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Harm Reduction for Alcohol Use

Whether you have a history of alcohol misuse or have recently tried to cut back on drinking, you might find that cutting alcohol out of your life entirely doesn’t work for you. Although abstinence is supported by organizations like Alcoholics Anonymous and many other alcohol treatment programs, these methods aren’t the best fit for everyone.

Harm reduction provides an alternative to abstinence-based treatments. Harm reduction can help you reduce some of the negative consequences associated with alcohol consumption without eliminating it from your life entirely.

At Ria Health, we support whichever approach will make the biggest difference in a person’s life. Get in touch with us to learn how we can help you make a meaningful change.

What Is Harm Reduction?

Harm reduction is a principle of substance use management that recognizes the simple fact that abstinence does not work for everyone. 

An abstinence-based approach proposes that recovery from something like alcohol use disorder (AUD) requires a person to refrain from consuming any alcohol. On the flip side, a harm reduction approach argues that any decrease in alcohol consumption can improve a person’s health and quality of life.

Harm reduction can encompass a wide range of social policies and programs. Some examples of harm reduction include: 

  • Social service programs that provide clean needles and syringes
  • Housing that doesn’t require residents to abstain from substances
  • Information about the safe consumption of drugs and alcohol
  • Harm reduction programs that support participants in reducing the need for substances rather than quitting cold turkey

Read more about Moderation-Based Treatment with Ria Health

Table of Contents

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Principles of Harm Reduction

The core principles of harm reduction include:

  • Respecting the rights and autonomy of people who use substances. Whether someone uses substances or not, they have the right to be respected and make decisions about their own lives, rather than having others make decisions for them.1
  • Following evidence-based best practices. Harm reduction strategies are backed by research and can have a positive impact on people and communities.
  • Practicing social justice in collaborating with people who use substances. Harm reduction acknowledges the different barriers to accessing services that people might encounter depending on their race, gender, gender identity, sexual orientation, economic status, and housing status.
  • Moving away from stigmatizing language and behavior. Harm reduction supports meeting people where they are and supporting them with compassion, rather than stigmatizing them.
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Goals of Harm Reduction

Some of the core goals of harm reduction include:

  • Preventing overdose and supporting positive change in people’s lives. Principles of harm reduction argue that keeping people alive is the most important aim to work towards. By moving away from stigmatizing language and behavior, supporting peoples’ autonomy, and approaching them with empathy and care, harm reduction helps prevent overdose and protect peoples’ health. Harm reduction programs can also support people in making positive changes in their life and reducing their dependence on substances.
  • Creating compassionate and supportive drug laws/policies. Many current substance use policies seek to punish people who use substances, rather than help and support them. Supporters of harm reduction advocate for things like decriminalizing substances, eliminating drug testing, and ending discrimination based on substance use. 
  • Evidence-based prevention and cessation of substance use. Harm reduction programs are rooted in research-based prevention and treatment strategies. Harm reduction programs provide an alternative to abstinence-based programs, prioritizing helping people who use substances over requiring them to abstain from them in order to receive assistance.

What Does Harm Reduction Mean in Practice?

In practice, harm reduction programs seek to improve the quality of a person’s life by reducing the negative consequences they experience from consuming substances. In practice, this might look like providing education on the risks and consequences of consuming substances. 

Harm reduction can also include practices that reduce peoples’ need to consume substances to cope. For example, helping them get access to stable housing and employment, supporting stress reduction techniques, or helping improve their lives in some other way.

Arguments For Harm Reduction 

There are many positive arguments in support of harm reduction. Supporters argue that harm reduction strategies are more compassionate and supportive of people who use substances. Instead of stigmatizing people or taking away their autonomy, harm reduction supports any improvement in a person’s life regardless of their substance use. 

Harm reduction is also backed by scientists and major government organizations, like SAMHSA.2 Researchers have repeatedly found evidence that harm reduction reduces the risk of death, injury, and overdose among people who use substances.3

Harm reduction can also be more realistic, much like approaches to sex education. Rather than teaching that abstinence is the only path, harm reduction strategies acknowledge that adults can make their own decisions and weigh the benefits and consequences of their choices. Harm reduction also acknowledges that if people choose to use substances, they still deserve to be treated with dignity and respect. It also acknowledges that an abstinence-only approach does not work for everyone.

