The Alcohol Dependence Scale (ADS; Skinner & Allen, 1982) was used to assess severity of alcohol dependence. This 25-item scale measures alcohol dependence symptoms over the past 12-months and has been shown to contain items that are very relevant for alcohol dependent drinkers (Kahler, Strong, Stuart, Moore, & Ramsey, 2003), such as the ones recruited in the present study. After five years, the majority remained abstinent and described SUD in line with the views in the 12-step programme. For some, attending was just a routine, whereas others stressed that meetings were crucial to them for remaining abstinent and maintaining their recovery process. Additionally, we offer exceptional continuing care so even after completing your programme; you’re never alone in this fight against alcohol addiction.
Alcohol Addiction Treatment at CATCH Recovery
Abstinence three years following treatment did not predict better functioning ten years following treatment. Rather, functioning at three years following treatment (profiles 3 and 4) predicted better psychological functioning at ten years following treatment. As recently proposed, focusing on functioning rather than drinking practices per se may be more useful when defining successful AUD recovery and forecasting how an individual will fare over the long run4,13,16,17,45.
In three Swedish projects, on recovery from SUD, 56 clients treated in 12-step programmes were interviewed approximately six months after treatment (Skogens and von Greiff, 2014, 2016; von Greiff and Skogens, 2014, 2017; Skogens et al., 2017). Therefore, the client should be at the end of or have recently completed post-treatment intervention and be judged by a professional to be in a positive change process regarding their SUD. In the initial interviews, all the clients declared themselves abstinent and stressed that substance use in any form was not an option. The purpose of this paper is to investigate how clients – five years after completing treatment interventions endorsing abstinence – view abstinence and the role of Alcoholics Anonymous (AA) in their recovery process. Our approach is not one-size-fits-all; instead, it’s grounded in empathy, respect for your individuality, and a deep understanding of how alcohol misuse impacts different people in different ways.
- The second, Combined Behavioral Intervention (CBI), consisted of up to twenty, 50-minute sessions which integrated aspects of cognitive behavioral therapy, 12-step facilitation, motivational interviewing, and involvement of support systems.
- Thus, studies will need to emphasize measures of substance-related problems in addition to reporting the degree of substance use (e.g., frequency, quantity).
- For example, while interventions that emphasize or allow for drinking reduction rather than abstinence may attract more individuals with alcohol problems – and thus have potentially greater reach – they may possibly have a smaller positive impact on health and wellness.
- This 25-item scale measures alcohol dependence symptoms over the past 12-months and has been shown to contain items that are very relevant for alcohol dependent drinkers (Kahler, Strong, Stuart, Moore, & Ramsey, 2003), such as the ones recruited in the present study.
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). Additionally, in the United Kingdom, where there is greater access to nonabstinence treatment (Rosenberg & Melville, 2005; Rosenberg & Phillips, 2003), the proportion of individuals with opioid use disorder engaged in treatment is more than twice that of the U.S. (60% vs. 28%; Burkinshaw et al., 2017). Multiple theories of motivation for behavior change support the importance of self-selection of goals in SUD treatment (Sobell et al., 1992). For example, Bandura, who developed Social Cognitive Theory, posited that perceived choice is key to goal adherence, and that individuals may feel less motivation when goals are imposed by others (Bandura, 1986).
Alcohol Moderation Management: Programs and Steps to Control Drinking
When the premise of AA was transformed into the 12-step treatment programme, it was performed in a professional setting. Many clients in the study described that the 12-step programme was the only treatment that they were offered. The context of treatment in a professional setting, and in many cases, the only treatment offered, gives the 12-step philosophy a sense of legitimacy.
Historical context of nonabstinence approaches
However, prior studies have defined“recovery” based on DSM criteria, and thus may have excluded individualsusing non-abstinent techniques that do not involve reduced drinking. Furthermore, noprior study has considered length of time in recovery when comparing QOL betweenabstinent and non-abstinent individuals. The current aims are to identify correlates ofnon-abstinent recovery and examine differences in QOL between abstainers andnon-abstainers accounting for length of time in recovery. 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.
A betterunderstanding of the recovery process and tools utilized by non-abstinent vs. abstinentindividuals would inform clinical practice; for example, is it more important for those inabstinent recovery to have abstinent individuals in their social networks? Finally, we hope tofurther investigate the overlap between “remission” and“recovery” from AUD, especially in the context of harm reduction. We do not know what factors relate to non-abstinent vs. abstinent recovery amongindividuals who define themselves as in recovery. In addition, no priorstudy has examined whether quality of life differs among those in abstinent vs.non-abstinent recovery in a sample that includes individuals who have attained longperiods of recovery. Here we discuss exploratory analyses of differences between abstinentand nonabstinent individuals who defined themselves as “in recovery” fromAUDs.
However, this approach is consistent with the goal of increasing treatment utilization by reaching those who may not otherwise present to treatment. Alternatively, researchers who conduct trials in community-based treatment centers will need to obtain buy-in to test nonabstinence approaches, which may necessitate waiving facility policies regarding drug use during treatment – a significant hurdle. Harm reduction therapy has also been applied in group format, mirroring the approach and components of individual harm reduction psychotherapy but with added focus on building social support and receiving feedback and advice from peers (Little, 2006; Little & Franskoviak, 2010). These groups tend to include individuals who use a range of substances and who endorse a range of goals, including reducing substance use and/or substance-related harms, controlled/moderate use, and abstinence (Little, 2006). Additionally, demi lovato first album some groups target individuals with co-occurring psychiatric disorders (Little, Hodari, Lavender, & Berg, 2008).
Abstinence from alcohol and other drugs has historically been a core criterion for recovery, defined by the Betty Ford Institute as a “voluntarily maintained lifestyle characterized by sobriety, personal health, and citizenship” (Betty Ford Institute Consensus Panel, 2007, p. 222). As recovery processes stretch over a long period, it is suggested that stable recovery is obtained after five years at the earliest (Hibbert and Best, 2011). Some strategies and guidelines to consider if you’re aiming to practice controlled drinking include setting limits, eating before drinking, choosing drinks with lower alcohol content, alternatives with non-alcoholic beverages and having abstinent days. Multivariable stepwise regressions (Table2) show that younger individuals were significantly more likely to benon-abstinent, and movement to the next oldest age category reduced the odds ofnon-abstinence by an average of 27%.
Abstinence Vs. Moderation Management: Success and Outcomes
The ultimate goal of CBT is to provide the skills that can prevent a relapse and maintain drinking goals, whether they be abstinence or controlled drinking (Marlatt & Gordon, 1985; Marlatt & Witkiewitz, 2005). A recent meta-analysis of CBT for substance use disorders found support for a modest benefit of CBT over treatment as usual (Magill & Ray, 2009). Furthermore, one report using a trajectory analysis of the COMBINE study data found the Combined Behavioral Intervention (CBI), which is principally grounded in CBT, to reduce the risk of being in an “increasing to nearly daily drinking” trajectory.
