Addictive behaviors
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Addictive behaviors · Nov 2002
ReviewHarm reduction approaches to alcohol use: health promotion, prevention, and treatment.
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. ⋯ 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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In the past decade, prevention science has emerged as a discipline built on the integration of life course development research, community epidemiology, and preventive intervention trials [Am. Psychol. 48 (1993) 1013; Am. J. ⋯ San Francisco: Jossey-Bass]. The CTC system is widely implemented, and process evaluations of CTC suggest that it can assist communities to develop more effective prevention systems. This paper describes the background and use of the CTC operating system and results of evaluations of implementation of the system.