Examining Harm Reduction: A Compassionate Approach to Addiction Recovery that Saves Lives

In this thought-provoking podcast episode, we have a deep conversation with Dr. Michael Lukens, a renowned clinical psychologist and an expert on human motivation, about substance use disorders and the concept of harm reduction. Harm reduction is a modern approach to public health that focuses on reducing substance use risks and harmful effects. Dr. Lukens explains how harm reduction can help those with substance use disorders in a humane and respectful manner. The episode highlights how harm reduction recognizes addiction as a health issue and challenges the previously held notion of addiction as a moral failing or a criminal problem. Dr. Lukens also clears up some common misconceptions about harm reduction, discusses the practice's future, and introduces the concept of “emotion(ing),” our inherent desire to escape, and the constant need for love in clinical settings. If you are interested in exploring the nuances of addiction—its treatment and recovery—the possible benefits of harm reduction as part of “successive approximations,” and the importance of a compassionate approach to substance use disorders, don't miss this enlightening conversation.

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Antonio Matta: [00:00:00] Welcome to another episode of Recovery Dialogues and Sober Stories brought to you by Wish Recovery. If you or someone you know is ready to take the first step to overcoming addiction, contact Wish Recovery today. To learn about their luxurious, personalized, comprehensive inpatient and outpatient treatment programs.

In today's episode, with the help of a very special guest, Dr. Michael Lukens, we will look at the life saving, compassionate approach to recovery through harm reduction. Harm reduction is a progressive public health strategy. [00:01:00] that values safety, compassion, and respect for those dealing with substance use disorders.

It centers around mitigating the potential harm and adverse consequences associated with substance use and meets individuals where they are in their journey toward recovery. The approach is human centric, prioritizing the rights and dignity of those struggling with addiction. It involves comprehending the intricacies of substance use and launching effective measures to prevent overdose.

Safer Substance Use focuses on empowering individuals with knowledge about their consumption methods. offering clean and sterilized equipment and administering controlled substances under vigilant [00:02:00] medical supervision. Needle exchange programs provide clean needles, reducing the transmission of life threatening diseases like HIV and hepatitis C.

And overdose prevention is achieved through the widespread distribution of naloxone, a life saving medication capable of reversing opioid overdoses. Harm reduction challenges traditional perspectives on substance use and addiction that often include moral judgments and stigmatization. It humanizes addiction.

As a health issue, instead of vilifying it as a moral failing or a criminal issue, this compassionate approach prioritizes individual well being above all else, placing the focus on reducing harm and preserving lives. Harm reduction is committed. To [00:03:00] meeting individuals exactly where they are in their recovery journey.

It acknowledges the uniqueness of each individual's recovery process and extends nonjudgmental support. Celebrating every step towards reducing harm as a victory. In essence, harm reduction is a compassionate, respectful, and practical approach to managing substance use disorders. It prioritizes safety, cherishes individual lives, and relentlessly aims to reduce the damaging effects of substance use.

It is not just a strategy, it is a call to action, a revolution in how we view and respond to addiction. I am pleased to introduce our featured guest for today, Dr. Michael Lukens. He is an author. [00:04:00]Emotions Theorist, Clinical Psychologist, and Expert in Human Motivation. Dr. Lukens has developed theories and modalities to understand the complexities of emotions and motivations.

He believes in acknowledging our true meanings and motives, challenging the common belief that actions speak louder than words. Dr. Lukens advocates for love. Understanding and Genuine Curiosity and Studying Human Behavior. He authored two book series, The Physics of Emotioning and Addiction and Emotion, and introduced the deconstruction of ambivalence in the CICT modality.

He aims to empower individuals to overcome emotional resistance and discover their true desires. I'm honored to have him on the show. As I am confident that his [00:05:00] expertise will help us look at addiction recovery and harm reduction from a more evolved and comprehensive perspective. Dr. Lukens, how has your understanding of harm reduction evolved and how important is it in transforming addiction recovery?

