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Harm Reduction vs Abstinence

Posted By: Marc F. Kern Ph.D.

No one I have ever met really wants to stop drinking completely. Most people stop because they have to, not because they want to. If you want to experiment with moderation, there are "harm reduction" methodologies and resources that can help some people.

Q: I have a problem with alcohol, but I don't want to quit entirely. What should I do?

A: You are normal. No one I have ever met really wants to stop drinking completely. Most people stop because they have to, not because they want to. If you want to experiment with moderation, there are "harm reduction" methodologies and resources that can help some people.

Remember, though, it is really hard to "have your cake and eat it, too." Even in the best of circumstances, it is generally agreed that once you have had a problem with alcohol, it is easier to stop than to try to moderate. Successful, long-term moderation requires long-term vigilance.

Moderation of your behavior can also be a stepping stone to abstinence. If you are insistent on attempting moderate drinking, give me a call and let me help you determine if moderating your alcohol use is a viable goal for you. Further, let me be your coach because you will attain it faster and maintain it longer. Moderation is not a goal that you should try to attain alone. Read my book, Responsible Drinking, and join Moderation Management online. 

Q: I have a problem with drugs , but everyone is telling me I have to stop drinking alcohol as well. What should I do?

A: This is a tricky one. The truth is that if alcohol is a stepping stone for you to your drug of choice, then you should seriously consider giving up alcohol as well. If, on the other hand, you really believe that you can drink without returning to your drug of choice, you will probably give this approach a try. But learn from your experiences. In general, I recommend that we do a more thorough evaluation of your addictive behaviors, and talk more about how to successfully balance abstinence from drugs and moderate use of alcohol.

Q: My loved one thinks that the only way to overcome addiction is by total, lifelong abstinence. I want to learn how to drink in moderation. How can I convince them that abstinence isn't the only way?

A: To start with, the proof is in the pudding, so to speak. If you have had a problem with alcohol (or drugs ) in the past, it will be very hard for them to trust that your moderate drinking will stay moderate. If they had a parent or other relative or friend that had a problem with alcohol, it will be doubly difficult, because they are extremely sensitive to the problem.

While I would be happy to talk with them directly for you, ultimately, you will have to demonstrate your belief in moderation through your actions and long-term and stable moderate drinking. No amount of talking will convince them otherwise.

~ ~ ~

Psychologist Marc F. Kern, Ph.D. has over 30 years of clinical psychotherapy experience helping people overcome addiction and self-defeating habits, and acquire the insights and skills to live happier lives.

He is the founder and director of Addiction Alternatives, a division of Life Management Skills, Inc., wrote the practical self-help book "Take Control Now!" and has appeared on more than 80 television and radio shows including 20/20 and Larry King Live.

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