Alcohol Abuse and Harm Reduction

Outside of the U.S. the concept of "Harm Reduction" isOverall, the results are clear - almost 58% of those
frequently the first step in addressing problems relatedclassified as alcoholics managed to moderate their
to alcohol abuse, dependence or addiction. Thedrinking!
concept is easy to understand: any reduction in aHow does this fit with the "progressive disease"
problem behavior is progress. Put together enoughmodel? Obviously, it doesn't. But again, what we have
reductions and the problem will be eliminated or at leastall observed time after time doesn't fit with that model
moderated.either.
While the concept is easy to understand, and theAfter all, we all know people who have simply quit
results frequently positive, the Harm Reduction model isdrinking or moderated their use for any number of
opposed by most of the alcoholism treatment industryreasons. Many others maintain the same level of
in the U.S. because it doesn't support their discrediteddrinking for decades, whether that level is healthy,
"disease" model. Most of the so-called alcohol rehababusive, or dependent. And, yes, we all know individuals
providers are wedded to a single 12-Step Minnesotawhose use has progressed to addiction and who
Model that holds that alcohol problems are the result ofappear to suffer from something akin to a disease. But
an ill-defined disease whose only alternative isgeneralizing from this last group to the other 95% of
abstinence and a process of life-long recovery.the alcohol consuming population doesn't make any
Research and most people's personal experience, ofsense - nor does it make for services that are either
course, supports the Harm Reduction model.desirable or effective for most people.
According to the 2001/02 U.S. National EpidemiologicIt's no wonder that most people are unwilling to look for
Survey on Alcohol and Related Conditions, forhelp until their alcohol related problems are far
example, more than one-third (36 percent) of U.S.advanced. Who wants to be diagnosed with an
adults with alcohol dependence (alcoholism) that beganincurable, progressive, and demeaning "disease" whose
more than one year ago were in full recovery a yearonly antidote is said to be life-long "recovering?"
later (according to the National Institute on AlcoholFrankly, the biggest current alcohol problem in the U.S.
Abuse and Alcoholism).is belief in a model that discourages people from
The fully recovered individuals show symptoms ofgetting help at the onset of their alcohol abuse. That's
neither alcohol dependence nor alcohol abuse. Theywhen it's still a symptom rather than a cause, and
either abstain or drink at levels below those known tousually amenable to correction and a return to healthful
increase relapse risk. They include abstainers (18moderate levels of consumption.
percent) and low-risk, moderate drinkers (18 percent)The best time to address alcohol problems is sooner,
and medium risk, but not dependent, moderate drinkersnot later, and when moderation is still, by far, the likeliest
(12 percent).outcome. Look for help from those providers who
One-quarter (25 percent) of the individuals with alcoholtreat you and your situation, not some created
dependence are still dependent and 28 percent are in"disease," and who will help you discover the best
partial remission (that is, their use has moderated but isoutcome for you, not sentence you to punishing,
still above health enhancing levels).pre-ordained, and counter-productive rituals.