Dr. Lukens: I've been studying addiction in one form or another for... Three and a half decades and Marlatt's harm reduction therapy and his ideas Geez, I don't know exactly when they came out But they I ran across them early and I think I've been operating philosophically with a point of view Along those lines way back when but since that time I've actually developed my own theory of motivation based on the concept that I refer to as emotioning, as I see the drive forces that come from hunger and [00:06:00]thirst as being, primitive and lizard brain motivated, but the essential motivations for humans, particularly as these would relate to Different forms of acting out that includes addiction.

They happen due to the limbic activity, the involvement of love, for instance. I was trying to understand all addiction and all aspects of addiction relative to my evolving understanding of what actually motivates the human will, what drives the mind to make choices and decisions and to create intentions, and even what affects the built in confirmation bias and all our perceptual and conceptual activities, what we perceive and what we believe.

So as I thought about harm reduction, I wasn't actually subscribing to the idea of the addiction as a disease, [00:07:00] co op disease, and I wasn't subscribing to the corollary to that kind of once an addict, always an addict. And and that in any way, shape or form, I also believe that There was nothing there but for the grace of God go I was my understanding about all things acting out and diction in my theory fit into the category, predominantly as a major category or subcategory of human acting out.

It's one of the most popular ways we defend against the emotional business that we're unable to tolerate or handle. So Why not harm reduction from very early on and then eventually as I got involved in the addiction field I began to get a little more vociferously committed to the idea recognizing that I what I thought was counterproductive on the other side [00:08:00] to define addiction as the disease like you had it other people don't have it how unfortunate that is and what Made no sense to me as I looked at every human being as having built within them the machinery given the right conditions to become an addict.

Now not everybody would have the right conditions to get addicted to fentanyl or huffing glue or have an eating disorder or bite their fingernails to the point of causing them to bleed. A lot of different manifestations of that kind of addiction pattern. of scratching an itch with a behavior that, that somehow comforts or distracts, but never gets to the source of what's producing the itch in the first place.

So we all have this potential built in from birth because of the way we're built, the machinery of our minds, given the right conditions to succumb to the impulse to self medicate. [00:09:00] Like it's a, to me it's a given. It could happen to you if so far you haven't had the childhood traumas or the chronic stressors or the the existential vacuum that affect the rest of the population, the addicted population.

What's to say that won't happen to you next week or some version of that won't fall in your lap next week? So this kind of shared vulnerability obviously makes me a harm. reductionist. We all, so those who have, if you looked at their lives and you say, you know what, if I scour with a fine tooth comb, I don't see any form of addictive acting out in their behavior patterns.

So first of all, if you found that and they were over the age of two, I would write you a check for 500, 000 because I don't think you can actually find them. I think your assessment was too shallow. So would we call it an addiction if somebody had a mental technique? of continuously [00:10:00] imagining rainbows and dinosaurs when they're upset.

We would begin to consider that if they lost their job because they were too busy in their reverie trying to make themselves feel better and neglecting All the other requirements of their living a functional existence. I could be doing that fantasy so much I neglect my hygiene. Then what makes me any different from the alcoholic or the opiate addict?

This led me to write the two books, the two volume set about addiction and emotions. So I have a different take on it. I think there's an escapist waiting. To be cultivated given enough uncontrollable itch, quote unquote, from some hard to identify or hard to heal source.

Antonio Matta: Can you explain the fundamental harm reduction principles and how they offer a new approach to treating [00:11:00] substance use disorders compared to traditional methods?

Dr. Lukens: I don't actually consider myself a trained practitioner per se. I incorporated the basic philosophy and the fundamental understanding, the perspective of harm reduction, like I said many years ago. So I was an early proponent, but it's not like I went and studied it. I just incorporated what I understood about it as I picked up things.

So I, let me just advance what I know as a, As an idea about it, since we're all escapists, it's inevitable that life brings us painful things that we would love to put off dealing with, like forever, and even if it's not available, like to my last breath, I'd rather not go there. You see this with clients.

So I was a client of my own therapy and [00:12:00] I had some places I'd rather not go into therapy and realizing my hypocrisy was one of the things that had effective leverage. Forced me to be more honest than my comfort or even my natural stretching of my comfort might have allowed we are avoidant species, so the other thing that this is important for me as an idea is that the confusion about willpower and the role that It might play if it exists in recovery and people are not quick to realize how contradictory they sound when they speak about willpower.

