We’ve all heard the term ‘everything in moderation’ countless times. But, when we really look into this notion – we find that this is generally not what many people believe. I mean, this doesn’t really apply when we talk about taking certain drugs such as heroin or crack does it? What about alcohol? Can alcohol be consumed and enjoyed moderately? What about people with alcohol dependencies or ‘alcoholism’? The word ‘moderation’ in the recovery world seems to be one that is often quickly scurried out of the conversation and dismissed as a viable or sensible option.
Having explored the world of alcohol moderation myself for the last four months I have become incredibly interested in this concept as a whole, and have been diving into the research and information available on various ‘alternative treatment’ approaches to those such as AA, which advocate total alcohol abstinence (hereafter referred to as TA). Many of these approaches seem to encourage total abstinence, except for Moderation Management (MM), which suggests that moderation may, in fact,be a viable option for certain people.
In this blog post I hope to touch on some of the interesting research I have come across along the way on the topic of alcohol ‘moderation’, as well as some of my own personal experiences over the last few months. There is, of course, no a one-size-fits all approach in the world of recovery. So whilst treatment that includes total alcohol abstinence may not be the way forward for some, moderation and other individualized treatment plans may work better for others. This is a very individual process and I speak from my own experience and findings.
Before I moved into the moderation game I abstained from drinking alcohol completely for 9 months. And whilst I would not have identified or considered myself as an ‘alcoholic’ (I have issues around these labels – but that’s an article for another day), I knew that drinking was creating more unhappiness in my life than it was good. So whilst the decision to stop may have rattled others around me (weird how you only have a problem with alcohol once you stop drinking the stuff), I knew this was the best decision for myself.
So, there I was, the only person I knew in the world who didn’t drink by choice (not for religious, medical or pregnancy reasons). Suddenly I found myself without a support group, without any references of how to do this and very little information in mainstream media about not drinking.
The only ‘solution’ for a person in my situation, it seemed, was to attend an AA meeting of sorts. Having had one brief encounter with one of these meetings around 8 years ago I knew enough to know that this was not the approach for me. And whilst I could respect that this is as a system, approach and support that worked for many people, I knew that this did not sit well with me for various reasons, and I needed to find my own way.
Given this, the problem I then faced, was that there did not seem to be many other ways or approaches for people ‘like me’. It was either I join the AA club, or that I learn to fend for myself in a society which had very little support or information available on how to do so. I chose the latter. I remember at this time reading an article that mentioned that around 90% of problem drinkers do not identify as being an ‘alcoholic’ (and therefore might not feel that AA be the right place for support), and so, in fact, a massive percentage of people are left without the means or tools to get the help they might need. I fell into this category, and like many others, had to create my own way.
I am so fortunate that within the first two weeks of sobriety I discovered the power of an online support community called Hello Sunday Morning (HSM) – where I joined thousands of others in committing to alcohol abstinence and moderation ‘challenges’. Starting on a 3-month challenge, the months flew by, and before I knew it I had completed 9 months of total sobriety. Never would I have thought I’d been able to have gone 1 month without drinking, let alone 9. On HSM I discovered a wealth of information, perspectives and community support that equipped me to walk side-by-side with people from around the globe in learning to live wonderful lives without the booze. It was so incredible to realise that I was, in fact, not alone, but that there are many many people out there doing the same. I had found a place with a bunch of ‘normal’, interesting and also young people from around the world on the same path as me. As well joining HSM I also picked up various hobbies, ditched hanging out in alcohol-fueled environments, started blogging and reading ferociously on the matter. I had quickly found another addiction – reclaiming all the hours I had lost drunk over the last 14 years of my life.
My life changed, in the most wonderfully positive and fantastical of ways – many of which you can read in some of my other posts. And it was the best decision I have ever made to this day. However, after the 8 month, for the first time, I felt I needed a new challenge. Not drinking had become easy and normal, and I wanted to know whether I could step into the elusive ‘moderation’ game. When I started to blog about these thoughts online, I quickly found out that that ‘moderation’ seemed to be a dirty word in the world of recovery, and these thoughts were met with a LOT of caution and even panic by some of the people I had met online. The common thread was – ‘don’t do it’ and that moderation is essentially a state of denial – in that I might just be fooling/ lying to myself and will spiral back to where I first started. Fair enough – this had been be a ‘slippery slope’ for many people, they had tried and failed, and they were concerned.
