Monthly Archives: February 2023

Remember that every person’s journey is unique; there are no one-size-fits-all solutions for managing alcohol intake. People suffering from alcohol addiction will thrive in absolute abstinence and drug rehab statistics success rates 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. When it comes to choosing between total abstinence or limiting your intake, the answer isn’t black and white. Several factors influence this decision, including societal perception, cultural factors, psychological impact, and health implications.

How Many Drinks a Day Is Considered an Alcoholic?

We do not know what factors relate to non-abstinent vs. abstinent recovery amongindividuals who define themselves as in recovery. In addition, no priorstudy has examined whether quality of life differs among those in abstinent vs.non-abstinent recovery in a sample that includes individuals who have attained longperiods of recovery. Here we discuss exploratory analyses of differences between abstinentand nonabstinent individuals who defined themselves as “in recovery” fromAUDs. Study (WIR) dataset, one of the largest repositoriesof individuals in recovery available.

Abstainers

It’s during this period that peer support becomes invaluable; it helps to know that others are experiencing similar struggles or have overcome them already. When I first set about writing this article, many of the issues I was going to bring up had to do with research on alcohol relapse patterns, my own story, and other evidence I’ve already introduced on All About Addiction. The thing is that the amount of alcohol or drug use per se is not a part of the definition of addiction or abuse (other than in the “using more than intended” factor but even there an absolute amount isn’t introduced) and I don’t think it should be a necessary part of the solution either. Possibly, but one will benefit from being on guard for them, as they can reappear years later.

4. Consequences of abstinence-only treatment

Previous studies suggests that these strict views might prevent people from seeking treatment (Keyes et al., 2010; Wallhed Finn et al., 2014). The present study indicates that the strict views in AA also might prevent clients in AA to seek help and support elsewhere, since they percieve that this conflicts with the AA philosophy (Klingemann and Klingemann, 2017). Initially, AA was not intended to offer a professional programme model for treatment (Alcoholics Anonymous, 2011). When the premise of AA was transformed into the 12-step treatment programme, it was performed in a professional setting. Many clients in the study described that the 12-step programme was the only treatment that they were offered.

In other studies of private treatment, Walsh et al. (1991) found that only 23 percent of alcohol-abusing workers reported abstaining throughout a 2-year follow-up, although alcoholics and narcissism the figure was 37 percent for those assigned to a hospital program. According to Finney and Moos (1991), 37 percent of patients reported they were abstinent at all follow-up years 4 through 10 after treatment. Clearly, most research agrees that most alcoholism patients drink at some point following treatment. At one extreme, Vaillant (1983) found a 95 percent relapse rate among a group of alcoholics followed for 8 years after treatment at a public hospital; and over a 4-year follow-up period, the Rand Corporation found that only 7 percent of a treated alcoholic population abstained completely (Polich, Armor, & Braiker, 1981). At the other extreme, Wallace et al. (1988) reported a 57 percent continuous abstinence rate for private clinic patients who were stably married and had successfully completed detoxification and treatment—but results in this study covered only a 6-month period.

2. Established treatment models compatible with nonabstinence goals

Moderation is possible for some people, and Ria Health offers it as a treatment option for problem drinking. These answers will vary from individual to individual, and your choice of moderation vs. abstinence is a personal one. Our program offers expert medical support, recovery coaching, and a variety of tools and resources—all delivered 100 percent virtually. It involves the use of medications like naltrexone which help reduce alcohol cravings. They’re able to enjoy an occasional drink while still avoiding negative drinking behaviors and consequences.

In fact, even most research institutions and well-informed providers use total abstinence as the marker for addiction treatment success. People suffering from alcoholism typically experience a physical and psychological dependence on alcohol, making it extremely challenging to maintain moderation. This approach underestimates the compulsive nature of addiction and the neurological changes that occur with prolonged alcohol abuse. For individuals with severe alcohol dependence, abstinence remains the most effective and safe strategy to avoid the devastating consequences of alcohol-related health issues, social disruption, and the potential for relapse. 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.

Goodwin, Crane, & Guze (1971) found that controlled-drinking remission was four times as frequent as abstinence after eight years for untreated alcoholic felons who had “unequivocal histories of alcoholism”. Results from the 1989 Canadian National Alcohol and Drug Survey confirmed that those who resolve a drinking problem without treatment are more likely to become controlled drinkers. Only 18 percent of 500 recovered alcohol abusers in the survey achieved remission through treatment. Alcoholic remission many years after treatment may depend less on treatment than on posttreatment experiences, and in some long-term studies, CD outcomes become more prominent the longer subjects are out of the treatment milieu, because patients unlearn the abstinence prescription that prevails there (Peele, 1987). By the same token, controlled drinking may be the more common outcome for untreated remission, since many alcohol abusers may reject treatment because they are unwilling to abstain.

