Moderation management vs. abstinence

Moderation Management vs. Abstinence: Which Strategy is Best for Substance Use Disorder?

Is it possible to manage problem drinking, or do you have to give up alcohol altogether? The moderation management vs. abstinence debate has been around since the 1960’s. When people first enter substance abuse treatment, they’re often looking to cut back on drinking rather than stop altogether. In many cases, people have difficulty seeking help due to barriers such as denial and stigma. The decision to try moderation or abstinence depends on individual circumstances. 

Is abstinence better than moderation management?

Which strategy works best relates to a person’s level of dependency. The more dependent a person is, the less likely moderation will work as a strategy to stop substance misuse. Abstinence helps severely dependent drinkers maintain their goals. In contrast, moderation management may be effective for a person with non-dependent drinking problems.

What is Moderation Management?

Moderation management, or controlled drinking, is a drug and alcohol harm reduction strategy. The individual sets goals to reduce substance use. This approach is designed for people who do not or believe they do not have symptoms of physical dependency or substance use disorder. It is a valuable program to reduce harms such as driving while intoxicated, risky sexual, spending, or other unhealthy  behaviors. Starting with moderation management may help people avoid the progressing down the path of addiction. 

What is Abstinence?

Abstinence refers to avoiding problem substances or behaviors altogether. For example, a person is abstaining from alcohol when they do not drink at all. Abstinence was initially developed to treat alcoholism, but it can be used for many types of addiction. 

Moderation Management vs. Abstinence 

Moderation management can work for people who are not dependent on alcohol. This strategy can work for people who have a few negative consequences from substance use but have not developed a pattern of alcohol addiction. The goal of this strategy is to guide individuals to limit use before they progress down the path of addiction.  In contrast, moderation is usually unsuccessful for those who are already dependent on alcohol. Abstinence may be the best option for many dependent drinkers. 

Motivating Change

Moderation management can be a step toward behavior change. Even when a person recognizes they have a substance use problem, they may be reluctant to give up drinking. Substance use has become a part of their existence that they can’t imagine life without it—even though drinking has put their relationships, jobs, and health in peril. 

When a person says they want to drink less, they are indicating a willingness to change. However, demanding abstinence right out of the gate may drive people away. Starting with moderation management as a motivational strategy lets the individual sets work towards their goals. If controlled drinking doesn’t work, they may realize their best choice is abstinence.

Individualized Strategies 

There is no one-size-fits-all solution to substance misuse. The decision to use moderation management vs. abstinence depends on a person’s situation. Moderation is a starting off point for behavior change. It can be an effective strategy for non-dependent drinkers or a motivational tool to work towards abstinence. If you or someone you know needs coaching on choosing the right approach, schedule a consultation today—call 877-449-6393.

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