Classification precision (defined by relative entropy) was used to evaluate how well the final latent profile solution classified individuals into latent classes and values of entropy greater than .80 were considered good classification precision (Nylund et al., 2007). These health risks can be severe, and some even contribute to alcohol-related mortality rates. On the other hand, upon cutting back on drinking, many heavy drinkers experience improvements in sleep, cognitive function, weight alcohol abstinence vs moderation loss, productivity, interpersonal relationships, energy, and overall mental health. Your specific health goals, health risks, and medical history may play a role in your choice to either moderate or abstain from alcohol. This is especially true if you suffer from specific health conditions or are cutting back to avoid increased risk of specific health consequences. When a person chooses to be abstinent, it means that they refrain from all alcohol consumption for a duration of time.

2. Relationship between goal choice and treatment outcomes

You don’t have to attend AA meetings and introduce yourself as an alcoholic, and you don’t have to answer questions at parties or social gatherings when people notice you aren’t drinking. Though sobriety has a clear definition, you may still be asking yourself, what is sobriety, and what will it mean to me? Oftentimes it can mean learning how to manage cravings, engaging in alcohol treatment, finding community, and introducing alcohol alternatives into your daily life. A sober lifestyle is something to be proud of, and the team at Monument is here to provide answers and encouragement throughout your journey. Briefly, as the Supplementary File presents, 14.71% of the included trials were considered low risk, 66.67% were considered unclear risk, and 20.59% were considered high risk (Figure S6A). The unclear ROBs were mainly concentrated in the randomization, allocation concealment, and blinding to therapists and patients, while the high ROBs existed from the implementation to the reporting stage (Figure S6B, details listed in Table S6).

• For example, a recent study found that patients stating a preference for abstinence had better treatment outcome than those stating a preference for non-abstinence (Adamson, Heather, Morton, & Raistrick, 2010).
• Individuals with expected membership in Class 5 (low risk and heavy drinking) had a low probability of abstinence days during treatment, whereas individuals in Class 6 (abstinence and low risk drinking) had a higher probability of abstinence days throughout treatment.
• In this case, moderation serves as a harm reduction strategy that minimizes the negative consequences of drinking.
• Both Fan and colleagues (2019) and Dawson and colleagues (2005) used a 4+/5+ drinks per day cutoff for defining “high-risk” drinking.

3. The harm reduction movement

• Miller, whose seminal work on motivation and readiness for treatment led to multiple widely used measures of SUD treatment readiness and the development of Motivational Interviewing, also argued for the importance of goal choice in treatment (Miller, 1985).
• Abstinence benefits extend beyond just physical improvements though; they also encompass mental health improvements.
• Model fit was examined using the Lo Mendell Rubin Likelihood Ratio test (LRT), the Bootstrapped Likelihood Ratio Test (BLRT), Bayesian Information Criterion (BIC) and sample-size–adjusted BIC (aBIC).
• We used the mean of the distribution of ranks for each intervention to present its relative order of preference based on the network meta-analysis.
• Additionally, individuals are most likely to achieve the outcomes that are consistent with their goals (i.e., moderation vs. abstinence), based on studies of both controlled drinking and drug use (Adamson, Heather, Morton, & Raistrick, 2010; Booth, Dale, & Ansari, 1984; Lozano et al., 2006; Schippers & Nelissen, 2006).
• Like the Sobells, Marlatt showed that reductions in drinking and harm were achievable in nonabstinence treatments (Marlatt & Witkiewitz, 2002).

Given low treatment engagement and high rates of health-related harms among individuals who use drugs, combined with evidence of nonabstinence goals among a substantial portion of treatment-seekers, testing nonabstinence treatment for drug use is a clear next step for the field. Ultimately, nonabstinence treatments may overlap significantly with abstinence-focused treatment models. Harm reduction psychotherapies, for example, incorporate multiple modalities that have been most extensively studied as abstinence-focused SUD treatments (e.g., cognitive-behavioral therapy; mindfulness).

• Studying low risk drinking patterns during the course of the treatment episode is important to inform future clinical decision making regarding the likelihood of long term outcomes.
• The primary outcome measure was dichotomous, ideally extracted as the number of patients who remained abstinent (no alcohol intake) after randomisation, out of the total number of participants randomised.
• The objective of this study is to elucidate the contribution of drinking goal to treatment outcome in the context of specific behavioral and pharmacological interventions.
• The ability to control drinking varies significantly from person to person and is influenced by a range of factors including genetics, environment, emotional state, and individual psychology.
• In contrast, individuals with greater SUD severity, who are more likely to have abstinence goals, generally have the best outcomes when working toward abstinence (Witkiewitz, 2008).

Models of nonabstinence psychosocial treatment for SUD

While moderation may be more achievable for those with a mild or moderate diagnosis than those with severe alcohol use disorder, it’s also a great starting point for those exploring making a change. With the support of an expert Care Team, many people begin their journey by gradually reducing their weekly alcohol consumption.The idea of moderation and mindful drinking is also a great way for people who are asking themselves “should I stop drinking? Proactively cutting back on drinking can start to illuminate how drinking less can give you more, and create the mental clarity to identify your goals and values. There are no requirements for changing your relationship with alcohol and seeking treatment. Earlier research utilizing drug use goals analogous to goals used in the present study found commitment to absolute abstinence, measured at the end of treatment, to predict days to relapse across nicotine, alcohol, and opiate dependence (Hall & Havassy, 1986; Hall, Havassy, & Wasserman, 1990).

What this study adds

• Non-abstainers are younger with less time in recovery and less problem severitybut worse QOL than abstainers.
• The main screener missed none of the studies eventually included in the review, indicating a low likelihood that trials were missed in the other sources.
• 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.

In addition to shaping mainstream addiction treatment, the abstinence-only 12-Step model also had an indelible effect on the field of SUD treatment research. Most scientists who studied SUD treatment believed that abstinence was the only acceptable treatment goal until at least the 1980s (Des Jarlais, 2017). Abstinence rates became the primary outcome for determining SUD treatment effectiveness (Finney, Moyer, & Swearingen, 2003; Kiluk, Fitzmaurice, Strain, & Weiss, 2019; Miller, 1994; Volkow, 2020), a standard which persisted well into the 1990s (Finney et al., 2003). Little attention was given to whether people in abstinence-focused treatments endorsed abstinence goals themselves, or whether treatment could help reduce substance use and related problems for those who did not desire (or were not ready for) abstinence.

Consider the health benefits

Her counselor agreed that limiting her drinking could be a good solution and they set a goal for Sara to cut back her consumption to these special occasions only. If you’re facing your drinking, you’ve probably tried to moderate it before, with little success. The structure and support groups found in MM are likely similar to AA, but with tolerance and more trust put into the person who has a drinking problem. The simple https://ecosoberhouse.com/ fact is that if you’re considering any program at all, a part of you likely knows that your drinking is uncontrollable. If you’ve been unable to moderate your drinking on your own, many would ask why you think this program will be any different. No patients were involved in setting the research question or the outcome measures, nor were they involved in developing plans for design or implementation of the study.

Abstinence Vs. Moderation Management: Success and Outcomes