HAMS: Harm Reduction for Alcohol

Responsible Drinking and Responsible Alcohol Policy

What does responsible drinking or responsible drug use really mean? Responsible drinking does not preclude recreational intoxication. It does not necessarily mean "moderation in all things".

Responsible drinking and drug use means that you take precautions with your drinking or drug use so that it does not harm yourself, your family, or society at large. For some people, responsible drinking means taking safety precautions. For others it may mean cutting back on amounts consumed. For still others it may mean quitting. Self harm can also entail trade-offs--we generally espouse the right of the individual to eat meat even if vegetarianism may lead to a longer life-span--the same right of choice ought to extend to drug and alcohol use.

AA is fine for the people that it works for and we applaud anyone who successfully stops drinking via AA. However, the research of the past couple of decades clearly demonstrates that the AA program fails the vast majority of people with alcohol problems and can even make some people's alcohol problems worse. An alcohol policy which attempts to force everyone into a program which is a poor fit for most people with alcohol problems is clearly an irresponsible policy. Many people are unwilling or unable to abstain and are better served by a program which encourages harm reduction rather than one which shames and degrades people who are unwilling to embrace total abstinence from alcohol as the only acceptable goal. Many people also find AA's theological constructs repugnant to their own religious beliefs or sense of logic. It is unfortunate that AA tells anyone who dares to question AA's program of spirituality and abstinence that those persons need to go out and drink more until they hit bottom or die in the process.

A responsible alcohol policy and program offers a secular alternative for those who do not believe in God or who find AA's conception of God to be repugnant. A responsible alcohol policy and program offers support, information and strategies to aid those who are either unwilling or unable to abstain totally from alcohol.

We also disagree with Audrey Kishline's approach to alcohol problems which insisted that those who were unable to stay within moderate drinking limits or to do a 30 day abstinence period needed to go to AA. This was essentially using AA as a threat of punishment for those who drank beyond moderate limits. However this "stick" did not prove to be a good motivator. Asking people to punish themselves for failing to achieve a perfectionistic goal likely never works well in a behavioral change program. Kishline herself failed to maintain moderate drinking limits and while she was punishing herself by forcing herself to attend AA, she managed to kill two people while driving drunk.

A responsible alcohol program and policy respects people as adults who have their own value systems and their own issues and the ability to make choices for themselves.

If you are ready to take responsibility and to take action to minimize the harms your alcohol use may cause to yourself or others then please visit the HAMS homepage. There you will find practical and hands-on strategies to help you develop more responsible drinking habits. Whether you choose a goal of safer drinking, reduced drinking, or quitting, HAMS offers support, information, and practical strategies to help you to succeed.

HAMS does not accept the disease theory--we believe that anyone over the age of 3 is responsible for what they put into their own mouths. Statements like "Harm reduction does not work for the 'true alcoholic' who must abstain" are both bogus and irresponsible. Perfect abstinence can be attained by a few but harm reduction strategies are available to anyone. The people who need harm reduction strategies the most are precisely those people who are failed by AA. Research shows that AA works well for people who need to be told what to do (Poldrugo and Forti, 1988), regardless of how much or how little these people drink. Research shows that AA works poorly for people of independent spirit, also regardless of how much or how little these people drink.

A truly responsible approach to alcohol problems emphasizes the need to reduce harm at all levels for all persons including AA dropouts and others who are unwilling or unable to abstain. AA is fine for the small minority for whom it works, but the majority of people need a different approach.

We agree with J S Mill who said, "The only freedom which deserves the name is that of pursuing our own good in our own way, so long as we do not attempt to deprive others of theirs, or impede their efforts to obtain it. Each is the proper guardian of his own health, whether bodily, or mental or spiritual. Mankind are greater gainers by suffering each other to live as seems good to themselves, than by compelling each to live as seems good to the rest."


Dateline MSNBC Road to Recovery

Kishline, A. (1994). Moderate Drinking. See Sharp Press. Tucson, AZ.

NIAAA Five Year Strategic Plan FY07-11

Peele, S. (1989). Diseasing of America: addiction treatment out of control. Lexington Books. Lexington, Mass.

Poldrugo F, Forti B. (1988). Personality disorders and alcoholism treatment outcome. Drug Alcohol Depend. 21(3), 171-6.
PubMed Info

Rudy, D. R. (1986). Becoming alcoholic. Southern Illinois University Press. Carbondale.

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

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