We first describe treatment models with an explicit harm reduction or nonabstinence focus. While there are multiple such intervention approaches for treating AUD with strong empirical support, we highlight a dearth of research testing models of harm reduction treatment for DUD. Next, we review other established SUD treatment models that are compatible with non-abstinence goals. We focus our review on two well-studied approaches that were initially conceptualized – and have been frequently understanding drug use and addiction drugfacts discussed in the empirical literature – as client-centered alternatives to abstinence-based treatment. Of note, other SUD treatment approaches that could be adapted to target nonabstinence goals (e.g., contingency management, behavioral activation) are excluded from the current review due to lack of relevant empirical evidence. A number of studies have examined psychosocial risk reduction interventions for individuals with high-risk drug use, especially people who inject drugs.
In this case, abstinence is the best way forward for your health and safety. By quitting drinking completely, your body can begin to repair the damage caused by alcohol. Another study found that it is widely assumed that light or moderate drinking is the safest way to to drink alcohol.
The thing is that the amount of alcohol or drug use per se is not a part of the definition of addiction or abuse (other than in the «using more than intended» factor but even there an absolute amount isn’t introduced) and I don’t think it should be a necessary how to create a meaningful life in 7 days and make part of the solution either. An intervention may involve friends or family members telling someone how much they care about them and want to see them live a better life. They may point out ways that alcohol addiction is hurting them or others around them.
- However, the amount of coverage you’ll receive depends on various factors, including your specific policy and the treatment center you choose.
- Previous reviews have described nonabstinence pharmacological approaches (e.g., Connery, 2015; Palpacuer et al., 2018), which are outside the scope of the current review.
- 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.
- By eliminating the sometimes daunting notion of zero-alcohol use, many find a moderation-based approach more attainable in their daily lives.
- While total abstinence is necessary in some cases, in other cases people are able to reduce their drinking to moderate levels without needing to abstain totally.
The idea is to teach problem drinkers more responsible drinking habits so that they don’t devolve their habits into all-out alcoholism. One way to evaluate whether you may be making risky choices with alcohol is to take this 10-question True/False evaluation to review your usual drinking practices. These individuals notably made up just 14% of the sample, the smallest group of the three. At least based on these data, they are likely to make up a minor sub-set of individuals who seek moderation-focused treatment. Through the use of suggestion, association, and visualization, a hypnotherapist may be able to help you change negative behaviors like substance abuse.
Does moderate drinking cause cancer?
After all, how many people who are dependent on alcohol take advice from anyone to abstain? It’s common that alcoholics who eventually accept treatment, do so because of some type of serious consequence of their drinking. The loss may be of a marriage, a home, a job, relationships with children, prison, serious health problems or something else. No one can say what will convince a particular dependent person to quit drinking, but advice is rarely a motivation.
1. Nonabstinence treatment effectiveness
An alcohol assessment is a screening tool to determine whether you have a drinking problem. This may include referring you to other resources, identifying and improving habits, and preparing for difficult situations. As you compare your treatment options, be sure to consider each of the following factors.
Here are additional reflection questions from a therapist to help you understand your own relationship with alcohol, and if moderation meets your needs and preferences. Take our short alcohol quiz to learn where you fall on the drinking spectrum and if you might benefit from quitting or cutting back on alcohol. Take this “getting back to normal” as a chance to rethink your relationship with alcohol. Doing a reality check with a simple online self-assessment might be the first step. Take the Alcohol Use Disorders Test (AUDIT) developed by the World Health Organization (WHO) online.
History of SMART Recovery
Learning for oneself that just a drink or two per day isn’t possible may provide an individual with evidence that he or she needs treatment. Conventional wisdom may have you believe that if you suffer with alcohol issues on any level then abstinence-based recovery is the only option since it is an incurable disease that will get worse over time. Alcohol abstinence is the decision to cut booze out of your life completely and permanently. Depending on the severity of the presenting issue, this is often seen as the safest way to move forward, and for many, it eliminates any risk or uncertainty that may come with finding the right path to moderation. When considering or committing to complete abstinence, the AA is the most commonly known program of support, offering more than 123,000 meetings worldwide, working through the infamous “12-step programme”, created in 1935. This program is the predominant recovery method in treatment centres all around the world (interestingly around 90% of centres in the US).
Medication-Assisted Treatment (MAT)
The progression from excessive drinking to dependence to the ill health and social effects of alcoholism is much more easily understood by someone who drinks too much, yet hasn’t developed a dependency and the denial that accompanies alcoholism. Drinking in moderation is attainable for this group and can save them from that dangerously rocky, downhill road of alcoholism. Although moderation may be a good starting point for many drinkers, it is not the best approach for everyone with a drinking problem. People with severe drinking problems generally find moderation difficult to maintain and often do better with abstinence.
You might think having a few drinks regularly is harmless, but even consuming alcohol in moderation carries some risks. You might wonder if there’s a healthy way to drink, how much alcohol consumption is considered moderate, and how much is too much. Furthermore, when alcohol begins to take priority over friends and family, work responsibilities, or personal health, it may be time to consider a treatment plan. Understanding your relationship with alcohol is easier said than done, but there are some signs to look out for if you or a loved one are dealing with alcohol abuse.
Alternatively, researchers who conduct trials in community-based treatment centers will need to obtain buy-in to test nonabstinence approaches, which may necessitate waiving facility policies regarding drug use during treatment – a significant hurdle. Drinking in moderation can teach individuals better drinking habits without eradicating alcohol from their lives. Moderate drinking can be achieved through keeping track of how much you drink, pacing yourself when you drink, avoiding drinking with heavy drinkers, and pinpointing your heavy drinking triggers. By eliminating the sometimes daunting notion of zero-alcohol use, many find a moderation-based approach more attainable in their daily lives. Before deciding whether you want to embark on an abstinence or moderation-based journey, it’s essential to pinpoint your condition and desire to quit drinking. It’s important to note, too, that not everyone considering these approaches has an alcohol use disorder (AUD).
Individuals with severe AUD often find that in the long term, sobriety is the most achievable goal for them. Keeping alcohol in your life in a healthy way can be really challenging, especially for people who have exhibited more severe drinking habits and patterns. The harm reduction movement, and the wider shift toward addressing public health impacts of drug use, had both specific and diffuse effects on SUD treatment research.
Tools and Support for Moderation
TV presenter and alcohol moderation advocate Adrian Chiles, in his 2022 book The Good Drinker shares his journey from over drinking to wellness. Chiles points out the “tragedy” is that many people are frightened to seek support for their drinking because they believe they’ll be told that abstinence in their only option. He argues that because of this, “their consumption of alcohol won’t be addressed, and they’ll sink deeper into problem drinking territory and a level of dependence that means, abstinence, in the end, really could be the only answer”.
The JAMA study didn’t go as far as the Lancet article in linking low levels of drinking to mortality risk. While moderate drinking doesn’t equal a health benefit, it also doesn’t seem to raise the risk of death by very much, the authors said. Alcohol moderation programs are endorsed as an effective three inspirational recovery stories option by organizations like the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Substance Abuse and Mental Health Services Administration (SAMHSA). The Sinclair Method (TSM), which involves taking the drug naltrexone to relearn moderation, has a success rate of 78%.