More recent versions of RP have included mindfulness-based techniques (Bowen, Chawla, & Marlatt, 2010; Witkiewitz et al., 2014). The RP model has been studied among individuals with both AUD and DUD (especially Cocaine Use Disorder, e.g., Carroll, Rounsaville, & Gawin, 1991); with the largest effect sizes identified in the treatment of AUD (Irvin, Bowers, Dunn, & Wang, 1999). As a newer iteration of RP, Mindfulness-Based Relapse Prevention (MBRP) has a less extensive research base, though it has been tested in samples with a range of SUDs (e.g., Bowen et al., 2009; Bowen et al., 2014; Witkiewitz et al., 2014). There is less research examining the extent to which moderation/controlled use goals are feasible for individuals with DUDs.

Addiction Treatment at FHE Health

The dearth of data regarding individuals in long-term recovery highlights theneed to examine a sample that includes individuals with several years of recoveryexperience. Moreover, although previous studies have examined treated, non-treated andgeneral population samples, none has focused on individuals who identifythemselves as “in recovery” from alcohol problems. Instead, paststudies have equated “recovery” with DSM-IV diagnostic criteria and nationalguidelines for low-risk drinking; these criteria may exclude people who considerthemselves “in recovery.” For example, individuals involved in harmreduction techniques that do not involve changed drinking may consider themselves inrecovery.

Patients and Methods

controlled drinking vs abstinence

The path towards moderation management comes with its unique set of challenges which can include social pressure or dealing with underlying emotional issues that contribute towards excessive drinking habits. Individual factors like personal motivation, mental health status, and support system also play a key role in determining how controlled drinking vs abstinence well someone will fare within a programme. Relapse Prevention (RP) is another well-studied model used in both AUD and DUD treatment (Marlatt & Gordon, 1985). In its original form, RP aims to reduce risk of relapse by teaching participants cognitive and behavioral skills for coping in high-risk situations (Marlatt & Gordon, 1985).

  • Harm reduction provides a good method for matching these individuals at that stage and providing motivational incentives (e.g., discussing the negative consequences the person is experiencing) to motivate their desire for positive change” (Marlatt & Witkiewitz, 2002).
  • Finney and Moos (1991) reported a 17 percent “social or moderate drinking” rate at 6 years and a 24 percent rate at 10 years.
  • The Rand study quantified the relationship between severity of alcohol dependence and controlled-drinking outcomes, although, overall, the Rand population was a severely alcoholic one in which “virtually all subjects reported symptoms of alcohol dependence” (Polich, Armor, and Braiker, 1981).
  • After the interviews, the clients were asked whether they would allow renewed contact after five years, and they all gave their permission.
  • Future research must test the effectiveness of nonabstinence treatments for drug use and address barriers to implementation.
  • Multivariable stepwise regressions estimating the probability of non-abstinentrecovery and average quality of life.

Is Harm Reduction Right for Me?

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). Abstinence continues to be the dominant approach to alcohol treatment in the United States, while non-abstinent approaches tend to be more acceptable abroad (Klingemann & Rosenberg, 2009; Luquiens, Reynaud, & Aubin, 2011). The debate between abstinence and non-abstinence approaches, specifically controlled drinking (CD), has remained a controversial topic in the alcoholism field since the 1960s (Davies, 1962; Miller & Caddy, 1977).

  • Any controversial points were resolved with discussion after an independent review of the list of papers by another author (P.Z.).
  • The present study indicates that the strict views in AA also might prevent clients in AA to seek help and support elsewhere, since they percieve that this conflicts with the AA philosophy (Klingemann and Klingemann, 2017).

3. The harm reduction movement

Simply put, MM is a moderate drinking program that provides a solution other than complete abstinence. Moderation Management is a program that looks to set guidelines to help people who struggle with their alcohol intake. The advantages of MET and CT were indicated for abstinence in AUDs in this meta-analysis. They are two alternative psychotherapies on the primary care list of priorities to help persist in abstinence. However, at present, a comparison of rehabilitation strategies through MET for patients in different periods of AUDs remains to be explored. This study also shows some psychotherapies with significant efficacy but low or very low quality, requiring further research and investment.

controlled drinking vs abstinence

Study Screening and Selection

Alcoholics Anonymous most effective path to alcohol abstinence – Stanford Medical Center Report

Alcoholics Anonymous most effective path to alcohol abstinence.

Posted: Wed, 11 Mar 2020 07:00:00 GMT [source]

These results suggest that drinking goal represents a highly predictive clinical variable and should be an integral part of the clinical assessment of patients with alcohol dependence. Assessment of patients’ drinking goals may also help match patients to interventions best suited to address their goals and clinical needs. People suffering from alcoholism typically experience a physical and psychological dependence on alcohol, making it extremely challenging to maintain moderation. This approach underestimates the compulsive nature of addiction and the neurological changes that occur with prolonged alcohol abuse. For individuals with severe alcohol dependence, abstinence remains the most effective and safe strategy to avoid the devastating consequences of alcohol-related health issues, social disruption, and the potential for relapse. While you may see the appeal in a programme that allows for some level of drink intake, it’s crucial to consider the potential drawbacks that could come with this approach.

  • 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.
  • Despite the reported relationship between severity and CD outcomes, many diagnosed alcoholics do control their drinking.
  • The dearth of data regarding individuals in long-term recovery highlights theneed to examine a sample that includes individuals with several years of recoveryexperience.
  • This resistance to nonabstinence treatment persists despite strong theoretical and empirical arguments in favor of harm reduction approaches.
  • This is particularly important in light of the overall low treatment seeking rates for alcoholism, with only 27.8% of alcohol dependence cases seeking treatment in the past year (Cohen, Feinn, Arias, & Kranzler, 2007).

Comparison with Prior Studies

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. Alcoholism is characterised by a loss of control over one’s drinking behaviour and an inability to consistently limit consumption. Attempting controlled drinking in such cases often reinforces the addictive cycle rather than breaking it.

controlled drinking vs abstinence

  • Moreover, in committing to a moderate drinking plan, it’s essential to recognise that slip-ups can happen and these instances should not discourage you from continuing on your path towards moderation management, but rather serve as reminders of why moderation is necessary in the first place.
  • To assess small-study effects, funnel plots for meta-analyses including at least 10 trials of varying sizes were planned (when available).
  • 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.

Alcohol Moderation Management: Programs and Steps to Control Drinking

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