Arguments Against Harm Reduction

Opponents of harm reduction feel that harm reduction strategies don’t focus enough on prevention. Rather than educating people before they begin to use substances, or restricting access to substances, harm reduction strategies focus on helping people after they’ve already developed a dependence on substances.

Opponents also argue that harm reduction doesn’t work for everyone. Some people may find that using substances to any degree leads to misuse and abuse. For some, taking an approach of “just one drink” can lead to periods of binge consumption and relapse.

Harm reduction also isn’t aligned with current US policies and general sentiment. Many state and federal policies criminalize substance use, putting harm reduction strategies in opposition to these policies.4

Read more: Harm Reduction vs. Abstinence

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What Harm Reduction Means When It Comes To Alcohol

When it comes to harm reduction for alcohol, proponents support harm reduction strategies that minimize some of the negative consequences of alcohol use and misuse. 

For example, one potential negative consequence of alcohol consumption is intoxicated driving. Harm reduction for alcohol would support assigning a designated driver or taking a cab, as opposed to avoiding drinking at all.

Another potential negative consequence would be feeling hungover after a night of drinking. Harm reduction for alcohol would have you consume fewer drinks, or alternate each alcoholic drink with a glass of water.

Harm Reduction Strategies for Alcohol

Are you interested in trying some harm reduction strategies to reduce your alcohol use? Here are some things you can try:

  • Set limits on your alcohol consumption, and stick to them—like limiting yourself to 2 drinks per day.
  • Consume alcohol mindfully, paying attention to how much you consume, where, and when. You might even consider tracking your consumption or keeping a journal to track the metrics that are important to you.
  • Reflect on why you’re drinking and what emotions you’re feeling. Are you drinking to cope with negative emotions? Is there an alternative activity you could choose to cope with those emotions?
  • Have a designated driver for nights out, or plan to stay at a friend’s house rather than drive home.
  • Try abstinence periods. For instance, plan to skip drinking on Sundays, or take a break from alcohol during Dry January.
  • Set start and end times for your drinking and try to stay within those limits. For instance, only drinking between the hours of 5pm to 12am.
  • Avoid drinking to help yourself fall asleep. Despite the immediate benefit of helping you feel drowsy, alcohol can actually make your sleep worse.
  • Explore medication to curb your drinking. Medications like naltrexone and acamprosate can reduce your alcohol cravings and reduce your risk of relapse.

Harm Reduction With Ria Health

At Ria, we support either abstinence or moderation from alcohol, depending on the individual’s needs, which is essentially a harm reduction approach. For some people, quitting alcohol completely is the best (or only) option. But for others, who may not be experiencing life-threatening consequences from drinking and have trouble sticking with total abstinence, reducing how much they drink might be the best route.

Ria Health’s program offers: 

  • Customized treatment plans based on an individual’s unique needs and goals
  • Several medications that can reduce alcohol cravings and make moderation easier to achieve 
  • Support for moderation-based recovery approaches like the Sinclair Method 
  • Weekly coaching sessions to help Ria members adapt to a new relationship with alcohol and stay the course
  • Flexible, app-based treatment that fits an individual’s schedule, making help for alcohol misuse less disruptive
  • A private, stigma-free approach that respects an individual’s choices, and helps them be their healthiest self

The goal of our program is to make it as easy as possible for people to make meaningful change. We uphold the dignity of every individual in our program, and seek to provide them with the tools they need to reach their goals.

Learn more about our approach to treatment

Ready for a change?

Ria Health offers online coaching, anti-craving medication, and digital tools to help you make a meaningful change in your relationship with alcohol.

About the Author

Dr. Chelsea Hetherington (she/her) is a developmental psychologist, writer, coach, and consultant. She helps therapists, coaches, and other businesses in the mental health space connect with their audiences and attract their dream clients through educational content writing. Her writing bridges the gap between research and practice by making complex mental health and personal development topics more accessible and easy to understand. You can find more of her writing at www.mindfultype.co

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