Driving Blog

In addition to issues with administrative discharge, abstinence-only treatment may contribute to high rates of individuals not completing SUD treatment. About 26% of all U.S. treatment episodes end by individuals leaving the treatment program prior to treatment completion (SAMHSA, 2019b). Studies which have interviewed participants and staff of SUD treatment centers have cited ambivalence about abstinence as among the top reasons for premature treatment termination (Ball, Carroll, Canning-Ball, & Rounsaville, 2006; Palmer, Murphy, Piselli, & Ball, 2009; Wagner, Acier, & Dietlin, 2018). One study found that among those who did not complete an abstinence-based (12-Step) SUD treatment program, ongoing/relapse to substance use was the most frequently-endorsed reason for leaving treatment early (Laudet, Stanick, & Sands, 2009).

• It is, however, an important clinical finding that CBI conferred no advantage over a brief, medically oriented intervention for participants whose drinking goal was complete abstinence.
• Additionally, the system is punitive to those who do not achieve abstinence, as exemplified by the widespread practice of involuntary treatment discharge for those who return to use (White, Scott, Dennis, & Boyle, 2005).
• Analysis accommodated the clustering of observations by site through the estimation of a random intercept term.

People suffering from alcohol addiction will thrive in absolute abstinence and find solace in sobriety groups like Alcoholics Anonymous, while others will less severe drinking habits will be able to manage their relationship with alcohol through controlled moderation techniques without feeling deprived or isolated socially. The path towards moderation management comes with its unique set of challenges which can include social pressure or dealing with underlying emotional issues that contribute towards excessive drinking habits. Individual factors like personal motivation, mental health status, and support system also play a key role in determining how well someone will fare within a programme. 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. Alcohol moderation management programmes are often successful when tailored to an individual’s specific needs and circumstances.

Abstinence or controlled drinking?

Sara explained to her therapist that she didn’t think she could quit drinking altogether. 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.

• However, it is also possible that adaptations will be needed for individuals with nonabstinence goals (e.g., additional support with goal setting and monitoring drug use; ongoing care to support maintenance goals), and currently there is a dearth of research in this area.
• As we get back to more social events, business meetings, and situations where you may have abused alcohol in the past, it may be time to consider how you can achieve moderation.
• The rationale and methods of the COMBINE study have been described in detail elsewhere (aCOMBINE Study Research Group, 2003a, COMBINE Study Research Group, 2003b).
• As the IP had a successful outcome, six months after treatment, their possibilities for CD might be better than for persons with SUD in general.
• These contacts had often complemented the support from AA but in some cases also complicated it as the IPs found that their previous SUD was related to other things that were not in line with the approach to addiction as a disease (e.g. IP19).

“Moderation” is a term that is often used to suggest that a person with an alcohol or drug problem does not really have to give it up but can “control” it. A program called Moderation Management advocates this alternative to abstinence as a solution for a substance abuse disorder2. This team of researchers undertook to compare self-identified members of Moderation Management with self-identified members of Alcoholics Anonymous (AA). They looked at demographics—who attends AA versus who attends MM—as well as the relative severity of the drinking problems in the two groups. In the present follow-up, the recovery process for clients previously treated for SUD was investigated, focusing on abstinence and CD.

Controlled Drinking vs. Abstinence

It was also hypothesized that, given naltrexone’s effect on hedonic response to alcohol (King et al., 1997; McCaul et al., 2001; Ray et al., 2010), naltrexone would be more effective among those with a controlled drinking goal versus those with an abstinence oriented goal. This hypothesis was not supported by the data in that there was no significant drinking goal × naltrexone interaction controlled drinking vs abstinence in any of the outcome measures. This may be due to the fact that the vast majority of participants (78%) consumed alcohol during the trial, such that the drinking mediated effects of naltrexone were not restricted to patients with controlled drinking goals. The current review highlights multiple important directions for future research related to nonabstinence SUD treatment.

Differentiating these concepts opens up for recovery without necessarily having strong ties with the recovery community and having a life that is not (only) focused on recovery but on life itself. Also, defining sobriety as a further/deeper step in the recovery process offers a potential for 12-step participants to focus on new goals and getting involved in new groups, not primarily bound by recovery goals. Further, describing recovery as a process also implies paying attention to contributing factors outside the https://ecosoberhouse.com/ treatment context, such as the importance of work, family and friends. 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. Severity of alcoholism is the most generally accepted clinical indicator of the appropriateness of CD therapy (Rosenberg, 1993).