Absolutely, there's room for harm reduction approaches as well. There's an approach called the Sinclair Method that uses counseling and a drug called Naltrexone with the goal of reducing episodes of heavy drinking, and I do know one person who has had success with that.
As an aside, I certainly don't mean to suggest that AA is the be-all end-all, just that it's a tool that is often the target of abuse from those who don't necessarily know better.
AA indeed does emphasize complete abstinence. Many people, myself included, reach a point where moderation ceases to be a viable path - such a person may moderate successfully for a short period of time, but their alcohol use typically escalates rapidly back to the level that got them into AA or beyond.
Some people might be able to go from alcoholic drinking patterns back to safe alcohol use, but the only way I know of to find out if an individual falls into that class is to let them drink and see what happens. The risk/reward ratio there does not favour drinking - if it works out, you can have a few beers with friends (and not feel any of the effects that makes an alcoholic want to drink). If it doesn't work out, it could end in homelessness, cirrhosis, imprisonment and so on.
The outcomes in the above risk/reward scenario is not hypothetical - I have met people with a lot of sobriety under their belt who returned to what they thought would be controlled drinking and who failed miserably. A good friend of mine reached 8 years sober and was suspended from his job for 18 months after falling off the wagon. 20 years sober, started drinking and got a divorce and wound up in a rehab facility for the indigent. 15+ (I forget exactly) years sober, lost his license to practice law and spent some time in prison. For myself, one of my returns to "controlled drinking" ended with me consuming 26 ounces of liquor in 90 minutes, picking a horrific argument with my wife, and going out to the bar by myself for at least 15 more standard drinks. As a fun side note, I punched that into a blood-alcohol calculator at one point and my BAC was around the LD50 mark. I have no idea how I was physically capable of walking, let alone ordering more.
Alcoholics obsess, in the real sense of the word, over finding a way to return to moderate alcohol use (or heavy alcohol use without negative consequences). I think helping people moderate is a reasonable goal, but I'd think you would need to have an accurate picture of their drinking to determine if it's a safe course of action, and addicts tend to lie about their substance abuse - as far as my doctor was concerned, I only drank moderately a few times a week. She only found out that was not the case when I made an appointment specifically to seek help.
I think this post is a bit self-contradictory in a way. I am all for harm reduction where it makes sense, but in my experience, when somebody reaches the point where they are clearly alcoholic, that door has already closed. I think the role of harm reduction for alcohol abuse might really be to stop people from getting to that point.
As an aside, I certainly don't mean to suggest that AA is the be-all end-all, just that it's a tool that is often the target of abuse from those who don't necessarily know better.
AA indeed does emphasize complete abstinence. Many people, myself included, reach a point where moderation ceases to be a viable path - such a person may moderate successfully for a short period of time, but their alcohol use typically escalates rapidly back to the level that got them into AA or beyond.
Some people might be able to go from alcoholic drinking patterns back to safe alcohol use, but the only way I know of to find out if an individual falls into that class is to let them drink and see what happens. The risk/reward ratio there does not favour drinking - if it works out, you can have a few beers with friends (and not feel any of the effects that makes an alcoholic want to drink). If it doesn't work out, it could end in homelessness, cirrhosis, imprisonment and so on.
The outcomes in the above risk/reward scenario is not hypothetical - I have met people with a lot of sobriety under their belt who returned to what they thought would be controlled drinking and who failed miserably. A good friend of mine reached 8 years sober and was suspended from his job for 18 months after falling off the wagon. 20 years sober, started drinking and got a divorce and wound up in a rehab facility for the indigent. 15+ (I forget exactly) years sober, lost his license to practice law and spent some time in prison. For myself, one of my returns to "controlled drinking" ended with me consuming 26 ounces of liquor in 90 minutes, picking a horrific argument with my wife, and going out to the bar by myself for at least 15 more standard drinks. As a fun side note, I punched that into a blood-alcohol calculator at one point and my BAC was around the LD50 mark. I have no idea how I was physically capable of walking, let alone ordering more.
Alcoholics obsess, in the real sense of the word, over finding a way to return to moderate alcohol use (or heavy alcohol use without negative consequences). I think helping people moderate is a reasonable goal, but I'd think you would need to have an accurate picture of their drinking to determine if it's a safe course of action, and addicts tend to lie about their substance abuse - as far as my doctor was concerned, I only drank moderately a few times a week. She only found out that was not the case when I made an appointment specifically to seek help.
I think this post is a bit self-contradictory in a way. I am all for harm reduction where it makes sense, but in my experience, when somebody reaches the point where they are clearly alcoholic, that door has already closed. I think the role of harm reduction for alcohol abuse might really be to stop people from getting to that point.