In the field of addiction, abstinence describes the process of completely avoiding certain potentially addictive substances (drugs and alcohol) or behaviors. If someone does not use a substance or engage in the behavior, they are said to be abstinent. Even centuries ago, before addictions were considered medical conditions, this method was the recommended treatment for drug or alcohol dependence. Today, we know that it is still the safest way to prevent a relapse. Read on to learn more.
The Root of Abstinence
Perhaps the strongest argument for the abstinence model of recovery is its reflection of the disease model of addiction. If exposure to a substance creates a negative health effect, treatment indicates no amount of that substance should be consumed. It’s also often viewed as a physical allergy, followed by a mental obsession – this allergy extends to all mood- and mind-altering substances, meaning that they should be avoided at all costs.
Often in the context of meetings, attendees will hear speakers and professionals say that “a drug is a drug is a drug,” emphasizing that any substance – even those perceived as less harmful by the public, such as marijuana or alcohol – has addictive potential. In fact, within Alcoholics Anonymous, those who consume anything mind-altering (such as marijuana) are not considered to be sober. Similarly, people in Narcotics Anonymous cannot drink. In both cases, other substances are considered a slippery slope that will eventually bring addicts back to their drugs of choice.
In the United States, the abstinence approach makes up approximately 96% of all addiction treatments. Abstinence from alcohol involves completely avoiding any intake of the substance, which contrasts completely with the concept of harm reduction: controlled drinking.
Moderation or Abstinence?
The core of this approach is structure and rigidity, as required by the disease model of addiction. While some people believe that those with drug or alcohol problems are able to decrease their substance use through moderation, this is simply not a recommended approach for complete recovery.
The reasons for this are varied and complex. Programs like Moderation Management claim to value early self-recognition of risky behavior, but they fall short in comparison to 12-Step programs. Moderation Management is not long-term or intensive. Membership is primarily online, meaning that groups do not form easily or last long. Contrast this with AA, which is an international organization with established hubs in nearly every city.
It’s generally accepted that many people who practice moderation eventually transition into full abstinence, choosing to move from programs like Moderation Management into Alcoholics Anonymous. This includes the founder of Moderation Management.
Moderation has been heavily criticized because it relies on the self-control of those who cannot control their substance use, as well as their reliable self-reporting. Furthermore, one is relying on someone with a demonstrated addiction to decide what amount of alcohol or drugs is acceptable (and not problematic). Because of these factors, it is extremely difficult to measure success in the harm reduction model.
Additionally, while moderation is a topic of debate for those misusing alcohol, it does not hold much weight when discussing illicit substances, such as meth, cocaine, or heroin. A single errant dose of heroin after attempted sobriety can be the difference between life and death; over 70,000 Americans died of drug overdoses in 2017, while the number of deaths from alcohol poisoning is 2,200. For this reason, the commonly-held belief is that there is no such thing as a safe amount of these drugs.
Your Path to Complete Recovery
Abstinence is an effective method of treatment when maintained. Of those who remain abstinent from drugs and alcohol for one year, almost 70% will avoid relapse. At the five year mark, 86% will remain free of their substance use disorder. Those seeking this goal will experience the best results with professional treatment. Segue Recovery offers ongoing long-term support for those in the critical early stages of addiction recovery. Please call 1-866-905-4550 to learn more.