Problematic alcohol abuse is treated either by aiming for complete abstinence, abstinence for the duration of therapy or controlled alcohol consumption. Disorders in alcohol consumption are among the most common, having the highest impact on morbidity and mortality, in mental health care. Fourth, only a small subset of original participants in the outpatient arm of Project MATCH at the Albuquerque site were followed successfully over 10 years, and the extent to which the sample may be biased cannot be thoroughly ascertained. Third, all measures included in the study were self-reported, and collateral information from providers or family were not available.
Quality of life / Functioning
It’s not an easy road to lasting recovery, but with the right support and resources, it can definitely be a journey worth taking. Remember that every person’s journey is unique; there are no one-size-fits-all solutions for managing alcohol intake. Several factors influence this decision, including societal perception, cultural factors, psychological impact, and health implications. When it comes to choosing between total abstinence or limiting your intake, the answer isn’t black and white. Imagine the satisfaction of knowing that your commitment to sobriety has led to stronger connections with loved ones while also improving many facets of your life holistically – now isn’t that worth raising a glass (of water) to? rockland recovery treatment centers Think about all the money spent on drinks over time – that could turn into savings or investments for future goals instead.
Mental Health, Quality of Life & Social Functioning:
As hypothesized, the two highest functioning profiles at three years following treatment (profile 3 and 4) generally had the best psychological functioning outcomes, including greater purpose in life and lower levels of depression, at ten years following treatment. 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. For example, using follow-up data from the COMBINE Study24, we found that individuals who were high functioning at three years post-treatment, regardless of level of alcohol consumption, had the best self-reported health and fewer hospitalizations at 7–9 years post-treatment25.
Quality of life and functioning
Alcohol moderation management isn’t just about cutting back and reducing your blood alcohol concentration, it’s a deeply personal journey that can empower you to regain control of your life and reconnect with those who matter most. One of the most commonly studied issues in alcohol research is the effect of drinking on cardiovascular functioning. In addition, while studies tend not to find helpful effects of drinking reduction on health care utilization, abstinence, on the other hand, tends to be related to less health care utilization.
Specifically among older persons, better outcomes are experienced with abstinence rather than controlled drinking. Full abstinence leads to reduced physical and mental health risks, improved physical and psychological health, and greater well-being. This approach eliminates all risks tied to drinking, such as intoxication and other health complications. Controlled drinking, also referred to as moderation, involves consuming alcohol occasionally without exceeding safe limits. To the extent that a perceived requirement to have a goal of complete abstinence is a barrier for some to enter treatment in the first place, a key clinical implication here is that communicating that some (e.g., those with lower AOD involvement and impairment) may be able to resolve cocaine abuse and addiction an AOD problem without necessarily needing to abstain completely may help such individuals access helpful resources sooner.
The Reframe app equips you with the knowledge and skills you need to not only survive drinking less, but to thrive while you navigate the journey. Is controlled drinking or moderate drinking the same as mindful drinking? An “alcoholic” — the colloquial term for someone with alcohol use disorder (AUD) — is defined as a person who is unable to quit or cut back on alcohol despite negative consequences.
As a check that number of lifetime psychiatric diagnoses was a reasonable measure reflecting clinical severity in our sample, we examined the correlation between number of lifetime psychiatric diagnoses and Kessler-6 scores capturing psychiatric distress. While the harms of ongoing substance use for individuals with comorbid psychiatric disorder (Bruce et al., 2005, Bahorik et al., 2017) suggest abstinence may be the most optimal goal, it is clear many individuals with co-occurring disorders continue some form of substance use and are likely to benefit from additional clinical support and substance use harm reduction strategies. It is possible that individuals with comorbidities have more psychosocial stress and challenges, taxing their coping resources, thus increasing the likelihood of ongoing substance use as a strategy to relieve mental health symptoms. ‘Ageing out’ itself may consist of substance use becoming less compatible with individuals’ lifestyles and developmental contexts as they grow older. National Recovery Study rates of abstinent recovery were lower, however, relative to the 88.0% with alcohol problems in the What is Recovery Study (Subbaraman and Witbrodt, 2014). Though this work is cross-sectional, these results speak to the value of harm reduction ‘gradations’ that occur with shifts from higher-, to lower-risk substance use and abstinence.
