The Difference Between Abstinence and Moderation

Ever been told that there is only one way to recovery? That you have to choose abstinence and that moderation simply will not work? What about being told that AA is the only way to go and that all other methods are not well-documented to create lasting change? I want to explore these ideals and help present information so you can make an informed decision for yourself. You know you better than anyone else but when we delve into the realm of addiction, sometimes hearing other perspectives can help. Click here to learn more about The Active Recovery Online Program.

Recovery

I have written blog posts explaining in more detail additional important topics of addiction. You can find them below.

• Click here to learn more about the difference between addiction and substance use disorder.
• Click here to learn more about addiction criteria.
• Click here to learn more about withdrawals.
• Click here to learn more about triggers.
• Click here to learn more about cravings.
• Click here to learn more about support systems.
• Click here to learn more about relapse prevention planning.
• Click here to learn more about drink tracking.
• Click here to learn more about mood fluctuations.

What Is the Difference

Moderating alcohol consumption and abstaining from alcohol are two distinct approaches to managing one's relationship with alcohol. Here are the key differences between the two:

Moderating Alcohol:

Controlled Consumption:

• Goal: The primary aim is to maintain a level of alcohol consumption that is considered moderate and does not lead to negative consequences.
• Limits: Set specific limits on the amount and frequency of alcohol intake.

Flexible Approach:

• Occasional Drinking: Moderation allows for occasional or social drinking without complete avoidance of alcohol.

Personal Responsibility:

• Self-Monitoring: Will need to be vigilant and self-monitor alcohol intake to ensure it remains within the defined limits.

Risk Management:

• Awareness of Risks: Moderation acknowledges the potential risks associated with alcohol but aims to minimize these risks through self-control.

Potential Challenges:

• Difficulty for Some: Moderation may be challenging for those who struggle with impulse control or have a history of alcohol abuse.

Abstaining from Alcohol:

Complete Avoidance:

• Goal: The primary goal is to abstain from consuming any alcoholic beverages entirely.

Zero Tolerance:

• No Drinking Allowed: Abstaining involves a strict policy of not drinking any alcohol, regardless of the circumstances.

Clarity and Simplicity:

• Clear Boundaries: Abstaining provides clear and unambiguous guidelines, eliminating the need for constant monitoring and decision-making regarding alcohol consumption.

Treatment for Addiction:

• Recovery from Alcoholism: Abstinence is often recommended for those recovering from alcohol addiction or dependence.

Reduced Risks:

• Elimination of Risks: Abstinence eliminates the risks associated with alcohol consumption, making it a safer option for those who have trouble controlling their drinking.

Personal and Cultural Reasons:

• Choice or Cultural/Religious Beliefs: Some choose to abstain from alcohol for personal reasons, such as health, religious beliefs, or cultural practices.

Considerations:

• Individual Variation: What works for one person may not work for another. Some people can successfully moderate their alcohol intake, while others may find it easier to abstain.
• Health Factors: Health conditions and individual circumstances may influence the decision to moderate or abstain. For example, those with certain medical conditions may be advised to abstain.
• Support System: Having a supportive social network or seeking professional help can be crucial for both approaches, but it may be especially important for those attempting to moderate their alcohol consumption.

Ultimately, the choice between moderation and abstinence depends on individual circumstances, goals, and the ability to maintain a healthy relationship with alcohol. But let's explore this further.

Abstinence Vrs Moderation

Before we get into the meat and potatoes of abstinence versus moderation, I want to throw out some statistics to help determine which method is best for you based on your unique situation.

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), half will relapse in the first year of abstinence. Notably, a third of Americans meet the criteria for alcohol use disorder (AUD) sometime during the course of their life. That is around 15 million Americans struggling with alcohol use at any given time during their life. Only about 10% of those struggling with alcohol abuse seek treatment.

So why no statistics on moderation in the first year, you ask? Because you can find a variety of studies that give different outcomes based on whether they are enmeshed with Alcoholics Anonymous (AA) or Moderation Management (MM). What research consistently has shown is that confidence in recovery leads to better outcomes.

