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Moderation: Recovery’s Best Kept Secret

by Thaddeus Camlin, Psy.D.

moderation in addiction and recoveryThe greatest trick the puritanical tyranny of abstinence ever pulled was convincing the world that moderate drug use doesn’t exist.  For over a century addiction recovery, despite the facts, successfully fought and relegated moderate substance use to the shadows of quackery.  As is often the case, we only fight what we fear, and clearly an industry built on abstinence would have just cause to fear the truth of moderation’s viability.  However, after decades of devoted work that didn’t come without significant costs to professional reputations and quarterly profit margins, the efforts of addiction pioneers (see below) are, at long last, finally paying off.  Alcohol.org recently posted an article discussing alcohol moderation in an unbiased and straightforward manner that conveys the long overdue legitimacy of moderation as a viable outcome for substance use disorders.

Moderation: A Common Outcome

Research continues to pile up showing that, despite the myths perpetuated by media, cultural ignorance, and a less than noble treatment industry, most people recover from addiction and roughly half of those who recover do so by moderating.  Moderation Management has been shown to reduce alcohol intake and problems related to alcohol.  As our understanding of problematic addictive behavior continues to improve, and behaviors like compulsive over-eating, gambling, internet usage, smart phoning, instagramming, gaming, etc. are increasingly considered addictive, it will likely become clear that moderation is far and away the most common outcome and total abstinence the exception.  It would take a creative argument to make a case for abstinence as a practical goal for addictive behavior patterns with food, internet, and smart phones.

NIAAA: Moderation is a Viable Option

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) “only about 9% of alcoholics in the United States are classified under the subtype of chronic severe,” and the chronic severe subtype “will need to abstain from drinking completely.”  Said another way, moderation is a viable option for about 91% of people with diagnosable alcohol problems.  The fact that organizations like NIAAA and alcohol.org are discussing moderation in an objective manner as a viable treatment outcome for problematic addictive behavior is no small event.  Of course, NIAAA’s use of outdated terms like ‘alcoholic’ leaves much to be desired, but acknowledging moderation’s legitimacy is undeniable progress.

A Drastic Shift in the Landscape of Recovery and Addiction

The landscape of addictive behaviors is undergoing drastic shifts.  Generations to come will likely look back on the era of abstinence-only as archaic, perhaps even abusive and inhumane.  As is often the case, those who pioneer change are rarely rewarded with the credit they deserve.  As the care for and understanding of problematic addictive behavior improves it is important to pause and appreciate those who suffered in an era of ignorance and intolerance, and to acknowledge those who sacrificed personally and professionally to effect needed change.

“In a world of fugitives the person taking the opposite direction will appear to run away.”  T.S. Eliot

A few of the addiction pioneers this article refers to are:  Dr. Reid Hester, Dr. Michler Bishop, Dr. Patt DenningDr. Tom Horvath, Dr. Stanton Peele, Anne FletcherDr. Andrew Tatarsky, Dr. G. Alan Marlatt, Dr. William Miller, Dr. Robert MeyersJeannie Little, Dr. Jeff Foote, Dr. Bruce Alexander