Harm Reduction vs. Abstinence Based Treatment for Alcohol Use Disorders

Harm Reduction vs. Abstinence Based Treatment for Alcohol Use Disorders

By: Sara Y. Arce, LMHC, CAP

Alcohol Use Disorders (AUD) affect 17 million american’s; 11.2 million men, 5.7 million women and 855,000 adolescents ages 12–17. (National Institute on Alcohol Abuse and Alcoholism, 2012) Some of the characteristics of an AUD include drinking more than one intended to, difficulty stopping or reducing the use, continued drinking despite negative consequences and symptoms of withdrawal or cravings when you stop consuming alcohol. Some treatment approaches to AUDs include Medication Management, Complete Abstinence and The Harm Reduction Model. Treatment and support can be obtained through outpatient counseling, residential treatment or community groups.

Historically, abstinence was the most widely accepted modality for assisting people with AUDs achieve recovery. 12 step models such as Alcoholics Anonymous (AA), founded in 1935 by Dr. Bill Wilson and Bob Smith, believe in an anonymous fellowship that focuses on spiritual and character development. AA has helped to popularized the widely accepted belief that Alcoholism is a disease and member must first accept that they are powerless over the substance. Through sponsorship, regular meeting attendance and abstinence, members work the 12-steps to recovery.

The Harm Reduction Model as an approach to AUDs has become increasingly accepted over the past decade. In this type of approach a person is not required to maintain perfect abstinence as part of treatment. Instead, each person sets personal goals for how they will reduce their alcohol use, with the objective of reducing risky and harmful behaviors associated with maladaptive alcohol use. The Harm Reduction Alcohol Abstinence and Moderation Support (HAMS) was founded by Kenneth Anderson as a support community for people with AUDs. Anderson believes that for some people, complete abstinence may not be a realistic expectation or an achievable goal. In his book titled “How to Change Your Drinking: A Harm Reduction Guide to Alcohol”, he discusses individual choice and empowerment in deciding how much is too much alcohol. Anderson explains his belief that “There is nothing evil, sinful or diseased about drinking alcohol moderately…” (Anderson, 2010).

Regardless of which approach seems best for you, the important thing is that you get help now. Untreated AUDs can lead to life changing consequences like divorce, DUI’s, job loss, health problems and many more. If you or a loved one may be struggling with an AUD this Alcohol Use Self Assessment may be helpful in deciding if it is time to see a professional.

Additional Resources: 

Alcoholics Anonymous 

Find a Treatment Center

Harm Reduction Alcohol Abstinence and Moderation Support

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