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AA Alternatives: What Is HAMS and Does Harm Reduction Work?

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If you or someone you love is struggling with alcohol misuse, joining a peer support group can significantly increase your chances of long-term recovery.1 While Alcoholics Anonymous (AA) is typically the first such group people think of, AA is not right for everyone. There are alternatives to AA, such as HAMS alcohol support groups, that may work better for you. As with many aspects of alcohol treatment and recovery, the best support group for you is the one that best meets your needs.

Harm Reduction, Abstinence, and Moderation Support

HAMS stands for Harm Reduction, Abstinence, and Moderation Support. Like AA, HAMS support groups are peer-led and free of charge. In addition to live meetings, members can receive support via an online forum, chat room, Facebook group, and email support group. These groups are open for anyone to join.

HAMS is a non-profit corporation and was founded by Kenneth Anderson in 2007. Anderson holds a master’s degree in mental health and substance abuse counseling from the New School for Social Research in New York City and has worked in the field of harm reduction since 2002.

HAMS Versus AA

Unlike AA, HAMS does not advocate for total abstinence from alcohol. Instead, the HAMS approach acknowledges that alcohol use is a reality in the lives of many people. While alcohol misuse can lead to harm, you can learn to reduce the harm associated with alcohol.

HAMS advocates for everyone’s autonomy and supports each member’s recovery goals, whether the goal is abstinence, reduced use of alcohol, or safer use of alcohol.2 While HAMS is focused on alcohol harm reduction, you can also participate in HAMS meetings if you use other substances or wish to reduce the harm associated with other harmful, compulsive, or addictive behaviors.

HAMS also maintains that while some people—especially those also experiencing mental health issues such as depression, anxiety, or post-traumatic stress disorder (PTSD)—may benefit from the use of psychotherapy and certain medications, everyone can make better choices and improve their lives.

HAMS rejects the idea that people are powerless over alcohol and must turn their lives over to a higher power. This is in direct contrast with the 12 Steps of AA, and similar programs like Celebrate Recovery, which state “we admitted we were powerless over alcohol” and “came to believe that a Power greater than ourselves could restore us to sanity.”3

The HAMS Definition of Recovery

HAMS also differs from AA in its definition of recovery. Harm reduction models focus on your quality of life and overall wellbeing rather than total abstinence from alcohol.

One of HAMS’ mottos is “better is better,” meaning that any reduction in alcohol use is an improvement and that no positive change is “too small to count.” One day of no alcohol use is better than none. Switching from 10 drinks a day to 9 drinks a day is also an improvement. This philosophy is closely associated with certain types of behavioral therapy, such as dialectical behavior therapy (DBT), which focuses on eliminating life-threatening behaviors and then reducing behavior that interferes with treatment before making long-term goals.

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The harm reduction approach allows for safer alcohol consumption and use in moderation, which is more attainable for many people than complete abstinence.

The HAMS Approach

While AA has its well-known 12 Steps, the HAMS approach is based on 17 elements.

The 17 HAMS elements are as follows:4

  1. Complete a cost-benefit analysis of your drinking.
  2. Choose a drinking goal—safer drinking, reduced drinking, or quitting.
  3. Learn about risk ranking and rank your risks.
  4. Learn about the HAMS tools and strategies for changing your drinking.
  5. Make a plan to achieve your drinking goal.
  6. Use the alcohol-free time to reset your drinking habits.
  7. Learn to cope without alcohol.
  8. Address outside issues that affect drinking.
  9. Learn to have fun without alcohol.
  10. Learn to believe in yourself.
  11. Use a chart to plan and track your drinks and drinking behaviors day by day.
  12. Evaluate your progress—honestly report struggles—revise plans or goals as needed.
  13. Practice damage control as needed.
  14. Get back on the horse.
  15. Graduating from HAMS, sticking around, or coming back.
  16. Praise yourself for every success.
  17. Move at your own pace—you don’t have to do it all at once.

Resources, videos, and worksheets related to the 17 elements can be found on the official HAMS website.4

Harm reduction may include stopping, reducing, or changing your alcohol use.Everyone’s timeframe for working through the elements is different. Some people may be able to design a drinking plan and implement it immediately, but most people find that real change takes longer. Try not to compare your progress to that of others. It is perfectly valid if you need to spend additional time on a particular element or need to return to it periodically.

The elements differ from AA’s 12 steps in two primary ways.

Nonlinear

The 12 Steps of AA are intended to be completed in order. Members may revisit the steps throughout their recovery and repeat the entire process several times. The HAMS 17 elements, however, are all optional and can be completed in any order. You can pick and choose the ones that work for you and disregard the ones that don’t.

