Alcohol Moderation Management: Programs and Steps to Control Drinking
Generally, except in the most mild drinkers (less than 1 drink per day on average), drinking reductions are related to better cardio outcomes. In one study with moderate drinkers who were drinking 3-6 drinks daily, reducing drinking by 67% was related to improved (i.e., reduced) blood pressure, an average of a reduction by 3 systolic points over 2 diastolic points. In addition, while studies tend not to find helpful effects of drinking reduction on health care utilization, abstinence, on the other hand, tends to be related to less health care utilization. Importantly, though, treatments that help people reduce their drinking – rather than quit entirely – are indeed related to less health care utilization and longer time to hospital readmission on the whole. It appears to be something gained from the treatment itself, though, rather than the drinking reduction that is helpful. In the same 16-year follow-up, for those abstinent in the year before the follow-up assessment, only 18% were hospitalized compared with 43% who were non-abstinent.
While there are many obstacles to the widespread acceptance of CD as a treatment approach (Sobell & Sobell 2006), it is important to note that not all individuals entering treatment do so with the goal of achieving abstinence. To that end, the use of abstinence as the dominant drinking goal across alcoholism treatment programs in the United States may in fact deter individuals who would otherwise Ketamine withdrawal Ketamine detox seek treatment for alcohol problems should CD be proposed as an acceptable goal. Sobell et al. (1992) found that many patients entering an outpatient treatment facility for alcohol problems preferred self-selection of treatment goals, versus adoption of the goals selected by the therapist.
Who Is Most Likely to Benefit from Moderation-focused Alcohol Treatment?
If you believe that harm reduction therapy may help, you may be interested in our alcohol addiction program. Simply put, those who want to learn to drink in moderation are less likely to achieve their goal, while those who set a goal of quitting drinking entirely see greater success. When out for a nice dinner or attending a get-together, she still wanted the freedom of having a drink or two. Her counselor agreed that limiting her drinking could be a good solution and they set a goal for Sara to cut back her consumption to these special occasions only. After the interviews, the clients were asked whether they would allow renewed contact after five years, and they all gave their permission. The majority of those not interviewed were impossible to reach via the contact information available (the five-year-old telephone number did not work, and no number was found in internet searches).
What is Alcohol Moderation Management?
Psychologically, you might be dealing with a range of emotions from guilt over past incidents to anxiety about future relapses. Also, consider your health – excessive drinking can lead to serious conditions like liver disease or heart problems. It’s heartbreaking to see loved ones caught in the grip of addiction, but there’s hope – research shows that many people find success with programmes aimed at reducing consumption.
Historical context of nonabstinence approaches
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. Even moderate drinking can lead to long-term health problems such as liver disease, heart disease, and increased risk of certain cancers. Besides, alcohol affects your sleep quality and mental health too; it’s not uncommon for people who drink regularly to struggle with anxiety or depression. Non-abstainers are younger with less time in recovery and less problem severitybut worse QOL than abstainers. Clinically, individuals considering non-abstinent goalsshould be aware that abstinence may be best for optimal QOL in the long run.Furthermore, time in recovery should be accounted for when examining correlates ofrecovery.
- For example, in one study, reducing one’s weekly drinking by about 30% (in total volume) was related to fewer injuries and 44% fewer sick days over a 2-year period.
- Tailoring treatment approaches to patients’ goals, whether complete or conditional abstinence or controlled drinking may have positive results on treatment outcome.
- We identify a clear gap in research examining nonabstinence psychosocial treatment for drug use disorders and suggest that increased research attention on these interventions represents the logical next step for the field.
- Here we found that a number of factors distinguish non-abstainers from abstainersin recovery from AUD, including younger age and lower problem severity.
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Given the abstinence focus of many SUD treatment centers, studies may need to recruit using community outreach, which can yield fewer participants compared to recruiting from treatment (Jaffee et al., 2009). However, this approach is consistent with the goal of increasing treatment utilization by reaching those who may not otherwise present to treatment. Alternatively, researchers who conduct trials in community-based treatment centers will need to obtain buy-in to test nonabstinence approaches, which may necessitate waiving facility policies regarding drug use during treatment – a significant hurdle.
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). This model both accelerated the spread of AA and NA and helped establish the abstinence-focused 12-Step program at the core of mainstream addiction treatment. This standard persisted in SUD treatment even as strong evidence emerged that a minority of individuals who receive 12-Step treatment achieve and maintain long-term abstinence (e.g., Project MATCH Research Group, 1998). It is well known to both clinicians and researchers in the addiction field that patients in alcoholism treatment vary dramatically with respect to their alcohol use goals. Patients differ on the continuum between not wanting to change their drinking at all to seeking complete and long-term abstinence from alcohol. While drinking goal represents an important clinical variable, the literature is relatively limited as to the specific influence of drinking goal on treatment outcomes for alcoholism.
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. It is well known to clinicians and researchers in the field of alcoholism that patients vary with respect to drinking goal.
Together, this suggests a promising degree of alignment between goal selection and probability of success, and it highlights the potential utility of nonabstinence treatment as an “early intervention” approach to prevent SUD escalation. Tailoring treatment approaches to patients’ goals, whether complete or conditional abstinence or controlled drinking may have positive results on treatment outcome. For example, a recent study found that patients stating a preference for abstinence had better treatment outcome than those stating a preference for non-abstinence (Adamson, Heather, Morton, & Raistrick, 2010).
Given data demonstrating a clear link between abstinence goals and treatment engagement in a primarily abstinence-based SUD treatment system, it is reasonable to hypothesize that offering nonabstinence treatment would increase overall engagement by appealing to those with nonabstinence goals. Indeed, there is anecdotal evidence that this may be the case; for example, a qualitative study of nonabstinence drug treatment in Denmark described a client saying that he would not have presented to abstinence-only treatment due to his goal of moderate use (Järvinen, 2017). Additionally, in the United Kingdom, where there is greater access to nonabstinence treatment (Rosenberg & Melville, 2005; Rosenberg & Phillips, 2003), the proportion of individuals with opioid use disorder engaged in treatment is more than twice that of the U.S. (60% vs. 28%; Burkinshaw et al., 2017).
The objective of this study is to elucidate the contribution of drinking goal to treatment outcome in the context of specific behavioral and pharmacological interventions. Potential correlates of non-abstinent recovery, such as demographics andtreatment history, were based on NESARC results. Additionally, the survey asked about current quality oflife using a 4-point scale as administered by the World Health Organization (The WHOQOL Group 1998).
