Addiction treatment in America has long been shaped by a narrow focus that stigmatizes drug users. On the Overton Window podcast, Layal Bou Harfouch, drug policy analyst at the Reason Foundation, seeks to challenge this perspective.

Historically, addiction treatment authorities in the U.S. have measured progress only by the person’s completely abstaining from controlled substances. Bou Harfouch points out that this “all-or-nothing” mentality overlooks the significance of incremental changes in recovery.

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Through her work, Bou Harfouch has come to understand that addiction is a multifaceted issue. 

“It’s not just a social issue,” Bou Harfouch says. “It’s not just a healthcare issue. It spans so many different aspects of life.”

With a clinical background at Johns Hopkins Division of Addiction Medicine, Bou Harfouch has witnessed the harms of abstinence- based treatment firsthand. Through her research, she aims to increase recognition of harm reduction as a more effective and compassionate alternative to traditional treatment models.

Harm reduction prioritizes “saving lives and preventing disease rather than making abstinence the goal,” Bou Harfouch says. She recommends meeting people where they are in their journey and encouraging conversation. Treatment should not be about judging individuals, but rather about reducing the risks associated with substance use.

Despite the growing support for harm reduction methods, Bou Harfouch observes ongoing hesitancy from some individuals. “There’s still a lot of resistance from folks who are stuck in that old way of thinking—who see substance use as something to punish rather than address with compassion,” she says.

For these individuals, addiction is primarily seen as a moral failing, something to be punished, rather than a health issue requiring care and empathy. Bou Harfouch strives to be an advocate for change, saying, “My role is to bring empathy and human nature back into the conversation.”

Drawing on her clinical experience, Bou Harfouch shares the story of a woman who was first injected with heroin as an infant. "Some may not have had a choice in the matter, to end up in a place where they were addicted to this substance," she says. The story serves as a poignant reminder that many individuals are struggling with addiction through no fault of their own.

Bou Harfouch’s experiences in the field have fueled her desire for systemic change. She is committed to expanding access to medication-assisted treatments, which she describes as “life-changing for people.” Through her advocacy for more compassionate treatment, Bou Harfouch envisions a system that supports transitionary recoveries and confronts the underlying causes of addiction.

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