Just as a, for instance, I'm powerless to do anything about my addiction. Now I have to do everything every day about my addiction and find the power, but of course I'm not the source of the power, so I pray for it, but then [00:13:00] push comes to shove. If I'm not supported, it falls on me anyway, I've got to do it.

And so this arm wrestling we do with ourselves. It filters over into this distinction between the radical sober commitment as the only appropriate stance and an acceptance somehow of harm reduction, at least as an interim process, so I don't see it as something that I, the harm reduction principles, they work their way into the natural understanding I have that some people Despite what they understand to be their highest level of personal commitment, don't seem to be able to get this job done.

And this job requires confronting the pain. And I humbly look at some of my clients who have what I imagine to be pain that's ten times greater than my own. For instance, some who've lost children. And I fully appreciate their, [00:14:00] but for the grace of God go I, because I know that's a pain that my psyche, it doesn't have a measurement of it and it just assumes there'll be a short circuiting and an overwhelm, a level of trauma that will shake every foundation I think is unshakeable.

And in the face of that, everybody should have sympathy for everybody else's weak will in the face of the drive to escape.

How are you going to escape? Are you going to escape in a way that's so self destructive, it's an obvious death wish? That's one escapist agenda, and harm reduction in that particular case could be the lifesaver and the game changer. So the person, for instance, is drinking from morning till late night, and polishing off.

A ton of liquor, let's say, of some kind. And they [00:15:00] can't, they're just, they're hapless. Now, they've been detoxed 11 times, this is not an actual client I had, it's a set of clients that I've worked with. And they can't seem to pull it together. When you talk to them philosophically about the foundation of their desire to live, it's shaky and maybe they're still paying lip service to wanting to live.

Like they have some, they have somebody that depends on them that they're letting down that they feel so guilty and horrible about that they should be dead. And they just add that to the pile of incompletions that are making being inside their skin the worst place to be on a daily basis and they're not helping it with the.

The diet that they've got of nothing but alcohol, etc. And they're killing their relationships. And they're really just planning, declining an exit, but they're paying lip service to that not being the case. If we could talk that person into some commitment to harm reduction, we are doing them the favor of their life, perhaps.

Giving them a [00:16:00] chance. To pull something together at their foundation that they could then stand on and use as the springboard for digging deeper or finding a clearer commitment to staying alive, to sticking around and seeing if they might be able to break even for a change in the game of life.

So I have a humility about this when I talk to people and I realize my own biases about who's suffering more or what kind of suffering I could handle if it were me. That's just. useless conversational drivel. They're standing in their shoes with the pain that they have using the defenses they figured out how to use.

It's clearly not working. They're probably on some level recognizing it's not working. They've tried everything that seems to be recommended. If their heart wasn't in it, they don't know how to get their heart into it. [00:17:00] I'm going to have harm reduction come out of me naturally in a conversation with a person like that.

Let's not start in the morning. Let's give every morning A chance, and of course you're going to wake up hungover and shaky and so maybe we do need to get a detox done in order, get a detox done in order to go back to controlled drinking as an experiment. I'm just trying to get them to dig their fingernails into the edge of the cliff that they're hanging over.

Of course I use it. What am I going to say? Call me when you get your act together and you've got 14 days of committed sobriety. What if they come to my office drunk? Yeah, it depends. I don't think one size fits all there either. I know it's a ridiculous It's an anathema in the field to consider working with somebody who's not Sober at the moment, at least, and yet what do you have to work with?

What does the client what does the individual, what does that struggling person have to [00:18:00] work with? And if you're going to meet the client where they are, harm reduction should be in your repertoire. And you get creative about it, I don't think there's any given technique that you need to rely upon.

It's just you're looking to remove some lethal risk to make it non lethal, and then you're looking to downgrade the non lethal risk to non lethal. a point where it's damaging to themselves and to their, to a way of life, a healthier way of life, minimally. And a reasonable goal for every human is today you could learn or practice doing a little less harm to yourself than you did yesterday.

