How to talk to family
and friends about harm reduction
A letter to family and
Sources and suggested
readings in harm reduction
I appreciated the introductory explanation on the
harm reduction approach. Harm Reduction is a term that is quite widely used,
and it is an excellent idea to set out what is meant. The reasoning behind
looking for a new approach is carefully explained, without being too damning of
the weaknesses of the predominant twelve-step approach.
One of the reasons I liked this book is that it
is shaped around the process of change. Prochaska et al wrote their seminal
book "Changing for Good" many years ago, and I believe their ideas to
be very valuable for anyone involved in drugs and addictive behaviors. The
first 5 chapters are about evaluating the problem so one understands what type
of change is wanted; the last five about methods for effecting the change and
doing one's best to stay healthy and enjoy life while doing so.
I found the commentary "What
are these drugs anyway" on the effects and hazards of drugs extremely
enlightening -- including facts on my two legal drugs of choice, caffeine and
nicotine. As the proud father of two teenagers and two twenty something students, I am also grateful to the authors of Over the Influence for providing
me with additional factual information on substances that my wonderful kids may
be experimenting with.
Who is this for? Essentially the book is aimed
at those who are using and those who have a relationship with someone who is
using -- family, friends and relatives. I think it would also be a valuable
resource for professionals who are looking for a concise explanation of harm
reduction, but that isn't a stated target group.
Any gripes or complaints? There has to be one,
surely? Sure. The reference to Bufe's book "AA-Cult or Cure" cites
the 1st 1991 edition. There's a second edition from 1992 with quite
a lot more material (but no less damning of AA).
What else made this book so enjoyable for me?
As a highly interested amateur, reasonably widely read, I found myself
repeatedly nodding in agreement, grinning at new perceptions or surprised and
intrigued by new information. As I said at the beginning, this is a terrific
book -- very well written, informative, humane and kindly. Oh, and I think if
you have a habit you want to deal with, this would be a good starting point.
© 2005 Fred Ashmore
Fred Ashmore is a member of the
public with a strong interest in drugs, drink and addiction and how people
recover from them. He is active as a meeting host for the SMART Recovery® program, which offers
help for people who seek to modify harmful and addictive behavior.