| << Previous DEFINITION OF HARM REDUCTION "Any approach directed towards decreasing the adverse
health, social and economic consequences of alcohol use without
requiring abstinence from alcohol use." Heard the phrase, "You can't help a person with
an alcohol problem until the person wants to change."?
Don't believe it.
It has justified abandoning many people with alcohol
problems until some hoped-for time in the future. For seniors, this
can be a death sentence.
Part of helping involves understanding what motivates
the person to step away from where he or she is, and helping the
person muster the strength for some degree of change.
People always have and always will use alcohol,
even though it may adversely affect them in some way. For some,
this leads to problems with their health, their relationships, or
their finances.
In the past, abstinence has been seen as the only
way of addressing the problem. Many seniors and people who work
with them consider abstinence as a very limiting goal. The problem
may not be that severe, or it may be severe, but there are many
other major problems in the senior's life, or the senior may see
the abstinence approach as another example of how his or her independence
is rapidly being eroded or controlled by others.
Over the last 20 years, a different and complementary
approach to requiring abstinence before helping has been developing.
And it seems to hold a lot of promise for some seniors.
It is called harm reduction. It is a public health
approach to dealing with alcohol-related issues. It places first
priority on reducing the negative consequences of alcohol use. 9
Harm reduction attempts to minimize the potential
hazards associated with the alcohol, rather than focusing exclusively
on the alcohol use itself. Rather than focusing on eliminating alcohol
use or ensuring abstinence, harm reduction starts with focusing
on immediate harms and realistic goals. These are often the first
steps toward risk-free use or, if appropriate, abstinence. Harm
reduction does not remove a person's primary coping mechanisms such
as alcohol or prescription medications, until other means of coping
are in place.
Harm reduction philosophy addresses a person's
immediate needs, such as food and shelter, traditional and alternative
medical care and mental health treatment. The approach stresses
the need to be non-judgmental, and to provide help that is accessible
and culturally specific. These are central to the harm reduction
philosophy. The alcohol literature describes a broad range
of harms to seniors from overdrinking. Some are direclty attributed
to alcohol use. For example, a senior drinking heavily may fall
and break his hip. A senior may decide to try to quit drinking "cold
turkey", and end up with pneumonia or having a seizure because the
alcohol withdrawal was not monitored.
Other harms result as unintended consequences of
other people's efforts to deter alcohol use. For example, a family
member or professional might demand that the senior stop drinking,
or "I won't see you again". Having given the ultimatum, the person
may find the senior chooses to drink (or simply cannot stop at this
point). The potential harms increase, unabated.
Or, perhaps, a staff in a care facility search
the resident's room for alcohol (ostensibly "cleaning the room")
and throw out any alcohol they find. This undermines the senior's
trust in the staff. And the senior may decide to go off-grounds
to drink. Or the senior may rely on a "bootlegger" bring more alcohol
into the facility, leading to more conflict.
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