ShareTherefore, knowledge about whether and how QOL differs betweennon-abstinent vs. abstinent recovery remains limited. In addition, previous QOL analyses have not accounted for length oftime in recovery. Witkiewitz also arguedthat the commonly held belief that abstinence is the only solution may deter someindividuals from seeking help. In the broadest sense, harm reduction seeks to reduceproblems related to drinking behaviors and supports any step in the right directionwithout requiring abstinence (Marlatt and Witkiewitz2010). “Harm reduction” strategies, on theother hand, set more flexible goals in line with patient motivation; these differ greatlyfrom person to person, and range from total abstinence to reduced consumption and reducedalcohol-related problems without changes in actual use (e.g., no longer driving drunkafter having received a DUI).
With these qualifications, the present study adds to evidence that non-abstinent AUD recovery is possible and can be can you overdose on lsd acid maintained for up to 10 years following treatment. Future studies should include additional indicators and outcomes, such as cognitive functioning, social functioning, employment and housing issues, chronic pain, medical comorbidities, and other substance use to advance our understanding of functioning following AUD treatment. It is quite possible that individuals in profile 1 (low functioning frequent heavy drinking at year 3) were not able to sustain frequent heavy drinking without significant negative consequences and thus were more likely to abstain at 10 years. Rather, there appear to be multiple paths to recovery that can include moderate or heavy alcohol consumption post-treatment for some individuals16,23,25,48.
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.
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 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.
A standard drink is equivalent to 14 grams of pure alcohol. According to the CDC, drinking moderately refers to two standard drinks or fewer a day for men and one standard drink or fewer a day for women. Should we cut it out entirely, or is there a way to drink in moderation without adverse effects? However, there are benefits to both abstaining and cutting back on alcohol. While we may be looking for a definitive answer, both paths to recovery can work for different people. Treatment strategies differ greatly between institutions and the aim for controlled alcohol consumption remains controversial.
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. 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. Drinking practices and consequences, depression, purpose in life, and anger were assessed 10 years following treatment.
- In this case, the studies needed to measure the effects of alcohol reduction on physical or mental functioning, and they needed to measure the exact amount of alcohol (e.g., in grams of pure ethanol), rather than simply number of drinks.
- In one study with moderate drinkers who were drinking 3-6 drinks daily, reducing drinking by 67% was related to improved (i.e., reduced) blood pressure, an average of a reduction by 3 systolic points over 2 diastolic points.
- Harmful drinking and alcohol use disorder are among our nation’s most challenging public health problems.
- Reach out to Skyline Recovery Center today – our expert team offers personalized outpatient rehab options and harm-reduction strategies to enable you to build a healthier future.
- Indeed, our findings revealed a lack of a one-to-one correspondence between drinking behavior and psychological functioning during the process of recovery over time.
- From a broader public health perspective, increasing access to effective SUD interventions and recovery support services is likely to enhance their overall impact (Glasgow et al., 2003).
Plus, weight loss is often an unexpected bonus when you say no to those extra alcohol calories. 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. Over time, many find their relationships improve as they begin rebuilding trust with loved ones while discovering their own self-worth again in sobriety’s light. Abstinence benefits extend beyond just physical improvements though; they also encompass mental health improvements.
It might serve as a stepping stone to abstinence and help us address the root causes of our drinking. Determining whether moderate drinking or abstinence is better for us is a bit like debating whether the UCLA or USC football team is better. Moderate drinking and abstinence may seem daunting, but we have just the tips for you. Let’s explore some ways we can practice moderate drinking or abstinence. And if not, we can still develop a healthier relationship with alcohol.
Going cold turkey on your own can lead to discomforting and even dangerous withdrawal symptoms, so always consider medical care if you choose abstinence. It is a strategy to reset all drinking habits and improve overall well-being. Abstinence from alcohol means entirely avoiding any kind of consumption of alcoholic beverages. When you begin to drink more and more often and become wary of what it is doing to your mind and body, there will come a point where you want to change your relationship with alcohol. 9) This paper is limited in terms of assessing social influences on recovery pathways among persons who endorse resolving an AOD problem; there is a need for further research in this area. Individuals may have met criteria for a psychiatric disorder, but if they never interacted with a healthcare provider, they would not have been ‘diagnosed’ per se.
This multifaceted approach helps you develop coping mechanisms while fostering healthier habits that can sustain long-term recovery. That’s why our approach involves taking time to know you better, identify your triggers, and help chart a path forward that aligns with your life goals. But with patience, persistence and these strategies at hand – you’re better equipped than ever before on this journey towards healthier living minus harmful drinking habits. The role of nutrition should also not be overlooked as maintaining a balanced diet can help restore physical health damaged by excessive alcohol consumption. A holistic treatment approach is another crucial aspect of quitting alcohol effectively.
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 Cocaine vs Heroin weights, our results reflect an unbiased estimate of the population of US adults who self-reported having resolved an AOD problem.
Abstinence or controlled alcohol consumption?
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.
Second, recovery is likely best conceptualized as a dynamic process of change17, and the present study only examined outcomes in a three-month timeframe ten years following AUD treatment. Some differences in ten-year drinking outcomes among recovery profiles at three years following treatment were somewhat unexpected. Profile 4 had significantly lower anger, depression, and alcohol-related consequences, and greater purpose in life than profiles 1 and 2 and did not differ significantly from profile 3 on two important functioning outcomes at year 10 (i.e., depression and purpose in life). It is also important to note that profile 4 (high functioning, infrequent non-heavy drinking at year 3) had the best overall outcomes at year 10, despite the fact that some individuals in profile 4 had returned to some heavy drinking (average percent heavy drinking days of 10%) at year 10. 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. Our quantitative findings using a clinical treatment sample also are aligned with research indicating that functional outcomes, including quality of life and well-being, are highly valued among persons who self-identify as being in recovery20,21.
