APA Encourages Harm-Reduction & Telehealth During Pandemic

by Thaddeus Camlin, PsyD

The American Psychological Association (APA) recently published an article offering advice from leading professionals on effectively treating and preventing addictive problems during the COVID-19 pandemic.  Our own Dr. Horvath is quoted multiple times in the APA article, speaking about the value of telehealth during pandemic and the importance of fostering resilience through adversity.  The APA article’s endorsement of harm-reduction practices is also a subtle but revealing sign of the shifting landscape of addiction treatment.

For nearly a century the tyranny of abstinence dominated the zeitgeist of American thinking on treating addiction.  A major, national organization like the APA weaving in a concrete endorsement of harm-reduction as a viable approach to helping people manage adjustments to quarantine procedures is a telling sign of the times.  For many decades, moderation has been addiction recovery’s best-kept secret.  Some people will undoubtedly get through the COVID pandemic completely abstaining from all psychoactive substances, but they are the exception not the rule.

Unfortunately the APA, like most medical and mental health professions, has a rich history of lagging in their endorsement of important philosophical and ideological shifts. Psychiatrists and psychologists originally categorized everyone with alcohol problems as a sociopath.  We’ve come a long way in developing an accurate understanding that addictive problems are often rooted in trauma, not character defects.  The official diagnostic term for developmental delays used to be ‘mentally retarded.’  Homosexuality was a diagnosable disorder as recently as 1987, when it was referred to as ‘ego-dystonic homosexuality.’  Harm-reduction approaches were validated long-ago, and while the recent APA endorsement is encouraging, it is another example of ‘better late than never.”

Nobody will get through the COVID pandemic by handing everything perfectly, although some may claim their response was nothing short of beautiful, perfect, and terrific.  Demanding perfection from people with addictive problems and locking them in cages for anything short of it represents one of the great injustices of our time.  So long as people get through acute adversity alive there is hope.  The time to let go of demands for perfection from people with addictive problems is long overdue.  The APA’s explicit endorsement of harm-reduction and telehealth during the pandemic may be a sign that, at long last, the zeitgeist of American thinking on treating addiction is shifting from puritanical to practical.