A Survey of Practice Models and Outcomes in Michigan Residential Substance Use Disorder Treatment

The United States has a lengthy history of treating individuals experiencing substance use disorders (SUDs) from an abstinence-only framework. Harm reduction practices have grown a large base of empirical support in other parts of the world and have become central to treating individuals with SUDs. Within the United States, however, a substantial number of residential SUD treatment programs that continue to perpetuate an abstinence-only framework, which creates a lack of access for people who seek a harm reduction approach—and who likely need it the most. In this study, 66 residential treatment programs in Michigan were examined to determine whether they operated from an abstinence-only or harm reduction framework, and whether there were differences in success rates between the two models. Of the residential program respondents, 67.85% reported using both harm reduction and abstinence approaches. Many of these facilities, however, adopted a single harm reduction practice without adopting a comprehensive harm reduction philosophy. This study’s findings support the need for providers and treatment leaders to work through the barriers to adopting harm reduction strategies and philosophy.