Some studies indicate that drinking more than 100 grams of alcohol (approximately seven standard glasses of beer or wine) per week increases the risk of death in all alcohol-related causes. As MM rules allow men to drink up to 14 alcoholic beverages per week, there is growing evidence that these may controlled drinking vs abstinence be dangerous guidelines. For many individuals who feel they’re stuck in between not quite having an alcohol issue but drinking more than they think they should, MM offers a plan they can easily follow. Additionally, individuals can attend MM meetings to discuss where they are and how they’re coping.

Alcohol Moderation Management Steps and Process

While there is evidence that a subset of individuals who use drugs engage in low-frequency, non-dependent drug use, there is insufficient research on this population to determine the proportion for whom moderation is a feasible treatment goal. However, among individuals with severe SUD and high-risk drug or alcohol use, the urgency of reducing substance-related harms presents a compelling argument for engaging these individuals in harm reduction-oriented treatment and interventions. It is important to highlight that most of the studies cited above did not provide goal-matched https://ecosoberhouse.com/ treatment; thus, these outcomes generally reflect differences between individuals with abstinence vs. non-abstinence goals who participated in abstinence-based AUD treatment. 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. Among those seeking treatment for alcohol use disorder (AUD), studies with large samples have cited rates of nonabstinence goals ranging from 17% (Berglund et al., 2019) to 87% (Enggasser et al., 2015).

1 Sample demographics, help-seeking and problem severity

Therefore, the client should be at the end of or have recently completed post-treatment intervention and be judged by a professional to be in a positive change process regarding their SUD. In the initial interviews, all the clients declared themselves abstinent and stressed that substance use in any form was not an option. The results suggest the importance of offering interventions with various treatment goals and that clients choosing CD as part of their sustained recovery would benefit from support in this process, both from peers and professionals. 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. In other studies of private treatment, Walsh et al. (1991) found that only 23 percent of alcohol-abusing workers reported abstaining throughout a 2-year follow-up, although the figure was 37 percent for those assigned to a hospital program.

• Separate meta-analyses by intervention type (psychotherapies alone or combined) or time point (short-, medium-, and long-term) were planned to assess the robustness of the results; sensitivity analyses were planned that excluded studies with high ROBs; however, these were not completed owing to sparsity of data.
• You’re here because you’ve taken the first brave step in acknowledging that your relationship with alcohol needs a change.
• If you want to resolve problem drinking without medication, abstinence may be a better choice for you.
• Marlatt’s work inspired the development of multiple nonabstinence treatment models, including harm reduction psychotherapy (Blume, 2012; Denning, 2000; Tatarsky, 2002).
• As far as treatment outcomes are considered, there is no universally accepted definition of what constitutes successful CD.
• The only way to ascertain for certain whether you are capable of having just one or two drinks is to try it over a period of time, say 6 months.

How Does Harm Reduction Work in Therapy?

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. Your sobriety journey is personal, and what works best for you may not work as well for someone else. For instance, abstaining from alcohol can decrease the risk of liver disease, improve cognitive function, and enhance emotional resilience. Several said that starting drinking was preceded by concerns about whether an uncontrolled craving would occur. Unfortunately, the very program that Kishline created was one that worked for others but not for herself.

Moderate Drinking is About Having More Control Over Your Drinking

With this as a starting point, the IP was asked to describe the past five years in terms of potential so-called relapse and retention and/or resumption of positive change. The interview guide also dealt with questions on treatment contacts during the follow-up period (frequency, extent and type), the view of their own and others’ alcohol consumption and important factors to continue or resume positive change. Abstinence from alcohol and other drugs has historically been a core criterion for recovery, defined by the Betty Ford Institute as a “voluntarily maintained lifestyle characterized by sobriety, personal health, and citizenship” (Betty Ford Institute Consensus Panel, 2007, p. 222). 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). Interviews with 40 clients were conducted shortly after them finishing treatment and five years later.

She left the program when she realized that moderation was not something she could stick to. Kishline was an AA member for a while but sadly had a relapse and killed a father and daughter in a drunk driving accident in 2000. Briefly, as the Supplementary File presents, 14.71% of the included trials were considered low risk, 66.67% were considered unclear risk, and 20.59% were considered high risk (Figure S6A). The unclear ROBs were mainly concentrated in the randomization, allocation concealment, and blinding to therapists and patients, while the high ROBs existed from the implementation to the reporting stage (Figure S6B, details listed in Table S6).

Visual inspection of these results supported our classification system (i.e., controlled drinking, conditional abstinence, and complete abstinence) in that the two possible responses for both controlled drinking and conditional abstinence clustered together across outcomes. Since drinking goal is a three-level variable, following the omnibus test, planned analyses were conducted to test differences between the three drinking goal groups for effects observed on all outcome variables. When they are offered 12-step treatment, they get exposed to these strict views in a different setting than what was initially intended within AA, namely a self-help group that people join voluntarily. Williams and Mee-Lee (2019) have discussed this shift in the 12-step programme and argue that current 12-step-based treatment settings promote practices that run contrary to the spirit of AA. For example, they point out that the original AA teaching endorses abstinence only for people with severe addiction disorders, which in the 12-step approach has been changed to abstinence for all members. Williams and Mee-Lee (op. cit.) also claim that AA originally taught that it was not the responsibility of group members or counsellors to give medical advice to others while there is a widespread opposition to using medically assisted treatment in the 12-step approach.

Unlike AA, moderation management meetings aren’t necessarily meant to be therapeutic — although they often are. PDA was used to measure the self-control and was assessed by Timeline Followback Interviews (TLFBs) or Form-90.25 To some extent, the higher the PDA is, the better the patient’s ability to control drinking is. Change in DDD was assessed by TLFBs or Form-90 to evaluate the change in average drinking on a drinking day, using a “standard drink” as a measure. The motivational enhancement and the couple therapy show potential amelioration for alcohol abstinence. Additionally, the preferred interventions are different for improving PDA and change in DDD.

The Effects of Drinking Goal on Treatment Outcome for Alcoholism

• In the United Kingdom, where there is greater acceptance of nonabstinence goals and availability of nonabstinence treatment (Rosenberg et al., 2020; Rosenberg & Melville, 2005), the rate of administrative discharge is much lower than in the U.S. (1.42% vs. 6% of treatment episodes; Newham, Russell, & Davies, 2010; SAMHSA, 2019b).
• Individuals with greater SUD severity tend to be most receptive to therapist input about goal selection (Sobell, Sobell, Bogardis, Leo, & Skinner, 1992).
• You can have an occasional drink without feeling defeated and sliding deeper into a relapse.
• In the broadest sense, harm reduction seeks to reduceproblems related to drinking behaviors and supports any step in the right directionwithout requiring abstinence (Marlatt and Witkiewitz2010).
• Non-abstinent goals can improve quality of life (QOL) among individuals withalcohol use disorders (AUD).