Abstinence or controlled drinking a five-year follow-up on Swedish clients reporting positive change after treatment for substance use disorders

Potential correlates of non-abstinent recovery, such as demographics and
treatment history, were based on NESARC results. Additionally, the survey asked about current quality of
life using a 4-point scale as administered by the World Health Organization (The WHOQOL Group 1998). Administrative discharge due to substance use is not a necessary practice even within abstinence-focused treatment (Futterman, Lorente, & Silverman, 2004), and is likely linked to the assumption that continued use indicates lack of readiness for treatment, and that abstinence is the sole marker of treatment success.

This effect may be worse if the alcohol beverages you drink are high in sugar or mixed with sugary juices or sodas. While doctors have connected a person’s diet and smoking to making IBD worse, there aren’t as many studies about alcohol and IBD. The study was funded by the National Institute on Drug Abuse and the National Institute of Health.

Expanding the continuum of substance use disorder treatment: Nonabstinence approaches

Thus, brain CRF systems appear to remain hyperactive during protracted abstinence, and this hyperactivity is motivationally relevant to excessive alcohol drinking. Results such as these suggest that the emotional substrates of the brain that are dysregulated in the binge/intoxication and withdrawal/negative affect stages remain dysregulated and contribute to craving and relapse (see Chapters 1 and 2Chapter 1Chapter 2). They state it’s a “less-threatening first step toward a healthier lifestyle.” MM also claims that programs like theirs fuse moderation, or controlled drinking, with abstinence, are more effective than abstinence-only programs.

  • Even total abstinence from alcohol may achieve pain relief in only 50% of patients with moderate to mild chronic pancreatitis (Gullo et al, 1988).
  • 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.
  • First, some therapies included had few clinical studies and insufficient sample sizes for pooling or looping analyses.43 Second, the small number of included studies and the lack of severity stratification of results in some of the studies did not facilitate the exploration of the association between severity and outcomes.

This could include the number of days they drink per week, the number of drinks they have at a time, specific types of drinks they allow themselves to drink, as well as building awareness behind the types of emotional drinking they may engage in. Most importantly, this treatment model provides accountability, where clients are working weekly and sometimes more with their providers to monitor their progress. We often find that clients seeking alcohol treatment are interested in a harm reduction model. Imagine, as a young adult, you are aware that you drink too much and want to seek help.

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If you want to resolve problem drinking without medication, abstinence may be a better choice for you. However, the extent of their problems according to ICD-10 (International Statistical Classification of Diseases and Related Health Problems, 10th edition) or DSM 5 (Diagnostic and Statistical Manual of mental disorders, 5th edition) was not measured. Thus, there might be individuals in the sample who do not consider SUD as their main problem. Nonabstinence approaches to SUD treatment have a complex and contentious history, and significant social and political barriers have impeded research and implementation of alternatives to abstinence-focused treatment. We summarize historical factors relevant to non-abstinence treatment development to illuminate reasons these approaches are understudied. It often depends upon how much you drink, what you drink, and your overall intestinal response.

controlled drinking vs abstinence

Severity of alcoholism is the most generally accepted clinical indicator of the appropriateness of CD therapy (Rosenberg, 1993). Untreated alcohol abusers probably have less severe drinking problems than clinical populations of alcoholics, which may explain their higher levels of controlled drinking. But the less severe problem drinkers uncovered in nonclinical studies are more typical, outnumbering those who “show major symptoms of alcohol dependence” by about four to one (Skinner, 1990). In addition, Helzer et al. identified a sizable group (12%) of former alcoholics who drank a threshold of 7 drinks 4 times in a single month over the previous 3 years but who reported no adverse consequences or symptoms of alcohol dependence and for whom no such problems were uncovered from collateral records.

Fear of an Inability to Cope Without Alcohol Can Deter You From Trying

Traditional alcohol use disorder (AUD) treatment programs most often prescribe
abstinence as clients’ ultimate goal. In the broadest sense, harm reduction seeks to reduce
problems related to drinking behaviors and supports any step in the right direction
without requiring abstinence (Marlatt and Witkiewitz
2010). Witkiewitz (2013) has suggested
that abstinence may be less important than psychiatric, family, social, economic, and
health outcomes, controlled drinking vs abstinence and that non-consumption measures like psychosocial functioning and
quality of life should be goals for AUD research (Witkiewitz 2013). These goals are highly consistent with the growing
conceptualization of `recovery’ as a guiding vision of AUD services (The Betty Ford Institute Consensus Panel 2007). Witkiewitz also argued
that the commonly held belief that abstinence is the only solution may deter some
individuals from seeking help.

Likely, the concept of abstinence would be overwhelming, as alcohol is a major part of our culture. Expecting someone to potentially cut those events out of their lives to reduce the exposure to alcohol is not always realistic. According to research, “Many individuals experiencing problems related to their drinking (e.g., college students) are not interested in changing their drinking behavior and would most likely be characterized in the precontemplative stage of the transtheoretical model. 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). We do not know what factors relate to non-abstinent vs. abstinent recovery among
individuals who define themselves as in recovery.