Harm Reduction is often misunderstood. It reduces the harmful effects of any targeted behavior. This discussion focuses on harm reduction for drinking by young people. But the general principles also apply to other behaviors. These behaviors might be driving, gambling, engaging in sex, losing weight, and so on.
I. General Description
II. Suggested Specifics
III. Possible Objections
For example, we recognize that driving a car involves the danger of injury or death. We could try to discourage or even prevent people from driving. But that wouldn’t be practical.
Instead, we use harm reduction. It involves licensing people to drive after they’ve shown a level of driving knowledge and skill. We establish rules of the road, speed limits, laws against driving while impaired, require safety belt use, etc.
I. General Description of Harm Reduction
Here are some general facts about harm reduction. All of them describe the approach. Of course, they also describe harm reduction for drinking.
Practical. Harm reduction uses effective strategies to reduce harm from potentially dangerous activities. If something doesn’t work, it’s abandoned. Harm reduction doesn’t keep doing the same thing over and over, expecting different results.
Incremental. It recognizes that it’s easier to make small changes than major ones.
Realistic. People have been drinking for at least 12,000 years. They’re not likely to stop. Prohibition has been tried around the world and it has never worked. To the contrary, it creates new problems.
Non-judgmental. It doesn’t label people as alcoholics, irresponsible, weak, or sick. People shouldn’t be labeled but helped.
Supportive. Harm reduction helps people help themselves toward their behavioral goals.
Motivational. Harm reduction often uses motivational interviewing. It celebrates any change people make toward their harm reduction goals.
Non-authoritarian. It doesn’t tell people what their behavioral goals should be.
Humane. It meets people where they are in terms of their readiness to change. It doesn’t reject people until they reach a certain point in their readiness to change.
Non-coercive. Harm reduction doesn’t insist on abstinence. But it recognizes that this may be an ideal outcome.
Children, Alcohol and Parenting.
Drinking with Parents is “Protective.”
II. Suggested Specifics
Harm reduction for drinking can use many methods. Here are just a few directed toward reducing harm associated with drinking in college. You can develop more specifically suited for your situation.
Schedule 8:00 am MWF freshman classes. Scheduling classes early discourages late night partying. And the weekend now tends to begin Thursday night. It’s very important to focus on classes for first year students. That’s because they’re the ones most likely to drink to extreme.
Reduce Grade Inflation. Grade inflation makes it easier for students to have plenty of spare time. That, in turn, makes it easier for them to party and drink too much.
Implement Good Samaritan policies. Good Samaritan policies protect the health and lives of students who drink too much.. If they need medical help, speed is important. These policies assures people that they won’t be disciplined for obtaining medical help. Nor will the person receiving that help. Good Samaritan policies typically provide amnesty only if the students involved later complete an intervention or alcohol education program.
Give practical advice for personal safety. Colleges can develop their own lists based on their specific situations.
Teach safe drinking practices. It’s important for students to know that standard drinks of beer, wine and spirits contain the same amount of alcohol. They should also know to
- Eat while drinking.
- Sip their drinks slowly.
- Avoid drinking games.
- Have a non-alcoholic drink between alcoholic ones.
- Pace drinks. A general rule of thumb is no more than one alcoholic drink per hour.
- Accept an alcoholic drink only when it fits their drinking schedule.
- Stick with standard drink sizes. It’s easier to keep track of their intake of pure alcohol.
- Follow medical advice about drinking with any meds they’re taking.
Promote Designated Driving. Designated drivers have saved tens of thousands of lives. Promoting designated driving is a highly successful way to reduce harm.
Use Social Norms Marketing. Social norms marketing is based on a simple fact. Most young people think that most other young people drink, drink heavily, and drink often. Because they want to fit in, young people feel pressure to conform to the distorted beliefs. Once they discover the actual statistics on their campus, they’re empowered. Thus, they tend not to drink or not to drink as much and often. Learn more at What is Social Norms Marketing?
Offer college bus service. A regularly scheduled bus to take students from a city’s entertainment area back to campus can reduce accidents and other problems. Some may call this enabling. But it reflects a higher concern for student safety and life.
Sell alcohol in dining halls to students 21 or older who wish to buy it. This reduces the idea that drinking in moderation is something unnatural. It also provides good role modeling for those who choose to drink. And it does so in a sociallhy conrolled environment.
Offer non-credit alcohol appreciation course for students 21 or older. This helps students learn to savor alcoholic beverages and consume them slowly. Learning quality over quantity is imporetant in promoting harm reduction for drinking.
III. Objections to Harm Reduction for Drinking
A. Objection: Early onset of drinking harms young brains. It’s widely argued that drinking at an early age harms developing brains. However, there is no evidence that moderate drinking harms a young brain. There are major problems with the so-called evidence.
1. Samples used. The samples used are inappropriate. One source is lab rats. They’re fed massive amounts of alcohol, As a result, they often have damaged brains. That’s not surprising. But no one suggests it’s wise to serve young people massive amounts of alcohol.
The other source of evidence comes from young substance abusers in alcohol and drug rehabilitation. Again, no one suggests giving young people abusive amounts of alcohol, often with illicit drugs.
2. “Natural research.” The world has had a “natural” experiment for thousands of years. In many societies and other groups children begin drinking at an early age. Such groups include Jews, Greeks, Italians, French, and Portuguese. But there appears to be no evidence that these groups suffer any mental deficiencies as a result.
B. Objection: Early drinking causes later alcohol-related problems. It’s often argued that drinking at an early age causes people to have alcohol-related problems later in life. Indeed, there’s often a correlation between the two.
People in the U.S. who begin drinking at an early age are not typical. They tend to seek excitement and lack the ability to defer gratification well. Not only do they tend to drink at an early age. They also tend to drive fast, engage in unprotected sex, take illicit drugs, gamble, and engage in other high-risk behaviors.
Psychologists have been able to observe pre-school children playing together. Based on their observations, the psychologists have been able to predict those more likely to drink at an early age. And those same children also tended to have more alcohol-related problems.
So the evidence is very strong that innate predisposition cause both the early drinking and later drinking problems.
We’ve examined harm reduction for drinking. In so doing, we’ve presented a general description of harm reduction. Following this we’ve suggested specifics for applying the approach on a campus. Then we’ve considered possible objections to reducing harm.
It appears that harm reduction for drinking is effective.
- Harm Reduction 101 (video)
- Kinney, J. Loosening the Grip: a Handbook of Alcohol Information. NY: McGraw-Hill.
- Marquis, N. Preventing and Reducing Underage Drinking. NY: Nova.
- N.Z. Med Assn. Reducing Alcohol-Related Harm. Wellington: The Assn.
- Watkins, C. Alcohol Abuse. Detroit: Green.
- Woollard, J. Alcohol: Reducing the Harm and Curtailing the Culture of Excess. Perth, W.A.: Parliament of W.A.