About 10% of individuals who report cannabis use in the past year meet criteria for a cannabis use disorder, while this proportion increases to 18%, 19%, 58%, and 65% of those with past year use of cocaine, opioids (misuse), methamphetamine, and heroin, respectively. These data suggest that non-disordered drug use is possible, even for a substantial portion of individuals who use drugs such as heroin (about 45%). However, they do not elucidate patterns of non-disordered use over time, nor the likelihood of maintaining drug use without developing a DUD.
- For some, attending was just a routine, whereas others stressed that meetings were crucial to them for remaining abstinent and maintaining their recovery process.
- This may also be the approach for heavy drinkers looking to cut back, but there are some concerns with this approach to alcohol recovery for those with alcohol use disorders.
- This approach underestimates the compulsive nature of addiction and the neurological changes that occur with prolonged alcohol abuse.
- Abstinence means giving up alcohol completely, and it’s the foundation of traditional treatment options like AA and most inpatient rehabs.
- Interviews with 40 clients were conducted shortly after them finishing treatment and five years later.
- Over the past few decades, research has demonstrated that complete abstinence isn’t always the most effective approach for treating alcohol abuse.
In regard to my therapeutic approach to harm reduction as a clinical psychologist, I usually start by understanding my client’s goals for drinking. We then start the process by monitoring their drinking as is, to understand the baseline they are starting at. This will include logging numerical data, but more importantly, triggers and impulses behind those drinks to better understand their motives.
Abstinence Vs. Moderation Management: Success and Outcomes
This strategy is not about total abstinence but involves setting moderate drinking goals that are safe and sensible for you, paying attention to social influences that may sway your decisions, and developing self-awareness around your triggers. Moderation techniques such as pacing yourself, choosing lower-alcohol options, or having alcohol-free days can be practical tools in this journey. There has been little research on the goals of non-treatment-seeking individuals; however, research suggests that nonabstinence goals are common even among individuals presenting to SUD treatment.
Abstinence benefits extend beyond just physical improvements though; they also encompass mental health improvements. Emotional resilience begins to grow as you learn new ways to cope with stress or anxiety without reaching for a drink. Your sobriety journey is personal, and what works best for you may not work as well for someone else. However, studies have shown that abstinence often yields more benefits in the long run. For instance, abstaining from alcohol can decrease the risk of liver disease, improve cognitive function, and enhance emotional resilience. You’re here because you’ve taken the first brave step in acknowledging that your relationship with alcohol needs a change.
Controlled Drinking – Alcohol Dependence Treatment Method
While harm reduction can be effective and successful in helping a person be more cognizant of their drinking behaviors and therefore decreasing them, it is not for everyone. While, of course, no one is perfect, and we expect “mistakes” or “hiccups” along the way, there are some individuals who try harm reduction and are able to recognize they cannot exercise this controlled drinking vs abstinence type of self-control. In those cases, harm reduction can be a helpful tool as a last resort, to help the individual come to the conclusion themselves that abstinence is the right avenue for them, rather than having it enforced upon them at the start of treatment. Moderation gives you control of your drinking and allows you to take back control of your life.
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. Although controversial controlled drinking is a strategy which helps a person to reduce their alcohol consumption to a moderate level. Set over a period of time, often between 6 and 8 months, the idea is that by lowering the consumption of alcohol, the consequences produced by dependency can be addressed and minimized.
Theoretical and empirical rationale for nonabstinence treatment
Experts generally recommend that SUD treatment studies report substance use as well as related consequences, and select primary outcomes based on the study sample and goals (Donovan et al., 2012; Kiluk et al., 2019). While AUD treatment studies commonly rely on guidelines set by government agencies regarding a “low-risk” or “nonhazardous” level of alcohol consumption (e.g., Enggasser et al., 2015), no such guidelines exist for illicit drug use. Thus, studies will need to emphasize measures of substance-related problems in addition to reporting the degree of substance use (e.g., frequency, quantity). AA was established in 1935 as a nonprofessional mutual aid group for people who desire abstinence from alcohol, and its 12 Steps became integrated in SUD treatment programs in the 1940s and 1950s with the emergence of the Minnesota Model of treatment (White & Kurtz, 2008). The Minnesota Model involved inpatient SUD treatment incorporating principles of AA, with a mix of professional and peer support staff (many of whom were members of AA), and a requirement that patients attend AA or NA meetings as part of their treatment (Anderson, McGovern, & DuPont, 1999; McElrath, 1997).
Over time, without positive reinforcement, there comes a decrease in the desire to drink. When used over a period of 4-6 months, heavy or dependent drinking behaviour is extinguished. It’s important to note that pharmacological extinction does not change the drinking experience. If a person has a tendency to chase the thrill of drinking, such as going to parties, behavioural therapies may also want to be included in the treatment. Unlike treatment clinics that generally prescribe naltrexone or nalmefene to be taken on a daily basis, The Sinclair Method asks patients to take the medication 1-2 hours before consuming alcohol on any day that alcohol will be consumed.
Evidence on the efficacy of abstinence-based programs, such as Alcoholics Anonymous, is hard to come by because the nature of these programs involves anonymity. However, thirty percent of MM members end up choosing to move on to abstinence-based programs. When your drinking is under control, you may have the internal bandwidth to accept the professional psychological support that can help you develop healthier ways of coping. You could also get help to better manage your emotions, address past trauma, and understand how anxiety, depression, or other emotional difficulties have powered your alcohol abuse. Additionally, we offer exceptional continuing care so even after completing your programme; you’re never alone in this fight against alcohol addiction.