Reducing or Quitting Drinking? An Extensive Review of Health Benefits Recovery Research Institute

Polich, Armor, and Braiker found that the most severely dependent alcoholics (11 or more dependence symptoms on admission) were the least likely to achieve nonproblem drinking at 4 years. Furthermore, younger (under 40), single alcoholics were far more likely to relapse if they were abstinent at 18 months than if they were drinking without problems, even if they were highly alcohol-dependent. 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.

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). Traditional alcohol use disorder (AUD) treatment programs most often prescribeabstinence as clients’ ultimate goal. “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).

Alcohol Moderation Management: Steps To Control Drinking

Individuals with fewer years of addiction and lower severity SUDs generally have the highest likelihood of achieving moderate, low-consequence substance use after treatment (Öjehagen & Berglund, 1989; Witkiewitz, 2008). Notably, these individuals are also most likely to endorse nonabstinence goals (Berglund et al., 2019; Dunn & Strain, 2013; Lozano et al., 2006; Lozano et al., 2015; Mowbray et al., 2013). In contrast, individuals with greater SUD severity, who are more likely to have abstinence goals, generally have the best outcomes when working toward abstinence (Witkiewitz, 2008). Together, this suggests a promising degree of alignment between goal selection and probability of success, and it highlights the potential utility of nonabstinence treatment as an “early intervention” approach to prevent SUD escalation. This paper presents a narrative review of the literature and a call for increased research attention on the development of empirically supported nonabstinence treatments for SUD to engage and treat more people with SUD.

Help for Achieving Lasting Recovery

These findings support the clinical validity of the recovery profiles and reaffirm the importance of considering indicators of psychological functioning, and not simply alcohol consumption levels, when defining long-term recovery from AUD. Indeed, our findings revealed a lack of a one-to-one correspondence between drinking behavior and psychological functioning during the process of recovery over time. Abstinence three years following treatment did not predict better functioning ten years following treatment. Rather, functioning at three years following treatment (profiles 3 and 4) predicted better psychological functioning at ten years following treatment. As recently proposed, focusing on functioning rather than drinking practices per se may be more useful when defining successful AUD recovery and forecasting how an individual will fare over the long run4,13,16,17,45. Our quantitative findings using a clinical treatment sample also are aligned with research indicating that functional outcomes, including quality of life and well-being, are highly valued among persons who self-identify as being in recovery20,21.

Recent conceptualizations of the term ‘recovery’ have shifted to emphasize the broader biopsychosocial process of improvement that is related to, but not solely determined by, alcohol consumption. As noted by Ashford and colleagues13, stakeholder institutions, including the American Society of Addiction Medicine (ASAM), have updated and modified their operational definitions of recovery over the past two decades. In 2005, ASAM’s public policy statement on recovery highlighted a state of psychological and physical health in which an individual’s abstinence from substance use was “complete and comfortable”14. Empirical support for a broader conceptualization of recovery has been reviewed in recent work16–18 and also expressed by individuals who self-identify as being in recovery19–21. Given data demonstrating a clear link between abstinence goals and treatment engagement in a primarily abstinence-based SUD treatment system, it is reasonable to hypothesize that offering nonabstinence treatment would increase overall engagement by appealing to those with nonabstinence goals.

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 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 strongest vodka proof 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. However, they will be included in a further analysis on young adults based on the same premises as in present article but with experience from other treatments than the 12-step treatment. Some strategies and guidelines to consider if you’re aiming to practice controlled drinking include setting limits, eating before drinking, choosing drinks with lower alcohol content, alternatives with non-alcoholic beverages and having abstinent days.

4. Current status of nonabstinence SUD treatment

Edwards et al. (1983) reported that controlled drinking is more unstable than abstinence for alcoholics over time, but recent studies have found that controlled drinking increases over longer follow-up periods. Finney and Moos (1991) reported a 17 percent “social or moderate drinking” rate at 6 years and a 24 percent rate at 10 years. In studies by McCabe (1986) and Nordström and Berglund (1987), CD outcomes exceeded abstinence during follow-up of patients 15 and more years after treatment. Harm reduction therapy has also been applied in group format, mirroring the approach and components of individual harm reduction psychotherapy but with added focus on building social support and receiving feedback and advice from peers (Little, 2006; Little & Franskoviak, 2010). These groups tend to include individuals who use a range of substances and who endorse a range of goals, including reducing substance use and/or substance-related harms, controlled/moderate use, and abstinence (Little, 2006).

1. It is important to highlight that most of the studies cited above did not provide goal-matched treatment; thus, these outcomes generally reflect differences between individuals with abstinence vs. non-abstinence goals who participated in abstinence-based AUD treatment.
2. That’s why our approach involves taking time to know you better, identify your triggers, and help chart a path forward that aligns with your life goals.
3. WIR is alsocross-sectional by design, though it did include questions about lifetime drug and alcoholuse.
4. Profile 4 had significantly lower anger, depression, and alcohol-related consequences, and greater purpose in life than profiles 1 and 2 and did not differ significantly from profile 3 on two important functioning outcomes at year 10 (i.e., depression and purpose in life).

An observational study of individuals with AUD surveyed participants about their drinking practices, psychosocial functioning, and life contexts at baseline and 1, 3, 8, and 16 years later. Regardless of whether they had recently sought help or achieved abstinence, many participants showed improvement in alcohol-related functioning, life contexts, and coping26. Taken together, these studies may inform a longstanding debate in the field concerning the risks and stability of non-abstinent recovery9 and the utility of broader conceptualizations of recovery that emphasize improvements in biopsychosocial functioning16,17.

Is Controlled Drinking Possible for Alcoholics?

For example, in three separate randomized trials, reduced drinking did not lead to changes in anxiety or life satisfaction. Studies generally show that reducing drinking is related to reductions in injuries and likelihood of death over the long-term, but not over the short-term (e.g., less than 1 year). For example, in one study, reducing one’s weekly drinking by about 30% (in total volume) was related to fewer injuries and 44% fewer sick days over a 2-year period.

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). 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. A considerable number of clients reported changed views on the programme, some were still abstinent and some were drinking in a controlled way.

Therefore, our programme includes evidence-based therapies such as cognitive behavioural therapy (CBT) or dialectical behaviour therapy (DBT). This multifaceted approach helps you develop coping mechanisms while fostering healthier habits that can sustain long-term recovery. Our approach is not one-size-fits-all; instead, it’s grounded in empathy, respect for your individuality, and a deep understanding of how alcohol misuse impacts different people in different ways. That’s why our approach involves taking time to know you better, identify your triggers, and help chart a path forward that aligns with your life goals. 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.