But, being the stubborn person I am, I decided I needed to know this for myself. Could I drink moderately? The only way I could know was by trying.
So by my 9th month I had made the decision to move into moderation and dived into the information available on the best ways to go about this.
If you have ever searched for information on Moderation Management treatment you will notice how there isn’t a lot of information out there, and the info and websites on this topic look like something straight out of the 90’s. Nevertheless, I started finding some really key research on these pages, which started to paint a very interesting picture around this approach. Here are some findings I came across:
Moderation Fun Facts:
- It had an awkward start:
‘Moderation Management has been around since 1994, but it was living more or less in the shadows from 2000 to 2012, mired in controversy over its founder, Audrey Kishline. After starting MM, Kishline left the group, realizing that she could not moderate her drinking after all. She returned to AA, then fell off the wagon, drunk-driving in March 2000 and killing a man and his 12-year-old daughter. She was released from prison in 2003, and in 2014, plagued by guilt and other demons, Kishline killed herself’. (1)
- In recent years, with the increasing burden on health care companies to fund the treatment on alcohol dependency, more scrutiny is being put on the efficacy of mainstream treatment approaches such as AA. With some studies suggesting this approach has as little as a 5-8% success rate – more research is being put into alternative treatment solutions, including Moderation Management. (2)
- Moderation Management suggests that a person starts with a 30 day abstinence period before followed by a slow reintroduction of alcohol, and eventually a plan to limit your intake: no more than 14 drinks a week for men, nine a week for women, and no drinking more than three or four days a week for either. (3)
- It is often used as diagnostic tool – to see if someone can moderate or not or if they might require full abstinence or other treatment options.
- It allows for flexibility and self-empowerment – placing the power back in the individuals hands as opposed to saying that individuals are always ‘powerless’ against these substances / addictions.
- Whilst some schools of thought purport that moderation be used in the early development/ treatment of alcohol dependency…
‘MM promotes early self-recognition of risky drinking behaviour and how to make changes to moderate or reduce drinking as an achievable goal or a platform toward abstinence.’ (6)
- …other prominent research suggest that, in fact, one fifth of ‘alcoholics’ were also able to drink moderately after treatment:
‘About one fifth of the fully recovered individuals abstained, another fifth moderated their drinking back to healthy levels, one-quarter were still dependent, another quarter were in partial remission, and a tenth had moderated but showed symptoms of possible future relapse.’ (3)
‘For decades the research, both formal studies and informal observations, has shown that some alcoholics can return to moderate or controlled drinking, and that many do.1/3 of those who seek treatment were ‘fully recovered’About one fifth of the fully recovered individuals abstained, another fifth moderated their drinking back to healthy levels, one-quarter were still dependent, another quarter were in partial remission, and a tenth had moderated but showed symptoms of possible future relapse.’ (2)
- Moderation Management refutes the concept that a person has to reach rock-bottom before they get help but one that can be used to treat people before they become fully dependent on alcohol.
- The use of medicinal support such as the use of Naltrexone alongside professional support in moderation is becoming more well established.
- Some suggest that for some individuals, abstinence can be counterproductive, creating an “alcohol-deprivation effect…which have since been confirmed by many other studies, suggested a fundamental flaw in abstinence-based treatment: going cold turkey only intensifies craving“. (5)
- Moderation Management is not for everyone. As Marc Kern, MM Director states, ‘Lots of people come into my group and really should be abstaining. But in my opinion, they need to figure that out themselves. We give them parameters and enable them to come to a reasonable decision for themselves’. (7)
I found many of these insights very interesting – as they challenge the assumptions and beliefs around addiction as we know it.
As far as how to go about moderation, there are several guidelines online (here and here for example) as well as a very recent and detailed article posted on Positive Health Wellness recently, however I thought I would share some of my own tactics which have kept me on track:
My Moderation Guidelines:
- A period of abstinence is vital before diving into moderation – and whilst MM suggests a month minimum – I would really recommend going alcohol-free as long as you can. See how long you are able to go and learn the joys of life without alcohol – for me this was 9 months. You are going to need to pull on these experiences. I strongly believe I would not be able to moderate now if I didn’t stop for as long as I did.
