Here’s a question I get on a pretty regular basis: “With proper precaution, can alcoholics drink in moderation?”
The answer is complex, but I would say the answer is basically “no”, with a few **very important caveats.
When it comes to problem drinkers who may not yet have descended into full blown alcoholism, there’s definitely strong support for the idea that harm reduction and moderating alcohol intake may be better solution than 100% abstinence.
For more on this, see my article on Moderation Management.
Keep in mind that “moderation” here does NOT mean “oh, I’ll try not to puke when I go out this weekend”, it means seeking out a qualified program or professional who specializes in harm reduction oriented treatment.
However, when it comes to true alcoholism, successfully drinking in moderation becomes much, much less likely (some would say impossible). There are definitely those who claim that alcoholics can be taught moderation. I would argue that – while it’s certainly possible for an alcoholic to limit themselves to 1-2 drinks and moderate their drinking – that doesn’t mean an alcoholic can drink in moderation successfully.
What do I mean by this?
To better understand what I’m saying, let’s look at what happens when an alcoholic limits themselves to 1-2 drinks:
- Every alcoholic wants to get hammered, even if that feeling is deeply repressed. The taste and smell of alcohol triggers strong emotions attached to the desire to drink.
- The “moderate” amount of alcohol offers none of the release and emotional masking alcoholics often seek.
- This means the alcoholic doesn’t have fun while drinking their 1-2 drinks. In fact, it takes a massive amount of self-control and willpower to drink and not end up completely smashed.
- The feelings above often mean that 1-2 drinks eventually leads to a bender and full relapse.
By definition, an alcoholic is someone who not only abuses alcohol to the detriment of their lives and those around them, it’s someone who cannot get drunk without losing control. If an alcoholic could get drunk and have fun without losing control, they wouldn’t really be an alcoholic in the first place. If they limit themselves to 1-2 drinks the way alcoholics must in order to remain in control, they’re not getting any of the emotional release they causes them to turn to alcohol in the first place.
There’s No “In-Between”
This boils down to the alcoholic either nursing their 1-2 drinks and resenting that they can’t get hammered, or the alcoholic getting hammered and relapsing. There is no “in-between” scenario where the alcoholic gets a little tipsy, has a wholesome fun time, and stays away from the bottle for the next few months.
If an alcoholic were somehow able to enjoy a few drinks without getting hammered, and without resenting the fact that they’re not getting hammered, then that would truly be an amazing thing. But by definition, this person would be no longer an alcoholic – they would be cured. As anyone who has been in recovery knows, this sort of thing simply doesn’t happen. I suppose if someone were able to achieve this, then kudos, but any such person almost certainly wasn’t a true alcoholic to begin with.
Is Abstinence The Only Way?
So there’s one answer. Yes, an alcoholic could try to enjoy a glass of red wine with dinner; they’ll probably be fine for awhile too. But it only takes one slip up to fall back into the grip of addiction. Each successful confrontation with alcohol will embolden the alcoholic, giving them a greater illusion of control.
Before you know it, you’ve let your guard down, and one day – perhaps even years down the road – you go overboard and relapse. It’s inevitable. Any addict who consistently puts themselves in the face of temptation is likely to fail.
Total abstinence really does work. Don’t be entrapped by the temptation of “moderation” – seek true freedom.
**An Important Caveat
This article originally ended with the paragraph above. I wrote it awhile back and it was meant more as a reflection of my personal beliefs and experiences.
However, after reading a lot on harm reduction and talking to alcoholics and addicts who have benefited from harm reduction approaches, I felt compelled to include this caveat:
While I personally feel that true alcoholics (not mere problem drinkers) should look to abstinence as the ultimate goal, there is certainly merit to the idea of harm reduction. How many alcoholics hide their relapse because they know that if they turn to their 12 step program for help, they’re going to get reprimanded and told to abstain?
I have to think for at least some of these people, they’d be much better off if they knew they had access to a program that focuses on harm reduction. It’s easy – and I believe logical – to promote abstinence as a goal, but on a case-by-case basis, there might be individuals – even full blown alcoholics – who would benefit from moderation management and harm reduction programs.
How Can You Reconcile Moderation & Harm Reduction With Abstinence?
This is a tricky issue, and I won’t pretend to have all the answers. In fact, I don’t think there is a 1 size-fits-all answer to this question.
Here’s my attempt to reconcile these opposing points of view and formulate a coherent viewpoint on this complex question:
- Based on my own experiences in recovery, I personally feel that abstinence should be the ultimate goal for any alcoholic in recovery. I feel that the surest path to successful recovery is through abstinence. Aiming for moderation is a likely recipe for failure.
- However, if you’re concerned about your drinking behavior, but you don’t want to go to a 12 step program and be forced to abstain, a good first step would be a Moderation Management style program. Keep in mind that moderation doesn’t just mean cutting back to a six pack instead of 12 beers, it means seeking out a support group or therapist that specializes in helping people manage and moderate dangerous drinking behavior.
- Harm reduction might be a better option than abstinence for some people. This goes against 12 step orthodoxy, but if – for example – someone has been a chronic alcoholic in and out of 12 step programs with no success, they might benefit from a harm reduction focused program.
People respond differently to different things. Just because something works for me or you, doesn’t mean it will work for someone else.
When we find ourselves taking something as complex as alcohol addiction and prescribing a 1 size-fits-all treatment – we really need to start questioning our methods and attitudes.