The major prevention approach thus became to identify “alcoholics” and persuade them to abstain, but otherwise to leave drinkers (and the alcohol industry) to their own devices. It seems to have been resolved in the (mistaken) belief that only certain people (namely, alcoholics) cannot drink safely, because they are constitutionally different from normal people. When prohibition was repealed and alcohol became freely available in American society, there was a national crisis of cognitive dissonance. prohibition, during which the public had been taught that no one could drink alcohol safely, and that the only alternatives were abstinence or insanity and death. This all-or-none view was a hold-over from U.S. An impassioned debate raged around the term “controlled drinking,” and the common belief was that a person was either an alcoholic (in which case moderate drinking was impossible, or at best ill-advised) or not an alcoholic (in which case one could drink with impunity). Behavioral self-control training, which had been used for behavior change in other areas (such as weight loss and eating patterns) seemed a sensible approach to help people learn to moderate their drinking and keep it within limits unlikely to cause them health or other problems.Īlthough primary care physicians are now routinely urged to identify heavy drinkers and help them moderate their alcohol use, this was highly controversial in the 1970s. ![]() ![]() I was interested in an early intervention for people who were drinking too much, but were unlikely to seek treatment before their problems became more severe. This was the first line of research that I undertook, beginning with my dissertation in 1974 (Miller, 1978). Behavioral Self-Control Training (“Controlled Drinking”)
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