Antonio Matta: How does harm reduction complement other treatment approaches, such as therapy or medication assisted treatment? Are there any potential conflicts or benefits to combining these methods?

Dr. Lukens: As I've said, it's something that's interwoven into my own way of practicing.[00:19:00]

I do think the folks in the field with a more rigid or monolithic idea. About how it needs to be done. A lot of that is a confirmation bias that stems from their own recovery And you're not going to talk people out of it. I tried 17 things, one of them worked. That's the thing that works. You've tried 14 things.

You haven't tried my thing. You should try my thing. It's a reasonable argument. But if you're gonna say, if my way isn't working for you and you've tried it, there's nothing else that we're giving up on you. I don't buy that whatsoever. And so I can't rule out the idea that the paper clip in the ear helps people stop smoking.

I can't rule that out. Empirically, I actually think there's evidence for it. I can't explain it. I think most practitioners who have studied the phenomena from the outside [00:20:00] in, not just the inside out, They have a more, not live and let live, but a sort of, there's more freedom of movement here. We can think the unthinkable and we can imagine the unimagined and we can accept multiple manifestations and pathways to support a, an agreed upon process and a somewhat agreed upon outcome, the process of recovery and what it should look like, what it consists of.

Are you recovered if you're slipping three times a year, and you've done that for a decade? These definitions, they don't, they actually don't fit anybody exactly. And so there's this conceptual thing that people do, they turn their ideas into a Procrustean bed that forces every newcomer that knocks on the door to fit into the pre existing box.

[00:21:00] I'm not that way. I was raised by... in the field by a mentor who lived outside the box. I always saw the box of understanding as part of the problem. I think that's part of what makes addicts, too. So the problem of rigid conceptualizing, if that carries on in your life post recovery, I actually think it contains the seeds of your own downfall.

So on a meta level, just being open minded about how John versus Jonathan are going to recover even though they're both quote unquote crack addicts,

or cigarette smokers, or emotional eaters, or sex addicts. We lump people into categories based on their substance or their behavior. And I think we're on to something that applies to all of them and sometimes that's actually more misleading than true.[00:22:00]

I think everybody in some respects that works in the field already incorporates some measure of harm reduction considerations and the work that they're doing in the trenches. Whatever they're saying they're doing or describing it, they might leave that part out because politically or philosophically, they're, they think they're arguing against their beliefs.

Their beliefs are just... More multi form than they give themselves credit for.

Everybody actually sees the evidence of harm reduction in every AA gathering that they go to where there's coffee, donuts, and cigarettes. And also some people that are, that have an addiction to a certain kind of conversation. In, in the human realm of pain management and escapism, We have [00:23:00]forms of escapism, and we have very few people that have escaped escapism as a way of dealing with living.

And so for me, that's the ultimate goal. It gives me an argument against looking at harm reduction as a permanent condition.

Looking at addiction as a permanent condition. It's not, we don't have to look at it. As permanent, but we can't confuse substituting one form of escapism for another as any kind of, that's what we're all doing until we make that qualitative leap into no longer escaping. And who are those 14 people?

Actually, one or two of them. Hanging around in recovery circles and usually they're a person that sponsors 75 other people and you want to get next to their energy and you want to role model [00:24:00]yourself after them and they might be a little eccentric but they're definitely deep and there's a stillness inside and you realize these people are really seriously recovered and it's because they've shaken the deeper commitment to being an escapist and so it just keeps applying.

There's another reason to escape, there's another reason to escape, there's another pain that's unmanageable. And they face them with a different kind of forthright courage over and over again. That's what we're all looking to achieve. And how do we get there? Maybe it's baby steps. So that's the harm reduction idea.

It's either baby steps or toddler steps. Which kind of steps are you taking? And every once while there's an individual that takes a quantum leap and that's something we're studying and talking about for sure. Absolutely.

Antonio Matta: Can you share examples of successful harm reduction strategies that have reduced harm [00:25:00] and help people on the path to recovery?

