Apart from complete abstinence, among the strategies of addiction recovery is moderation. However, is it true or false?

If you have worked in a rehab facility or are familiar with recovery strategies, you know that people regularly preach on abstinence. However, in this regard, there is another strategy for recovery that keeps popping up – moderation.

Questions are understandably present about it, as it does not seem to be effective, at least in terms of guaranteeing the person gets off the drug. In addition, is it even possible for an addict to consume less amounts of the drug until their system quits it completely? After all, it is possible that some people engage in risky behaviors like drug abuse and they do not fall prey to it. The overlying question though is why is the strategy so secret and why do they not mention it as much?


This is the most common and traditional drug treatment, and it is used in alcohol rehabilitation as well. It involves total elimination of the substance, and does not advocate for the slightest consumption, which has its own problems. A good example of a program promoting abstinence would be AA (Alcoholics Anonymous).

While it has long remained the only method of fighting an addiction, in addition to being very effective when it is achieved, it actually has its own issues that come with it – as abstinence goals are difficult to achieve without help and support.

The treatment approach of abstinence is effective due to one factor – maintenance. The main problem is the sustaining of that maintenance. In fact, to put it in perspective for alcohol, some studies show that about 34% of relapse cases occur in the period of one to three years of total abstinence. The number reduces to about 14 percent when the person manages to abstain for five years or more.

At the end of the day, professional help is the best way to achieve the goal of abstinence, and the person needs to be willing to seek treatment. In fact, when the addict themselves is willing to seek help, they stand a better chance of long-term abstinence.

In the case of opioids such as heroin and other drugs such as amphetamine, the abusers have even less chances of total recovery. A study showed that 27 percent if recovering addicts from these drugs were totally abstinent for at least four months, taking into account they began using the drugs 20 years before. A significant part of the addicts were dead twenty years later – mostly due to relapses.

 Moderation approach

Abstinence is not the only way for people to recover from drug abuse, as moderate consumption is viewed as a slower but more effective method in some quarters. It may sound counter-intuitive, but the theory subscribes to the school of thought that someone has better control over their addiction when they consume the drug in smaller quantities.

It may end up working best for the individuals that are not physically dependent on the drugs, and they have not suffered as many side effects from using it, which include substance cravings and delirium tremens.

It is important to note that moderate consumption does not work for everyone. There are cases that exist of binge drinkers, for instance, which leads to alcohol poisoning and death. However, there exists a trail of even more users that die from one use of hard substances such as heroin. Statistics from 2013, for example, showed that more than 8,000 people in the United States alone died from a single use of heroin. Therefore, it goes to show that moderation management is dangerous for certain individuals, and you may never know how their bodies will react.

There is also the point of not many medical professionals advocating for the approach of moderate consumption. Even among the treatment providers, their views on substance abuse have changed significantly and caused many differences in opinion. To put it in perspective, about 25 percent of some 913 counselors thought it was okay for occasional drinks among alcoholics in 1994. In 2012 though, the percentage has risen to 50 percent.

Another criticism comes from many from the general public, and you may not agree with it as well. Some see it as a veiled excuse to relapse, as the biggest risk factor is remaining accountable to someone (which is not the case for abstinence treatment). For instance, if you were a participant in the program, you may sometimes be tempted to not reveal your drug consumption habits, or you use the program as an excuse to consume more drugs than you usually do. It is however important to note that the same can be said for people in abstinence programs – accountability is important at the end of the day.

Proponents give a different stand though. The main argument is moderation is helpful for individuals that can control their consumption habits, while those who cannot move on to abstinence programs. Another argument could be prevention of ‘cold turkey’ approaches that might lead to unfortunate fatalities happening.

Final thoughts

Moderation management does not really aim to remove the drug abuser from abstinence options or eliminate their commitment to such programs. Instead, the main concern would be substance abusers who do not bother seeking treatment because they do not ‘feel ready to quit’. You may have seen this attitude in a loved one, or you may have had hesitations about quitting. The figure of addicts who do not feel ready is higher than you may think – accounting for about 90 percent of substance abusers, or even higher. The treatment seeks to be an alternative to these individuals and act as a more realistic way of seeking help.

However, the other side is the abstainers that tell you all substance abusers seem to have something in common – they cannot control their consumption. So they raise a valid question – how can the addict control their habit? People are exposed to drugs so many times, and advocates of this method say that the temptation of relapse is high. At the end of the day, you still need to seek professional help before embarking on any of these methods, and encourage your loved ones to do the same.

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