However, these interventions also typically lack an abstinence focus and sometimes result in reductions in drug use. 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). Models of nonabstinence psychosocial treatment for drug use have been developed and promoted by practitioners, but little empirical research has tested their effectiveness.

• Thus, advocates for AA often rail at those who offer the wishy-washy solution of controlled drinking.
• Both his book, “Take Control of Your Drinking,” and “Last Call” were published nearly simultaneously, perhaps in an attempt to keep the alcoholism treatment debate lively.
• We do not know what factors relate to non-abstinent vs. abstinent recovery amongindividuals who define themselves as in recovery.
• 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.

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Additionally, drinking goal was initially analyzed as a five-level variable keeping all possible self-report responses separate. Visual inspection of these results supported our classification system (i.e., controlled drinking, conditional abstinence, and complete abstinence) in controlled drinking vs abstinence that the two possible responses for both controlled drinking and conditional abstinence clustered together across outcomes. Since drinking goal is a three-level variable, following the omnibus test, planned analyses were conducted to test differences between the three drinking goal groups for effects observed on all outcome variables. 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.

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Clients reporting CD in the present study only met one of these criteria – an initial period of abstinence (Booth, 2006; Coldwell and Heather, 2006). 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. Learn more about moderation with Ria Health, or find out how our program works.

Expanding the continuum of substance use disorder treatment: Nonabstinence approaches

Indeed, there is anecdotal evidence that this may be the case; for example, a qualitative study of nonabstinence drug treatment in Denmark described a client saying that he would not have presented to abstinence-only treatment due to his goal of moderate use (Järvinen, 2017). Additionally, in the United Kingdom, where there is greater access to nonabstinence treatment (Rosenberg & Melville, 2005; Rosenberg & Phillips, 2003), the proportion of individuals with opioid use disorder engaged in treatment is more than twice that of the U.S. (60% vs. 28%; Burkinshaw et al., 2017). There has been little research on the goals of non-treatment-seeking individuals; however, research suggests that nonabstinence goals are common even among individuals presenting to SUD treatment.

• Abstinence means giving up alcohol completely, and it’s the foundation of traditional treatment options like AA and most inpatient rehabs.
• This would probably reduce the risk of negative effects while still offering the positive support experienced by the majority of the clients in the study.
• We are not perfect beings, we are fallible and breaking a commitment is not the same as giving up on one.

• But 61 percent of those who achieved remission without treatment continued drinking.
• The goal of a moderation program is to support a person’s journey toward understanding their drinking behavior and create a safe environment for them to explore how to drink moderately.
• 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.
• Instead, the literature indicates that most people with SUD do not want or need – or are not ready for – what the current treatment system is offering.

Furthermore, qualityof life appeared significantly better among abstainers than non-abstainers. A betterunderstanding of the recovery https://ecosoberhouse.com/ process and tools utilized by non-abstinent vs. abstinentindividuals would inform clinical practice; for example, is it more important for those inabstinent recovery to have abstinent individuals in their social networks? How do thespecifics of AA and other mutual aid group involvement affect long-term recovery?