In 1990, Marlatt was introduced to the philosophy of harm reduction during a trip to the Netherlands (Marlatt, 1998). He adopted the language and framework of harm reduction in his own research, and in 1998 published a seminal book on harm reduction strategies for a range of substances and behaviors (Marlatt, 1998). Marlatt’s work inspired the development of multiple nonabstinence https://ecosoberhouse.com/ treatment models, including harm reduction psychotherapy (Blume, 2012; Denning, 2000; Tatarsky, 2002). Additionally, while early studies of SUD treatment used abstinence as the single measure of treatment effectiveness, by the late 1980s and early 1990s researchers were increasingly incorporating psychosocial, health, and quality of life measures (Miller, 1994).
History of SMART Recovery
While your relationship with alcohol is entirely personal, reflecting on outside influences can be helpful when considering the relative benefits of sobriety or moderation. These influences may include family dynamics, workplace culture, friendships, strained relationships, and lifestyle elements. Though sobriety has a clear definition, you may still be asking yourself, what is sobriety, and what will it mean to me? Oftentimes it can mean learning how to manage cravings, engaging in alcohol treatment, finding community, and introducing alcohol alternatives into your daily life.
Correlates of substance use status
In France in the 1920s, the average was 22.1 liters of pure alcohol per person per year. This equals 184 one-liter wine bottles per person per year.2 Note that in contrast to the modern statistics that are expressed in alcohol consumption per person older than 15 years, this includes children as well – the average alcohol consumption per adult was, therefore, even higher. Global trends on alcohol abstinence alcohol abstinence vs moderation show a mirror image of drinking prevalence data. This is shown in the charts as the share of adults who had not drunk in the prior year and those who have never drunk alcohol. As such, I think these results are very encouraging in terms of offering another possible solution for individuals who are looking to reduce their alcohol consumption and the problems that keep creeping up along with it.
Cons of Moderate Drinking
The negative effects of your drinking may have turned you off of alcohol entirely, and that’s completely okay. If your reason for choosing abstinence is simply that you want to, that’s a perfectly valid reason to quit alcohol altogether. So, how can you tell whether moderation or abstinence is a better goal for you? In South Africa and Papua New Guinea, more than half of all traffic deaths are attributable to alcohol consumption.
The most recent national survey assessing rates of illicit drug use and SUDs found that among individuals who report illicit drug use in the past year, approximately 15% meet criteria for one or more DUD (SAMHSA, 2019a). About 10% of individuals who report cannabis use in the past year meet criteria for a cannabis use disorder, while this proportion increases to 18%, 19%, 58%, and 65% of those with past year use of cocaine, opioids (misuse), methamphetamine, and heroin, respectively. These data suggest that non-disordered drug use is possible, even for a substantial portion of individuals who use drugs such as heroin (about 45%). However, they do not elucidate patterns of non-disordered use over time, nor the likelihood of maintaining drug use without developing a DUD. 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 is because the withdrawal symptoms will also be severe and are likely to need specialist treatment.
- There’s an episode in the TV series Friends where Chandler tries to quit smoking.
- 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).
- Like the Sobells, Marlatt showed that reductions in drinking and harm were achievable in nonabstinence treatments (Marlatt & Witkiewitz, 2002).
Alcohol as a risk factor for mortality
Reframe supports you in reducing alcohol consumption and enhancing your well-being. Moderate drinking can limit adverse effects of alcohol and be a positive stepping stone in helping us quit or cut back further. Another potential disadvantage of alcohol abstinence is that some may find it too restrictive and unsustainable. When the root cause of our drinking isn’t addressed, avoiding alcohol can backfire into binge drinking.
Associations between substance use status and individual characteristics
Should we cut it out entirely, or is there a way to drink in moderation without adverse effects? Let’s delve into the pros and cons of both approaches to help us decide which one is better for us. The map shows the share of all road traffic deaths attributed to alcohol consumption over the national legal limit for alcohol consumption.
- People with alcohol use disorder who try to quit drinking often ask whether they have to stop consuming alcohol forever—or if they can learn to drink in moderation.
- Little information exists, however, regarding the prevalence of this resolution pathway, or how continued substance use after resolving an AOD problem, relative to abstinence, relates to functioning, quality of life, and happiness (i.e., well-being).
- 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).
- SMART Recovery is a programme of training and tools to support recovery from addiction.
- When we look at gender differences, we see that in all countries, men have a higher alcohol consumption than women.
Alcohol Moderation Management Steps and Process
- In its original form, RP aims to reduce risk of relapse by teaching participants cognitive and behavioral skills for coping in high-risk situations (Marlatt & Gordon, 1985).
- Planning exactly how you’ll say no—in a quick, polite, and convincing way—can make it easier for you to stick with your convictions and avoid a spiral of uncomfortable excuses.
- The main argument against moderate drinking is that any amount of alcohol can be harmful.
- Emergent technologies relevant to home-based drinking practices – including apps that encourage users to ‘check in’ to alert their friends when they are drinking (see, for example, Beer with Me, 2020) – also present new opportunities for consumption that enable people to ‘drink socially’ even when physically separated.
- The global ‘lockdowns’ and social distancing measures triggered by the COVID-19 pandemic have brought about unprecedented social changes, including the sudden, temporary closure of licensed venues and significant modifications to leisure and drinking practices.