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. This resistance to nonabstinence treatment persists despite strong theoretical and empirical arguments in favor of harm reduction approaches. AA was established in 1935 as a nonprofessional mutual aid group for people who desire abstinence from alcohol, and its 12 Steps became integrated in SUD treatment programs in the 1940s and 1950s with the emergence of the Minnesota Model of treatment (White & Kurtz, 2008). The Minnesota Model involved inpatient SUD treatment incorporating principles of AA, with a mix of professional and peer support staff (many of whom were members of AA), and a requirement that patients attend AA or NA meetings as part of their treatment (Anderson, McGovern, & DuPont, 1999; McElrath, 1997).
Expanding the continuum of substance use disorder treatment: Nonabstinence approaches
Therefore, our programme alcohol and brain fog 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. Remember that every person’s journey is unique; there are no one-size-fits-all solutions for managing alcohol intake.
At CATCH Recovery, we understand that your journey towards overcoming addiction is deeply personal and unique to you. We believe in the power of personalised therapy, where our experts tailor a recovery plan suited to your needs and circumstances. It’s not an easy road to lasting recovery, but with the right support and resources, it can definitely be a journey worth taking.
Alcohol Moderation Management: Steps To Control Drinking
The Swedish treatment system has been dominated by total abstinence as the goal, although treatment with CD as a goal exists (e.g., Agerberg, 2014; Berglund et al., 2019). Administrative discharge due to substance use is not a necessary practice even within abstinence-focused treatment (Futterman, Lorente, & Silverman, 2004), and is likely linked to the assumption that continued use indicates lack of readiness for treatment, and that abstinence is the sole marker of treatment success. In the United Kingdom, where there is greater acceptance of whats the legal drinking age in russia nonabstinence goals and availability of nonabstinence treatment (Rosenberg et al., 2020; Rosenberg & Melville, 2005), the rate of administrative discharge is much lower than in the U.S. (1.42% vs. 6% of treatment episodes; Newham, Russell, & Davies, 2010; SAMHSA, 2019b). In the 1980s and 1990s, the HIV/AIDS epidemic prompted recognition of the role of drug use in disease transmission, generating new urgency around the adoption of a public health-focused approach to researching and treating drug use problems (Sobell & Sobell, 1995). The realization that HIV had been spreading widely among people who injected drugs in the mid-1980s led to the first syringe services programs (SSPs) in the U.S. (Des Jarlais, 2017). Early attempts to establish pilot SSPs were met with public outcry and were blocked by politicians (Anderson, 1991).
Alcohol Moderation Management Programs
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 rockland recovery treatment centers 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. While there are many obstacles to the widespread acceptance of CD as a treatment approach (Sobell & Sobell 2006), it is important to note that not all individuals entering treatment do so with the goal of achieving abstinence. To that end, the use of abstinence as the dominant drinking goal across alcoholism treatment programs in the United States may in fact deter individuals who would otherwise seek treatment for alcohol problems should CD be proposed as an acceptable goal.
Take our free, 5-minute substance use self-assessment below if you think you or someone you love might be struggling with substance use. The evaluation consists of 11 yes or no questions that are intended to be used as an informational tool to assess the severity and probability of a substance use disorder. If you are struggling with some of the following signs above, be sure to contact your physician or seek help at a substance abuse treatment facility.
- Many advocates of harm reduction believe the SUD treatment field is at a turning point in acceptance of nonabstinence approaches.
- At the first interview all IPs were abstinent and had a positive view on the 12-step treatment, although a few described a cherry-picking attitude.
- With this as a starting point, the IP was asked to describe the past five years in terms of potential so-called relapse and retention and/or resumption of positive change.
For instance, abstaining from alcohol can decrease the risk of liver disease, improve cognitive function, and enhance emotional resilience. The FHE Health team is committed to providing accurate information that adheres to the highest standards of writing. If one of our articles is marked with a ‘reviewed for accuracy and expertise’ badge, it indicates that one or more members of our team of doctors and clinicians have reviewed the article further to ensure accuracy. This is part of our ongoing commitment to ensure FHE Health is trusted as a leader in mental health and addiction care. Unfortunately, the very program that Kishline created was one that worked for others but not for herself.
They found that their controlled drinking intervention produced significantly better outcomes compared to usual treatment, and that about a quarter of the individuals in this condition maintained controlled drinking for one year post treatment (Sobell & Sobell, 1973). With these qualifications, the present study adds to evidence that non-abstinent AUD recovery is possible and can be maintained for up to 10 years following treatment. The findings support recent proposals to move beyond viewing abstinence as a central defining feature of AUD recovery and relying heavily on quantity-frequency measures of drinking practices as the primary outcome indicator. Future research that expands the scope of outcome indicators to include measures of biopsychosocial functioning and AUD diagnostic criteria50 is important for advancing understanding of the multiple pathways to recovery from AUD. Additional research should examine whether remission from AUD diagnostic symptoms, which were not examined in the current study, are useful in defining recovery or whether focusing on well-being and psychological functioning is sufficient to characterize recovery from AUD.
