Abstinence or Moderation: Which Treatment Goal is Right for You?
Author: Sam DeFilippo, MS, LPC, NCC, CAADC
When we talk about substance abuse and addiction, it is generally recommended that people take an abstinence based approach to their recovery. However, that is not always the best fit for everyone. So, what is the difference between abstinence and moderation, and how do you know which one is going to be best for you?
Most people are aware that abstinence means fully refraining from any form of substance use, including social drinking and drug use, no matter the circumstances. Moderation, on the other hand, refers to using substances occasionally and not in excess, which usually requires a good amount of self-control and intention setting prior to substance use. In this article, I will be using examples related to alcohol use, but these strategies can be applied to other substances and behavioral addictions.
If you are someone who is able to drink socially with friends, and only find yourself drinking more than you intended on occasion, , you may be someone who would benefit from a moderation approach. When trying to drink in moderation, it is important to set intentions before drinking, including a number of drinks you are planning to have and identify why you are planning to drink at all (i.e. celebrating a birthday or promotion). It is important to check in with yourself throughout the course of drinking to see how you are feeling in order to ensure that you are not drinking to cope with feelings of anxiety or sadness. It is also important to assess your ability to stop drinking once you’ve hit your intended number of drinks. If you are consistently drinking more than you intended to, you may not be able to moderate, and instead, should consider an abstinence based approach.
If you are someone who feels like you never have control over your drinking, and you consistently overdo it any time you are consuming alcohol, even if you tell yourself “I’m only going to have one or two”, you may be someone who would benefit from abstinence. Typically, when your drinking is at a point where it is all or nothing, you may tend to choose to go all in rather than moderating. I will often have clients tell me, “well I don’t drink in the morning, I only drink after 5pm” or “I don’t drink during the week, I only drink on weekends.” However, the frequency is not necessarily the problem, and frequency is not a good indicator of whether you need to be abstinent or whether you can moderate. The deciding factor is going to be whether you are able to gain control over your drinking patterns, or whether you continue to feel out of control whenever you engage in alcohol use.
The decision between being abstinent or moderating is a very individualized decision and has to be made intentionally, considering all of the factors. If you feel like you need to develop healthier habits surrounding your substance use, but you have never tried moderating before, that can be a good place to start. What that looks like is setting an intention prior to use. For example, if you know you are going out drinking with friends after work, set an intention of how many drinks you are planning to have. If you tell yourself “I’m only going to have two drinks”, see if you can hold yourself accountable to stop after two drinks. If you drink more than you intended to, you can try again until you reach a point where either, you realize that you are able to set an intention and successfully meet it, or you will find that every time you set an intention, you go beyond it, which might be a sign that abstinence would be a better choice for you.
Recovery is not a one size fits all approach, which is why it is so important to have a therapist that understands this and can help guide you in making the decisions that are going to be right for you. Feel free to reach out to Equilibria to get connected with a therapist who can help you navigate your decision making process regarding your substance use.
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