Help for Achieving Lasting Recovery
Based on 8 studies, the research suggests that abstinence may be needed for individuals with harmful drinking – defined in this review as drinking at least 3-4 drinks on average per day in men and 2-3 in women depending on the study – or alcohol use disorder, to achieve social benefits. Not surprisingly, reducing drinking can substantially improve liver functioning – authors suggest total abstinence is the most effective approach for individuals with alcohol related liver problems. For example in one study of alcohol use disorder treatment patients, across 16 years of follow-up, 73% of individuals who relapsed died while only 30% of abstainers died – primarily from heart attack or heart failure (more on this in “Why is this study important” below). Our results also differ from those of an outpatient treatment studywhich showed that low-risk drinkers had better medical outcomes than abstainers (Kline-Simon et al. 2013). Longitudinal comparisons of non-abstainers and abstainers arecrucial for better understanding what kinds of people remain in non-abstinent recovery, aswell as how recovery statuses vary over the life course. The study capitalizes on a large national sample of individuals whoself-describe as “in recovery” from alcohol and/or drugproblems recruited in the context of the What Is Recovery?
Alcohol Addiction Treatment at CATCH Recovery
- First, the current study examined profiles of recovery and long-term outcomes among an outpatient sample collected at one site over a decade ago, and findings may not generalize to inpatient or more contemporary samples.
- A program called Moderation Management advocates this alternative to abstinence as a solution for a substance abuse disorder2.
- Based on 8 studies, the research suggests that abstinence may be needed for individuals with harmful drinking – defined in this review as drinking at least 3-4 drinks on average per day in men and 2-3 in women depending on the study – or alcohol use disorder, to achieve social benefits.
- Participants were asked to indicate whether they had ever received outpatient or inpatient AOD treatment in their lifetime.
- For each substance with lifetime use, participants indicated the age at which they first used the substance, age at which they initiated regular use (i.e.., weekly) if applicable, and age of last use for substances they no longer used at the time of survey completion.
- Multivariable stepwise regressions (Table2) show that younger individuals were significantly more likely to benon-abstinent, and movement to the next oldest age category reduced the odds ofnon-abstinence by an average of 27%.
- For example, in three separate randomized trials, reduced drinking did not lead to changes in anxiety or life satisfaction.
In the fully saturated models, any twelve-step attendancedecreased odds of non-abstinence by 57–76% (Model 4), while each additional mixing muscle relaxers and alcohol DSMsymptom decreased odds of non-abstinence by 73–89% (Model 4). In regard to help-seeking and problem severity, having attended at leastone 12-step meeting and the number of DSM-IV dependence symptoms were both significantlyrelated to non-abstinence. Table 1 displays results from Chi-squaretests comparing demographics, help-seeking, and severity between abstainers andnon-abstainers.
Distal Outcomes at the 10-Year Follow-Up
The path towards moderation management comes with its unique set of challenges which can include social pressure or dealing with underlying emotional issues that contribute towards excessive drinking habits. While some cultures romanticise heavy drinking others promote temperance; being aware of these cultural influences can aid in reshaping your own relationship with alcohol and eliminate harmful drinking patterns. Recognise patterns of thought that lead to excessive drinking like stress, boredom or loneliness; addressing these underlying issues is often a key part of cutting down or cutting out alcohol. This strategy is not about total abstinence but involves setting moderate drinking goals that are safe and sensible for you, paying attention to social influences that may sway your decisions, and developing self-awareness around your triggers.
From a broader public health perspective, increasing access to effective SUD interventions and recovery support services is likely to enhance their overall impact (Glasgow et al., 2003). Such ongoing substance use may mean moderating use of a primary problem substance or abstaining from one or more substances while continuing the use of others (e.g., abstaining from opioids while consuming cannabis). It appears that although abstinence is, for many, not a requisite for overcoming an AOD problem, it is likely to lead to better functioning and greater well-being.
Thus, these participants could be coded as 0 (totally abstinent from all AOD since AOD problem resolution), or 1 (current abstinence from all AOD but with at least some use of a substance since resolving an AOD problem) since these codes did not rely on primary substance. The What is Recovery study secondary analysis used a binary variable to operationalize substance use status and employed a non-representative sample. When it comes to recovery, there are arguments for drinking in moderation versus complete abstinence from alcohol. 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. 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.
Together they can make abstinence seem more attainable, especially since quitting cold turkey can be dangerous and may present too drastic a change for some. Moderate drinking can be an integral aspect of mindful drinking. We can use active awareness to make more informed decisions about our drinking. Strategies for mindful drinking are focused on increasing awareness.
Links to NCBI Databases
Sample descriptives and bivariate differences between non-abstainers and abstainers forthe What is Recovery? In terms of help-seeking and problemseverity, a full two-thirds had attended formal treatment and 95% had attended AlcoholicsAnonymous (AA). Half of the WIR sample had a collegeeducation or higher degree and 53% were married. First, bivariate differences between abstainers and non-abstainers were examinedusing Chi-square and t-tests.
