What does harm reduction actually mean—and why has it become one of the most misunderstood concepts in addiction care? In this episode, we sit down with Dr. Elizabeth Salisbury-Afshar, physician, addiction medicine specialist, and leader in harm reduction, to explore the philosophy that has transformed the way many professionals approach substance use treatment. Rather than viewing harm reduction as an alternative to recovery, Dr. Salisbury-Afshar explains why it exists along the same continuum as treatment, medication, and abstinence. She shares how her experiences in rural Illinois and volunteering with the Chicago Recovery Alliance shaped her commitment to meeting people where they are—with respect, dignity, and compassion. Together, we discuss: What harm reduction really meansWhy "any positive change" mattersThe role of syringe service programs, naloxone, and other harm reduction servicesWhy stigma continues to shape addiction treatment differently than other chronic illnessesThe importance of trust, patient-centered care, and welcoming people back after setbacks"Nothing About Us Without Us" and including people with lived experienceThe evolving political landscape surrounding harm reduction fundingHow clinicians can continue practicing compassionate care regardless of changing terminologyWhether you're a counselor, physician, peer specialist, social worker, policymaker, or someone personally impacted by addiction, this conversation offers practical insights into building systems that prioritize dignity first. About the Guest Elizabeth Salisbury-Afshar, MD, MPH, is a UW Health addiction medicine doctor and an associate professor in the Department of Family Medicine and Community Health at the University of Wisconsin School of Medicine and Public Health. Using a combination of medication, therapy and other resources, Dr. Salisbury-Afshar treats people with substance use disorders, including addictions to alcohol and other drugs. She has extensive experience working with people who have opioid use disorders. Dr. Salisbury-Afshar recognizes that every person has a unique set of circumstances that led to their addiction, as well as a unique road to recovery. Dr. Salisbury-Afshar works with patients to help them figure out what type of support they need and to develop an action plan that continually moves them closer to their goals. Dr. Salisbury-Afshar creates a safe, judgment-free space where her patients can share their feelings, experiences and goals. She admires their courage and treats them with dignity and respect. Dr. Salisbury-Afshar feels honored to sit with people in their challenging moments and to celebrate with them in their successful ones. Outside of work, Dr. Salisbury-Afshar enjoys spending time with her family and advocating for addiction recovery support and harm reduction services at the state and national levels. Links: https://www.uwhealth.org/providers/elizabeth-m-salisbury-afshar-mdSupport the show Thank you for listening to this episode of Talking Addiction & Recovery Podcast. To learn more about the podcast visit www.andrewjschreier.com To inquire being a guest on the podcast or sponsorship opportunities you can e-mail hello@andrewjschreier.com The podcast is also a platform for FREE continuing education. Licensed and certified professionals are able to listen to select episodes at no cost. Listen to an episode. Take a quiz. Complete an eval. Earn a certificate. Learn more at www.andrewjschreier.com/continuing-education Talking Addiction & Recovery Podcast is the follow-up to the book "Addiction & Recovery" by author and clinician Andrew J. Schreier. This podcast explores discussions regarding important issues related to addiction and recovery. Information you learn here is not typical of what you will find in academic textbooks and resources; and comes from the experiences of a clinical supervisor, clinical substance abuse counselor, and licensed professional counselor and the work with individuals and others involved in this field. Listen as guests join the show and cover a wide range of topics looking to educate individuals, families, communities, organizations, institutions, mental health professionals, educators, and anyone else impacted by addiction and recovery. Content is not intended to be treatment and is not affiliated with any specific group.
