Moderated Drinking: A Creative Strategy to Treat Alcoholism?


Witkiewitz (2013) has suggestedthat abstinence may be less important than psychiatric, family, social, economic, andhealth outcomes, and that non-consumption measures like psychosocial functioning andquality of life should be goals for AUD research (Witkiewitz 2013). These goals are highly consistent with the growingconceptualization of `recovery’ as a guiding vision of AUD services (The Betty Ford Institute Consensus Panel 2007). Witkiewitz also arguedthat the commonly held belief that abstinence is the only solution may deter someindividuals from seeking help. It was also hypothesized that, given naltrexone’s effect on hedonic response to alcohol (King et al., 1997; McCaul et al., 2001; Ray et al., 2010), naltrexone would be more effective among those with a controlled drinking goal versus those with an abstinence oriented goal.

Study Inclusion Criteria

If you believe that harm reduction therapy may help, you may be interested in our alcohol addiction program. For example, a person who has one glass of wine every night may think they’re okay, but under MM, they’re breaking the rules. It’s crucial that people give their body a break from alcohol every few days, and the MM rules generally encourage this. If missing information could not be provided, partial publication data were not considered. Studies excluded due to missing data were discussed with regard to their main characteristics to exclude possible biases. Finding useful information and resources about addiction or alcoholism can be a minefield.

The Irrationality of Alcoholics Anonymous – The Atlantic

The Irrationality of Alcoholics Anonymous.

Posted: Wed, 15 Apr 2015 07:00:00 GMT [source]

How to Get Help for Drug or Alcohol Misuse

The dynamic nature of drinking goal may be an important clinical variable in its own right (Hodgins, Leigh, Milne, & Gerrish, 1997). The present study was limited to the assessment of drinking goal at the onset of treatment and future studies examining drinking goals over the course of treatment seem warranted. Likewise, further research should consider matching patients’ drinking goals to specific treatment modalities, whether behavioral or pharmacological in nature. While there are many obstacles to the widespread acceptance of CD as a treatment approach (Sobell & Sobell 2006), it is important to note that not all individuals entering treatment do so with the goal of achieving abstinence.

Historical context of nonabstinence approaches

However, they no longer found themselves in need of this help and did not express ambivalence regarding their decision to stop attending meetings. On the other hand, some clients in the present study had adopted the 12-step principles, intensified their attendance and made it more or less central in their life. Regarding the limitations, the completion and conviction of the conclusion may be weakened by the following aspects. First, some therapies included had few clinical studies and insufficient sample sizes for pooling or looping analyses.43 Second, the small number of included studies and the lack of severity stratification of results in some of the studies did not facilitate the exploration of the association between severity and outcomes. Third, there was a lack of rigorous reports on randomization methods, allocation concealment, and control of implementation bias.

3. The harm reduction movement

It’s not an easy road to lasting recovery, but with the right support and resources, it can definitely be a journey worth taking. Some interview person (IP) were former polydrug users and altered between AA and NA meetings. I don’t think I have a problem, but I might be someone that could get it [problems] more than anyone else […] (IP30). Take our free, 5-minute substance use self-assessment below if you think you or someone you love might be struggling with substance use. The evaluation consists of 11 yes or no questions that are intended to be used as an informational tool to assess the severity and probability of a substance use disorder. The test is free, confidential, and no personal information is needed to receive the result.

Therefore, knowledge about whether and how QOL differs betweennon-abstinent vs. abstinent recovery remains limited. Regarding pharmacological interventions for alcohol use disorders, recent laboratory studies of naltrexone have elucidated its mechanisms of action. Importantly, one study examined the effects of naltrexone on alcohol non-abstainers and found that participants who drank regularly during the treatment period benefited more from naltrexone relative to placebo (Ray, Krull, & Leggio, 2010). Together, these findings suggest that naltrexone may be better suited to a controlled drinking approach and thus may be more effective among patients with controlled drinking goals. Unfortunately, there has been little empirical research evaluating this approach among individuals with DUD; evidence of effectiveness comes primarily from observational research. For example, at a large outpatient SUD treatment center in Amsterdam, goal-aligned treatment for drug and alcohol use involves a version of harm reduction psychotherapy that integrates MI and CBT approaches, and focuses on motivational enhancement, self-control training, and relapse prevention (Schippers & Nelissen, 2006).

The Complex Link Between Anxiety and Pornography Addiction

  • It is well known to both clinicians and researchers in the addiction field that patients in alcoholism treatment vary dramatically with respect to their alcohol use goals.
  • 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.
  • A brief description of the controversy surrounding controlled drinking provides a context for a discussion of various approaches to controlled drinking intervention as well as relevant clinical research.
  • Change in DDD was assessed by TLFBs or Form-90 to evaluate the change in average drinking on a drinking day, using a “standard drink” as a measure.

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. Questions on main drug and other problematic drug use were followed by the interviewer giving a brief summary of how the interview person (IP) had described their change process five years earlier.

4. Consequences of abstinence-only treatment

controlled drinking vs abstinence

Expecting someone to potentially cut those events out of their lives to reduce the exposure to alcohol is not always realistic. According to research, “Many individuals experiencing problems related to their drinking (e.g., college students) are not interested in changing their drinking behavior and would most likely be characterized in the precontemplative stage of the transtheoretical model. Harm reduction provides a good method for matching these individuals at that stage and providing motivational incentives (e.g., discussing the negative consequences the person is experiencing) to motivate their desire for positive change” (Marlatt & Witkiewitz, 2002). Potential correlates of non-abstinent recovery, such as demographics andtreatment history, were based on NESARC results. Additionally, the survey asked about current quality oflife using a 4-point scale as administered by the World Health Organization (The WHOQOL Group 1998). The ability to control drinking varies significantly from person to person and is influenced by a range of factors including genetics, environment, emotional state, and individual psychology.

The position of ALCOHOLICS ANONYMOUS (AA) 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 (and, often, other intoxicating substances). By extension, for all those treated for alcohol abuse, including controlled drinking vs abstinence those with no dependence symptoms, moderation of drinking (termed controlled drinking or CD) as a goal of treatment is rejected (Peele, 1992). 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.