I love my alcohol. Some days, too much. Since I believe in self-empowerment and balanced living, the abstinence goal of groups like AA did not feel right to me. That’s why I’m happy to present today’s guest blogger, Laura Givens, with her article on the latest FDA guidelines for alcohol consumption.
One of the hottest news items in the world of alcohol rehabilitation is the recent proclamation by the FDA that abstinence (refraining from drinking altogether) is not always attainable in clinical settings, and that there can be significant benefits when drinking is reduced. What isn’t new, is the thought that ‘no heavy drinking days’ (in which people consume no more than four or less standard drinks a day) can confer significant benefits.
The new FDA guidelines are not so much the product of a new way of thinking, if not a written indication of the FDA’s current view on the topic. Studies have shown that lowering heavy drinking to ‘low-risk’ daily limits, is sufficient to avoid many of the physical and psychosocial consequences of alcoholism.
The debate on harm reduction
The issue of harm reduction has always attracted heated debate. Those who are opposed to the concept have stated that the FDA is giving in to big pharma lobbying, promoting prolonged use of medication so that people get ‘hooked’ on other substances. They have also noted that it isn’t possible to turn alcoholics into social drinkers, and that another country which used harm reduction for many years, is reintroducing abstinence into its legal system because it is the only road to recovery.
The role of medication in recovery
Currently, there are only three FDA-approved medications for alcohol use disorders. Brown University Professor of Medicine, Dr. Peter D. Friedmann, notes that effective remittive therapies for alcohol dependence such as naltrexone should not be viewed any differently from any other disease-modifying therapies. While abstinence is certainly ideal , it is not always attainable. By changing harmful use to less harmful use, individuals can become motivated to attempt abstinence. Drinking less can be particularly useful for those whose problem is not so severe.
A change of focus
In harm reduction, the focus is removed from the use of alcohol itself, and placed on the consequences of addictive behavior. Thus, it attempts to lower the incidence of risky behavior, such as getting in fights, engaging in unsafe sex and sharing needles. The hope is that as clients begin to feel better, they may decide to make long-lasting changes.
Changing points of view
Views about harm reduction may be changing in conventional clinical addiction circles, as can be gleaned from a 2012 survey of over 900 National Association of Alcoholism and Drug Addiction Counselors from across the United States. Approximately 50 per cent of respondents said that it would be acceptable for some of their clients to reduce their alcohol intake without completely giving up. This is about twice the number of counselors who said the same thing 12 years ago.
The fact is that while many rehabilitation centers in the US offer abstinence-only programs ‘on paper’, in reality, they do take a harm reduction approach when counselors feel it may work with particular clients. To a certain degree, it makes sense to embrace whatever works for a client, and frees them from the clutches of addiction.
About the Author
Laura Givens is now a writer. She’d spent a large part of her career prior to this working in the health care sector, and also worked in voluntary capacity for a few charities that specialize in mental health and addiction issues. Laura is herself a recovering alcoholic and she now feels best placed to write on the topics closest to her heart. She keeps herself well now, and is mom to two small girls who make everything worthwhile again.
Complementing this article is Overcoming Addiction: Why a Non-12 Step Program May Work for You. What do you think of the FDA’s new alcohol consumption guidelines?