- Moderation means abstinence for 90% of the time for me.
- The MM guidelines are just that – guidelines. You need to figure out how many drinks you are comfortable with. For example, I am definitely not comfortable with the guidelines of ‘max 3 alcohol drinks in one sitting, 3 times a week’. This is a lot of alcohol in my opinion and does not sit well for me. Moderate drinking for me means I might have a drink or two once a week or every few weeks.
- Take a break between drinks. Drink sparkling water, coffee or sodas in between drinks – always.
- Dilute drinks whenever possible. Mix your wine with sparkling water to make wine spritzers and mix lemonade in your beers to make beer shandys.
- Make sure you eat, and never drink on an empty stomach. I would rather overeat than over-drink if I had the choice.
- As a rule, I don’t drink shots. Instead I choose to enjoy my drinks slowly and deliberately.
- Learn to enjoy non-drinking environments – just because you have started to drink again does not mean you should rush back to alcohol-fueled environments such as bars and clubs.
- Alcohol should not be the focal point of an event or celebrations – make sure you remind yourself of all the other important things such as connecting with friends, having amazing conversations, REMEMBERING conversations or learning something new.
- If you start to feel the effects of alcohol, drink water. This has become a natural impulse for me. I do not enjoy the feeling of being tipsy/ or drunk anymore. After experiencing life so wide awake and full of energy – falling into a blurry, alcohol fog does not appeal to me. I listen closely to my body – sometimes I might have a hot flush, or feel a wave of tiredness and after a few sips of alcohol, that’s when I slow down or stop drinking.
- You don’t have to finish your drinks. Sometimes at a party or dinner I may accept a drink or glass of wine – have a few sips and put it down and not drink the rest.
- Accountability is important. I am still a part of the Hello Sunday Morning community where I am on the ‘moderation challenge’. Every week or so I check in there on how I am doing/ feeling – I strongly advise you find a community where you can check-in, even if its with friends or family. I also have this blog, which is a very public place where I journal on my journey. This helps keep me on track.
- Carry on drinking those delicious non-alcohol alternatives. There are more and more amazing non-alcohol drinks out on our shelves these days. Just because you may want to drink alcohol here and there does not mean you need to do this at every occasion. For many of these occasions enjoy your hangover- free alternatives.
- Pay very close attention to the negative side effects you might experience after drinking, such as a headache the next day, mood swings, anxiety, sadness. These are VITAL to keeping you on your path, and also in knowing the times that you perhaps should and should not be drinking. These are some of the negative effects alcohol has on me, sometimes even after one drink, and so this helps keep me on track in deciding not to drink at various occasions.
- Be honest with yourself, if you are not able to do the above, or if introducing alcohol back in to your life brings about more complications than good – this approach might not be for you.
I am still early on in my path of moderation, and so can only speak from where I stand at this point in time. I know that this is something I will need to keep an eye on continuously. As said by the philosopher Saint Augustine, ‘Complete abstinence is easier than perfect moderation’. This is a valid argument, and sometimes it is easier to take the option completely off the table than to deal with the ongoing self-regulation that moderation requires. This is a decision that everyone needs to make for themselves.
Personally, I feel a sense of freedom from the grips of alcohol in my life, I do not think about it much, do not crave it, and every now and then when I feel certain triggers to overdrink, I am able to catch myself in these moments and come back to myself.
Since starting this journey a year ago there has been a surge in the information available on sober and mindful living, especially among younger generations who are starting to trade alcohol-fueled living in for more mindful and purposeful lives. ‘Sober is the new black’, is a concept we are seeing more and more of. There is also a host of research coming out to support newer approaches to treatment, be it in the form of medical breakthroughs, sociological approaches, cognitive behaviour therapy (CBT), recovery coaching and as well as the revival of moderation practices.
With the taboos being challenged around these issues, the rejection of the ‘disease model’ of addiction, greater treatment options available, more resources available online as well as a greater variety of events available that are less focused on alcohol, the recovery space is evolving rapidly.
Never has there been a better time to make these changes in our lives.
Why not start now?