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For many people with alcohol use disorder, meaningful improvement in quality of life, and in some cases mere survival, is predicated on reducing or eliminating drinking. As a result, this is often an immediate treatment target. However, the requirement to reduce alcohol use prior to enriching other life domains may inadvertently undermine both treatment efficacy and treatment seeking. This chapter first summarizes theoretical and empirical support for alcohol treatments that emphasize the broader goal of “building a life worth living” versus the narrow goal of reducing alcohol use. Behavioral economic research is reviewed that provides robust support for reducing drinking by increasing the availability of alcohol-free sources of reward, followed by a review of brief low threshold and more comprehensive alcohol treatments that include a focus on enhancing alternatives to alcohol. The chapter concludes with a discussion of the importance of disseminating these interventions to high-risk and underserved populations.
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