Column: What the health do alcohol and drug counselors do?

By Gus Bode

What really happens in substance abuse counseling? Many students have preconceived ideas that a professional counselor judges them, telling them ‘don’t drink’ or don’t do other things. A majority of the students I work with come in by referral for alcohol or drug violations. However, some do voluntarily seek assistance to learn more about their own use, deal with addiction, talk about how to handle cravings, explore coping skills or want support for addressing the addictions of family members and loved ones. Even those who are mandated to come see me gain new knowledge when they allow themselves to be open to the experience. Many do.

Generally speaking, I see myself as a guide. As a counselor and educator, that is my role. I am not here to tell anyone what to do or how to live their lives. First, ‘just say no’ doesn’t work. Second, judgment of a behavior or action related to alcohol or drug use serves no purpose. My goal is to help each individual develop further awareness into how and why they use a substance.

Not all people who come to see me have problems with alcohol or drugs. Most are not alcoholics or drug addicts. But many have had problems in their lives caused by using a substance, whether they were legal, social, academic, family or health-related issues. It may seem like a splitting of hairs, but the distinction is great. True addiction, the brain disease that is evidenced by a compulsion to use and a loss of control, requires abstinence for remission of symptoms. Other types of substance use that lead to problems can be addressed through the practice of harm reduction, and abstinence is an option.


The harm reduction philosophy is simple. Insight into the consequences of one’s actions can reduce risks of negative impact of use. A basic example is that if you choose to drink, don’t drive. So my goal is to inform and plan ways to avoid such risk.

In essence, each individual has the ability and right to choose what they will and will not implement, regardless of any recommendations. That does not mean I won’t challenge perceptions of individual or peer using behaviors. That does not mean I will agree with personal reasons for continuing a behavior. However, the students I meet with are free to disagree with my ideas. Many have identified and implemented changes in their lives prior to ever entering my office. Others, I ask to consider the possibility of entertaining an alternative viewpoint.

In the end, I try to be genuine and authentic with each student I meet. This includes acknowledging my own imperfections. This means I don’t have all the answers they may be looking for. But, I can guide someone to the answers they already possess within themselves.

I do what I do, not because I expect a certain outcome from each person I work with, but because the journey to self-awareness is important. I do what I do because someone once helped me. Many someones. Many still do.

Chris Julian-Fralish is alcohol and other drug coordinator at the Wellness Center.