When it comes to drinking, the popular explanation in our culture is that heavy drinkers suffer from the disease of alcoholism, and that a feature of this disease is a loss of control. But that only begs the question why? It’s very hard to believe that millions of people have a mystery behavioral disease for which there is no cure, and the only treatment is lifelong abstinence.

There is a continuum of alcohol/drug use: Instead of seeing alcohol or drug use in black-and-white terms of using or not using, the idea of a continuum recognizes that there are different levels of use, from occasional, to regular, to heavy, and on to chaotic use. In general, the closer you are to the low-use end of the continuum, the more harm you are reducing.