Recovery Confidence

Confidence in alcohol recovery refers to your belief in your ability to successfully overcome alcohol addiction and maintain long-term sobriety. This confidence is often rooted in a person's self-efficacy, which is the belief that one can successfully execute the necessary actions to produce a desired outcome. In the context of alcohol recovery, confidence plays a crucial role in achieving and sustaining positive outcomes for several reasons:

• Motivation and Commitment: Confidence serves as a powerful motivator. When one believes in their ability to overcome challenges, they are more likely to remain committed to the recovery process. This commitment is essential for facing the difficulties and setbacks that may arise during the journey to sobriety.
• Resilience in the Face of Challenges: Recovery is often accompanied by challenges, including triggers, cravings, and stressors. Those with high confidence are more resilient and better equipped to navigate these challenges without relapsing. They view setbacks as temporary obstacles rather than insurmountable failures.
• Positive Mindset: Confidence contributes to a positive mindset, which is very important for recovery. A positive outlook can enhance a person's ability to cope with stress, adopt healthier coping mechanisms, and make positive lifestyle changes. This mindset shift is associated with better overall well-being and a reduced likelihood of relapse.
• Active Participation in Treatment: Confident people are more likely to actively engage in and adhere to treatment plans. This may include attending therapy sessions, participating in support groups, and following through with the recommendations of healthcare professionals. Active participation increases the likelihood of successful recovery.
• Building a Support System: Confidence can facilitate the development of a strong support system. Individuals who believe in their ability to recover are often more open to seeking help from others, whether it be friends, family, or support groups. A robust support system is crucial for maintaining sobriety.
• Setting and Achieving Goals: Confidence empowers to set realistic and achievable goals for themselves. As they accomplish these goals, whether they are short-term or long-term, their confidence in their ability to stay sober is reinforced. Setting and achieving goals provides a sense of accomplishment and progress in the recovery journey.

Which Method Is Right for You

Now which route is best for you? Treatment plays a huge role in either choice. Studies show that treatment increases recovery outcomes by 30%. What that means is that attending treatment, whether that is rehab or outpatient services, will increase that 50% chance of sustained recovery in the first year to potentially 80%! This has been shown to be the case for either abstinence or moderation.

The key to deciding which route is best for you is to explore. The NIAAA set a standard drink for women at one a day or seven a week and two a day or fourteen a week for men. This has a lot to do with metabolism and muscle mass along with weight. Age is a factor as well overall; women just tend to tipsy quicker than men.

Studies have found that those who do better with moderation tend to fall into the mild to moderate drinking criteria based on the Diagnostic and Statistical Manual of Mental Disorders known as the DSM-5. There is a spectrum that substance use disorders (SUDs) fall under; mild use, moderate use, and severe use. Those who fall under the severe drinking criteria would be better suited to exploring a period of abstinence before traversing into moderation. How long should the period of abstinence be? It really depends on the level of alcohol consumption. MM encourages a dry period of 30 days. MM also recommends abstinence if moderation is too difficult.

Attempting to moderate alcohol use rather than abstaining entirely is a strategy that can work for some, especially if they do not want to commit to complete sobriety. However, for those with heavy alcohol use issues, moderation can be challenging and may not be effective. Here are signs that moderating alcohol use may not be working:

• Loss of Control: If you find it difficult to stick to the limits you set for yourself regarding alcohol consumption, such as the number of drinks or the frequency of drinking, it may indicate a loss of control. Difficulty stopping once you've started drinking is a red flag.
• Increased Tolerance: If you notice that over time you need to drink more to achieve the same level of intoxication or relaxation, your tolerance may be increasing. This can be a sign that your relationship with alcohol is becoming problematic.
• Preoccupation with Drinking: If a significant amount of your time is spent thinking about drinking, planning when and where to drink, or recovering from the effects of alcohol, it could be an indication that alcohol is taking up too much mental space.
• Neglect of Responsibilities: If your alcohol use is interfering with your responsibilities at work, school, or in your personal life, it suggests that your drinking is having a negative impact on your overall functioning.
• Continued Drinking Despite Negative Consequences: If you continue to drink even when it leads to negative consequences, such as strained relationships, health problems, or legal issues, it's a sign that your drinking is problematic.
• Failed Attempts to Cut Down: If you've made repeated attempts to cut down on your drinking and have been unsuccessful, it suggests that moderation may not be a realistic goal for you.
• Withdrawal Symptoms: Experiencing withdrawal symptoms when not drinking, such as tremors, anxiety, or irritability, is a sign of physical dependence and may indicate that moderation is not a viable option.
• Loss of Interest in Other Activities: If activities you once enjoyed are taking a backseat to drink or if you find that you no longer engage in hobbies or social activities that don't involve alcohol, it may signal a problematic relationship with alcohol.
• Increased Risk-Taking: Engaging in risky behaviors while under the influence of alcohol, such as driving under the influence or engaging in unprotected sex, indicates impaired judgment and an increased risk of harm.

