Abstinence, Moderation, and Harm Reduction
After last week’s Newsletter came out a couple of writers asked whether or not we support moderation and harm reduction as alternatives to abstinence when we are working with clients.
The answer is yes.
The reason is that neither we, nor anyone else, can tell you what you can or can’t do when it comes to your alcohol abuse problems. Therefore we don’t attempt to tell people what they have to do.
We do ask you to tell us your preferred outcome based on what you know about yourself, and we will give you our opinion on whether or not it’s likely but, regardless, we will work with you to give you the best chance of successfully reaching your desired goal.
And that includes changing your mind along the way.
It’s important to remember that the “abstinence only” injunction is another AA invention that has no basis in people’s actual lives and experience. All the research shows the same thing, as I’m sure your personal experience does, that people modify their alcohol use all the time.
Simple examples: Many young adults abuse alcohol throughout their college years but with graduation, career building, marriage, or a dozen other “life events,” the excessive drinking disappears. The same can be said for becoming a parent, discharge from the military, and so on.
Moderation is, in fact, the norm, when it comes to alcohol usage and Harm Reduction is simply one way of achieving that end for people who are unwilling to discontinue drinking altogether or even for a period of time.
Some definition will help. Different parts of the world define alcohol abuse differently but we tend to define it as more than two drinks a day for women or four for men. No, you can’t save them up and have 14 every Friday if you are a women, or 28 for a man. Yes, you can juggle some and your liver won’t rebel, but staying within these guidelines is reasonably safe for most people strictly as a health issue.
Start ramping up your consumption and abuse sets in and eventually a few people may become alcohol dependent. The operative word here is “may.” Again, AA misleads everyone with their definition of alcoholism as a “progressive disease,” when it’s rarely progressive and almost never a “disease.”
That’s right – it’s a choice and a coping mechanism gone awry.
So now that we have a definition, and you find yourself on the wrong side of the equation, what do you want to do about it?
For the answer to that, let’s look at the options in the next article.
Abstain, Moderate, and How to Use Harm Reduction.
Frankly, for most, it’s easier to abstain for a while and see how that goes and then make an informed decision, revocable of course, about reintroducing alcohol into your life.
It’s easier, usually, because it involves addressing whatever conditions you’re medicating and, as you have less need to medicate, becomes easier not to, and also easier to return to modest social drinking when it’s just that and not a defense or a weapon.
But some of you are unwilling to go that route, and a few don’t need to if the over indulgence is modest and recent.
Regardless, Harm Reduction is a method of managing, or learning to manage, your alcohol consumption in a less damaging manner. It’s comparable to wearing a seat belt instead of not driving, or using a condom to mitigate unsafe sex practices instead of giving up sex.
The “Harm Reduction” motto is “Better Is Better” and that means that any change that lessens your abuse is applauded and understood as progress. The hope is that, over time, the changes will accumulate and eventually lead to successfully moderating your drinking back to healthy levels.
There are a couple of problems that have to be overcome in following this route. The big one is the time it takes. One of our early clients, a research psychologist, chose this option, and it worked for her, but it took two and a half years. A lot of you don’t have that much time, or family patience.
Another problem is that it’s easy to decide that enough is enough while still drinking at dangerously high levels. That may satisfy you but isn’t apt to placate a spouse, employer, or judge.
Again, we’re happy to work with you in achieving any outcome you decide on – it’s pointless to try anything else – and we’ll help you design the most effective and efficient program to achieve your goals.
Once again – it’s another of the reasons why we only work with individuals. We work with you on your personal outcomes, using your strengths, interests, and abilities to create a better life based on your own definition of a “better life” – not some cult’s mindless myths.
So what does your better life look like? We’re always available to talk about it.