Alcohol harm reduction strategies and techniques
Current alcohol harm reduction strategies and techniques focus on five (5) main approaches. A complementary approach to harm reduction therapy, these strategies are being used in medical settings, university campuses, and in the workplace. Alcohol harm reduction is an important alternative to abstinence only programs and although some people are ready totry to stop drinking for 30 days or want to learn how to abstain from alcohol, others are not even interested. The top current techniques for alcohol harm reduction are:
1. Brief interventions
2. Contingency management
3. Cognitive behavioral skills training
4. Mindfulness meditation
Here, we review what each of these alcohol harm reduction techniques aims to do, and where they may be applied. We invite your questions or comments about alcohol harm reduction strategies at the end.
Recommended alcohol harm reduction reading
Plus, if you are interested in learning more about any of these strategies for alcohol harm reduction, check out the book Harm Reduction: Pragmatic Strategies for Managing High Risk Behaviors. We highly recommend this book for anyone interested in science-based alternatives to abstinence only drinking programs, especially LCSWs, psychologists and addiction professionals working with people who have a “drinking problem”. The book not only addresses alcohol harm reduction, but explores best practices in harm reduction and clinical experiences with drug use, tobacco use, and sexual behaviors. Plus, an entire section devoted to helping special populations. All in all, a thorough review of today’s best practices in harm reduction strategies that should be on the shelf of anyone working to help addicted men and women today.
Alcohol harm reduction technique #1. Brief interventions
Included in this approach is the practice of Motivational Interviewing (MI), Motivational Enhancement Therapy (MET), skills based interventions, personalized feedback, and/or physician advice. Brief interventions based on Motivational Interviewing have received a lot of support on recent years and are helping advance harm redictopn for alcohol problems. But what happens during such interventions? And where can brief interventions be applied?
During intervention talk sessions (either individual or groups), psychologists explore changing drinking patterns or behaviors with clients. Instead of supporting abstinence only, the brief motivational interventions support autonomous decision making about creating a goal related to drinking. Sessions last from 5 to 10 minutes up to four hourly meetings. In addition to counseling based interventions, web based software can also help people make decisions that help reduce harm. Brief interventions can be applied to may different settings, and have been found useful in:
- College or university settings
- Medical settings
- Work settings
Alcohol harm reduction technique #2 Contingency management
Contingency management for alcohol harm reduction is based on the psychological model of operant conditioning. In other words, we repeat behaviors that are reinforced by biological and environment factors. To help encourage desired treatment outcomes, contingency management provides positive reinforcement for positive actions. Although this model has not been widely used in alcohol-only populations, contingency management can be used in almost any treatment setting as long as program cost, alcohol use monitoring, and staffing issues can be resolved.
Alcohol harm reduction technique #3 Cognitive behavioral skills training
This technique aims to help problem drinkers change unhelpful thoughts and behaviors. As training, the goal is to transfer coping and social skills to alcohol drinkers so that they can know how to handle daily life stresses. Particular skills include direct relapse prevention skills as well as more general communication, listening and conversation skills. Drink refusal is also an important skill to learn.
However, in addition to these interpersonal skills, cognitive behavioral skills training also includes intrapersonal skills that are useful for all problem drinkers. Learning to manage urges and cravings, restructuring negative thinking, and anger management are all practical skills that drinkers can apply to their lives. Although effective in reducing alcohol use and problems, it is not clear exactly which cognitive behavioral skills training are best used in which setting now.
Alcohol harm reduction technique #4 Mindfulness meditation
This technique focuses on developing awareness and acceptance of thought, emotions, and sensations without judgment. Mindfulness can help problem drinkers identify cravings and triggers of problem drinking such as emotional states or physical arousal. Clinical trials and research are relatively new for this technique, although indications are that mindfulness can help treat alcohol abuse.
Alcohol harm reduction technique #5 Pharmacotherapy
Medications can both reduce heavy drinking episodes and promote abstinence from alcohol. The three current medicines used to help reduce alcohol harm include:
1. Acamprosate – Helps east symptoms of alcohol withdrawal.
2. Disulfiram – An aversion therapy that induces unpleasant symtpoms when you drink alcohol.
3. Naltrexone – Reduces alcohol’s ability to stimulate dopamine release, making the effects of alcohol less pleasurable.
Alcohol harm reduction strategy questions
Do you still have questions about alcohol harm reduction? Please leave your questions or comments below. We will be happy to respond to you with a personal and prompt reply ASAP.
Reference Sources: Harm Reduction: Pragmatic Strategies for Managing High Risk Behaviors (2012)
Photo credit: CDC