Harm Reduction and Alcohol

Yonks ago those of us working in the field of alcohol problems used, if asked, to try to decide if someone was ‘alcoholic’ or not. Nowadays we are a little bit more sophisticated and instead try to use the categorisations; Low-risk, Hazardous, Harmful and Dependent in relation to alcohol. We have various skills, questionnaires, and clinical experience at our disposal to help decide which category a patient may be in at this current time but it is not easy to fully decide, even for the trained eye, except in the extremes.  As implied risk status vis-a-vis alcohol can also change at any time or over time so it is not a static once for all time assessment. Labelling is not the most important issue in my view. Far more important is the harm a person’s drinking is having on his/her own health and well-being. Often, sadly, people are blisfully or miserably unaware that their drinking is badly affecting themselves and/or their loved ones, often with eventual disastrous consequences. Denial is strong in all forms of addiction due to perceived opinions, fear, anxiety, shame and guilt. The impact on children and spouses/partners is particularly severe when someone is dependent on alcohol but harmful and hazardous drinkers can unwittingly make the lives of those around them unbearable too. Assessment of risk status is also difficult because factors such as age, gender, occupation, mental and physical health, hereditary, previous traumatic events, and many others as well, can also adversely affect one’s relationship with alcohol. Following the asessment or assessments some patients are advised to abstain while others may be able to reduce their intake to avoid harm to themselves and others. Tips can be offered as well as insight into socail or personal triggers that set people off. However each person needs to take control of their own drinking behaviour. Of course all of us are vulnerable with blind spots and it can help greatly to talk with a trained addiction specialist who will engage appropriately in a collaborative manner to help alleviate problems and to find solutions. The main point is that reducing drinking occasions and amounts can make an enormous difference to all concerned. Specific tips to reduce or abstain from alcohol will be offered in my next blog.

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