Maintaining Abstinence vs Achieving Alcohol Sobriety

Those in moderation management recovery from alcoholism are individuals who have encountered difficulties with alcohol but have learned how to begin again, in addition to recovering their constitutional right to abstain from alcohol – as outlined in The Big Book. In the United Kingdom, the NICE guidelines investigated the scientific basis for treatment recommendations in problematic alcohol use [26]. For example, the Abstinence violation effect Definition of Abstinence violation effect NICE recommendations have been accepted by the French guidelines [109, 110, 111] and in the German guidelines put together by a representative group of stakeholders from Germany, Switzerland, and Austria [112, 113]. For people who struggle to make healthy drinking choices, but are not alcoholics, Moderation Management may be a good program to help them learn decision-making skills that can improve their lifestyle.

  • No reinforcement behaviour is used, nor is abstinence being forced upon an individual.
  • Rarely has anyone come into my office with concerns about alcohol abuse because of drinking three or four drinks a few times a week.
  • In addition, Helzer et al. identified a sizable group (12%) of former alcoholics who drank a threshold of 7 drinks 4 times in a single month over the previous 3 years but who reported no adverse consequences or symptoms of alcohol dependence and for whom no such problems were uncovered from collateral records.
  • Losing control of alcohol is no longer a threat to them since losing control over alcohol is no longer a threat.

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. Living without it might seem like an unattainable idea that is essentially out of the question. Thus, demanding abstinence may ultimately drive a dependent person away from dealing the issue. Your drinking goal should be based on what is best for your long-term health, as well as what is realistic for you, your family and friends, and other aspects of your lifestyle. If you feel that avoiding alcohol completely is not for you, there are other options.

Establish Your Drinking Goal

Polich, Armor, and Braiker found that the most severely dependent alcoholics (11 or more dependence symptoms on admission) were the least likely to achieve nonproblem drinking at 4 years. However, a quarter or this group who achieved remission did so through nonproblem drinking. Furthermore, younger (under 40), single alcoholics were far more likely to relapse if they were abstinent at 18 months than if they were drinking without problems, even if they were highly alcohol-dependent. Thus the Rand study found a strong link between severity and outcome, but a far from ironclad one. Clinical studies and peer reviewed research have demonstrated that controlled drinking is possible, and various moderation-based treatment could be preferred over abstinence-based treatment. Nevertheless, especially in the United States, zero tolerance has remained the treatment approach most popular among the public and professionals.

A dry drunk is an individual who abstains from alcohol (or drugs) but continues to act in much the same way as when they were drinking. In AA, it is common to hear about people who haven’t touched alcohol in years, but have still not managed to find sobriety. Such individuals can be difficult to be around because they are bitter and resentful about their abstinence, and do not appear to be enjoying life, though they have stopped abusing drugs and alcohol. The white knuckle effort of staying sober day after day means that life in recovery is not much fun.

Recovery After Rehab: Moderation or Abstinence?

The person that decides to drink socially or now and then, is going to be consistently re-introducing that substance to the body, therefore always leaving the body craving more. Those who choose abstinence will completely avoid all alcohol, including that in food or in hygiene products such as mouthwash. Before a person can successfully begin their recovery, a vital question to ask is what is my goal?

  • These results were unexpected in the treatment field, and the authors were accused of bias and unprofessional conduct (for details, see [52]).
  • For example, patient preferences for drinking goals were taken into account in the United Kingdom Alcoholism Treatment Trial.
  • These answers will vary from individual to individual, and your choice of moderation vs. abstinence is a personal one.
  • 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.