If You're Afraid That Alcohol Counseling Will Require You to Stop Drinking, Read This
Many people struggle with substance or alcohol abuse, and many are looking for help, but not all drinkers are the same. Not everyone who drinks has a problem.
So why do so many treatment programs and mental health professionals often only recommend abstinence as a solution?
Since not all drinkers are the same we need to have individualized solutions for everyone needing help.
The Spectrum of Alcohol Use—and the Lack of Options in Alcohol Counseling
To recap from a post I wrote a few months ago, alcohol use falls on a spectrum, with complete abstinence on one end of that spectrum, alcoholism on the other, and a wide range of use in between.
About 35% of the nearly 140 million drinkers in the U.S. drink only socially or on occasion.
About 28% drink regularly or too much, putting them at risk for alcohol dependence and alcohol-related problems.
Another 22% are alcohol abusers; their drinking is causing problems in their daily lives.
Only 6% of drinkers are truly addicted “alcoholics” and are physically dependent upon alcohol (Turner, 2017).
And yet about 80% of treatment programs offer only abstinence-only approaches to treatment. Moreover, many mental health professionals who don't specialize in substance use disorders—clinicians who are often on the front lines helping people with their relationships, anxiety, depression, or other problems that may be alcohol-related—often refer those who have problems with drinking but who aren’t alcoholics to abstinence-only programs like 12-step groups.
So why is this a problem?
Why Alcohol Counseling Needs to Change
Maybe you’ve thought about getting help for your alcohol use or alcohol-related problems but are afraid to be labeled as an addict or alcoholic. Maybe you want help with your drinking or some related problems in your life but don’t see abstinence as the only solution.
You’re not alone. Many problem drinkers who aren’t alcoholics don’t like being treated like one.
So maybe you’ve avoided getting alcohol counseling or seeing a therapist for alcohol-related problems, and even if you have, you may not have been fully honest about your alcohol use.
Abstinence Should Not Be the Only Goal for All Alcohol Counseling
Let me say this very clearly: Refraining form drinking entirely, that is, total abstinence, is a life-saving and necessary goal for some. Many drinkers, especially that 6% of drinkers that are alcoholic and physically dependent on alcohol, choose and indeed need this solution.
Others drinkers, no matter where they may fall on the spectrum of use, may opt for abstinence because their marriage is at a breaking point and can’t take any more drinking. Or they don’t want any more alcohol-related problems. Or they find that managing their drinking and consuming alcohol more moderately isn’t for them.
Whatever the case, recommending abstinence as the only solution to all problematic drinking is limiting and treats everyone like alcoholics. It’s like saying everyone who has a cough has pneumonia and should undergo a strong regimen of antibiotics.
Harm Reduction: Tailoring Alcohol Counseling to Each Person’s Goals
Harm reduction psychotherapy is a form of alcohol counseling and substance abuse treatment that seeks to reduce the harmful consequences of substance use and other risky behaviors without requiring abstinence.
It can be a great fit for those who are experiencing alcohol-related problems but who aren’t alcoholics and don’t need to go to an intensive treatment program for 30 days or more.
Harm reduction uses an individualized approach tailored to your specific needs. Harm reduction can help you to drink differently and has helped many people reduce their drinking while also reducing the negative effects of problematic drinking on their health and relationships.
If you’d like help with your alcohol use and the problems it’s causing in your life, it’s a good idea to see a therapist who can help you figure out what treatment is right for you. Please check out Moderation Management for more information. If you’re in the southern California area, feel free to contact me, I’d love to hear from you.