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Harm reduction approaches to alcohol use
Abstract
Harm reduction approaches to alcohol problems have endured a controversial history in both the research literature and the popular media. Although several studies have demonstrated that controlled drinking is possible and that moderation-based treatments may be preferred over abstinence-only approaches, the public and institutional views of alcohol treatment still support zero-tolerance. After describing the problems with zero-tolerance and the benefits of moderate drinking, the research literature describing prevention and intervention approaches consistent with a harm reduction philosophy are presented. Literature is reviewed on universal prevention programs for young adolescents, selective and indicated prevention for college students, moderation-based self-help approaches, prevention and interventions in primary care settings, pharmacological treatments, and psychosocial approaches with moderation goals. Overall, empirical studies have demonstrated that harm reduction approaches to alcohol problems are at least as effective as abstinence-oriented approaches at reducing alcohol consumption and alcohol-related consequences. Based on these findings, we discuss the importance of individualizing alcohol prevention and intervention to accommodate the preferences and needs of the targeted person or population. In recognizing the multifaceted nature of behavior change, harm reduction efforts seek to meet the individual where he or she is at and assist that person in the direction of positive behavior change, whether that change involves abstinence, moderate drinking, or the reduction of alcohol-related harm. The limitations of harm reduction and recommendations for future research are discussed.
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“however, these approaches may not be clinically indicated for individuals adverse to the disease model of addiction (6) or whose spiritual beliefs and/or lifestyle are in conflict with the 12-step philosophy.”
From Mindfulness-Based Relapse Prevention for Substance Use Disorders: A Pilot Efficacy Trial (2009) · cites this paper as [6]
Citations
Cites
Jacobson, N. S., & Truax, P. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.59.1.12 · Cited by 7,770
The Explanatory and Predictive Scope of Self-Efficacy Theory
Bandura, A. (1986) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.1986.4.3.359 · Cited by 3,771
The world health report 2001 - Mental health: new understanding, new hope
Sayers, J. (2001) · Europe PMC (PubMed Central) · doi:10.1590/s0042-96862001001100014 · Cited by 3,307
Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors
Washton, A. M. (1986) · Journal of Studies on Alcohol · doi:10.15288/jsa.1986.47.260 · Cited by 2,531
The Transtheoretical Approach: Crossing Traditional Boundaries of Therapy
Sporakowski, M. J., Prochaska, J. O., & DiClemente, C. C. (1986) · Family Relations · doi:10.2307/584540 · Cited by 1,976
(1997) · Journal of Studies on Alcohol · doi:10.15288/jsa.1997.58.7 · Cited by 1,905
Naltrexone in the Treatment of Alcohol Dependence
Volpicelli, J. R. (1992) · Archives of General Psychiatry · doi:10.1001/archpsyc.1992.01820110040006 · Cited by 1,828
Wechsler, H., Lee, J. E., Mohler‐Kuo, M., & Lee, H. (2000) · Journal of American College Health · doi:10.1080/07448480009599305 · Cited by 1,177
The Disease Concept of Alcoholism.
Ehrlich, H. J., & Jellinek, E. M. (1961) · American Sociological Review · doi:10.2307/2090702 · Cited by 1,142
Marlatt, G. A., Baer, J. S., Kivlahan, D. R., Dimeff, L. A., Larimer, M. E., Quigley, L. A., Somers, J. M., & Williams, E. (1998) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.66.4.604 · Cited by 877
Self-citation
Research works printed but not linked: 3
- Alho, 1999, Naltrexone for alcohol dependence: double-blind placebo-controlled Finnish trial, Alcoholism: Clinical and Experimental Research, 23, 46A
- Balldin, 1997, A randomized 6 month double-blind placebo-controlled study of naltrexone and coping skills education programme, Alcohol and Alcoholism, 32, 325
- Squires, 2002, Development of a computer-based, brief intervention for drinkers: the increasing role for computers in the assessment and treatment of addictive behaviors, Behavior Therapist, 25, 59
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Harm Reduction and Risky Behaviors
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Stevens, A. K., Blanchard, B. E., Shi, M., & Littlefield, A. K. (2020) · Wiley eBooks · doi:10.1002/9781119057840.ch178 · Cited by 1
Bigler, M. O. (2014) · doi:10.1093/obo/9780195389678-0148 · Cited by 1
Johnson, E. (2022) · Digital Archive @ GSU · doi:10.57709/5528171 · Cited by 1
Rocco, J. (2007) · California State University ScholarWorks (system-wide DSpace) · Cited by 1
Tchamba, G. (2015) · ScholarWorks - WMU (Western Michigan University)
Psychosocial Predictors of High School Adolescents' Sun-tanning and Sun-protective Behaviors
Land, D. M. (2015) · OpenSIUC (Southern Illinois University Carbondale)
How does relevant theory inform a public alcohol policy model?