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. You might find yourself constantly preoccupied with thoughts about when you’ll have your next drink or whether you’re staying within your limits – this constant monitoring can create stress and mental exhaustion over time. Moreover, in committing to a moderate drinking plan, it’s essential to recognise that slip-ups can happen and these instances should not discourage you from continuing on your path towards moderation management, but rather serve as reminders of why moderation is necessary in the first place. 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.

History of SMART Recovery

1. For instance, abstaining from alcohol can decrease the risk of liver disease, improve cognitive function, and enhance emotional resilience.
2. Possibly, but one will benefit from being on guard for them, as they can reappear years later.
3. Marlatt’s work inspired the development of multiple nonabstinence treatment models, including harm reduction psychotherapy (Blume, 2012; Denning, 2000; Tatarsky, 2002).
4. They’re able to enjoy an occasional drink while still avoiding negative drinking behaviors and consequences.

Quitting alcohol for good does water flush alcohol out of urine is a life-changing decision with countless benefits that will make you wonder why you didn’t quit sooner. Your liver will start to recover and function better, your skin can become clearer, and your risk of serious diseases such as heart disease and certain types of cancer can significantly decrease. Plus, weight loss is often an unexpected bonus when you say no to those extra alcohol calories.

Attempting controlled drinking in such cases often reinforces the addictive cycle rather than breaking it. Understanding the psychological factors involved in controlled drinking is crucial too. Your thoughts, feelings, and behaviours all play a role in how you manage your alcohol consumption. It’s important to acknowledge any emotional ties you might have to alcohol as these could make both moderation and complete abstinence more challenging.

It’s not an easy road to lasting recovery, but with the right support and resources, it can definitely be a journey worth taking.

Non-abstainers how to recover from being roofied 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. Some people find it’s still too overwhelming to be around alcohol, and it’s too hard to change their habits.

How do I make the commitment?

This word “abstinence” can be an intimidating word to many, especially those in the early stages of recovery. Your whole body may convulse saying, “I’ll do anything, just don’t ask me or tell me that I have to stop forever.” This is normal. If this is how you feel, commit yourself to being open to new ideals and beliefs that may result in a healthier and more fulfilling lifestyle. Multivariable stepwise regressions estimating the probability of non-abstinentrecovery and average quality of life.

What Are the 4 Types of Drinkers?

Regarding SUD treatment, there has been a significant increase in availability of medication for opioid use disorder, especially buprenorphine, over the past two decades (opioid agonist therapies including buprenorphine are often placed under the “umbrella” of harm reduction treatments; Alderks, 2013). Nonabstinence goals have become more widely accepted in SUD treatment in much of Europe, and evidence suggests that acceptance of controlled drinking has increased among U.S. treatment providers since the 1980s and 1990s (Rosenberg, Grant, & Davis, 2020). Importantly, there has also been increasing acceptance of non-abstinence outcomes as a metric for assessing treatment effectiveness in SUD research, even at the highest levels of scientific leadership (Volkow, 2020). Many advocates of harm reduction believe the SUD treatment field is at a turning point in acceptance of nonabstinence approaches. Indeed, a prominent harm reduction psychotherapist and researcher, Rothschild, argues that the harm reduction approach represents a “third wave of addiction treatment” which follows, and is replacing, the moral and disease models (Rothschild, 2015a).

These goals are highly consistent with the growingconceptualization of `recovery’ as a guiding vision of AUD services (The Betty Ford Institute Consensus Panel 2007). Witkiewitz also arguedthat the commonly held belief that abstinence is the only solution may deter someindividuals from seeking help. Researchers have long posited that offering goal choice (i.e., non-abstinence and abstinence treatment options) may be key to engaging more individuals in SUD treatment, including those earlier in their addictions (Bujarski et al., 2013; Mann et al., 2017; Marlatt, Blume, & Parks, 2001; Sobell & Sobell, 1995). To date, however, there has been little empirical research directly testing this hypothesis.

Expanding the continuum of substance use disorder treatment: Nonabstinence approaches

The purpose of this paper is to investigate how clients – five years after completing treatment interventions endorsing abstinence – view abstinence and the role of Alcoholics Anonymous (AA) in their recovery process. 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.

While abstinence refers to behaviour, sobriety goes deeper and concerns the roots of the problem (addiction) and thereby refers to mental and emotional aspects. 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 treatment context, such as the importance of work, family and friends. Some no longer attended meetings but remained abstinent with a positive view of the 12-step programme.

AA was established in 1935 as a nonprofessional mutual aid group for people who desire abstinence from alcohol, and its 12 Steps became integrated in SUD treatment programs in the 1940s and 1950s with the emergence of the Minnesota Model of treatment (White & Kurtz, 2008). 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. By 1989, treatment center referrals accounted for 40% of new AA memberships (Mäkelä et al., 1996). 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). The dearth of data regarding individuals in long-term recovery highlights theneed to examine a sample that includes individuals with several years of recoveryexperience.

