Additionally, while early studies of SUD treatment used abstinence as the single measure of treatment effectiveness, by the late 1980s and early 1990s researchers were increasingly incorporating psychosocial, health, and quality of life measures (Miller, 1994). This pinpoints the conflicting issues experienced by some clients during the recovery process. If the 12-step philosophy and AA were one option among others, the clients could make an informed choice and seek options based on their own situation and needs. This would probably reduce the risk of negative effects while still offering the positive support experienced by the majority of the clients in the study.
- Additionally, for some individuals entering treatment, CD may be a viable drinking goal.
- But other research indicates that the pool of those who achieve remission can be expanded by having broader treatment goals.
- These hypotheses were supported by the present study, such that participants with a self-reported goal of complete abstinence had better overall clinical outcomes following 16 weeks of alcohol dependence treatment.
- Today, there is a solid push for help on the drug front that can help some difficult consumers in checking their liquor misuse in moderation management.
4. Current status of nonabstinence SUD treatment
Dr. Stanton Peele, recognized as one of the world’s leading addiction experts, developed the Life Process Program after decades of research, writing, and treatment about and for people with addictions. His work has been published in leading professional journals and popular publications around the globe. Although critics controlled drinking vs abstinence claim Alcoholics Anonymous has poor success rates, and some sources estimate it at fewer than five percent, AA to the contrary claims its success rates aren’t truly accurate due to its anonymity.15 Moderation Management has its drawbacks as well, and its opponents are also concerned about it. A study conducted at the University of Gothenburg, Sweden found that the Reagans of the world are more successful in treatment than the Saras.
2. Relationship between goal choice and treatment outcomes
These findings were such that participants committed to complete abstinence took longer to slip and longer to relapse, defined as drug use on four or more days in a week. Critically, Hall et al. (1986, 1990) examined participants with an abstinence goal allowing for occasional slips and found that these participants did not fare as well as participants with complete abstinence goals. Harm reduction may also be well-suited for people with high-risk drug use and severe, treatment-resistant SUDs (Finney & Moos, 2006; Ivsins, Pauly, Brown, & Evans, 2019). These individuals are considered good candidates for harm reduction interventions because of the severity of substance-related negative consequences, and thus the urgency of reducing these harms. Indeed, this argument has been central to advocacy around harm reduction interventions for people who inject drugs, such as SSPs and safe injection facilities (Barry et al., 2019; Kulikowski & Linder, 2018). It has also been used to advocate for managed alcohol and housing first programs, which represent a harm reduction approach to high-risk drinking among people with severe AUD (Collins et al., 2012; Ivsins et al., 2019).
Alcohol Addiction Treatment at CATCH Recovery
The harm reduction movement, and the wider shift toward addressing public health impacts of drug use, had both specific and diffuse effects on SUD treatment research. In 1990, Marlatt was introduced to the philosophy of harm reduction during a trip to the Netherlands (Marlatt, 1998). He adopted the language and framework of harm reduction in his own research, and in 1998 published a seminal book on harm reduction strategies for a range of substances and behaviors (Marlatt, 1998). Marlatt’s work inspired the development of multiple nonabstinence treatment models, including harm reduction psychotherapy (Blume, 2012; Denning, 2000; https://ecosoberhouse.com/ Tatarsky, 2002).
This study examined the effects of drinking goal on clinical outcomes in the COMBINE Study. It was hypothesized that patients whose drinking goals were oriented towards complete abstinence would have better treatment outcomes as indexed by a greater percentage of days abstinent, longer period until relapse, and an overall higher global clinical outcome. These hypotheses were supported by the present study, such that participants with a self-reported goal of complete abstinence had better overall clinical outcomes following 16 weeks of alcohol dependence treatment. Participants with a goal of controlled drinking had the worst drinking outcomes, whereas those with a conditional abstinence goal comprise an intermediate group between complete abstinence and controlled drinking. This pattern of results was robust and replicated across all primary outcome measures.
