I didn’t stop drinking because I was a drunk – I quit because I no longer wanted to be one. But what about those people who say they don’t want to escape addiction. Do they still deserve help if they are not willing to change? Is it ever right to enable their behavior?
The Drunken Refuge Collectors of Amsterdam (great name for a band)
There is an article on BBC News website today about how alcoholics in Amsterdam are being offered beer in exchange for collecting litter. This project is organized by the Rainbow Group, and it is funded by the Dutch government.
This booze-for-litter scheme (not an official name – I just made it up) is targeted at homeless chronic-alcoholics in Amsterdam. These guys work for a few hours collecting litter in the local parks and in exchange they are given beer, food, and cigarettes. The goal of this project is not to get these people to stop drinking, but to help them enjoy a better quality of life.
Giving beer to alcoholics in exchange for work does seem to be having a positive impact. It means that these people feel like they are making a positive contribution to their community. The scheme also seems to have led to a reduction in crime in the local area.
The Ethics of Harm Reduction
Harm reduction is based on the idea that some improvement is better than no improvement. If people are going to abuse alcohol anyway, shouldn’t they be encouraged to do so in the safest way possible? If chronic-alcoholics are given the right type of help, it gives them a better quality of life and the chance to live a bit longer.
Critics of harm reduction see it as a form of enabling. This is because by improving the quality of life for alcoholics, it prevents them from hitting rock bottom. Proponents of this view might say that it is justifiable to watch alcoholics suffer because it is a type of medicine.
The problem is the rock bottom for many of these people is a miserable death. I don’t believe in ‘hopeless cases’, but I’ve met plenty of alcoholics who have no interest in giving up drinking. These were individuals who understood the consequences of their behavior but still wanted to carry on regardless.
Should Alcoholics Have a Better Quality of Life
I managed to escape alcoholism because I didn’t want to be a drunk any longer. It wasn’t the mental and physical pain that made me want to quit, and it wasn’t guilt about how my behavior impacted other people – that just made me want to drink even more. I developed the motivation to quit because I briefly experienced a better quality of life, and I wanted more of it.
This project in Amsterdam isn’t designed to promote abstinence, but it does sound like it is increasing the participant’s self-esteem. By improving the quality of life of these people, it could encourage them to want even more.
When I read the headline on the BBC website, my initial response was to feel cynical about this project. I want these people to be helped to give up alcohol and not encouraged to continue as they are. The problem is this way of looking at things is naive. There are people out there who are never going to quit alcohol, and these harm reduction projects can improve their quality of life.