Models of nonabstinence psychosocial treatment for drug use have been developed and promoted by practitioners, but little empirical research has tested their effectiveness. This resistance to nonabstinence treatment persists despite strong theoretical and empirical arguments in favor of harm reduction approaches. Traditional alcohol use disorder (AUD) treatment programs most often prescribeabstinence as clients’ ultimate goal.

Is Controlled Drinking Possible for Alcoholics?

In addition to shaping mainstream addiction treatment, the abstinence-only 12-Step model also had an indelible effect on the field of SUD treatment research. Most scientists who fun recovery games for groups studied SUD treatment believed that abstinence was the only acceptable treatment goal until at least the 1980s (Des Jarlais, 2017). Abstinence rates became the primary outcome for determining SUD treatment effectiveness (Finney, Moyer, & Swearingen, 2003; Kiluk, Fitzmaurice, Strain, & Weiss, 2019; Miller, 1994; Volkow, 2020), a standard which persisted well into the 1990s (Finney et al., 2003). Little attention was given to whether people in abstinence-focused treatments endorsed abstinence goals themselves, or whether treatment could help reduce substance use and related problems for those who did not desire (or were not ready for) abstinence. It is essential to understand what individuals with SUD are rejecting when they say they do not need treatment. In this model, treatment success is defined as achieving and sustaining total abstinence from alcohol and drugs, and readiness for treatment is conflated with commitment to abstinence (e.g., Harrell, Trenz, Scherer, Martins, & Latimer, 2013).

1. It is essential to understand what individuals with SUD are rejecting when they say they do not need treatment.
2. The results suggest the importance of offering interventions with various treatment goals and that clients choosing CD as part of their sustained recovery would benefit from support in this process, both from peers and professionals.
3. These results indicate that strict views on abstinence and the nature of alcohol problems in 12-step-based treatment, and AA philosophy may create problems for the recovery process.

Therefore, knowledge about whether and how QOL differs betweennon-abstinent vs. abstinent recovery remains limited. Despite the growth of the harm reduction movement globally, research and implementation of nonabstinence treatment in the U.S. has lagged. Furthermore, abstinence remains a gold standard treatment outcome in pharmacotherapy research for drug use disorders, even after numerous calls for alternative metrics of success (Volkow, 2020).

In sum, the current body of literature reflects multiple well-studied nonabstinence approaches for treating AUD and exceedingly little research testing nonabstinence treatments for drug use problems, representing a notable gap in the literature. A common objection to CD is that most people fail to return to “normal” drinking, and highlighting those able to drink in a controlled way might attract people into relapse, with severe medical and social consequences. On the other hand, previous research has reported that a major reason for not seeking treatment among alcohol-dependent people is the perceived requirement of abstinence (Keyes et al., 2010; Wallhed Finn et al., 2014, 2018). In turn, stigma and shame have been reported as famous fetal alcohol syndrome adults a reason for not seeking treatment (Probst et al., 2015).

WIR is alsocross-sectional by design, though it did include questions about lifetime drug and alcoholuse. Finally, the WIR survey did not ask about preferential beverage (e.g., beer, wine,spirits), usual quantities of ethanol and other drugs consumed per day, or specificsregarding AA involvement; because these factors could impact the recovery process, we willinclude these measures in future studies. A number of studies have examined psychosocial risk reduction interventions for individuals with high-risk drug use, especially people who inject drugs.

Regular physical activity can act as a healthy coping mechanism when dealing with cravings or anxiety related to your efforts towards alcohol moderation management. Lastly, this being a study, it is very possible that participants were better motivated, more informed, and more likely to put in the effort required to use the moderatedrinking.org program. Future work would need to assess the effectiveness of this tool what type of drug is mary jane in the field without such interference. The idea of giving up drinking completely is intimidating or discouraging for some people.

Sample

Abstinence may not be a realistic solution with some addictions, such as eating and in some cases sexual addictions. Alcohol moderation programs are endorsed as an effective option by organizations like the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Substance Abuse and Mental Health Services Administration (SAMHSA). The Sinclair Method (TSM), which involves taking the drug naltrexone to relearn moderation, has a success rate of 78%. The general definition of moderate drinking is up to one drink per day for women and up to two daily drinks for men. Take our short alcohol quiz to learn where you fall on the drinking spectrum and if you might benefit from quitting or cutting back on alcohol. The negative effects of your drinking may have turned you off of alcohol entirely, and that’s completely okay.

What Are the Different Types of Drugs?