Dr. Lukens: I'm thinking about two things. One in terms of everybody wants to know about strategies and I understand that and I want to provide some ideas and guidance there. But I'm not the biggest fan of the strategy ahead of time, like the diagnosis fitting the strategy ahead of time. We need to categorize these things, we need to be able to communicate with each other.

I'll suggest a couple categories that I think in that then guide my ideas about what strategies to use. So let's just take an example, it's pretty common. The person that's using whatever they're using all day long, morning, noon, and night. And then let's divide that group into how much lethal risk is [00:26:00]present in the current behavior pattern.

So somebody's smoking crack every day in a place downtown that's dangerous with drug transactions and violence and stuff. The lethal risk is huge. Any given day, there's much greater possibility that person will not see the end of the day from the overdose risk to the incidental death risk. So your strategies for harm reduction are get the hell out of there and you don't even think of them as harm reduction, you're thinking of them as basic survival, but that's what they are.

You want to reduce the risk. So that's always in the background in people's minds who are involved in treatment. or who lives in love with somebody who has an addiction problem. So the, so that, that dictates a lot of what might be considered [00:27:00] legitimate harm reduction considerations and illegitimate harm reduction considerations.

So let's say somebody is really distraught about some emotional eating that they've been engaging in ferociously for a rather protracted time at a high level, where as before they had been largely an emotional eater that Was causing more peripheral damage to themselves including their self esteem, but now they're more you're getting morbidly obese Let's say or something to that effect.

So again, the lethality risk is there, but it's not like tomorrow And so the ability to experiment with a harm reduction Strategy there. There's just more freedom of movement there because we don't we're not facing the possibility That something has to be done and be effective in the next 24 to 48 or 72 or, 100 hours.

So we're really considering harm reduction of two different kinds here. One is take the gun out of their hand harm reduction and because lethal risk is there. [00:28:00] And the other is let's use it as a strategy to support recovery. That's what I'm saying.

So let's talk about that category. Where it's a, it's an actual, legitimate, psychological, professional intervention. And that's to suggest, this is what I would do, and this is what I found useful. I suggest that whether it's a delay in the beginning, or trying to accomplish it one whole day without, depending on the medical issues involved.

What is it that I could ask you to commit to, and you could ask yourself to commit to? That doesn't involve the entire, commit to entire recovery and sobriety starting this minute. Somehow find this self control that you know you don't have. So what level of self control could you make an argument for?

Could you not begin? Your [00:29:00] addictive behavior pattern until noon. Could you put it off till afternoon? Because there was a point in time in your life where that's probably what you did. You probably didn't do it in the morning and it grew on you. So could you do that? And then see that becomes, and we're not, there's no discussion about that's the endgame.

We're still talking about what the endgame of all this is, which is everybody's consensus idea about a full recovery, whatever the hell that might be. But that's really what we're shooting for. We're taking baby steps. When I was an undergraduate at Temple, I had a behaviorism class and learned about this concept of successive approximations, which I think at the time I found very impressive and I still think it applies.

Some gigantic complex tasks can be broken down into pieces, and as you [00:30:00] approximate the completion of one of the pieces, you're actually beginning the entire process. So every little beginning helped the stairway, even if you have to divide. One stair into four stairs to get to that stair. And by successive approximations, which means you're really optimizing successes, you're building on successes.

That's what successive approximation amounts to, you're building on successes. If you shoot for too much, if you expect too much, if you demand too much from the learner, from the process of learning, you often lose them because the gap is something they can't cross. themselves. So I think just in principle, stretching out the beginning, stretching out the amount, the time of whatever.

And this actually creates an interesting, if you're establishing rapport with the client or the person at that point, it creates an interesting sort of paradox because you win either way. If they fail, if we fail to find a baby step, [00:31:00] a mini step that they can succeed at, then we're supporting the idea of surrendering.

and pulling up the fight stakes and surrendering and moving to a higher level of care. So we don't, we're not telling somebody they need treatment, they're discovering that they need inpatient treatment because they can't make a small step regimen work on the outside. And I think that's, you're in good faith advocating for a process that you believe in and if they fail at it, it actually advocates for just a different path to beginning this process, like inpatient and detox, let's say.