12 Reasons to Seek Treatment

Treatment should always be an option when considering recovery. Remember those statistics I mentioned earlier? Treatment for alcohol can address a variety of issues and provide support in multiple areas of a person's life. The goals of treatment are generally to help achieve and maintain recovery, improve overall well-being, and develop skills to cope with life's challenges. Here are some key aspects that treatment for alcohol use can help with:

1. Assessment and Diagnosis: Treatment typically begins with a thorough assessment to understand the severity of the alcohol use disorder and any co-occurring mental health issues. This helps in developing an individualized treatment plan.
2. Detoxification: For those with physical dependence on alcohol, a supervised detoxification process may be necessary to manage withdrawal symptoms safely. Medical professionals can provide support during this phase.
3. Medical Stabilization: Treatment can address and stabilize any medical issues related to alcohol use. Chronic alcohol consumption can lead to various health problems, and addressing these is crucial for safety. Alcohol is one of those substances that can cause death if the consumption is high enough and one decides to go cold turkey. Do your research before detoxing.
4. Psychological Support: Therapy, such as cognitive-behavioral therapy (CBT), motivational enhancement therapy (MET), dialectical behavior therapy (DBT), and many others, can help explore the underlying issues contributing to alcohol use and develop healthier coping mechanisms.
5. Education and Skill Building: Treatment programs often include education about the nature of alcohol use disorders, the impact on physical and mental health, and strategies for relapse prevention. Skill-building sessions focus on developing coping skills, stress management, and communication skills.
6. Group Therapy: Group therapy provides a supportive environment where individuals can share their experiences, gain insights from others, and receive encouragement. It fosters a sense of community and reduces feelings of isolation.
7. Family Involvement: Involving family members in the treatment process can help repair relationships, enhance communication, and create a supportive home environment. Family therapy may be a component of treatment.
8. Medication Management: Some may benefit from medications to support their recovery. Medications can help manage cravings, reduce withdrawal symptoms, and address co-occurring mental health conditions.
9. Relapse Prevention: Learning to identify triggers and developing strategies to prevent relapse is a crucial aspect of alcohol treatment. This involves developing a personalized plan to navigate high-risk situations.
10. Lifestyle Changes: Treatment often encourages positive lifestyle changes, including adopting healthy habits such as regular exercise, improved nutrition, and stress reduction techniques.
11. Aftercare Planning: Planning for the transition from formal treatment to ongoing recovery is an important component. Aftercare may include ongoing therapy, support groups, and other resources to maintain sobriety.
12. Addressing Co-occurring Disorders: Many with alcohol use disorders also experience co-occurring mental health conditions. Treatment aims to address these dual diagnoses concurrently for more comprehensive care.

In my work as an addiction counselor, I have seen both abstinence and moderation work. The key is to seek treatment from a provider that supports both because not all providers believe in moderation, and to stick to the treatment plan that both you and the addiction specialist collaborate together to make. Moderation is going to look different from abstinence, in that there will be elements of drink tracking where abstinence does not track drinks because you are abstaining from alcohol by no longer drinking.

Whichever path you choose, it is your choice to make. You do not have to be forced into either. Do what you feel is best for you. But what I do encourage is seeking treatment. Underlining trauma can be a huge factor in alcohol self-medicating and can also be the determinant of how long your recovery lasts. Long-lasting results come from experiencing the uncomfortable so you can be comfortable with either choosing not to have that drink with dinner rather than fixating on wishing you had that drink with dinner for the rest of the evening.

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More Resources

If you are interested in learning more, click here. For more information on this topic, we recommend the following:

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About the Author

Jessica Taylor is a licensed therapist and board certified coach who contributes to the promotion of mental health and addiction awareness by providing educational resources and information.