Abstinence from alcohol and other drugs has historically been a core criterion for recovery, defined by the Betty Ford Institute as a “voluntarily maintained lifestyle characterized by sobriety, personal health, and citizenship” (Betty Ford Institute Consensus Panel, 2007, p. 222). As recovery processes stretch over a long period, it is suggested that stable recovery is obtained after five years at the earliest (Hibbert and Best, 2011). The results suggest the importance of offering interventions with various treatment goals and that clients are all toads poisonous choosing CD as part of their sustained recovery would benefit from support in this process, both from peers and professionals.

What are Some Benefits of Moderation vs. Abstinence?

“Harm reduction” strategies, on theother hand, set more flexible goals in line with patient motivation; these differ greatlyfrom person to person, and range from total abstinence to reduced consumption and reducedalcohol-related problems without changes in actual use (e.g., no longer driving drunkafter having received a DUI). In the broadest sense, harm reduction seeks to reduceproblems related to drinking behaviors and supports any step in the right directionwithout requiring abstinence (Marlatt and Witkiewitz2010). Witkiewitz (2013) has suggestedthat abstinence may be less important than psychiatric, family, social, economic, andhealth outcomes, and that non-consumption measures like psychosocial functioning andquality of life should be goals for AUD research (Witkiewitz 2013).

After transcribing the interviews, the material was analysed thematically (Braun and Clarke, 2006) by coding the interview passages according to what was brought up both manually and by using NVivo (a software package for qualitative data analysis). After relistening to the interviews and scrutinizing transcripts, the material was categorized and summarized by picking relevant parts from each transcript. By iteratively analysing and compiling these in an increasingly condensed form, themes were created at an aggregated level, following a process of going back and forth between transcripts and the emerging themes as described by Braun and Clarke (op. cit.). In the present article, descriptions of abstinence and CD and views on and use of the AA and the 12-step programme were analysed.

At the first interview all IPs were abstinent and had a positive view on the 12-step treatment, although a few described a cherry-picking attitude. 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. On the other hand, as the group expressed positive views on this specific treatment, they might question the sobriety goal in a lesser extent than other groups. In the results, we mention that there were a few IPs that were younger, with a background of diffuse and complex problems characterized by a multi-problem situation. Research on young adults, including people in their thirties (Magaraggia and Benasso, 2019), stresses that young adults leaving care tend to have complex problems and struggle with problems such as poor health, poor school performance and crime (Courtney and Dworsky, 2006; Berlin et al., 2011; Vinnerljung and Sallnäs, 2008). Thus, this is interesting to analyse further although the younger IPs in this article, with experience of 12-step treatment, are too few to allow for a separate analysis.

If you have health problems related to alcohol, it may be unsafe to drink at all, period. By quitting drinking completely, your body can begin to repair the damage caused by alcohol. Family involvement plays an important role too since their understanding and encouragement can fuel your determination even more on challenging days. Remember that the path towards lasting recovery isn’t linear — there will be ups and downs. But with patience, persistence and these strategies at hand – you’re better equipped than ever before on this journey towards healthier living minus harmful drinking habits. A key aspect of abstinence is understanding and navigating through the withdrawal process – a daunting task indeed but necessary for recovery.

1. People who have a more severe drinking problem and find moderation difficult to maintain often do better with abstinence.
2. Thus, this is interesting to analyse further although the younger IPs in this article, with experience of 12-step treatment, are too few to allow for a separate analysis.
3. Finney and Moos (1991) reported a 17 percent “social or moderate drinking” rate at 6 years and a 24 percent rate at 10 years.
4. Quitting alcohol for good is a life-changing decision with countless benefits that will make you wonder why you didn’t quit sooner.
5. By quitting drinking completely, your body can begin to repair the damage caused by alcohol.

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 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).

An additional concern is that the lack of research supporting the efficacy of established interventions for achieving nonabstinence goals presents a barrier to implementation. The current review highlights a notable gap in research empirically evaluating the effectiveness of nonabstinence approaches for DUD treatment. While multiple harm reduction-focused treatments for AUD have strong empirical support, there is very little research testing models of nonabstinence treatment for drug use. Despite compatibility with harm reduction in established SUD treatment models such as MI and RP, there is a dearth of evidence testing these as standalone treatments for helping patients achieve nonabstinence goals; this is especially true regarding DUD (vs. AUD).

Additionally, the survey asked about current quality oflife using a 4-point scale as administered by the World Health Organization (The WHOQOL Group 1998). Our second goal was to examine differences in quality of life betweenabstainers and non-abstainers controlling for length of time in recovery. 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).

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. In Britain and other European and Commonwealth countries, controlled-drinking therapy is widely available (Rosenberg et al., 1992). The following six questions explore the value, prevalence, and clinical impact of controlled drinking vs. abstinence outcomes in alcoholism treatment; they are intended to argue the case for controlled drinking as a reasonable and realistic goal. Studies have shown that in some cultures there are a small percentage of people who can return to moderate drinking. Attempts at moderation may not be worth the effort or the risk when considering the consequences.