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Over the InfluenceReview - Over the Influence
The Harm Reduction Guide for Managing Drugs and Alcohol
by Patt Denning, Jeannie Little and Adina Glickman
Guilford Press, 2003
Review by Fred Ashmore
Feb 23rd 2005 (Volume 9, Issue 8)

This is a terrific book. Recovering from alcohol and drug habits isn't a fun subject, but it's an interesting one. People's reasons for starting with a substance are as varied as people are.  What this book showed me is that the habit is just one aspect of a person's life. To understand it or offer help, you'd best try to see the whole picture and focus on what you want to achieve.

The title phrase "Harm Reduction Guide" is central to what Over the Influence is trying to do (my opinion) which is to help people with a problem.  In contrast to the widely adopted advise that complete abstinence is the only way to start recovery, that you have to hit rock bottom before you can start recovery Over the Influence is about learning how to reduce the damage that a habit does.  Sure, this may work out as complete abstinence in due time, but the important thing for many, many users is to improve life.  Now, if possible. 

The authors describe themselves as "therapists who have worked with hundreds of people who use drugs -- both the legal ones and the illegal ones."  It shines through.   If I was in a severe fix with a drug habit, these are people who would listen, would not judge (in the censorious sense) and who would have sensible ideas on what I could try to improve my position. 

I very much appreciated the respectful tone.  The message seems to be, "You have a problem with a substance related habit?  Here are some facts we know, this is how we see their meaning, here are some options that you might like to think about in relation to your situation."  I have read a good number of self-help books, and many of them try to achieve this tone.  Few manage it.

OK, enough lavish praise (I suspect that I'll break out again before the end of this review, though).  What is the book content?  Here are the chapter titles.

What is Harm Reduction, Anyway?

1.      Addiction: is it all or nothing?

2.      So if we're not addicts, what's the harm?

3.      How much is too much?

4.      To change or not to change

5.      How do I know exactly what my problem is?

What are these drugs, anyway? (factual information on the main groups of drugs)

6.      Practicing harm reduction: substance use management

7.      Practicing  harm reduction: how to take care of yourself while still using

8.      Finding the right help

9.      Is harm reduction workin?

10.  How to talk to family and friends about harm reduction

A letter to family and friends


Sources and suggested readings in harm reduction

I appreciated the introductory explanation on the harm reduction approach.  Harm Reduction is a term that is quite widely used, and it is an excellent idea to set out what is meant.  The reasoning behind looking for a new approach is carefully explained, without being too damning of the weaknesses of the predominant twelve-step approach.

One of the reasons I liked this book is that it is shaped around the process of change.  Prochaska et al wrote their seminal book "Changing for Good" many years ago, and I believe their ideas to be very valuable for anyone involved in drugs and addictive behaviors.  The first 5 chapters are about evaluating the problem so one understands what type of change is wanted; the last five about methods for effecting the change and doing one's best to stay healthy and enjoy life while doing so.

I found the commentary "What are these drugs anyway" on the effects and hazards of drugs extremely enlightening -- including facts  on my two legal drugs of choice, caffeine and nicotine.  As the proud father of two teenagers and two twenty something students, I am also grateful to the authors of Over the Influence for providing me with additional factual information on substances that my wonderful kids may be experimenting with.

Who is this for?  Essentially the book is aimed at those who are using and those who have a relationship with someone who is using -- family, friends and relatives.  I think it would also be a valuable resource for professionals who are looking for a concise explanation of harm reduction, but that isn't a stated target group.

Any gripes or complaints?  There has to be one, surely?  Sure.  The reference to Bufe's book "AA-Cult or Cure" cites the 1st 1991 edition. There's a second edition from 1992 with quite a lot more material (but no less damning of AA).

What else made this book so enjoyable for me?  As a highly interested amateur, reasonably widely read, I found myself repeatedly nodding in agreement, grinning at new perceptions or surprised and intrigued by new information.  As I said at the beginning, this is a terrific book -- very well written, informative, humane and kindly.  Oh, and I think if you have a habit you want to deal with, this would be a good starting point. 


© 2005 Fred Ashmore


Fred Ashmore is a member of the public with a strong interest in drugs, drink and addiction and how people recover from them. He is active as a meeting host for the SMART Recovery® program, which offers help for people who seek to modify harmful and addictive behavior.


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