These goals are highly consistent with the growingconceptualization of `recovery’ as a guiding vision of AUD services (The Betty Ford Institute Consensus Panel 2007). Moderated drinking could give you the space to address those issues you’ve been pushing aside. The ranking probabilities and surface under the cumulative ranking curve (SUCRA) values are presented in Figure S8A–C and Table S8A–C for the three following outcomes. Dr. Stanton Peele, recognized as one of the world’s leading addiction experts, developed the Life Process Program after decades of research, writing, and treatment about and for people with addictions.
Multivariable stepwise regressions estimating the probability of non-abstinentrecovery and average quality of life. If you are struggling with alcohol use and are ready for change, moderation or abstinence are not easy to come by. However, for those with alcohol use disorder and major health complications, abstinence is the healthier, sustainable option. In a nutshell, if your drinking has not yet led to any major concerns of abuse or dependence, or other health complications, then moderation with strict limits can be good for you.
- Abstinence at three years did not predict better psychological functioning at ten years.
- Among individuals in recovery from alcohol problems in the What Is Recovery?
- Moderate drinking (also known as “controlled drinking”) consists of limiting our alcohol intake, thereby limiting alcohol’s negative effects on our health and well-being.
- Even moderate drinking can lead to long-term health problems such as liver disease, heart disease, and increased risk of certain cancers.
- Melody is here to help as you adjust to a life with less (or no) alcohol.
- Nevertheless, when stated by the patient, it may be a useful predictor of treatment outcome.
- Around 90 percent of patients who were in agreement with their care provider on total abstinence were still sober at the follow-up, whereas only 50 percent who were in agreement with their care provider on controlled consumption treatment had succeeded in controlling their drinking at follow-up.
Over time, a sober lifestyle is better – abstinence indeed shows stronger positive outcomes compared to moderation. The present study highlights the prevalence of different substance use patterns, ranging from total AOD abstinence to ongoing use of both primary and secondary substances, and its relationship to indices of functioning and well-being among US adults who endorse having resolved an AOD problem. There were associations found between lower risk substance use and greater self-esteem, happiness, quality of life and functioning, recovery capital, and lower psychological distress in both the unadjusted and adjusted models (Table 3). Graph showing percentage of the 22.35 million American adults who have resolved an alcohol or other drug (AOD) problem who have been abstinent since AOD problem resolution (20.3%), are currently abstinent but endorse some Adderall Heart Risks substance use since problem resolution (33.7%), are using a secondary substance (21.0%), are using their primary substance (16.2%), and are using both their primary and a secondary substance (8.8%) In this secondary analysis of a nationally representative, US sample of individuals who resolved an AOD problem (Kelly et al., 2017), we found that almost half reported currently using either a secondary substance, their primary substance, or both a secondary and primary substance.
1 Non-abstinent recovery from alcohol use disorders
Cultural perspectives on alcohol also influence our attitudes towards its use and misuse, shaping norms around what constitutes acceptable levels of consumption. Your thoughts, feelings, and behaviours all play a role in how you manage your alcohol consumption. Moderation techniques such as pacing yourself, choosing lower-alcohol options, or having alcohol-free days can be practical tools in this journey.
- Additionally, we offer exceptional continuing care so even after completing your programme; you’re never alone in this fight against alcohol addiction.
- Effects for shorter lengths of recovery (i.e., 1–2 years,3–5 years) were in the same direction yet not significant at the traditionalPvs.
- Moderation is a method to reduce alcohol’s harmful effects by not drinking too much or too often.
- Some differences in ten-year drinking outcomes among recovery profiles at three years following treatment were somewhat unexpected.
- Overall, study findings support and extend a growing body of literature that suggests that abstinence is not the only path to achieve and/or sustain a high level of psychosocial functioning in the years following alcohol treatment.
- Different types of alcohol have different amounts of alcohol in them.
- Individual factors like personal motivation, mental health status, and support system also play a key role in determining how well someone will fare within a programme.
These measures, however, don’t capture treatment duration and intensity, which will have varied from participant to participant. 5) To assess treatment effects, we asked participants whether they received inpatient or outpatient treatment for their AOD problem, and whether they ever regularly attended 12-step meetings. Though this response rate is similar to other nationally representative surveys, the GfK KnowledgePanel represents a subset of individuals who agreed to participate in surveys and acquiring data from non-respondents might have provided different results. 3) The subjective nature of ‘problem’ and ‘problem resolution’ in the National Recovery Study’s initial survey question, “Did you used to have a problem with drugs or alcohol, but no longer do?
