Moderation vs. Abstinence: Which Works Best For Problem Drinkers?
A long-standing philosophy of alcoholism treatment has been that total abstinence is necessary and that there is no possibility that someone with a drinking problem could handle moderate drinking. Today we know a lot more about addiction thanks to research and we know that it is more complicated than was previously thought. So, is it possible for a problem drinker to continue drinking responsibly and in moderation? Or is abstinence the only way to go?
What Does Moderation Mean?
One immediate problem comes to mind when debating the possibility of moderate and responsibly drinking, and that is how to define it. Many problem drinkers and alcoholics are in denial about how much they drink and how much of an issue it is. It is not difficult to imagine that an alcoholic attempting moderation would use it as an excuse to keep drinking all the while claiming his habit was surely moderate.
At a basic level moderation means setting reasonable drinking limits and sticking with them. According to the organization Moderation Management, which guides problem drinkers toward reducing their alcohol consumption, men should have no more than four drinks at one time and no more than 14 per week. For women, that amount is three at once and no more than nine per week. Both men and women are supposed to restrict drinking to three to four days each week.
Does Moderation Work For Problem Drinkers?
There are many proponents of moderation who claim that problem drinkers can more successfully establish a healthy relationship with alcohol by moderating than by abstaining. Research does seem to support this viewpoint. One study included participants, all of whom were problem drinkers to varying degrees, who attempted to moderate their habit rather than stop drinking completely. They used a website application designed to guide them through the process. Some used a simple website, while others used an interactive application.
The problem drinkers that used the website alone were able to raise their abstinent time during each month by about four percent. On days they did drink, their blood alcohol content dropped by 50 percent or more, which indicates that they reduced the amount of drinks significantly. For participants using an interactive application, the number of days without drinking at all doubled. Those that used both tools were able to reduce their drinking to fully moderate levels across the board.
Can True Alcoholics Drink Responsibly?
The study that showed moderation could be successful included some very heavy drinkers. However, they did not include people who experienced withdrawal, a key characteristic of alcoholism. So far there is little to no evidence that moderation could be possible for anyone who is seriously dependent on alcohol. In fact, many experts are in agreement that trying to drink moderately could be dangerous for true alcoholics.
This doesn’t mean that moderation is not a great way to help many people. Among all people who have a problem with drinking, most of them have not yet crossed the line into alcohol dependence. If these people can be reached with tools to help them change their drinking from a problem to responsible moderation, the incidence of alcoholism, and all the problems that go along with the disease, could be reduced.
For those people who are already physically and psychologically dependent on alcohol, abstinence is probably the only option. But, for millions of people across the country for whom drinking is a problem, moderation may be a strong motivational tool for making positive changes. The philosophy of abstinence only has been around for a long time, but a shift is starting to occur and it may be for the better.
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