Comparing Recovery-Related Outcomes as a Function of Harm Reduction Pathways to Recovery in Collegiate Recovery Participants

We explored the use of self-identified harm reduction (HR) strategies as a primary recovery pathway among collegiate recovery program (CRP) participants in substance use disorder recovery and investigated whether recovery capital, quality of life, grade point average (GPA), and family and other social support for recovery varied as a function of HR use. We used longitudinal data from the National Longitudinal Collegiate Recovery Study (CoRe Study; N = 780 from 90 CRPs). Participants indicated their primary pathways to recovery, categorized into any HR and no HR. The use of HR strategies increased over time and being non-binary (vs. men), and continued use of one’s secondary substance of choice (vs. abstinent) was associated with a higher likelihood of using HR strategies. The use of HR strategies did not differ as a function of other demographics, time in recovery, substance use history, or substance of choice. We found that CRP students who used HR as a recovery pathway had lower recovery capital, quality of life, and family support for recovery over time than those who did not use HR. GPAs and levels of other social support were comparable between the two groups. Abstinence from one’s primary and secondary substance of choice was generally associated with higher scores on outcomes. Findings contribute to our understanding of the role of HR strategies on recovery outcomes and highlight implications for practice and research in this rapidly growing area, particularly for college students in recovery. Findings also raise important questions about operationalizing HR, which may include abstinent-based approaches.