I've used that. Over and over again in my work with people with addiction issues. It's highly successful. It's, I recommend everybody consider it.

Antonio Matta: What ways does harm reduction [00:32:00] challenge the negative attitudes and assumptions about addiction in society? How can we provide more nonjudgmental support for someone in their recovery journey?

Dr. Lukens: I think some of the voices in the field are showing that we're beginning to recognize that anything that, that diminishes the compassion involved in recovery is probably not supporting recovery. And so that doesn't rule out tough love, by the way. We used to blame addicts, and we were obvious about it.

Now we still blame addicts, and we're less obvious about it. Arm reduction comes naturally to people who already have a mindset that folks aren't to blame. A crippled person trying their best to climb a mountain may not be able to get up the mountain without assistance.

And that's even somebody who just was freshly crippled by a recent [00:33:00] wound halfway up the mountain.

To question other people's spirit in their own individual mountain climbs and the degree to which they feel broken or are broken, there's a hubris in it and a kind of, I don't know, there's a little piece of contempt in it and there's a subtle blaming of the victim that still takes place. And I think people who aren't suffering with addiction A, A being worse than addiction B, they'll look at addiction A.

Sufferers and they say at least I'm not that bad and so they don't realize in a way what they're doing is as they say I'm glad I'm not that I'm not that bad off and they're feeling some sympathy and what have you that's different at least I'm not that bad And so the excuse covering their own shame and guilt about being as bad as they are Is that there's somebody badder and so they're participating in the blame the victim game.

They just don't realize [00:34:00] it So that doesn't just permeate society in general. That, that permeates people's minds. I guess you could say they're feeding off of each other. The minds are creating the culture that's creating the minds.

It's hard not to blame addicts because when you stand on the outside and you look at it, it's a ridiculous pattern of behavior. I'm intentionally being self defeating, watching my ship go down, and I'm sipping some bubbly while it's happening. Now I'm, it's just, if you look at this as escapism, And you take away the consideration of how much actual human suffering is involved.

And that, yes, there's an angle that tells you, you could label it self inflicted suffering. But it's really self expression of those who have been inflicted by suffering and living. Which none of us are immune to. And if you're gonna have compassion for your own wounds, why wouldn't you have [00:35:00] it for others?

People like Gabor Maté, he gets the idea. You love on people with some wisdom love and wisdom mixed together, and support some natural processes of healing.

And this is what allows people to become less escapist, less committed to escaping. People that are in, into self destructive escape modes are just giving up on weaker modes of escaping. And it turns out what they're left with is, I must escape being alive. So they don't mind playing Russian roulette. You have to understand that about those who have thrown in the towel.

And for that group, harm reduction is often the lifesaver as a something intuitively created between two people as an idea [00:36:00] that applies to the struggling, blameless, confused person who can't find commitment. enough to take care of themselves, to attempt to repair, to face the music. We can love them into that current.

Antonio Matta: How do harm reduction strategies like safe substance use and needle exchange programs help prevent the spread of infectious disease among those with substance use disorders?

Dr. Lukens: You can understand why there'd be some controversy or debate on this issue. The more monolithic view, all this is some sort of institutional enabling, I hate to contrast it this way, but the more compassionate view says that, no, we're trying to accomplish something any way we can that reduces the negative outcomes and the [00:37:00] unnecessary suffering.

That'll be decided in the empirical courts, like research. So I'm betting on the more compassionate view, but I am not an expert on all that, all those more systemic manifestations of harm reduction and principles. I have to be in favor of all of them, just theoretically, but the empirics of it all would make a difference in terms of my vote, per se, and I can't claim to be schooled enough in that.

But I do recognize that some inefficient strategies based on sounder principles will teach us more than somewhat effective, accidentally effective strategies based on unsound principles. I have no doubt that the compassion behind the harm reduction considerations will win out.

Antonio Matta: What are some common misconceptions about harm reduction [00:38:00] and how do you address these issues in your work?

