10 Harm Reduction Strategies for Alcoholics

Harm reduction strategies are a set of programs and practices that focus on reducing harmful consequences associated with substance use.1

Harm reduction could be an option for you if you are addicted to alcohol and have already tried other treatments and therapies. Here are ten harm reduction strategies if you struggle with alcohol misuse.

In this article: 

1. Participating in Brief Interventions

Brief interventions may be used to reduce your drinking if you have less severe alcohol misuse behaviors and cannot receive specialty treatment at an alcohol rehab center.2 These interventions are usually conducted by trained interventionists over one to four brief counseling sessions that last between 5 and 30 minutes.3

The goal of brief intervention is to help you identify and change your behaviors and thought patterns that lead to alcohol misuse. These adjustments can help you either reduce alcohol use to a safe level or achieve abstinence.3

During a brief intervention, the interventionist may suggest that you try abstaining from alcohol to see if you can successfully quit on your own or encourage that you participate in a peer support group such as Alcoholics Anonymous.2 Brief interventions may involve several different approaches. Some of these are unstructured and casual, while others are formally structured. This harm-reduction model may also involve educating you about the dangers and risks of alcohol misuse and the warning signs of physical dependency.2

A brief intervention typically consists of five steps:2

  1. Introducing the issue, which is alcohol misuse and related harms.
  2. Screening, evaluating, and assessing your alcohol misuse.
  3. Providing feedback in which the interventionist highlights certain aspects of your alcohol-using behavior.
  4. Talking about the possibility of changing your behavior, recognizing potential consequences, and setting realistic, attainable goals.
  5. Summarizing your discussion with the interventionist and reviewing the agreed-upon changes.

Brief interventions can occur in person, online, or over the phone with a physician, psychiatrist, psychologist, nurse, or social worker.3

2. Educating Yourself on Alcohol Use

Education about alcohol, its effects, and the consequences of alcohol addiction can be used as a harm reduction method to motivate you to make different choices related to your alcohol use. You may not currently understand how alcohol interacts with the brain and body, or how alcohol addiction affects your relationships, career, family, and overall well-being.

Alcohol and substance use education programs may be offered at local community centers, alcohol rehab centers, and middle schools and high schools.4

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3. Drinking in Moderation

Some harm reduction strategies focus on drinking in moderation as opposed to strictly abstaining from alcohol. Drinking in moderation means drinking occasionally or having no more than one drink a day if you’re a woman and no more than two drinks a day if you’re a man.5 One drink is equal to 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of spirits such as vodka, whiskey, or rum.5

Moderate drinking can be challenging as it may mean greatly reducing the amount of alcohol you use. It may be possible for you to eventually reach a moderate drinking level after gradually reducing the amount you drink, which may take several weeks or months.

4. Tapering Your Alcohol Use

Tapering involves gradually reducing the amount of alcohol you consume over a period of time until you have reached a moderate drinking level or have stopped drinking. Tapering may be a herm reduction strategy if you cannot immediately start drinking in moderation or become abstinent. Tapering may help reduce the severity of your alcohol withdrawal symptoms, including alcohol cravings and seizures. Alcohol withdrawal symptoms can occur when you suddenly stop drinking if you have been engaged in regular heavy drinking.6

Doctors, alcohol rehab centers, and harm reduction organizations may work with you to set up an alcohol tapering schedule based on the severity of your addiction. For example, tapering could involve consuming one less beer a week until you are no longer consuming alcohol at all.

5. Practicing Mindfulness

Mindfulness meditation is a common relapse prevention strategy that involves living in the moment and limiting your attention to current surroundings.7 In addition to helping you stay sober in recovery, mindfulness can also be used as a harm reduction method to help you consume less alcohol during a single occasion.7

Mindful drinking is the practice of tuning out distractions and being aware of what you’re drinking, the amount you’re drinking, and how it makes you feel. Mindful drinking involves taking a drink of alcohol, experiencing the taste, and evaluating your current emotions, including whether drinking offers any benefit. If you find that you do not enjoy the taste of your drink and it is not improving your mood and well-being, it might be easier for you to stop drinking.

6. Considering Medication Therapy

Certain prescription medications can help people limit or stop drinking. These medications include naltrexone, acamprosate, disulfiram, and topiramate.8

Naltrexone is shown to reduce alcohol cravings and alcohol misuse. Acamprosate may help reduce alcohol withdrawal symptoms and help you stay abstinent for several weeks or months at a time, topiramate similarly reduces alcohol cravings to help you stay abstinent. Disulfiram produces unpleasant physical reactions such as nausea and vomiting when you drink any alcohol.8

These medications can be prescribed by some doctors and are available through alcohol rehab centers.