Like previous findings, results here suggest that some with less prior AOD involvement and related impairment are able—to a large extent—subjectively improve to the point that they perceive their AOD problem to be resolved without abstaining completely, and with a minority of these perhaps even using intensively (i.e., both primary and secondary substances). Thus, abstinence rates may be higher among individuals with problem recognition versus those who meet criteria for SUD based on a structured clinical interview (e.g., First et al., 2015), but who may not recognize a problem. Based on these findings, it appears that AOD abstinence is, for many, not a requisite for overcoming an AOD problem, however, abstinence is likely to lead to better functioning and well-being.
Rates of abstinent recovery in the current study (54.0%) were greater than those among individuals in alcohol use disorder remission from the National Epidemiologic Survey on Alcohol and Related Conditions-III (54.0% vs. 28.9%; Fan et al., 2019). Specifically, we leveraged the data from the National Recovery Study (Kelly et al., 2017) to investigate national prevalence of abstinent versus types of non-abstinent recovery pathways, their correlates, and relationships to indices of quality of life, functioning, and well-being in a nationally representative sample of United States (US) adults who endorse having resolved a problem with a range of substances. Using latent profile analyses, Witkiewitz and colleagues also found that while the greatest proportion of higher functioning individuals were abstinent or low-risk drinkers (51%), a smaller subset were characterized as higher functioning, occasional heavy drinkers (17%), though such individuals reported more drinking consequences on average, than those belonging to the low-risk/abstinent, higher functioning profile. Thus, it is believed that greater adoption of flexible, patient-centered treatment and recovery approaches that support non-abstinence goals and harm reduction are likely to attract and engage more individuals in substance use related health behavior change, in turn benefitting public health. Furthermore, there is evidence that total alcohol and other drug (AOD) abstinence is not a requisite for achieving addiction recovery, defined here as an experience that captures both resolution of substance use problems and the development of a “healthy, productive, and meaningful life” (White, 2007). We also did not measure physical health, or medical outcomes at year 10, and we were not able to evaluate whether individuals who continued drinking heavily were at increased risk for physical health-related diseases6,49.
Moderate drinking is a harm-reduction strategy – it allows you to enjoy alcohol in social settings while also minimizing the negative effects that come with heavy drinking. Please read on to understand moderation vs abstinence, and how you can decide which one is the better option for you. What do you do, try to cut down on your drinking or choose abstinence? Approximately half of Americans who endorse having resolved an AOD problem are abstinent from AOD (54%), while the remainder endorse some form of continued substance use. We asked, “Which of the following substance use and/or mental health conditions have you ever been diagnosed with? At the same time, by using complex samples analyses that integrate survey weights, our results reflect an unbiased estimate of the population of US adults who self-reported having resolved an AOD problem.
Although this research adds to growing evidence that distinct longer term recovery profiles can be identified based on both alcohol-related outcomes and functioning indicators, important questions remain about whether these profiles forecast sustained positive outcomes over longer intervals. The study findings are relevant to the current debate on total abstinence vs. safe, controlled alcohol consumption as treatment goals in cases of alcohol dependence. For example, while interventions that emphasize or allow for drinking reduction rather than abstinence may attract more individuals with alcohol problems – and thus have potentially greater reach – they may possibly have a smaller positive impact on health and wellness. Comparisons of abstinence versus reduced or controlled drinking (sometimes called “harm reduction”) remains a hot topic in addiction treatment and recovery research.
Finally, the WIR survey did not ask about preferential beverage (e.g., beer, wine,spirits), usual quantities of ethanol and other drugs consumed per day, or specificsregarding AA involvement; because these factors could impact the recovery process, we willinclude these measures in future studies. Although therelationship between help-seeking and abstinence could reflect differences in dependenceseverity, results were robust to controlling for the number of DSM symptoms. These results imply that the longer anindividual is in recovery, the more likely he/she is to abstain. Effects for shorter lengths of recovery (i.e., 1–2 years,3–5 years) were in the same direction yet not significant at the traditionalPvs.
Behavioral Addictions: Are They More or Less Stigmatized than Alcohol & Drug Addictions?
For people suffering from alcohol use disorders, trying to moderate drinking isn’t advised and total abstinence is always recommended. 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. Regular physical activity can act as a healthy coping mechanism when dealing with cravings or anxiety related to your efforts towards alcohol moderation management. Controlled drinking, often advocated as a moderation approach for people with alcohol use disorders, can be highly problematic and unsuitable for those who truly suffer from alcohol addiction. Even moderate drinking can lead to long-term health problems such as liver disease, heart disease, and increased risk of certain cancers. It’s important to acknowledge any emotional ties you might have to alcohol as these could make both moderation and complete abstinence more challenging.
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