In working with alcoholism, opinion is divided as to which is the best approach: abstinence or harm reduction? If you are looking for relief from problem drinking, which route should you pursue?
What do abstinence and harm minimisation mean?
‘Abstinence’ refers to achieving a life that no longer involves consuming alcohol in any form. Alcoholics Anonymous is a proponent of this approach. ‘Harm minimisation’ takes a different view. It permits you to continue drinking alcohol, but teaches strategies for reducing alcohol consumption by learning new behaviours and ways of thinking.
In this blog post, I’m not going to explore the arguments for both. But I am going to offer my personal suggestion, based on my experience, as to what I believe works best and why.
It helps to understand alcoholism
First up, I want to emphasise that if you think you may be an alcoholic (and if you’re on my website that’s certainly possible), it’s essential to understand that the medical definition of alcoholism is – and I’m paraphrasing here – continuing to drink alcohol, regardless of the consequences.
So, what does that imply? In trying to deal with alcoholism, an alcoholic will naturally look for ways to continue drinking alcohol. The very nature of the condition means an alcoholic will want to solve the problem with the problem.
There is a second feature of alcoholism that may resonate with some readers: loud, obsessive thinking about alcohol, that is very difficult to turn off.
Does this type of negotiating with yourself sound familiar?
How many drinks should I have?
When should I have them?
Should I drink before the dinner party so I can look as if I’m only having one or two with my meal?
Should I have a bottle at home in case I need more afterwards?
Maybe I should alternate beer and vodka so I don’t get too drunk?
Or stick to wine because I don’t really like wine so I’ll drink less?
What if so-and-so sees me drinking?
What if they smell alcohol on my breath?
I promised I wouldn’t drink tonight, but maybe one will be ok?
And on and on…
It’s a painful, exhausting, circular battle that goes nowhere.
The harm minimisation approach suggests you can get on top of this by engaging with it.
The abstinence approach says you can’t and won’t, so don’t waste your time trying.
So what’s my view?
My view is that one drink starts you thinking about more, and sooner or later you’ll get drunk. And then you’re back rolling the dice with the consequences.
So, what have I learned in working with alcoholism? Even though a problem drinker often wishes they can keep on drinking and avoid the problems that follow, the reality is that abstinence is the best first step to significant relief and meaningful change. It’s simple: if you don’t drink, you can’t get drunk.
Importantly, abstinence can lead to recovery, and recovery is much more than just abstinence.
Why seek recovery?
Recovery means you’re no longer thinking about alcohol, let alone drinking it. The battle with alcohol has disappeared. This is the starting point for long-term stability, freedom, personal growth and fun. `
If you are looking for relief from alcoholism, it’s helpful to recognise that it is the alcoholism that tells you abstinence will be too hard, or you’ll lose friends if you can’t drink, or you won’t be able to enjoy watching sport, or go to a summer BBQ if you can’t have a beer in your hand.
Having helped many, many people recover from alcoholism, I have listened with joy as clients discover these worries are not truths. Instead, they are embarking on much more rewarding, satisfying lives, and never look back.
Start the change today
So, if you’re ready for change, and are even a tiny bit open to the idea of abstinence, please contact me for an appointment. Let’s talk and tailor-make your recovery journey together.