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7. Implementing Safer Drinking Practices

This harm reduction model involves implementing a series of drinking behaviors that reduces the risks associated with your alcohol use. This may involve drinking a glass of water after each alcoholic beverage or eating before and during drinking to avoid becoming intoxicated as quickly.

Other harm reduction examples of safe drinking methods include:9,10

  • Designating a specific length of time between drinks, such as one hour
  • Limiting yourself to a specific number of drinks during any single occasion
  • Adding juices and non-alcoholic mixers to drinks containing spirits
  • Drinking with friends and relatives who hold you accountable for negative behaviors or who can cut you off after a certain amount
  • Giving your keys and phone to someone you trust so you can avoid driving while intoxicated or hurting your interpersonal relationships
  • Avoiding drinking games like beer pong that encourage binge drinking and drinking in increasingly higher amounts
  • Avoiding alcohol use when you feel angry or depressed or when you are using medications that can amplify your mood or the effects of alcohol
  • Only accepting drinks poured in front of you by yourself or a bartender so you can monitor the amount of alcohol in each drink and protect yourself from unknowingly consuming other substances
  • Drinking beverages with lower alcohol percentages to avoid or delay intoxication

8. Changing Your Drinking Habits

Certain drinking habits can be changed to reduce the negative impact of alcohol on your life and well-being. For example, if using alcohol late at night contributes to poor sleep and hangovers, consider limiting your drinking to earlier in the day to allow the effects of alcohol to wear off before bedtime. Your sleep quality may improve, as well as your productivity at work or school.

Evaluate your current drinking habits and determine whether you can make any changes to decrease the harmful impact of alcohol use.4 A therapist or counselor may also be able to help you identify harmful alcohol use patterns that can be changed as a harm reduction strategy.

9. Choosing Where You Use Alcohol

Staying at home to drink may be a harm reduction method if when you go to bars or parties, you use more alcohol and experience more severe consequences, such as engaging in drunk driving or having encounters with law enforcement. Drinking at home eliminates these risks even though it may still result in the same level of alcohol use. Drinking at home can also keep others safe from your alcohol addiction, especially if you have difficulty interacting normally with others when intoxicated, such as experiencing a shorter temper.10

However, you should also pay attention to whether drinking at home encourages you to drink alone or to hide your alcohol use from others. Many people find accountability to another person to be an important part of harm reduction as secrecy can allow for alcohol misuse to feel like it is going unnoticed and not harming anyone but yourself. If you find yourself in this position, consider inviting a friend over for drinks and an activity or joining a support group like Alcoholics Anonymous (AA) where you can discuss your alcohol use frankly without judgement.

10. Seeking Treatment When You Need It

Though harm reduction can be beneficial, not everyone can improve their drinking behaviors sustainably with these methods. You may not be able to control or reduce your alcohol use using only harm reduction strategies.

Get help if you continue to use more alcohol than you intend to in a single sitting, to spend significant time getting and using alcohol, or to feel strong physiological urges to use alcohol as these are symptoms of an alcohol use disorder (AUD). An alcohol rehab center can help you safely detox from alcohol, developing a treatment program for you that addresses the root causes of your alcohol misuse.11

Call 800-839-1686Who Answers? to speak to a treatment specialist about nearby alcohol rehab centers and get help choosing the best facility for yourself or a loved one.

Resources

  1. Harm Reduction International. What is harm reduction?
  2. Substance Abuse and Mental Health Services Administration. (1999). Chapter 2—Brief Interventions in Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 34.
  3. Mattoo, S.K., Prasad, S., & Ghosh, A. (2018, February). Brief intervention in substance use disorders. Indian Journal of Psychiatry, 60(4), S466-S472.
  4. Kelly-Weeder, S., Phillips, K., Rounseville, S. (2011). Effectiveness of public health programs for decreasing alcohol consumption. Patient Intelligence, (3), 29-38.
  5. Department of Health and Human Services. (2020). Drink Alcohol Only in Moderation.
  6. National Library of Medicine. (2019). Alcohol withdrawal.
  7. Zgierska, A., Rabago, D., Zuelsdorff, M., Coe, C., Miller, M., & Fleming, M. (2008, September). Mindfulness meditation for alcohol relapse prevention: a feasibility pilot study. Journal of Addiction Medicine, 2(3), 165-173.
  8. National Institute on Drug Abuse. (2018). Alcohol addiction.
  9. Rethinking Drinking: Alcohol and Your Health. Tips to try.
  10. University of Puget Sound. Harm Reduction for Alcohol.
  11. Van der Stel, J. (2015). Precision in Addiction Care: Does It Make a Difference? Yale Journal of Biology and Medicine, 88(4), 415–422.

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