Let me start this by saying that when it comes to alcohol, I practice, and MUST practice, 100% abstinence. If you've read the blog post, Heroes, you read about how it went the last time I thought I could have a drink. Whenever that idea pops into my head (which is blessedly quite infrequent nowadays), I think back to that moment as having run my experiment and gotten the results. They were clear, they were not pretty, and I have no intention of ever running that experiment again. I will also say I know an awful lot of people just like me. People for whom one drink is a headlong dive down a slippery slope with its bottom in a treatment center (best case!), hospital bed, jail cell, or grave. Alcoholics Anonymous, which has been clinically shown as the most successful program of recovery, preaches abstinence.
I felt the need to start this post like that for safety's sake. There are many of us for whom abstinence is the only path. If you believe you are like me, and abstinence is working for you, please don't allow anything further down the page to convince you you should be doing anything different.
That said, I have seen many definitions of recovery since entering the peer recovery field. The Connecticut Community for Addiction Recovery (CCAR), which developed the training curriculum for peer recovery positions, defines recovery as such: You are in recovery when you say you are (click here for a CCAR blog post regarding the origin of that definition). While I respect the origins and intent of that definition, the definition of recovery with which I best identify (so far) is from Tom Hill, the current senior policy advisor at the White House Office of National Drug Control Policy (ONDCP) who has held numerous important positions regarding recovery over the years, both in and out of government:
Recovery is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. (Tom Hill, 2011)
You may have noticed that neither of those definitions mentions substances or abstinence. That's because recovery isn't about quitting or stopping, even though that may be a necessary step in the process. It's about living a better life. If you've explored my website, you've likely seen that I define what I do as helping people live their best lives while living with substance use disorder. For some, like me, that does require abstinence, or, at least, abstinence from that person's substance of choice, but there are no hard and fast rules. No one can tell you what your best life looks like but you (duh)!
For generations, alcohol has been an embedded component of American society. When discussing this with clients, with friends in mutual aid groups, or among colleagues, I frequently use the loyalty program reward I received from a local hardware store to illustrate. It's a nice, compact trenching tool, good to bring camping for digging out a firepit, etc. You can unscrew the handle for easy stowing, it has a compass on the knob of the handle, obviously useful for hiking or camping, and . . . it has a bottle opener notched into the edge of the spade. None of the water bottles I ever purchased to carry on a hike required a bottle opener. Not one.
In a January '23 survey of more than 1,000 Americans ages 21-78, 93% said they feel drinking is a big part of American culture, which is pretty amazing -- try getting 93% of Americans to agree on anything else! However, over the past several years, perhaps driven by an increase in drinking and isolation during the pandemic (Alcohol Consumption during the COVID-19 Pandemic: A Cross-Sectional Survey of US Adults), there are more and more Americans who are at least "curious" about changing their relationships with alcohol. In fact, in that same survey, 34% responded they want to reduce alcohol use in 2023.
So, what does reducing alcohol use look like? When I first began my practice, my clients were exclusively people who sought abstinence. Not by any design of my own. Alcohol and/or other substances had become a negative presence in their lives that they wanted to remove from the equation. Many were like me. There was no real choice. It was either full stop (abstinence) or full speed ahead to rehab (if you figure it out in time or someone gets you there), homelessness, handcuffs, or death.
But, more recently, I've had a number of clients who would prefer to change their relationship with alcohol rather than eliminate it. They still want to enjoy a glass of wine with dinner, a casual beer with friends, or even the occasional big night out, but they want to stop sneaking, binging, drinking alone, continuing to drink after getting home from a night out, or whatever they see as their over-use or problem drinking (and, yes, those can all be signs that you have or are developing a negative relationship with alcohol).
Much to the surprise of this alcoholic, for some of my clients, this works! Again, I'm going to caveat -- this is not for everyone. If I have one drink, I do not stop. It's physical. My brain has changed. There is no going back. I am not a doctor, but what I've taken away from the experience of working with such folks is that, while they may have developed some problem-drinking tendencies (the basis of a psychological addiction to come), they have not progressed into physical addiction where the old adage, "You can't turn a pickle back into a cucumber," holds true.
I delved into the concept of harm reduction a bit in the blog post Safety a while back. The National Harm Reduction Coalition, through which I received my training in the concept, defines harm reduction as follows:
Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.
Harm reduction can be as simple as clean needles (reducing risk of disease) or always using opioids in the presence of others while equipped with Narcan (if you need it, you won't be able to administer Narcan to yourself) -- i.e. reducing risk while using. Changing your relationship with alcohol to eliminate behaviors that data show to be risky, such as drinking alone, drinking and driving, or using alcohol as a coping mechanism, is also a form of harm reduction. Changing your behavior with substances to improve your relationships counts too!
While it's never up to me to decide if someone should enter recovery, or, if they do, what that should look like, the same methods and training that I've applied to helping people seeking abstinence seem to apply to helping people to modify their relationship with alcohol -- understanding their goals and working towards them by using my clients as resources, determining their strengths and passions, and working with them to apply those to their own recoveries.
And, if along the way, the sober curious person changing their relationship with alcohol determines that abstinence may actually be the right path, they've already taken a large step in that direction by exploring their relationship with alcohol and the strategies for changing that relationship.
Whether you are seeking abstinence, "sober curious," or just seeking a change in your relationship with substances for the better, the principles of peer recovery and recovery coaching apply. I'm here to help you on your path to recovery, whatever that looks like to you, but I can't find you. You have to reach out to me. I hope you do.
-- Chappy
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