Even once you have realized you needed help for alcohol addiction and that getting help for your addiction is the best way to put your life back in order, it can still be daunting to face the idea that you must give up alcohol for good.
After all, isn’t it etched in stone somewhere that an alcoholic can’t simply “have a drink” (without falling off the wagon) like other people? Does it have to be all or nothing?.
Perhaps not. Some addiction specialists advocate a treatment for alcoholism called controlled drinking. If you’ve heard of it, you may be wondering if it’s a better — or at least as good — option than conventional abstinence. It can certainly sound like a very appealing alternative to giving up alcohol for good. However, while this approach does work well for some, it’s not necessarily the best approach for everyone. It’s important to understand how it works before pursuing this option.
What is controlled drinking?
In a nutshell, controlled drinking is a strategy in which you reduce your alcohol consumption to a moderate level. The belief is that by reigning in consumption to lower levels, the negative outcomes that heavy drinking produces will be greatly reduced. Sometimes called “moderation drinking,” this approach — as a treatment option for alcohol addiction — has generated a lot of controversy among mental health and addiction experts for decades.
Pros of controlled drinking
Many people understand they drink too much, but the idea of embracing abstinence is just too overwhelming. In the belief that complete and total abstinence is their only option for rehabilitation, they reject the idea and continue drinking heavily. Controlled drinking, on the other hand, can be a very attractive recovery option because it provides a less restrictive path — a middle ground so to speak — allowing you to reduce your alcohol consumption to a safer, more manageable level without abstaining altogether.
Research suggests that controlled drinking may help some people who are dealing with alcohol addiction. For example, a small study of alcoholics who engaged in therapist-directed controlled drinking found that more than 80% of the patients improved their consumption levels.
Research findings also reveal that particular kinds of therapist-directed controlled drinking are successful. For instance, behavioral self-control training (BSCT) teaches practical skills that include monitoring urges, setting goals, developing refusal skills and managing the triggers of excessive consumption. A review of more than 30 controlled drinking studies shows that BSCT treatment was significantly more effective than no intervention or other methods of controlled drinking. The review also found it tended to be a more effective approach than abstinence programs.
Guided self-change (GSC) is another controlled drinking strategy that research suggests may work. This treatment assumes that mild to moderate problem drinkers can recover on their own through the process of self-change. The method is sometimes used by those who don’t view themselves as alcoholics but want to reduce consumption. In GSC therapy, you’ll learn motivational strategies as well as receive advice and information that reduces the appeal of drinking. Although this treatment hasn’t been well studied yet, the research that has been conducted found it can reduce alcohol consumption by more than 50%. Patients also doubled the number of days they were abstinent.
At least one study suggests that combining controlled drinking with the alcohol addiction medication naltrexone helped patients reduce the number of days they drank and the amount they consumed. Participants also reported they had a higher reduction in cravings for alcohol than those who used controlled drinking alone.
Cons of controlled drinking
Many mental health and addiction experts, including those who treat patients using the 12 step model developed by Alcoholics Anonymous (AA), believe that alcoholism is a serious, progressive and destructive disorder. It has the potential for irreversible damage, from breaking up a marriage to killing someone in a drunk driving accident. In addition, many professionals and recovering addicts feel strongly that, because alcoholism is a medical condition, its progression is out of the alcoholic’s control. By choosing moderation instead of abstinence, they argue that the alcoholic runs the very real risk of the addiction once again taking over their life. After all, it only takes one too many drinks to destroy a relationship or hurt someone you love.
Advice for successful controlled drinking
- Understand that controlled drinking is not the right approach for everyone. If you have a significant alcohol problem or have health issues related to your alcohol addiction, such as cirrhosis of the liver, a conventional abstinence plan will provide the safest path for your recovery. Other people who should not consider controlled drinking include pregnant women, anyone who takes medications that interact with alcohol, and those with psychiatric conditions made worse by drinking. There may be other factors that make abstinence the best treatment as well, so always consult with your doctor and / or a mental health professional (depending on your specific health issues) before choosing controlled drinking.
- Work with a mental health specialist. Research clearly shows that the most effective controlled drinking treatment plans involve a mental health professional. He or she will work with you to determine if this is the right strategy for you. If controlled drinking is an option for you, he or she will help you develop the tools needed to make it work, from identifying your triggers to finding resistance strategies.
- Treat co-existing conditions. Many people with alcohol addiction struggle with other psychiatric conditions, like depression, posttraumatic stress disorder (PTSD), anxiety or bipolar disorder. These underlying issues can make it harder for a moderation strategy to work. So give yourself the best chance for success by being evaluated for and entering treatment for any other medical or psychological problems you might be dealing with.
- Adjust your lifestyle. Even a policy of moderation will require a shift in the way you live life. Discover new activities or hobbies that help you stay away from excessive alcohol intake. For example, volunteer to dish out meals at a local shelter on Friday nights, or join a hiking club that explores nearby trails. Not only will these new interests keep you in environments that foster sobriety, activities like volunteering and exercise are natural mood lifters, helping you feel better about yourself and your choices.
Controlled drinking or abstinence?
Alcohol addiction is a serious disorder with potentially heartbreaking — and sometimes irreversible — consequences for you and your loved ones. When it comes to maintaining your emotional and physical health, you owe it to yourself to find the most effective treatment option. Talk with an addiction specialist or other mental health professional to determine whether or not a controlled drinking strategy is the best approach for your recovery.