Harm Reduction – Realistic Approach To Addictions?By Robert Rose
From Dr. Robert Rose’s Blog Talk Radio interview with Ken Anderson, author of How to Change Your Drinking: a Harm Reduction Guide to Alcohol
Author’s note: Understanding what Ken says about a different approach to people with ANY kind of addiction should be helpful to teachers and parents. The concept of reducing a problem’s effects, instead of forcing the child or adult to completely change is helping thousands. Applied to the problem of obesity might help teachers give each other help and support in dealing with theirs and that could change the school CULTURE and it would impact the children and their parents.
“Fatty, drunk, drug addict, weak-willed, pathetic, lazy, stupid,” are some of the words stated by, not your enemies, but by those who say they love you – and it may be true. Of course, it’s usually said out of complete frustration because they are loss on how to help you change. I say you, because no one is perfect and your parents, family, or spouse all tend to be willing to change you by pointing out your imperfections.
The fact that attacking you or enabling you to continue with your problem does not cause you to change or to resolve your problem does not stop them from continuing to try. It seems to be a human failing to keep repeating the same mantras even when everyone is acutely aware that they are not working.
Ken Anderson who was an alcoholic and had many other dysfunctional behaviors for years discovered the concepts that worked to get him clean and remain that way. He had tried AA, cold turkey, psychotherapy, group therapy, and a half way type home. He sometimes got better, but always relapsed. Harm Reduction saved his life.
The basic program in four statements.
“Meet people where they are.” As a teacher this meant properly assessing each student by listening to him and understanding how he sees his strengths and weaknesses. I then began from a position of realistic expectations as I gradually encouraged him to expand beyond his self-imposed limitations. It’s difficult when the “addicted” one’s behaviors messes up your life too, but expecting behavior before he is ready for what you want or need from him – well, it doesn’t work.
“Don’t LABEL people as addicted, diseased, or alcoholic.” Labeling is how the brain helps us organize our thinking. However, a person labeled in any dysfunctional way tends to believe the label (and its limitations) and acts out the ways that others think about and describe that label. Telling an obese person she is fat only reinforces what she knows and lessens any resolve to deal with her weight.
“EMPOWER people to choose their own goals, which can be safer drinking, reduced drinking, or abstinence.” Instead of nagging him to quit drinking or being always angry with him, talk to and listen to him about what he’s willing to do to make the negative effects less harmful. Most people with problems realize the heath consequences of their behavior. For drinkers if they would daily take a multivitamin it would help.
“Help people achieve the drinking GOALS that they have chosen.” With your relief that he is woking on his health issues from drinking, he will be more amenable to talking to you about what more you can expect from him. What is he is willing to commit to doing? You have minimized your nagging and bagging on him and he has admitted his behavior may be out of control. Now, if what he is willing to do is still not enough for you, you have the right to save yourself (and family) and leave or send him out. Harm Reduction is for the loved ones to limit the harm done to them too. They have the right to be protected from his bad choices. He chooses to either get better or not. You have the choice to help or leave.
This is just a taste of what Ken’s book, How to Change Your Drinking: a Harm Reduction Guide to Alcohol, can do. He goes into great detail about the 17 “elements” of harm reduction and you can pick and choose what you and he are willing to do. He gives considerable research evidence to back his claims about so many misconceptions about what works and what doesn’t (AA). He does say, if AA works for him, fine. He offers a flexible and mainly nonjudgmental approach to drinking – that works.
Listen to the audio interview at