McKeown, C. A. (2013) · UTAS Research Repository · doi:10.25959/23205911
Barker, P., & Chang, R. P. J. (2013) · Wiley eBooks · doi:10.1002/9781118624944.ch12
Oshri, A. (2009) · FIU - Digital Commons (Florida International University) · doi:10.25148/etd.fi09082406
The Drinker's Check‐Up: A Brief Motivational Intervention for Early‐Stage Problem Drinkers
Emmen, M. J., Schippers, G. M., Bleijenberg, G., & Wollersheim, H. C. H. (2011) · Wiley eBooks · doi:10.1002/9780470979952.ch21
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Nixon, S. J., & Prather, R. A. (2010) · Wiley eBooks · doi:10.1002/9780470710449.ch38
Homeless young adults : an exploratory study examining resiliency and coping
Lippman, A. D. P. (2012) · Texas ScholarWorks (Texas Digital Library)
Hammamy, R. D. (2010) · University Libraries (University of Maryland)
McKay, M. T., & Harvey, S. A. (2015) · Child Care in Practice · doi:10.1080/13575279.2015.1027661 · Cited by 1
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Evaluation of an Online Alcohol Education Program for First-Time-in-College Students.
Reiss, E. (2010) · Journal of International Crisis and Risk Communication Research
Mortalidad relacionada con el alcoholismo en el hospital general
Ponce, G. (2005) · Medicina Clínica · doi:10.1157/13079620
Corsi, A. M., Lockshin, L., & Kilov, K. (2011)
Sports and Spirits: A Mixed Methods Investigation of Student Sportspeople's Drinking.
Zhou, J. (2015) · Edge Hill University
Goh, Y.-G., Jung, T. Y., Chung, H., Che, X. H., Yu, S., Jo, M. J., 차수진, Moon, D. S., Suh, J. Y., & Cho, K. J. (2015) · Health Policy and Management · doi:10.4332/kjhpa.2015.25.2.71
DeCou, C. R., & Skewes, M. C. (2016) · Rural Mental Health · doi:10.1037/rmh0000039
Addiction, treatment, and evidence-based medicine
Wilcox, S. (2016)
Perceptions and enacted identities within the hiv prevention counseling context
Rogers, B. R. (2016) · J. Willard Marriott Library · doi:10.26053/0h-y377-0500
Commentary on Wilson et al . (2016): The meaning of success in failure
Moyer, A. E. (2016) · Addiction · doi:10.1111/add.13541
Rassool, G. H. (2011) · doi:10.1007/978-0-230-34456-3_16
Underground Markets in the USA
Horton, A. (2015) · Journal of Addiction Research & Therapy · doi:10.4172/2155-6105.1000227
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Abortion in Northern Ireland: rights and regrets.
Naughton, L. (2013) · PubMed
Alcohol Use and Policy Responses in Modern China: New Developments in a Changing Society
Lou, W.-M. C. (2015) · eScholarship (California Digital Library)
Medical Family Therapy in Alcohol and Drug Treatment
Soloski, K. L., & Cravens, J. D. (2018) · Focused issues in family therapy · doi:10.1007/978-3-319-68834-3_12
Psychedelic therapy as a complementary treatment approach for alcohol use disorders
Eischens, P., & Atherton, W. L. (2018) · Journal of Psychedelic Studies · doi:10.1556/2054.2018.005 · Cited by 3
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Douaihy, A. B., & Driscoll, H. P. (2018) · Springer eBooks · doi:10.1007/978-3-319-91005-5_4
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Kaplan, J., & Goh, L. S. (2019) · SSRN Electronic Journal · doi:10.2139/ssrn.3369231
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Tran, K. T., Robertson, K., & Thyne, M. A. (2019) · Journal of Nonprofit & Public Sector Marketing · doi:10.1080/10495142.2019.1707742
'You can't hate yourself thin' Obesity recovery and self-compassion
Ottley, K. (2019) · Otago University Research Archive (University of Otago)
Ongewenste effecten van voorlichting over recreatief drugsgebruik
Spronk, D. B., Voorham, L., & Goossens, F. X. (2020) · TSG - Tijdschrift voor gezondheidswetenschappen · doi:10.1007/s12508-020-00250-2
Tran, K. T. (2020) · Otago University Research Archive (University of Otago)
The Nature and Scope of Sexual Assault Victimization of Adults
Daigle, L. E., & Azimi, A. M. (2020) · Springer eBooks · doi:10.1007/978-3-319-62122-7_221-1
