Repeated measures latent class analysis (RMLCA; Collins & Lanza, 2009) was used to identify patterns of drinking across 12 weeks of treatment, as described elsewhere (Witkiewitz, Roos, et al., 2017). RMLCA is a latent variable mixture model in which the indicators of the latent class are repeated measures. After the classes of drinking during treatment were identified, we examined mean differences in three year functioning by latent class membership using a Wald chi-square test via a distal outcomes analysis (the “BCH” method; Asparouhov & Muthén, 2014; Bolck, Croon, & Hagenaars, 2004). Comparisons between classes derived from the RMLCA on 3-year post-treatment outcomes were examined for PDD, PHDD, DDD, DrInC total score, PFI social behavior subscale, and PFI social role subscale. For all we know, it might also be an option for people who do meet criteria for alcohol dependence but since the study we’re about to assess didn’t talk about it, we’ll leave that for later. Our research question and study eligibility criteria were designed to align with current practice to bridge the evidence gap in the care pathway of recently detoxified, alcohol dependent patients in a primary care setting.
Why Moderation May Be a Better Choice Than Abstinence
Importantly, the only published study that asked individuals in recovery (fromcrack or heroin dependence in this particular study) how they defined the term revealedthat less than half responded in terms of substance use; the other definitions were moregeneral, such as a process of working on oneself (Laudet2007). In addition, some might consider abstinence as a necessary part of therecovery process, while others might not. Non-abstinent goals can improve quality of life (QOL) among individuals withalcohol use disorders (AUD). However, prior studies have defined“recovery” based on DSM criteria, and thus may have excluded individualsusing non-abstinent techniques that do not involve reduced drinking. Furthermore, noprior study has considered length of time in recovery when comparing QOL betweenabstinent and non-abstinent individuals.
- According to Finney and Moos (1991), 37 percent of patients reported they were abstinent at all follow-up years 4 through 10 after treatment.
- Alcohol moderation management programmes are often successful when tailored to an individual’s specific needs and circumstances.
- Exercise is another key factor in recovery due to its numerous benefits such as stress reduction, improvement in mood and sleep patterns in addition to promoting overall wellbeing.
- Alcohol can fog your thinking processes and impair judgment, but once you eliminate it from your routine, you’ll likely find yourself thinking more clearly and making better decisions.
What is Controlled Drinking or Alcohol Moderation Management?
A similar approach was used for dropouts, defined as the number of patients who withdrew from the study at reported time points. The results suggest that the 12-step philosophy, with abstinence as the only possible choice, might mean that people in the AA community who are ambivalent and/or critical regarding parts of the philosophy must “hide” their perceptions on their own process. Experiences of the 12-step programmes and https://ecosoberhouse.com/article/should-you-have-relationships-in-recovery/ AA meetings were useful for a majority of the clients. Thus, it was not the sobriety goal in itself that created problems, but the strict belief presenting this goal as “the only way”. The results suggest the importance of offering interventions with various treatment goals and that clients choosing CD as part of their sustained recovery would benefit from support in this process, both from peers and from professionals.
Recovery starts with getting honest.
Despite compatibility with harm reduction in established SUD treatment models such as MI and RP, there is a dearth of evidence testing these as standalone treatments for helping patients achieve nonabstinence goals; this is especially true regarding DUD (vs. AUD). In sum, the current body of literature reflects multiple well-studied nonabstinence approaches for treating AUD and exceedingly little research testing nonabstinence treatments for drug use problems, representing a notable gap in the literature. Multiple versions of harm reduction psychotherapy for alcohol and drug use have been described in detail but not yet studied empirically. Consistent with the philosophy of harm reduction as described by Marlatt et al. (2001), harm reduction psychotherapy is accepting of a wide range of client goals, including risk reduction, moderation, and abstinence (of note, abstinence is conceptualized as consistent with harm reduction when it is a goal chosen by the client). Publications about harm reduction psychotherapy have included numerous case studies and client examples that highlight the utility of the approach for helping clients achieve reductions in drug and alcohol use and related problems, moderate/controlled use, and abstinence (Rothschild, 2015b; Tatarsky, 2002; Tatarsky & Kellogg, 2010).
- He adopted the language and framework of harm reduction in his own research, and in 1998 published a seminal book on harm reduction strategies for a range of substances and behaviors (Marlatt, 1998).
- It is also important to note that Project MATCH included individuals who met DSM-III-R criteria for alcohol abuse (4.6%) or dependence (95.4%), and it is unclear whether the small proportion of individuals with alcohol abuse would meet DSM-5 criteria for AUD.
- It’s heartbreaking to see loved ones caught in the grip of addiction, but there’s hope – research shows that many people find success with programmes aimed at reducing consumption.
- Moderated drinking could give you the space to address those issues you’ve been pushing aside.
- A second reviewer (RGE, LAM, SD, AT, or GJM) also independently screened the titles and abstracts identified from the primary source of randomised controlled trials (CENTRAL), comprising more than half of the search results.
- Your sobriety journey is personal, and what works best for you may not work as well for someone else.
- Future research must test the effectiveness of nonabstinence treatments for drug use and address barriers to implementation.
Although such support is currently managed by specialist care, primary care stands in a unique position to provide holistic care. The WIR data do not include current dependence diagnoses, which would beuseful for further understanding of those in non-abstinent recovery. In addition, the WIRquality of life measure is based on a single question; future studies could useinstruments that detail various aspects of mental and physical controlled drinking vs abstinence functioning. WIR is alsocross-sectional by design, though it did include questions about lifetime drug and alcoholuse. 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.