Alcohol Abstinence Vs Moderation. Degree Of Dependence Predicts Which Strategy Works Best

For participants using an interactive application, the number of days without drinking at all doubled. Those that used both tools were able to reduce their drinking to fully moderate levels across the board. At a basic level moderation means setting reasonable drinking limits and sticking with them. According to the organization Moderation Management, which guides problem drinkers toward reducing their alcohol consumption, men should have no more than four drinks at one time and no more than 14 per week. For women, that amount is three at once and no more than nine per week.

The position of ALCOHOLICS ANONYMOUS and the dominant view among therapists who treat alcoholism in the United States is that the goal of treatment for those who have been dependent on alcohol is total, complete, and permanent abstinence from alcohol . By extension, for all those treated for alcohol abuse, including those with no dependence symptoms, moderation of drinking as a goal of treatment is rejected . Instead, providers claim, holding out such a goal to an alcoholic is detrimental, fostering a continuation of denial and delaying the alcoholic’s need to accept the reality that he or she can never drink in moderation. The dearth of data regarding individuals in long-term recovery highlights the need to examine a sample that includes individuals with several years of recovery experience.

I am reminded of a study done in the 1970′s and actually published in the prestigious journal Science, which claimed that moderate drinking was possible for problem drinkers. The publication was highly influential in causing the mental health community to reevaluate the necessity of abstinence. Then, decades later, some researchers followed up the subjects of this study and found that many of them had met a sorry end — often alcohol-related, causing the mental health community to reevaluate the reevaluation. For all we know, it might also be an option for people who do meet criteria for alcohol dependence but since the study we’re about to assess didn’t talk about it, we’ll leave that for later. Believe it or not, abstinence isn’t the only path people try to take to sobriety.

But the research shows clearly that moderation is unlikely to be successful for patients who already meet criteria for dependence, whether defined by the DSM-IV or by a variety of assessment tools. Take some time to review and learn about your treatment options. If at any time you feel overwhelmed, frustrated, or confused, please pick up the phone. David Bohl is Executive Director of Kiva Recovery, the trusted resource in addiction treatment. Candidates for the Alcohol Moderation Program must be at least 21 years old, with reasonably high levels of psychosocial functioning, not dependent on alcohol or other drugs, and not suffering from serious or de-stabilizing psychiatric illness. All clients must be seen by the group leader (Dr. Washton) for an intake interview to establish initial rapport, determine eligibility, and provide an orientation as to how the group works and how to get the most out of group participation.

Alcohol use significantly decreased for abstinence only, moderation to abstinence, and moderation only groups from baseline to post-intervention and 3-month follow-up. While the abstinence to moderation group did not have significant reductions at the post-intervention assessment, the overall trend was significant for each outcome. Rational Recovery, which centers on a singular approach to recovery with no support groups or regular meetings to attend, utilizes the Addictive Voice Recognition Technique. In other words, the idea is that you are constantly battling a beast inside yourself that wants to lure you back to substance abuse.

  • And we will respectfully offer you our professional advice and recommendations.
  • Nonetheless, Helzer et al. rejected the value of CD outcomes in alcoholism treatment.
  • Kishline found that she could moderate her drinking with the help of cognitive behavioral therapy principles and in 1994 created Moderation Management as an organization for non-dependent problem drinkers to help maintain moderate alcohol use.
  • The group gave her ideas for ways she could take a few days away from all of it – the stress, the husband and the drinking – and suggested more therapy to deal with the psychological triggers of her drinking and depression.
  • There are many different pathways to success, and the key lies in finding which particular pathway works best for each person.
  • The decision is partly based on how much the heavy drinking is costing, because there is a range of costs.

Three out of the 10 people at the meeting I attended said they weren’t ready to do a 30 yet, but were planning Sober living houses shorter breaks. One man celebrated the fact that he’d taken one day off from smoking weed and drinking.

Alcohol Abstinence Vs Moderation. Degree Of Dependence Predicts Which Strategy Works Best

The current aims are to identify correlates of non-abstinent recovery and examine differences in QOL between abstainers and non-abstainers accounting for length of time in recovery. I can’t even think of how many times I’ve heard the notion that complete, total, abstinence should be the only goal for all people who abuse drug or alcohol. This idea is so pervasive that most addiction treatment providers actually expel clients for relapsing, a notion that makes no sense to me especially if you believe in the idea that addiction is a chronic disease. In fact, even most research institutions and well-informed providers use total abstinence as the marker for addiction treatment success. Selecting a specific goal is an important part of any behavior change. Some worry that moderation practices may encourage alcohol use among abusers, seeing drinking in moderation as a free pass to continue abusing alcohol when it has been an obvious problem in the abuser’s life. Those individuals who cannot maintain moderation habits in the MM program generally end up moving on to abstinence programs, something a reported 30 percent of MM participants do.

alcohol abstinence vs moderation

The possibility that the opportunity to drink moderately can be used as a reinforcer in treatment programs is discussed. Traditional alcohol use disorder treatment programs most often prescribe abstinence as clients’ ultimate goal. In the broadest sense, harm reduction seeks to reduce problems related to drinking behaviors alcohol abstinence vs moderation and supports any step in the right direction without requiring abstinence . Witkiewitz has suggested that abstinence may be less important than psychiatric, family, social, economic, and health outcomes, and that non-consumption measures like psychosocial functioning and quality of life should be goals for AUD research .

