Alcohol Moderation Management: Steps To Control Drinking

Even moderate drinking can lead to long-term health problems such as liver disease, heart disease, and increased risk of certain cancers. Besides, alcohol affects your sleep quality and mental health too; it’s not uncommon for people who drink regularly to struggle with anxiety or depression. But if they have a problem with alcohol, taking a harm reduction approach could be a constructive way to help them take a look at the negative consequences of their behavior and motivate them to make positive changes. Most people who seek out moderation management (MM) have already tried and been unsuccessful at stopping drinking or cutting down on their use. The debate between controlled drinking and abstinence approaches continues in the addiction treatment field.

Moderation techniques such as pacing yourself, choosing lower-alcohol options, or having alcohol-free days can be practical tools in this journey. In the 1970s, the pioneering work of a small number of alcohol researchers began to challenge the existing abstinence-based paradigm in AUD treatment research. They found that their controlled drinking intervention produced significantly better outcomes compared to usual treatment, and that about a quarter of the individuals in this condition maintained controlled drinking for one year post treatment (Sobell & Sobell, 1973). Some no longer attended meetings but remained abstinent with a positive view of the 12-step programme.

The success of controlled drinking largely depends on an individual’s ability to consistently adhere to set limits and develop healthier coping mechanisms. It’s important to note that controlled drinking is not recommended for individuals with severe AUD or those who have previously attempted moderation without success. More often than not, patients have mixed feelings about giving up alcohol, even if they are able to recognize the problem and how it is affecting their relationships, job, finances or health.

• Clients were recruited via treatment units (outpatient and inpatient) in seven Swedish city areas.
• In several clinics, controlled drinking has become an alternative treatment approach when the patient does not wish to, or feels they cannot be, completely abstinent.
• In studies by McCabe (1986) and Nordström and Berglund (1987), CD outcomes exceeded abstinence during follow-up of patients 15 and more years after treatment.

1. Review aims

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). Given data demonstrating a clear link between abstinence goals and treatment engagement in a primarily abstinence-based SUD treatment system, it is reasonable to hypothesize that offering nonabstinence treatment would increase overall engagement by appealing to those with nonabstinence goals. Indeed, there is anecdotal evidence that this may be the case; for example, a qualitative study of nonabstinence drug treatment in Denmark described a client saying that he would not have presented to abstinence-only treatment due to his goal of moderate use (Järvinen, 2017).

After five years, the majority remained abstinent and described SUD in line with the views in the 12-step programme. For some, attending was just a routine, whereas others stressed that meetings were crucial to them for remaining abstinent and maintaining their recovery process. Thus, while it is vital to empirically test nonabstinence treatments, implementation research examining strategies to obtain buy-in from agency leadership may be just as impactful. 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).

Controlled Drinking – Alcohol Dependence Treatment Method

At CATCH Recovery, we understand that your journey towards overcoming addiction is deeply personal and unique to you. We believe in the power of personalised therapy, where our experts tailor a recovery plan suited to your needs and circumstances. Quitting alcohol for good is a life-changing decision with countless benefits that will make you wonder why you didn’t quit sooner. Your liver will start to recover and function better, your skin can become clearer, and your risk of serious diseases such as heart disease and certain types of cancer can significantly decrease. Plus, weight loss is often an unexpected bonus when you say no to those extra alcohol calories.

Abstainers

• In sum, the current body of literature reflects multiple well-studied nonabstinence approaches for treating AUD and exceedingly little research testing nonabstinence treatments for drug use problems, representing a notable gap in the literature.
• I have to admit I did not enjoy my pregnancies and I think this was because I could not drink as I wanted to.
• Most importantly, this treatment model provides accountability, where clients are working weekly and sometimes more with their providers to monitor their progress.
• The majority of those not interviewed were impossible to reach via the contact information available (the five-year-old telephone number did not work, and no number was found in internet searches).
• These results showed a slow erosion in the ability to control alcohol consumption; thus, leading back into heavy drinking.
• It’s important to note that pharmacological extinction does not change the drinking experience.

