In Germany public health is impaired by high alcohol consumption and alcohol related damage. Yet very few people who participate in excessive forms of alcohol consumption obtain any alcohol specific treatment. The present German controversy surrounding Controlled Drinking (CD) as an appropriate treatment goal and a means to improve the range and effectiveness of the existing health care system is discussed. In this article the author provides an overview of the German CD trials. The German behavioral self-control programs (the “AkT” group program and the bibliotherapeutic “10 Steps Program”) that triggered the present debate on CD are discussed as well. It is concluded that with regard to public health, ethical, therapeutic, and effectiveness concerns, CD approaches should become adjunct to the traditional German abstinence oriented treatment system for alcohol and drug addicts.

The present study tested the effectiveness of a German behavioural self-control training (BSCT) for subgroups of drinkers differentiated by sex, ICD-10 diagnosis, and severity of dependence. Hazardous, harmful, and dependent drinkers were recruited through local mass media or referred by other treatment agencies. N ¼ 53 subjects (60% men, mean age 48.9 years, 76% employed, 64% alcohol dependent) participated in 10 weekly group treatment sessions and were assessed at intake, end of treatment, and 1-year follow-up (with 81% successfully contacted). Improvements made during BSCT remained stable over the 1-year follow-up period with 52% of subjects classified as improved (8% abstinent, 44% with a decline in alcohol consumption of at least 30%). In women, alcohol abusers and low dose drinkers (<800 g ethanol/w), alcohol intake had declined less than in men, alcohol dependent subjects, and high dose drinkers (>800 g/w). This study, as others, indicates that alcohol dependence in itself is no contraindication for controlled drinking (CD) treatment.