Nonspiritual and Nonreligious

While AA is not affiliated with any particular religion or organization, the 12 Steps are spiritual in nature. They promote reliance on a higher power and asking that higher power—however you define it—to remove shortcomings and “defects of character.” 3

HAMS, on the other hand, does not use any spiritual language. Instead, the HAMS approach is built on choices and hard work, combined with valuable tools and psychiatric support if needed. This secular approach may be appealing to those who don’t relate to the spiritual nature of the AA program. HAMS is one of several secular alternatives to AA, which also include the Secular Organizations for Sobriety and LifeRing.

HAMS Guidelines

HAMS support meetings, whether in person or online, are governed by guidelines that encourage respect among all participants.5 Members are encouraged to share as much or as little as they choose. No one is forced to speak, but an effort is taken to give speaking time to all those who wish to share.

Intoxication is not prohibited, as HAMS recognizes that some people would not be able to participate if sobriety were required. However, members are expected to be well-behaved, and people who are disruptive may be asked to leave. At in-person meetings, members are encouraged to help each other get home safely and not let other members drive under the influence of alcohol.

HAMS members are encouraged to set their own goals related to their alcohol use and choose the tools and strategies to help best them achieve those goals. The use of medications, therapy, or other therapeutic approaches is up to each person.

Evidence for Harm Reduction Models

Research indicates that harm reduction programs are useful tools in addiction treatment.6 If you were to reduce your alcohol use from 10 drinks a day to 5, an abstinence-based treatment program would consider that a failure. You could even be turned away from certain services that require abstinence, such as housing assistance at a halfway house or sober living home.

These types of all-or-nothing programs fail to recognize the value in reducing alcohol use or practicing safer alcohol use, as well as the impact that such actions can have on your quality of life. Harm reduction strategies meet people where they are and allow them to work on their chosen goals.

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Several small studies have demonstrated the effectiveness of harm reduction models in various settings. For example, abstinence-based programs tend to be ineffective for people with alcohol dependence experiencing homelessness and managed alcohol programs have been shown to help people remain in housing programs and improve their quality of life.7

Another study found that participants in a managed alcohol program reported less alcohol consumption, greater compliance with medical care, and fewer encounters with law enforcement.8

Harm Reduction Resources

The official HAMS website provides many resources for people interested in learning more about harm reduction approaches.2

The founder of HAMS, Anderson, has also co-authored two books about harm reduction. The first, ​​How to Change Your Drinking: a Harm Reduction Guide to Alcohol, is an in-depth review of the 17 elements and additional harm reduction tools and strategies. The second, BETTER IS BETTER!: stories of alcohol harm reduction, contains stories from people of all genders who have used harm reduction strategies to overcome alcohol use problems and improve their lives.

The HAMS website also includes information on in-person meetings and links to online groups and forums. Anderson also hosts a harm reduction podcast, which features many experts on substance use and recovery as guests.9

There are many approaches to alcohol addiction treatment, and the best approach for you depends largely on your personal needs and circumstances. Do not choose a treatment program simply because it works for someone else.

Your therapist or treatment team can help you decide the best approach for you. If you are considering a harm reduction approach such as HAMS, be honest with yourself about your alcohol use and how it affects your life. Can you improve your life with a harm reduction approach, or are you better suited to an abstinence program such as AA?

For many people, peer support groups like HAMS and AA are only part of their treatment plan. A qualified therapist or healthcare professional can help you determine the best level of support for your needs, which may include inpatient or outpatient rehab.

If you or someone you know is struggling with alcohol addiction, contact us today at 800-948-8417 Question iconWho Answers? to find addiction treatment services.

Resources

  1. Melemis, S. M. (2015, September 03). Relapse prevention and the five rules of recovery. The Yale journal of biology and medicine, 88(3), 325–332.
  2. HAMS. HAMS Mission Statement.
  3. W., Bill. (1981). Twelve Steps and Twelve Traditions: A co-founder of Alcoholics Anonymous tells how members recovery and how the society functions. Alcoholics Anonymous World Services, Inc.
  4. HAMS. The 17 Elements of HAMS.
  5. HAMS. (2014, February 05). Guidelines for HAMS Support Group Meetings.
  6. Logan, D., & Marlatt, G. (2010). Harm reduction therapy: a practice-friendly review of research. Journal of Clinical Psychology, 66(2), 201-214.
  7. Pauly, B., et al. (2016). Finding safety: a pilot study of managed alcohol program participants’ perceptions of housing and quality of life. Harm Reduction Journal, 13, Article number: 15.
  8. Podymow, T, et al. (2006). Shelter-based managed alcohol administration to chronically homeless people addicted to alcohol. Canadian Medical Association Journal, 174(1) 45-49.
  9. HAMS. Harm Reduction Radio. BlogTalkRadio.
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