Is Drinking in Moderation Possible for Alcoholics?

In general, the efficacy of both techniques does not appear to vary as a function of drinking severity but may vary as a function of drinking-related self-efficacy. Guided-self change is a relatively new and Top 5 Advantages of Staying in a Sober Living House brief cognitive-behavioral intervention that has demonstrated efficacy with problem drinkers. Interventions based on harm reduction principles have decreased alcohol use in various student populations.

How to Get Help for Drug or Alcohol Misuse

controlled drinking vs abstinence

Initially, AA was not intended to offer a professional programme model for treatment (Alcoholics Anonymous, 2011). When the premise of AA was transformed into the 12-step treatment programme, it was performed in a professional setting. Many clients in the study described that the 12-step programme was the only treatment that they were offered. The context of treatment in a professional setting, and in many cases, the only treatment offered, gives the 12-step philosophy a sense of legitimacy. 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).

Historical context of nonabstinence approaches

This narrative review considers the need for increased research attention on nonabstinence psychosocial treatment of SUD – especially drug use disorders – as a potential way to engage and retain more people in treatment, to engage people in treatment earlier, and to improve treatment effectiveness. Despite significant empirical support for nonabstinence alcohol interventions, there is a clear gap in research examining nonabstinence psychosocial treatment for drug use disorders. Future research must test the effectiveness of nonabstinence treatments for drug use and address barriers to implementation. As a data check, all outcomes presented in the primary COMBINE manuscript were replicated prior to any model testing for this study.

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In the fully saturated models, any twelve-step attendancedecreased odds of non-abstinence by 57–76% (Model 4), while each additional DSMsymptom decreased odds of non-abstinence by 73–89% (Model 4). 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).

  • Major federal investments into women’s health research are a vital step toward developing better prevention and treatment options for women.
  • Together, this suggests a promising degree of alignment between goal selection and probability of success, and it highlights the potential utility of nonabstinence treatment as an “early intervention” approach to prevent SUD escalation.
  • I don’t think I have a problem, but I might be someone that could get it [problems] more than anyone else […] (IP30).
  • Severity of alcoholism is the most generally accepted clinical indicator of the appropriateness of CD therapy (Rosenberg, 1993).

Total Alcohol Abstinence vs. Moderation: Which One Wins in the End?

On the other hand, as the group expressed positive views on this specific treatment, they might question the sobriety goal in a lesser extent than other groups. Some of the abstainers reported experience of professional contacts, such as therapists or psychologists. These contacts had often complemented the support from AA but in some cases also complicated it as the IPs found that their previous SUD was related to other things that were not in line with the approach to addiction as a disease (e.g. IP19). After transcribing the interviews, the material was analysed thematically (Braun and Clarke, 2006) by coding the interview passages according to what was brought up both manually and by using NVivo (a software package for qualitative data analysis). After relistening to the interviews and scrutinizing transcripts, the material was categorized and summarized by picking relevant parts from each transcript.

controlled drinking vs abstinence

controlled drinking vs abstinence

These findings were conceptualized in the context of the abstinence violation effect, whereby an initial lapse triggers heavier within-episode drinking among abstinence-oriented individuals (Marlatt & Gordon, 1985). In summary, these analyses of the COMBINE study provide strong evidence that drinking goal represents an important clinical predictor of treatment outcomes and thus should be an integral part of the clinical assessment of problem drinkers. Further, results from this study suggest that drinking goal may be useful in selecting a treatment approach. In particular, medically oriented treatments emphasizing abstinence appear to be an effective and cost efficient treatment modality for patients whose goals are oriented toward complete abstinence. Conversely, more intensive behavioral interventions may be particularly beneficial for patients whose goals are conditional abstinence or controlled drinking. On balance, this study is one of the few to empirically examine the effect of drinking goal on treatment outcome, and in particular, matching treatment options to drinking goals.

  • The aim is to investigate how these clients view abstinence and the role of AA[1] in their recovery process during the past five years.
  • For people who have not been able to maintain sobriety through Alcoholics Anonymous (AA) or other 12-step programs, they may wish to consider if moderation may be a more effective path for them to take.
  • Simultaneously, it is important to consider medical safety of abstinence to avoid potential alcohol withdrawal effects (Mirijello et al., 2015).