It actually is much easier to just give it up entirely than punish yourself trying to moderate or control your addictive behavior. Studies have shown that regardless of the method employed to become sober, the number one factor for sobriety success is a permanent commitment to discontinue use permanently; a commitment to abstinence. Given data demonstrating a clear link between abstinence goals and treatment engagement in a primarily abstinence-based SUD treatment system, it is reasonable to hypothesize that offering nonabstinence treatment would increase overall engagement by appealing to those with nonabstinence goals. Indeed, there is anecdotal evidence that this may be the case; for example, a qualitative study of nonabstinence drug treatment in Denmark described a client saying that he would not have presented to abstinence-only treatment due to his goal of moderate use (Järvinen, 2017). There has been little research on the goals of non-treatment-seeking individuals; however, research suggests that nonabstinence goals are common even among individuals presenting to SUD treatment.
- They may have adopted a sobriety challenge, such as Sober September or Dry January in order to gain the space to re-evaluate their relationship with alcohol.
- SMART Recovery was established in 1994 in the USA to meet the increasing demand of health professionals and their patients for a secular and science-based alternative to the widespread 12-Step addiction recovery program.
- It’s also important to know that you can change certain circumstances, and therapy can aid in helping you set boundaries that empower your progress.
- A permanent commitment to abstinence means we no longer have to fight a battle with moderation; but rather devote ourselves to sobriety permanently.
- The results of the Sobell’s studies challenged the prevailing understanding of abstinence as the only acceptable outcome for SUD treatment and raised a number of conceptual and methodological issues (e.g., the Sobell’s liberal definition of controlled drinking; see McCrady, 1985).
A month after we learned of his opiate use, he entered outpatient therapy and began working on abstinence with both drugs and alcohol. His experience with the ritalin and now the painkillers made it clear to him that he was seriously susceptible to any drug and that had to include alcohol. Attempts at moderation are a useful way for a person abusing drugs or alcohol to get feedback.
Cognitive Behavioral Therapy: Treatment of Addiction and Eating Disorders
We define nonabstinence treatments as those without an explicit goal of abstinence from psychoactive substance use, including treatment aimed at achieving moderation, reductions in use, and/or reductions in substance-related harms. We first provide an overview of the development of abstinence and nonabstinence approaches within the historical context of SUD treatment in the U.S., followed by an evaluation of literature underlying the theoretical and empirical rationale for nonabstinence controlled drinking vs abstinence treatment approaches. Lastly, we review existing models of nonabstinence psychosocial treatment for SUD among adults, with a special focus on interventions for drug use, to identify gaps in the literature and directions for future research. We identify a clear gap in research examining nonabstinence psychosocial treatment for drug use disorders and suggest that increased research attention on these interventions represents the logical next step for the field.
While multiple harm reduction-focused treatments for AUD have strong empirical support, there is very little research testing models of nonabstinence treatment for drug use. Despite compatibility with harm reduction in established SUD treatment models such as MI and RP, there is a dearth of evidence testing these as standalone treatments for helping patients achieve nonabstinence goals; this is especially true regarding DUD (vs. AUD). In sum, the current body of literature reflects multiple well-studied nonabstinence approaches for treating AUD and exceedingly little research testing nonabstinence treatments for drug use problems, representing a notable gap in the literature. The past 20 years has seen growing acceptance of harm reduction, evidenced in U.S. public health policy as well as SUD treatment research. Thirty-two states now have legally authorized SSPs, a number which has doubled since 2014 (Fernández-Viña et al., 2020). Nonabstinence goals have become more widely accepted in SUD treatment in much of Europe, and evidence suggests that acceptance of controlled drinking has increased among U.S. treatment providers since the 1980s and 1990s (Rosenberg, Grant, & Davis, 2020).
Expanding the continuum of substance use disorder treatment: Nonabstinence approaches
The moderation management program urges you to zero in on your substance misuse designs. Those are significant inquiries because their answers uncover wounds that need fixing and an overall absence of adapting abilities. It has been proven that when those problems are fixed, the tendency to drink when disturbed might be handled, and being able to avoid feelings may be accomplished. There are various ways that individuals can take advantage of face-to-face gatherings, very much like what is offered by moderation management, or they can settle on online experiences that can fulfill the same need in a more adaptable way. On the site of the program, one can find aides that show how much alcohol is permissible as well as commentaries that allow individuals to examine their battles and find recognition for their accomplishments. Various studies discovered that in certain cultures there is a certain percentage of people with the ability to stop drinking and practice moderation management, but the probability of that being the case is in the extreme range.
With commitment, perseverance, and the right support, you can overcome the challenges of addiction and build a brighter future. The current review highlights multiple important directions for future research related to nonabstinence SUD treatment. Overall, increased research attention on nonabstinence treatment is vital to filling gaps in knowledge. For example, despite being widely cited as a primary rationale for nonabstinence treatment, the extent to which offering nonabstinence options increases treatment utilization (or retention) is unknown.
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