Dr. Lukens: Like I was saying, I think the primary misconception is that harm reduction amounts to enabling or It's evidence of addicts being manipulative, or you're trying to accomplish something that doesn't matter in the end anyway. So there's downplaying the whole concept of successive approximations, which Has been proven empirically.

It's an effective training strategy for animal trainers even. This is how you get animals to execute all those complex tricks. You reward them for doing this piece of it then this piece of it, then this piece of it. So it's a proven strategy. What is happening in the minds of addicts and people who care about addicts.

I wouldn't include people who don't care about addicts because I don't think they're involved in the conversation although they might be part of the problem.[00:39:00]

Now, it's I don't. I'm not an apologist for it. It's just natural that as somebody that believes in the power of love and compassion and healing, that I have to be on the side of the compassionate argument about everything as best I can. And I don't think in this case is there's any doubt that harm reduction, think about it.

Prior to that, there are those who can't be helped. Harm reduction immediately suggests, wait a minute, we can do some help. And then some help becomes some more help and so on. There's no person who's abandoned ahead of time conceptually. There's nothing we can accomplish for them. There's always something we can accomplish together.

And that's the premise. It's hard to argue with and you don't really have to apologize for it to [00:40:00]somebody. You don't run into it from clients. It's not where that hardened belief is coming from. Although they might have been sold that and they're beating themselves up with their lack of self control being the problem in each and every case.

So I'm Harm Reductions an Advocacy for... Self understanding before the effort at self control has to be successful.

Antonio Matta: Does meeting individuals where they are in their addiction journey improve the effectiveness of harm reduction strategies in your professional experience?

Dr. Lukens: Yeah, again, with the framework that I operate with, there's nothing but meeting people where they are.

Otherwise, you're not meeting. It's not, I'm going to speak in code until you figure me out. No, I have to speak in a code that you already understand, and I'm trying to teach you new things perhaps, but I have to take you by the hand, which means I have to, [00:41:00] we have to connect. And so to me, rapport is everything.

And this is, God bless first responders and whatnot, instant rapport. with high demand for the rapport, the challenge of the conflict to maintaining rapport. As a clinician, the sense of urgency gives you the opportunity of one kind of rapport. If it's great versus This isn't urgent, even if it's pressing, if that makes any sense.

Everybody's problem's pressing. Not everybody's problem is urgent and pressing. And it's funny, some people's problems are urgent, but it's not pressing to them. And then there's plenty of people who think their press is everybody's urgent. We're all a bit confused about this.

Antonio Matta: What is the future of harm reduction in addiction recovery? Are there any new developments or trends that will improve its [00:42:00] effectiveness?

Dr. Lukens: In individual lives, just collectively across the spectrum of all addiction processes, and both in terms of development of addiction and recovery process. We're going to continue to find, I suspect, that where love needs to get the last word, there will be recovery if love does get the last word.

Where love needs to get the last word and it's not happening, there's going to be less or no recovery. What does that mean specifically? We'll be always finding out. We have normal science, we have the cutting edge, we have the lunatic fringe. Lunatic fringe are crazy until they're right. In which case they're cutting edge.

And I think that the direction of humans doing love better is required if we're going to do life longer. And we're going to do it [00:43:00] well.

Antonio Matta: Thank you, Dr. Lukens, for your insights, expertise, and philosophy. As we draw this enlightening episode of Recovery Dialogues and Sober Stories to a close, I'd like to once again extend my heartfelt gratitude to my guest, Dr.

Lukens, for his knowledge and insights on harm reduction, addiction, and human behavior have undoubtedly enlightened us all. His compassionate approach to recovery serves as a beacon of hope and a testament to the power of understanding and empathy. I'd also like to express profound appreciation to our sponsor.

The Outstanding Luxury Rehab Center Wish Recovery and their unwavering dedication to meeting individuals wherever they are on their journey to recovery. At Wish Recovery, compassion isn't just a word. It's a guiding principle that informs every aspect [00:44:00] of their treatment. They provide personalized care and support every step of the way, ensuring that each person's recovery journey is as comfortable, comprehensive, and successful as possible.

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