All About Addiction

Helping addicts get their lives back

A New Sobriety

Why Alcohol Moderation Programs Are Urgently Needed

By Adi Jaffe and Marc Kern

You might know someone who drinks alcohol. You might even be one of those drinkers; and you might be at risk.

Take this in:

  • Excessive alcohol use is the 4th leading preventable cause of death in the United States (CDC Press Release).

AND

  • 1 in 10 deaths among adults is due to excessive alcohol consumption (CDC Press Release).

Scary stuff right?

But how do you know if your own drinking is excessive or whether the way you drink is the kind recommended by the American Medical Association as health-promoting? It’s an alcohol-filled minefield out there.

So here are the numbers for you to memorize- According to the CDC, women are considered “heavy drinkers” if they have 8 or more drinks a week; for men the number is 15. And any episodes of binge drinking (more than 4 drinks for men, more than 3 for women) qualify you as well. There is some debate about the specific numbers here – but you get the picture.

It’s important to point out that if national statistics are to be believed then about 1 in 13 Americans are heavy drinkers. Among college-aged Americans that number is closer to 1 in 2! But if you went to college that probably doesn’t surprise you much.

It’s important to note that the CDC does not call these heavy drinkers “alcoholics.” Instead, the CDC researchers use an individual’s level of drinking as the problem indicator. Unfortunately, 99% of the more than 13,000 alcohol-treatment options available in the U.S. begin by assuming that patients (or “clients” as we call them at Alternatives) are alcoholics. What’s a heavy drinker to do?!

In Part 1 of this article series we will break down some of the reasoning behind our current treatment focus on abstinence, and break apart some of the myths used to support it.

So let’s go!

Why don’t we have more moderation programs?

There are a number of reasons why few non-abstinence programs are offered in the U.S.

  1. One of the primary fears is that moderation programs give permission to “true alcoholics” to continue drinking. 
  2. Another fear is that people who are currently abstinent will decide to try drinking again thinking they should be able to moderate.
  3. Lastly, some hold the notion that any use of a mind altering substance by individuals who have previously struggled with them is a means of escape and therefore unhealthy even if it’s non-problematic.

We’d like to tackle these one at a time -

Moderation programs give alcoholics “permission” to drink

The truth is that every member of AA has tried to reduce or moderate their drinking.  Before people hit “rock bottom,” they will try anything and everything to reduce or moderate their drinking before being labeled “an alcoholic.”  Even though they have essentially no formal way to be supported in these attempts, many individuals do successfully cut back and resume their lives being moderate drinkers (Dawson, 1996).

We know that many drinkers are reluctant to join AA because they fear that they will be told abstinence is the only option and they are not ready to stop drinking completely. These people are unwilling to consider a life attending support group meetings that will take time away from work and family.  They are ashamed and embarrassed and don’t want to be labeled an alcoholic.  Possibly they think they will lose all their friends if they stop drinking or don’t see their current drinking pattern as excessive. Right now we say these individuals are “resistant,” in “denial” or “unmotivated.”

But research has repeatedly shown us that only 10% of those struggling with drug and alcohol problems enter treatment (Cunningham et al., 1993; Jaffe et al., 2013). This level of penetration can be compared with the fact that over 70% of individuals diagnosed with diabetes seek and receive treatment for the condition (although it does take nearly 5 years to get there). Combine all of this with the knowledge that individuals are far more likely to enter and succeed in a treatment of their choice and we believe the only way to get heavy drinkers to really evaluate their drinking and decide to quit for themselves is to offer moderation as a goal.

 

People need to feel that they have personally concluded that abstinence is their only option.  They need to be vested in their sobriety.

In Part 2 we'll deal with the notion that currently abstinent drinkers will seek moderate drinking if such programs are offered…

 

Citations:

  1. CDC Press Release - http://www.cdc.gov/media/releases/2014/p0626-excessive-drinking.html
  2. Dawson, D.A. 1996. Correlates of past-year status among treated and untreated persons with former alcohol dependence: United States, 1992. Alcoholism: Clinical and Experimental Research 20(4):771-779.
  3. Cunningham, J.A., Sobell, L.C., Sobell, M.B., Agrawal, S., & Toneatoo, T. (1993). Barriers to treatment: Why alcohol and drug abusers delay or never seek treatment. Addictive Behaviors, 18(3): 347-353.
  4. Jaffe A., Murphy, D., Shaheed, T., Colman, A., Strahl, W., & Hser, Y. (2012, June). Not ashamed but still too poor: Changes in barriers to treatment entry for online treatment seekers. Poster presented at the 2013 meeting of the College on Problems of Drug Dependence, San Diego, CA.

 

© 2014 Adi Jaffe, All Rights Reserved

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Adi Jaffe, Ph.D., is the executive director of Alternatives Behavioral Health and a lecturer at UCLA and California State University Long Beach.

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