ebook THE GUILFORD PRESS OVER THE INFLUENCE Also Available For professionals Practicing Harm Reduction Psychotherapy, Second Edition: An Alternative Approach to Addictions Patt Denning and Jeannie Little Over the Influence The Harm Reduction Guide to Controlling Your Drug and Alcohol Use SECOND EDITION Patt Denning Jeannie Little THE GUILFORD PRESS New York London Copyright © 2017 The Guilford Press A Division of Guilford Publications, Inc. 370 Seventh Avenue, Suite 1200, New York, NY 10001 www.guilford.com All rights reserved The information in this volume is not intended as a substitute for consultation with healthcare professionals. Each individual’s health concerns should be evaluated by a qualified professional. Except as indicated, no part of this book may be reproduced, translated, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the publisher. Printed in the United States of America This book is printed on acid-free paper. Last digit is print number: 9 8 7 6 5 4 3 2 1 Library of Congress Cataloging-in- Publication Data is available from the publisher. ISBN 978-1-4625-2679-6 (paper) — ISBN 978-1-4625-3034-2 (hard) Artwork by Mariana Spada at Tectonica. As ever, to our muse, Edith Springer, who led the first wave of harm reduction in the United States and never stopped being on fire To our mentors, Paul Geltner, Alan Marlatt, and Bob Unger, whose skilled guidance has kept us attuned to the needs of people who drink and use drugs And to our parents, Eileen and Frank and Jean and Bill, who believed their daughters could do anything at times and in places where girls were not supposed to be groundbreakers and leaders Contents Acknowledgments ix Preface: How Did We Get Here? xi Introduction: Why Harm Reduction? 1 1 Welcome to Harm Reduction 7 2 Why Do People Use Drugs? 24 3 When Is Drug Use Harmful? 41 4 Why Do Some People Get into Trouble 67 While Others Don’t? 5 How Do I Know If I Am in Trouble? 87 6 How People Change 103 7 You Don’t Have to Quit to Change 118 8 Substance Use Management 140 9 Taking Care of Yourself While Still Using 168 vii viii Contents 10 How Can I Tell If Harm Reduction Is Working? 186 11 Finding the Right Help 200 12 A Letter to Family and Friends of People 218 Who Use Drugs What You Should Know about Drugs: 223 A Quick Reference Resources 273 Index 282 About the Authors 290 Purchasers of this book can download and print enlarged versions of the worksheets at www.guilford.com/denning2-forms for personal use or use with clients (see copyright page for details).
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