In sum, the current body of literature reflects multiple well-studied nonabstinence approaches for treating AUD and exceedingly little research testing nonabstinence treatments for drug use problems, representing a notable gap in the literature. A focus on abstinence is pervasive in SUD treatment, defining success in both research and practice, and punitive measures are often imposed on those who do not abstain. Most adults with SUD do not seek treatment because they do not wish to stop using substances, though many also recognize a need for help. 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.

As recovery processes stretch over a long period, it is suggested that stable recovery is obtained after five years at the earliest (Hibbert and Best, 2011). Therefore, our programme includes evidence-based therapies such as cognitive behavioural therapy (CBT) or dialectical behaviour therapy (DBT). This multifaceted approach helps you develop coping mechanisms while fostering healthier habits that can sustain long-term recovery. When it comes to choosing between total abstinence or limiting your intake, the answer isn’t black and white. Several factors influence this decision, including societal perception, cultural factors, psychological impact, and health implications. You may feel pressured by society’s view of what is acceptable drinking behaviour or fear being ostracised due to cultural norms surrounding alcohol use.

Important Things to Look for In An Addiction Rehab Centre

Should it be complete and total abstinence from alcohol, or can an alcoholic learn to use alcohol in moderate, controlled ways? The Alcoholics Anonymous organization states that the goal of treatment for those who are dependent on alcohol must be total, complete, Oxford House and permanent abstinence from alcohol. They reject controlled drinking—drinking moderate but never excessive amounts—as a goal of treatment, believingthat such a goal is harmful to the alcoholic.

1. Nonabstinence psychosocial treatment models

As treatment progresses, there should be a decline in alcohol consumption and an increase in sober days. The Sinclair Method also recommends patients to continue going to doctors appointments and counselling. We explore the concept of controlled drinking as a harm reduction strategy for alcohol dependency, addressing its historical context, controversial standing among professionals, and the success of alternative methods for those not inclined towards complete abstinence.

Detox By Substance

• Regarding SUD treatment, there has been a significant increase in availability of medication for opioid use disorder, especially buprenorphine, over the past two decades (opioid agonist therapies including buprenorphine are often placed under the “umbrella” of harm reduction treatments; Alderks, 2013).
• Also, defining sobriety as a further/deeper step in the recovery process offers a potential for 12-step participants to focus on new goals and getting involved in new groups, not primarily bound by recovery goals.
• In addition to evaluating nonabstinence treatments specifically, researchers could help move the field forward by increased attention to nonabstinence goals more broadly.
• While abstinence is generally considered the safest option, especially for those with severe AUD, controlled drinking may be a viable alternative for some individuals.
• Controlled drinking, often advocated as a moderation approach for people with alcohol use disorders, can be highly problematic and unsuitable for those who truly suffer from alcohol addiction.

It’s important to acknowledge any emotional ties you might have to alcohol as these could make both moderation and complete abstinence more challenging. Recognise patterns of thought that lead to excessive drinking like stress, boredom or loneliness; addressing these underlying issues is often a key part of cutting down or cutting out alcohol. In the context of “harm reduction,” individuals may make positivechanges in their lives that do not include reduced alcohol use and may consider themselves“in recovery” even though their AUD status remains unchanged (Denning and Little 2012). For example, among the 2005and 2010 National Alcohol Survey respondents, 18% of current drinkers who identified as“in recovery” from alcohol problems (who do not use drugs) are DSM-IValcohol dependent, and 26% of current drinkers who also use drugs are DSM-IV alcoholdependent. Thus relying on DSM criteria to define a sample of individuals in recovery mayunintentionally exclude individuals who are engaging in non-abstinent or harm reductiontechniques and making positive changes in their lives.

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). It is essential to understand what individuals with SUD are rejecting when they say they do not need treatment.