1 What Is Recovery? Study

The focus of moderation management is not to deter substance abusers from abstinence or draw them away from an already present commitment to such. Rather, there is more concern in the substance abuse treatment community over the number of addicts who never even attempt to seek treatment — a figure that accounts for around 90 percent of the substance-abusing population.

Among individuals in recovery from alcohol problems in the What Is Recovery? sample, the strongest factors related to non-abstinent recovery were fewer DSM alcohol dependence symptoms and younger age. The negative relationship between DSM severity and probability of non-abstinent (vs. abstinent) recovery supports past alcohol abstinence vs moderation findings from large general population (Dawson et al. 2005) and treatment samples. Consistent with past studies, we also found in the WIR sample that help-seeking (e.g., treatment, AA) for AUD was negatively related to the odds of non-abstinent recovery (Cunningham et al. 2000; Dawson et al. 2005; Sobell et al. 1996).

alcohol abstinence vs moderation

It also solved his ongoing dilemma of never knowing how much was too much. We decided to do a 30 together, and after two false starts – there was a party to go to! And a nice Italian dinner, which of course cannot go without wine – we are now 20 days in and feeling fine. It feels like something that might be very good to do once a year, in fact.

Reducing Barriers To Starting To Change One’s Drinking

Controlled drinking has an important role to play in alcoholism treatment. Controlled drinking as well as abstinence is an appropriate goal for the majority of problem drinkers who are not alcohol-dependent. Finally, reduced drinking is often the focus of a harm-reduction approach, where the likely alternative is not abstinence but continued alcoholism. Severity of alcoholism is the most generally accepted clinical indicator of the appropriateness of CD therapy . Untreated alcohol abusers probably have less severe drinking problems than clinical populations of alcoholics, which may explain their higher levels of controlled drinking. But the less severe problem drinkers uncovered in nonclinical studies are more typical, outnumbering those who “show major symptoms of alcohol dependence” by about four to one .

They were also able to reduce their scores on instruments assessing problem associated with drinking alcohol and their overall drinking problem severity. Importantly, even on drinking days, these participants reduced their blood alcohol content levels by almost 50 percent. Research shows that moderate drinking can work for those who abuse alcohol. The What is Recovery Study was a large and important undertaking in the field of recovery research. For example, while only 11% of these individuals were in the non-abstinent recovery group, as mentioned above nationally representative data suggest more than half of those in remission are not currently abstinent. Of course, however, defining oneself as “in recovery” and meeting the medical definition of remission are not the same.

alcohol abstinence vs moderation

When discussing goals of change, nearly all of my alcohol dependent clients would choose abstinence when they learned the limits of moderate drinking. A common response “That’s not drinking!” followed by a comment that it would be easier to refrain entirely than try to drink that little. Alcohol abuse is on the rise in the U.S. while dependence is declining and the Institute on Medicine has determined that problem drinkers who are not dependent are a significant cost to society and whose needs are unmet . And both programs are encouraging of abstinence if the drinker is unsuccessful with moderation.

Personal Experiences Of Moderation & Abstinence In Addiction Recovery

And it goes without saying that for anyone who has developed a really serious drinking problem, abstinence is by far the safest course. However, research also has shown that with proper help “problem drinkers” (non-alcoholics with less severe drinking problems) can and sometimes do successfully learn how to moderate their drinking and reliably keep it within safer limits. alcohol abstinence vs moderation We offer two types of treatment options for people who want help for drinking problems. One option is abstinence-based treatment for individuals who have decided to stop drinking completely and want to stay stopped over the long term. Their decision is often the result of failed attempts at controlled drinking and/or suffering severe alcohol-related consequences.

alcohol abstinence vs moderation

Many problem drinkers and alcoholics are in denial about how much they drink and how much of an issue it is. It is not difficult to imagine that an alcoholic attempting moderation would use it as an excuse to keep drinking all the while claiming his habit was surely moderate. Moderation Management is a secular non-profit organization providing peer-run support groups for anyone who would like to reduce their alcohol consumption.

But instead of swelling up after a bee sting, the alcoholic’s reaction to drinking is that the body craves more alcohol. The Big Book states that alcoholics have bodies that are wired differently. The book states that when a person drinks, they have a phenomenon of craving, which means an alcoholic cannot control the amount that they take. When someone is drinking in moderation, they are not drinking excessively. Sometimes an alcoholic can stop for a while, but their emotions and disposition probably aren’t positive or helpful. Have you ever been around an alcoholic who has tried to stop drinking without any help? But once they are finished drinking, they will not obsess over getting more like an alcoholic.

Take some time to decide which days are OK to have a drink and which days are off-limits. Once you start drinking, you may not be able to predict or control how much alcohol you’ll end up consuming. “Moderate consumption” is limited to one to two alcoholic drinks per day for healthy men and one alcoholic drink per day for healthy women. One drink is equivalent to 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of distilled spirits. For years, the answer was assumed to be no, there is no room for “just one drink” for anyone with a drinking problem. Today, there are programs like Moderation Management, which do allow for a certain level of controlled drinking and have helped many learn to drink safely. I also had a number of non-dependent clients who successfully learned to moderate ultimately choose to abstain.

Abstinence Vs Moderation: Can Moderation Work

When out for a nice dinner or attending a get-together, she still wanted the freedom of having a drink or two. Her counselor agreed that limiting her drinking could be a good solution and they set a goal for Sara to cut back her consumption to these special occasions only. The book states that the way an alcoholic drinks is as if they have an allergic reaction.

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