La réduction des risques et des dommages est-elle efficace et quelles sont ses limites en matière d’alcool ?

Although the philosophy and principles of harm and risk reduction were initially developed in the area of illicit drugs, many of its principles, objectives and techniques may also be applied to alcohol problems. Thus, risk reduction explores not only the means for decreasing use when abstinence is difficult to achieve, but also includes a variety of measures to prevent or to diminish alcohol-induced harms. Following several decades of controversy, it would seem that the results from treatments with a goal of decreasing use would have a similar effect size as treatments whose goal is abstinence. Refusal and inability to commit to abstinence represent major obstacles to treatment access. It is our hope that the philosophy and principles of harm and risk reduction will be more widely adopted by health professionals who have long been trained to use an approach that excludes follow up to alcohol dependant patients who desire to control or reduce their consumption. The 2015 Good Clinical Practices written by the French Society for Alcoology, clearly aim at harm and risk reduction and should be widely distributed to health professionals. The World Health Organisation has proposed a global strategy that aims to reduce harms related to risky alcohol consumption. Health care services should go beyond changing mentalities and representations among health professionals. They should systematically screen pregnant women for alcohol use and elaborate a care plan when necessary to prevent Foetal Alcohol Syndrome. Significant progress should also be made in marketing alcoholic beverages and in pricing policies.