Compton, W. M., & Blanco, C. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108632591.001
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Morris, V. L., Arshad, F., Balodis, I. M., Reed, D. D., MacKillop, J. M., & Amlung, M. T. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108632591.010
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Willick, D. H. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108632591.041
Strack, R. W., Orsini, M. M., Ewald, D. R., & Scheier, L. M. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108632591.019
Delile, J., & Couteron, J.-P. (2019) · Dunod eBooks · doi:10.3917/dunod.morel.2019.01.0135
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Sussman, S. Y. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108632591.002
Srivastava, A. B., & Gold, M. S. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108632591.033
Sussman, S. Y. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108632591.042
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Vergunst, F., & Zheng, Y. (2023) · doi:10.64628/aam.rxxtxysxc
Wattenmaker, M. (2013) · VCU Scholars Compass (Virginia Commonwealth University) · doi:10.25772/mtrq-1h83
Gwadz, M. V., Cleland, C. M., Freeman, R., Wilton, L., Collins, L. M., Hawkins, R. L., Ritchie, A. S., Leonard, N. R., Jonas, D. F., Korman, A., et al. (2021) · Figshare · doi:10.6084/m9.figshare.14131181
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Jitnarin, N., Haddock, C. K., Kaipust, C. M., Poston, W. S. C., Hollerbach, B. S., Koeppel, M. D. H., Jahnke, S. A., & Caetano, R. (2026) · Fire · doi:10.3390/fire9020083 · Cited by 2
Zulu, G. (2026) · Research Square · doi:10.21203/rs.3.rs-9100363/v1
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Palpacuer, C. (2018) · theses.fr (ABES) · doi:10.70675/aa77e495z482ez45b0z9aabz3b0862e3413e
Mullin, C. J., & Cservenka, A. (2026) · Psychoactives · doi:10.3390/psychoactives5020011
Collins, S. E., & Clifasefi, S. L. (2026) · Current Addiction Reports · doi:10.1007/s40429-026-00750-2
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Haass‐Koffler, C. L., & Foster, S. L. (2026) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2026.106921
Attonito, J. M., Mueller, J., Villalba, K., & Chakraborty, A. (2026) · Substance Use & Misuse · doi:10.1080/10826084.2026.2670620
Bleasdale, J., Schrimshaw, E. W., Bilello, L., Kuretski, J., Widmeyer, M., Cook, R. L., & Westmoreland, D. A. (2026) · AIDS and Behavior · doi:10.1007/s10461-026-05303-2
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Lee, G. K. W., Chan, G. H., Low, Y. T. A., & Lo, T. W. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1953018
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Metadata
- Authors
- Marlatt, G. A., & Witkiewitz, K.
- Affiliations
- University of Washington (US)
- Corresponding author
- Marlatt, G.Alan
- ORCID
- Witkiewitz, Katie
- Venue
- Addictive Behaviors
- Publisher
- Elsevier BV
- Published
- 2002-11
- Volume
- 27
- Issue
- 6
- Pages
- 867-886
- ISSN
- 0306-4603 (ISSN-L)
- OpenAlex
- W1261242356
- Cited by
- 491
- References
- 120
- Citations by year
- 2026: 10 · 2025: 13 · 2024: 20 · 2023: 15 · 2022: 23 · 2021: 32 · 2020: 78 · 2019: 16 · 2018: 21 · 2017: 17 · 2016: 25 · 2015: 24 · 2014: 19 · 2013: 23 · 2012: 21
- FWCI
- 1.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addictive Behaviors (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- harm reduction, alcohol consumption, abstinence, zero tolerance policy, alcohol prevention, university students, adolescents, primary care, pharmacotherapy, psychosocial interventions, self-help, personalized interventions, behavior change
- MeSH terms
- Adolescent, Adult, Aged, Alcohol Deterrents, Alcohol Drinking, Alcoholism, Behavior Therapy, Female, Health Education, Health Promotion, Health Services Accessibility, Humans, Male, Middle Aged, Preventive Health Services, Randomized Controlled Trials as Topic, Adolescent Health Services, Harm Reduction
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