HAMS: Harm Reduction for Alcohol

Controlled Drinking

Can you successfully control your drinking? Our experience at HAMS is that many people do successfully control their drinking. Many other people find that it is simpler, safer, and more effective to give up drinking entirely than to attempt to control their drinking. How can you know if your best option is controlled drinking or alcohol abstinence?

There are numerous tests out there intended to diagnose whether you are an "alcoholic" or have alcohol dependence or alcohol abuse ranging from the MAST test to the CAGE test to the DSM-IV criteria to the MMPI and numerous others. Unfortunately none of these tests is predictive of whether or not a person will do best with a goal of controlled drinking, or alcohol abstinence. Evidence shows that for people who have been given a diagnosis of Alcohol Dependence about one third will go on to successfully control their drinking, one third will quit drinking and about one third will drink themselves to death. When these people are given alcoholism treatment then about one sixth successfully control their drinking, one half abstain, and one third still drink themselves to death the same as in the untreated sample (from Vaillant, 1995)

HAMS recommends that you do the following to help you choose whether the best goal for you is controlled drinking or alcohol abstinence. First of all we recommend that you do a cost benefit analysis (CBA) comparing the goal of controlled drinking with the goal of alcohol abstinence. You can find sample sheets for doing a cost benefit analysis (CBA) here. We recommend that you do a CBA periodically every few months or so. The tools which you will find helpful for controlling your drinking are found in the HAMS cheat sheets for Moderate Drinking and Harm Reduction. Finally we recommend tracking your progress using both drink charts and by honestly reporting any alcohol related problems in your life to a HAMS support group.

Doing the CBA and tracking drinks and drink problems will help you to decide whether controlled drinking is right for you or whether it just isn't worth the accompanying problems and that alcohol abstinence will be your best shot.

There is one strong caveat that we would like to make here--be very careful about drinking again if you have ever had much participation in AA or 12 step programs. AA sets people up to self-destruct and kill themselves if they ever attempt to drink again. Most people who have been through AA require thorough cult deprogramming in order to successfully drink again. Without it they tend to drink and die.


Vaillant, G E. (1995).The natural history of alcoholism revisited Cambridge, Mass. Harvard University Press.

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