Controlled Drinking vs Abstinence Addiction Recovery

Keeping alcohol in your life in a healthy way can be really challenging, especially for people who have exhibited more severe drinking habits and patterns. In sum, research suggests that achieving and sustaining moderate substance use after treatment is feasible for between one-quarter to one-half of individuals with AUD when defining moderation as nonhazardous drinking. While there is evidence that a subset of individuals who controlled drinking vs abstinence use drugs engage in low-frequency, non-dependent drug use, there is insufficient research on this population to determine the proportion for whom moderation is a feasible treatment goal. However, among individuals with severe SUD and high-risk drug or alcohol use, the urgency of reducing substance-related harms presents a compelling argument for engaging these individuals in harm reduction-oriented treatment and interventions.

Another possible option is using medications such as naltrexone or disulfiram along with psychotherapy. You may be able to gradually decrease the amount you drink without needing to go for full abstinence from alcohol. Several said that starting drinking was preceded by concerns about whether an uncontrolled craving would occur.

Understanding the Harm Reduction Model (Controlled Drinking)

While working with a clinician is the best way to determine what goals and treatment approach is appropriate for you and your medical history, here are some useful pointers to consider when reflecting on the question of abstinence vs. drinking in moderation. The capacity to sustain abstinence prior to treatment significantly decreased the likelihood of heavy drinking. Two weeks of abstinence was the optimal split in COMBINE which is consistent with prior work by Stout (2000). In PREDICT, CDA was defined as more than three weeks of abstinence due to the differences in the data ranges between COMBINE and PREDICT, but this different categorization also showed that longer pre-treatment abstinence predicted a good response. Thus individuals with less abstinence prior to entering treatment may need additional support to improve their odds of a good outcome.

• The capacity to sustain abstinence prior to treatment significantly decreased the likelihood of heavy drinking.
• One study found that among those who did not complete an abstinence-based (12-Step) SUD treatment program, ongoing/relapse to substance use was the most frequently-endorsed reason for leaving treatment early (Laudet, Stanick, & Sands, 2009).
• For example, someone might want to cut back on the amount they drink, or maybe slow down their rate of drinking.
• At Monument, you can meet with a physician, such as myself, to discuss if medication to stop drinking is appropriate for you.
• When your drinking is under control, you may have the internal bandwidth to accept the professional psychological support that can help you develop healthier ways of coping.
• Indeed, this argument has been central to advocacy around harm reduction interventions for people who inject drugs, such as SSPs and safe injection facilities (Barry et al., 2019; Kulikowski & Linder, 2018).

By quitting drinking completely, your body can begin to repair the damage caused by alcohol. If you don’t consider yourself an alcoholic or don’t feel comfortable labeling yourself one, practicing moderation helps you avoid having that discussion when you’re not in the mood. You don’t have to attend AA meetings and introduce yourself as an alcoholic, and you don’t have to answer questions at parties or social gatherings when people notice you aren’t drinking.

Moderated Drinking May Empower You to Give Up Drinking Entirely

It’s heartbreaking to see loved ones caught in the grip of addiction, but there’s hope – research shows that many people find success with programmes aimed at reducing consumption. Alcohol moderation management programmes are often successful when tailored to an individual’s specific needs and circumstances. The effectiveness of these programmes can greatly vary depending on several factors such as treatment duration, individual factors, and programme challenges. There is less research examining the extent to which moderation/controlled use goals are feasible for individuals with DUDs. The most recent national survey assessing rates of illicit drug use and SUDs found that among individuals who report illicit drug use in the past year, approximately 15% meet criteria for one or more DUD (SAMHSA, 2019a). About 10% of individuals who report cannabis use in the past year meet criteria for a cannabis use disorder, while this proportion increases to 18%, 19%, 58%, and 65% of those with past year use of cocaine, opioids (misuse), methamphetamine, and heroin, respectively.

In recovery the word sobriety usually refers to something a lot more than just not drinking alcohol or abusing drugs. Those who advocate the 12 step approach view sobriety as a life where the individual is not only free of addiction but also moving towards complete physical, emotional, mental and spiritual health. Abstinence is something that can be forced onto an individual by others, but sobriety requires a lifelong commitment that requires personal effort. Getting sober in this instance is not a once-off event but instead a continuing process. Alcoholics Anonymous differentiates between problem drinkers and full-blown alcoholics. According to AA,  very heavy drinkers can give up drinking, “given sufficient reason.” Alcoholics, by contrast, cannot stop drinking even with the consequences, without a profound mental, physical, and spiritual intervention, and controlled drinking for this population is impossible.