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March 20, 2014 9:35 AM Suspending the Privilege to Drink

By Keith Humphreys

Husband, while opening a beer: “It’s every working man’s right to have a beer on the weekend!”

Wife: “It’s Wednesday and you’re unemployed.”

24/7 Sobriety is a program that mandates abstinence from alcohol for a number of months after a problem drinker is convicted of repeat drink driving or alcohol-related assault. Offenders’ alcohol use is regularly monitored, with any drinking being punished by a swift, certain but modest sanction (e.g., one night in jail). The program has been shown to reduce the rate of alcohol-involved vehicular deaths, drink driving arrests and domestic violence arrests.

You might think that no one could be against something that protects public safety while also helping people with drinking problems stay abstinent. But almost every time I give a talk about 24/7 Sobriety, a few people express upset that the “right to drink” of offenders is being compromised.

Sometimes it’s an ideological objection based on what I consider a overly literally interpretation of the harm reduction philosophy. For people with this viewpoint, state intervention in the use of a substance per se is always wrong. A second group of critics make an even balder criticism: “It’s every working man’s right to have a beer” — a senior male British politician used these very words when I was working with the U.K. Parliament on 24/7 Sobriety enabling legislation in 2012. (Not incidentally, the Parliamentary champions of the U.K. legislation were disproportionately female).

I have tried to persuade these critics to relent. For the first group of critics, I note that even though 24/7 Sobriety targets substance use per se it does a brilliant job of reducing harm. But this observation tends to inflame the opposition for the simple reason that it’s accurate (Nothing irritates an ideologue more than to have his or her philosophy empirically disconfirmed). For the second group of critics, I advance the argument that rights compete with each other, and the right of a man to drink could never trump the right of a woman not to have her nose broken by a drunken husband. Stony silence has been my usual reward for that argument.

I therefore am in debt to Beau Kilmer for providing a different framing of the issue that has on multiple occasions helped move the minority of critics towards consensus with the majority who are thrilled about the benefits of 24/7 sobriety. Beau noted that we don’t let some people drive or drink: Children and adolescents. When we become adults, we are granted these privileges but we all accept that if you prove to be a reckless driver, your driving privileges can be temporarily suspended. 24/7 sobriety is an extension of the same, widely-accepted concept: If you prove to be a reckless drinker your drinking privileges can also be temporarily suspended. That’s a perspective that everyone who cares about public health and public safety should be able to get behind.

[Cross-posted at The Reality-Based Community]

Keith Humphreys is a professor of psychiatry and behavioral medicine at the Stanford University School of Medicine.

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