Remember that the path towards lasting recovery isn’t linear — there will be ups and downs. But with patience, persistence and these strategies at hand – you’re better equipped than ever before on this journey towards healthier living minus harmful drinking habits. Remember that every person’s journey is unique; there are no one-size-fits-all solutions for managing alcohol intake.
- The dynamic nature of drinking goal may be an important clinical variable in its own right (Hodgins, Leigh, Milne, & Gerrish, 1997).
- Edwards et al. (1983) reported that controlled drinking is more unstable than abstinence for alcoholics over time, but recent studies have found that controlled drinking increases over longer follow-up periods.
- While abstinence refers to behaviour, sobriety goes deeper and concerns the roots of the problem (addiction) and thereby refers to mental and emotional aspects.
- 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.
- Attempts at moderation may not be worth the effort or the risk when considering the consequences.
Summary of the COMBINE Study
Second, realize a commitment to sobriety is not a commitment to be forever perfect. Before you consider that to be a SMART Recovery® license to relapse, it is not. The reality for alcohol addictions, for example, is that people have an average of two and a half relapses in their ultimate turn to permanent sobriety. A commitment to sobriety means that you are committed to a course of action, understanding that it is not an easy task and one that takes a great deal of patience, persistence and practice.
How to Get Help for Drug or Alcohol Misuse
Furthermore, one report using a trajectory analysis of the COMBINE study data found the Combined Behavioral Intervention (CBI), which is principally grounded in CBT, to reduce the risk of being in an “increasing to nearly daily drinking” trajectory. This study suggests that CBI may help participants control their drinking as opposed to simply encouraging abstinence (Gueorguieva et al., 2010). However, no studies to date have assessed the moderating role of drinking goal on CBI efficacy. This paper presents a narrative review of the literature and a call for increased research attention on the development of empirically supported nonabstinence treatments for SUD to engage and treat more people with SUD. We define nonabstinence treatments as those without an explicit goal of abstinence from psychoactive substance use, including treatment aimed at achieving moderation, reductions in use, and/or reductions in substance-related harms.
How do I make the commitment?
For people suffering from alcohol use disorders, trying to moderate drinking isn’t advised and total abstinence is always recommended. Some strategies and guidelines to consider if you’re aiming to practice controlled drinking include setting limits, eating before drinking, choosing drinks with lower alcohol content, alternatives with non-alcoholic beverages and having abstinent days. A holistic treatment approach is another crucial aspect of quitting alcohol effectively. This means addressing not just the physical symptoms of addiction but also the psychological, emotional, social, and spiritual aspects as well. Such approaches could include cognitive behavioural therapy to address mental health issues that may contribute to excessive drinking; yoga or meditation for stress relief; art therapy for expressing emotions; faith-based support groups for spiritual growth among others.
4. Consequences of abstinence-only treatment
As noted by Adamson and colleagues (2010), treatment goals may change over the course of treatment and must be continuously evaluated in order to promote the best possible outcomes. The current review highlights a notable gap in research empirically evaluating the effectiveness of nonabstinence approaches for DUD treatment. While multiple harm reduction-focused treatments for AUD have strong empirical support, there is very little research testing models of nonabstinence treatment for drug use. Despite compatibility with harm reduction in controlled drinking vs abstinence established SUD treatment models such as MI and RP, there is a dearth of evidence testing these as standalone treatments for helping patients achieve nonabstinence goals; this is especially true regarding DUD (vs. AUD).
Important features common to these groups include low program barriers (e.g., drop-in groups, few rules) and inclusiveness of clients with difficult presentations (Little & Franskoviak, 2010). Individuals with greater SUD severity tend to be most receptive to therapist input about goal selection (Sobell, Sobell, Bogardis, Leo, & Skinner, 1992). This suggests that treatment experiences and therapist input can influence participant goals over time, and there is value in engaging patients with non-abstinence goals in treatment. As the IP had a successful outcome, six months after treatment, their possibilities for CD might be better than for persons with SUD in general.
Reasons Abstinence From Alcohol May Be the Best Choice
After a period of moderate drinking, some people end up achieving abstinence anyway. If quitting is your ultimate goal, starting with moderation may help you achieve it. And even if you don’t plan to quit, you may find that you lose interest in alcohol after practicing moderation. Multivariable stepwise regressions (Table2) show that younger individuals were significantly more likely to benon-abstinent, and movement to the next oldest age category reduced the odds ofnon-abstinence by an average of 27%. Importantly, the confidence intervals were narrow andextremely similar across models, implying that the effect of age was robust to modelspecification. In regard to help-seeking and problem severity, having attended at leastone 12-step meeting and the number of DSM-IV dependence symptoms were both significantlyrelated to non-abstinence.
In addition, while controlled drinking becomes less likely the more severe the degree of alcoholism, other factors—such as age, values, and beliefs about oneself, one’s drinking, and the possibility of controlled drinking—also play a role, sometimes the dominant role, in determining successful outcome type. Finally, reduced drinking is often the focus of a harm-reduction approach, where the likely alternative is not abstinence but continued alcoholism. Nordström and Berglund, like Wallace et al. (1988), selected high-prognosis patients who were socially stable. The Wallace et al. patients had a high level of abstinence; patients in Nordström and Berglund had a high level of controlled drinking.
- The Haynes Clinic offers residential treatment for dependency on alcohol, drugs and prescription medication.
- Importantly, clinical assessment of drinking goal is a readily accessible clinical variable which, given the results presented herein, is potentially critical to treatment planning and prognosis.
- Some people aren’t ready to quit alcohol completely, and are more likely to succeed if they cut back instead.
- More recent versions of RP have included mindfulness-based techniques (Bowen, Chawla, & Marlatt, 2010; Witkiewitz et al., 2014).
- Levy, a treatment clinic director and a lecturer at Harvard Medical School, is exceedingly careful not to disparage AA.
- There is also a need for updated research examining standards of practice in community SUD treatment, including acceptance of non-abstinence goals and facility policies such as administrative discharge.
- This hypothesis was not supported by the data in that there was no significant drinking goal × naltrexone interaction in any of the outcome measures.
Moderation vs. Abstinence: Should You Cut Back or Quit Drinking Completely?
For many Americans, Alcoholics Anonymous is synonymous with alcohol addiction treatment, and for good reason. Its system of free support groups, a 12-step program, and confessional meetings over the smell of percolating coffee as members sit in a circle is part of the popular culture, giving birth to other legitimate groups such as Narcotics Anonymous and silly parodies such as Chocoholics Anonymous. There are various ways that individuals can take advantage of face-to-face gatherings, very much like what is offered by moderation management, or they can settle on online experiences that can fulfill the same need in a more adaptable way. On the site of the program, one can find aides that show how much alcohol is permissible as well as commentaries that allow https://ecosoberhouse.com/ individuals to examine their battles and find recognition for their accomplishments.
