Alcohol Moderation Management: Programs and Steps to Control Drinking

However, CD is a widely accepted treatment goal in Australia, Britain and Norway (Luquines et al., 2011). The Swedish treatment system has been dominated by total abstinence as the goal, although treatment with CD as a goal exists (e.g., Agerberg, 2014; Berglund et al., 2019). Administrative discharge due to substance use is not a necessary practice even within abstinence-focused treatment (Futterman, Lorente, & Silverman, 2004), and is likely linked to the assumption that continued use indicates lack of readiness for treatment, and that abstinence is the sole marker of treatment success. In the United Kingdom, where there is greater acceptance of nonabstinence goals and availability of nonabstinence treatment (Rosenberg et al., 2020; Rosenberg & Melville, 2005), the rate of administrative discharge is much lower than in the U.S. (1.42% vs. 6% of treatment episodes; Newham, Russell, & Davies, 2010; SAMHSA, 2019b).

Historical context of nonabstinence approaches

If you are struggling with some of the following signs above, be sure to contact your physician or seek help at a substance abuse treatment facility.

Summary of the COMBINE Study

Given low treatment engagement and high rates of health-related harms among individuals who use drugs, combined with evidence of nonabstinence goals among a substantial portion of treatment-seekers, testing nonabstinence treatment for drug use is a clear next step for the field. Ultimately, nonabstinence treatments may overlap significantly with abstinence-focused treatment models. Harm reduction psychotherapies, for example, incorporate multiple modalities that have been most extensively studied as abstinence-focused SUD treatments (e.g., cognitive-behavioral therapy; mindfulness). However, it is also possible that adaptations will be needed for individuals with nonabstinence goals (e.g., additional support with goal setting and monitoring drug use; ongoing care to support maintenance goals), and currently there is a dearth of research in this area.

History of Moderation Management

• 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).
• 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.
• 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.

Whether you’re considering moderation or complete abstinence, this article will provide information about how to begin an Alcohol Moderation Management (AMM), its effectiveness, potential drawbacks, and its applicability to people dealing with alcoholism. At the first interview https://ecosoberhouse.com/ all IPs were abstinent and had a positive view on the 12-step treatment, although a few described a cherry-picking attitude. 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.

4. Consequences of abstinence-only treatment

Here we found that a number of factors distinguish non-abstainers from abstainersin recovery from AUD, including younger age and lower problem severity. Furthermore, qualityof life appeared significantly better among abstainers than non-abstainers. A betterunderstanding of the recovery process and tools utilized by non-abstinent vs. abstinentindividuals would inform clinical practice; for example, is it more important for those inabstinent recovery to have abstinent individuals in their social networks? How do thespecifics of AA and other mutual aid group involvement affect long-term recovery?

Moderation vs. Abstinence: Should You Cut Back or Quit Drinking Completely?

By 1989, treatment center referrals accounted for 40% of new AA memberships (Mäkelä et al., 1996). This standard persisted in SUD treatment even as strong evidence emerged that a minority of individuals who receive 12-Step treatment achieve and maintain long-term abstinence (e.g., Project MATCH Research Group, 1998). Earlier research utilizing drug use goals analogous to goals used in the present study found commitment to absolute abstinence, measured at the end of treatment, to predict days to relapse controlled drinking vs abstinence across nicotine, alcohol, and opiate dependence (Hall & Havassy, 1986; Hall, Havassy, & Wasserman, 1990). These findings were such that participants committed to complete abstinence took longer to slip and longer to relapse, defined as drug use on four or more days in a week. Critically, Hall et al. (1986, 1990) examined participants with an abstinence goal allowing for occasional slips and found that these participants did not fare as well as participants with complete abstinence goals.

Expanding the continuum of substance use disorder treatment: Nonabstinence approaches

This 25-item scale measures alcohol dependence symptoms over the past 12-months and has been shown to contain items that are very relevant for alcohol dependent drinkers (Kahler, Strong, Stuart, Moore, & Ramsey, 2003), such as the ones recruited in the present study. If you have health problems related to alcohol, it may be unsafe to drink at all, period. 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. Abstinence means giving up alcohol completely, and it’s the foundation of traditional treatment options like AA and most inpatient rehabs.

What is Controlled Drinking or Alcohol Moderation Management?

At one extreme, Vaillant (1983) found a 95 percent relapse rate among a group of alcoholics followed for 8 years after treatment at a public hospital; and over a 4-year follow-up period, the Rand Corporation found that only 7 percent of a treated alcoholic population abstained completely (Polich, Armor, & Braiker, 1981). At the other extreme, Wallace et al. (1988) reported a 57 percent continuous abstinence rate for private clinic patients who were stably married and had successfully completed detoxification and treatment—but results in this study covered only a 6-month period. There are no long-term studies that can provide concrete insights into the program’s success. But walk into any MM meeting and you’ll find people who boast that it’s the answer to their problems. Recent research in this field has shown that our previous understanding of how much we can drink without negatively impacting our health was incorrect.