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This is probably not going to be a popular thing to say but total abstinence isn't necessarily the goal that everyone who has a drinking problem is aiming for.

This is probably not going to be a popular thing to say but total abstinence isn't necessarily the goal that everyone who has a drinking problem is aiming for. Just as those who over eat want to control their appetite for food rather than simply stop eating so do some who have a drink or drugs problem. In many cases the drink is a symptom not a cause. Remove the cause and for some people at least the drink problem will subside. I worry also that the AA members are also a subset of those who have a drinking problem, are we sure that they are a comparable subset to those who took other paths? How do the studies account for people who drop out of either AA or some other program and did the studies follow up years later to find out if people had fallen back into addiction? The article was a bit light on details. And lastly the article mentions relative efficacy but doesn't say anything about how efficacious any of the programs were leaving me wondering if any of them are worthwhile.

RookyNumbas 7y ago
> total abstinence isn't necessarily the goal that everyone who has a drinking problem is aiming for I guess you're technically right. But statements like these make me chuckle. They are very common, and a dead giveaway that you are not very familiar with addiction. Switch out drinking for shooting heroine or smoking crack, and see if the statement still makes sense. The rest of your comment is dead on though. The studies are very bad at making any sort of distinctions like you mentioned. They also ignore the astounding costs of some of these other programs, whether a person is there by choice or not, whether they are trying to quit for the first time or 20th, types and severity of relapses, and many other factors.
kelnos 7y ago
Yup, clicked through here to see if anyone was talking about this. I always hear people throwing around things like "the only way is abstinence". As if addiction is a binary thing, and is always caused by "a predisposition to addiction" itself, and can never have any other causes. I think marketing of programs like AA has pushed this narrative, with little to no evidence to back it up. Until I see a study that definitively shows that any further alcohol consumption after treatment will nearly always devolve back into abuse, I'm not buying it. Did they keep track of any people who went through any programs (AA or otherwise), and ended up with only occasional consumption without the abuse? Doesn't seem like they even took down any data on this. I see a sibling comment condescendingly hand-waving these questions away, with no evidence to back it up, and it makes me sad that our ability to treat alcohol abuse is so hobbled by hearsay.
handedness 7y ago
Great comment, except the first line is only true of some recovering alcoholics. It is not at all true for a great many of them, and for them that is downright dangerous advice.
- Broken_Hippo 7y ago
  Just because it isn't true for all doesn't mean we should eshew it. Yes, some folks find out they can't drink at all, ever. Others will do just fine being without for a bit, then learning how to drink moderately. It isn't dangerous advice, merely truthful and we can be honest about it not being right for everyone.
runawaybottle 7y ago
Sure, and I’ll add that one understated strategy in dealing with addiction is harm-reduction. Relapses basically occur when you pull the rug out from under you and just go full abstinence. Phasing down the dosage can be an effective strategy. If you drink 500ml of Vodka a day, could you go for 350ml for awhile? Crazy thing to suggest because at those levels you’re dealing with a full blown alcoholic, but it is definitely a strategy.

RookyNumbas 7y ago

> total abstinence isn't necessarily the goal that everyone who has a drinking problem is aiming for I guess you're technically right. But statements like these make me chuckle. They are very common, and a dead giveaway that you are not very familiar with addiction. Switch out drinking for shooting heroine or smoking crack, and see if the statement still makes sense. The rest of your comment is dead on though. The studies are very bad at making any sort of distinctions like you mentioned. They also ignore the astounding costs of some of these other programs, whether a person is there by choice or not, whether they are trying to quit for the first time or 20th, types and severity of relapses, and many other factors.

kelnos 7y ago

Yup, clicked through here to see if anyone was talking about this. I always hear people throwing around things like "the only way is abstinence". As if addiction is a binary thing, and is always caused by "a predisposition to addiction" itself, and can never have any other causes. I think marketing of programs like AA has pushed this narrative, with little to no evidence to back it up. Until I see a study that definitively shows that any further alcohol consumption after treatment will nearly always devolve back into abuse, I'm not buying it. Did they keep track of any people who went through any programs (AA or otherwise), and ended up with only occasional consumption without the abuse? Doesn't seem like they even took down any data on this. I see a sibling comment condescendingly hand-waving these questions away, with no evidence to back it up, and it makes me sad that our ability to treat alcohol abuse is so hobbled by hearsay.

handedness 7y ago

Great comment, except the first line is only true of some recovering alcoholics. It is not at all true for a great many of them, and for them that is downright dangerous advice.

Broken_Hippo 7y ago
Just because it isn't true for all doesn't mean we should eshew it. Yes, some folks find out they can't drink at all, ever. Others will do just fine being without for a bit, then learning how to drink moderately. It isn't dangerous advice, merely truthful and we can be honest about it not being right for everyone.

runawaybottle 7y ago

Sure, and I’ll add that one understated strategy in dealing with addiction is harm-reduction. Relapses basically occur when you pull the rug out from under you and just go full abstinence. Phasing down the dosage can be an effective strategy. If you drink 500ml of Vodka a day, could you go for 350ml for awhile? Crazy thing to suggest because at those levels you’re dealing with a full blown alcoholic, but it is definitely a strategy.