Differences between abstinent and non-abstinent individuals in recovery fromalcohol use disorders PMC

Our second goal was to examine differences in quality of life between
abstainers and non-abstainers controlling for length of time in recovery. This approach could produce biased estimates when the proportion of missing data is large and/or the assumptions that dropouts have relapsed to heavy drinking is untenable. To investigate the sensitivity of our conclusions, we performed alternative analyses on completers only and when subjects with missing drinking data were coded as not heavy drinking. The results were very similar, that is the first two splits of all trees were exactly the same, deterministic forests identified the same top three predictors and there was significant overlap in the remaining top predictors (Supplemental Table 3). This is probably due to the small proportion of subjects with missing data but speaks to the robustness of our conclusions. In studies with larger proportion of missing data, multiple imputation may be considered (Hapfelmeier et al., 2012).

While there are multiple such intervention approaches for treating AUD with strong empirical support, we highlight a dearth of research testing models of harm reduction treatment for DUD. Next, we review other established SUD treatment models that are compatible https://ecosoberhouse.com/ with non-abstinence goals. We focus our review on two well-studied approaches that were initially conceptualized – and have been frequently discussed in the empirical literature – as client-centered alternatives to abstinence-based treatment.

Comparison with Prior Studies

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). Over the past few decades, research has demonstrated that complete abstinence isn’t always the most effective approach for treating alcohol abuse. While total abstinence is necessary in some cases, in other cases people are able to reduce their drinking to moderate levels without needing to abstain totally. For people who have not been able to maintain sobriety through Alcoholics Anonymous (AA) or other 12-step programs, they may wish to consider if moderation may be a more effective path for them to take.

• Unfortunately, few quantitative, survey-based studies have included substance use during treatment as a potential reason for treatment noncompletion, representing a significant gap in this body of literature (for a review, see Brorson, Ajo Arnevik, Rand-Hendriksen, & Duckert, 2013).
• Controlled drinking, often advocated as a moderation approach for people with alcohol use disorders, can be highly problematic and unsuitable for those who truly suffer from alcohol addiction.
• Take this “getting back to normal” as a chance to rethink your relationship with alcohol.
• They looked at demographics—who attends AA versus who attends MM—as well as the relative severity of the drinking problems in the two groups.
• Clinically, individuals considering non-abstinent goals
  should be aware that abstinence may be best for optimal QOL in the long run.

A considerable number of clients reported changed views on the programme, some were still abstinent and some were drinking in a controlled way. Some of the abstainers still attended meetings because of a fear of what might happen if they stopped, although they questioned parts of the philosophy. For these clients, the recovery process, aiming to reach sustained recovery in the broader sense covering parts of their lives other than the SUD, was in part at odds with the ongoing participation in AA. These results indicate that strict views on abstinence and the nature of alcohol problems in 12-step-based treatment, and AA philosophy may create problems for the recovery process.

1. The study samples

In the initial interviews, all the clients declared themselves abstinent and stressed that substance use in any form was not an option. Successful moderation involves understanding yourself (what factors trigger excessive drinking), planning (how much you are going to drink and how you are going to stop), and taking concrete steps to exit or avoid situations where you won’t be able to moderate. Limited social drinking is a realistic goal for some people who struggle with alcohol, and should definitely be considered by people who controlled drinking vs abstinence have not been able to successfully adhere to abstinence. Moderation gives you control of your drinking and allows you to take back control of your life. While complete abstinence often requires you to avoid any circumstances or people that might tempt you to drink, moderation allows you to still participate in work functions and social events while empowering you to have more control over when and how much you drink. Relapse Prevention (RP) is another well-studied model used in both AUD and DUD treatment (Marlatt & Gordon, 1985).

If you use alcohol to manage stress or self-medicate, fear of how you’ll cope without alcohol might hamper your efforts to regain control of your drinking. If you consider alcohol as a coping strategy, then it makes sense why heading straight to abstinence would be terrifying. Nonabstinence approaches to SUD treatment have a complex and contentious history, and significant social and political barriers have impeded research and implementation of alternatives to abstinence-focused treatment. We summarize historical factors relevant to non-abstinence treatment development to illuminate reasons these approaches are understudied. If you believe that harm reduction therapy may help, you may be interested in our alcohol addiction program.