[Abstinence or controlled alcohol consumption?]

Disorders in alcohol consumption are among the most common, having the highest impact on morbidity and mortality, in mental health care. Treatment strategies differ greatly between institutions and the aim for controlled alcohol consumption remains controversial. The risk of (somatic) complications of alcohol abuse increase with a higher quantity of consumption, however there is no clear threshold regarding the development of certain health issues due to numerous factors determining individual susceptibility. Problematic alcohol abuse is treated either by aiming for complete abstinence, abstinence for the duration of therapy or controlled alcohol consumption. Considering a medical perspective aiming for abstinence in alcohol consumption is preferred, which however results in large amounts of untreated patients and limited effectivity. In our opinion, this advocates for a role of controlled alcohol consumption as 'harm reduction', focusing on the perspective of personal and communal recovery.