Alcohol Moderation Management: Programs & Steps to Control Drinking
Moderate or “controlled” drinking is a harm reduction approach tailored toward people with a drinking problem who do not exhibit the symptoms of physical dependence on alcohol.
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What is Alcohol Moderation?
Alcohol moderation management is a form of harm reduction for those struggling with the consequences of alcohol use and who do not have an alcohol use disorder. Alcohol moderation is not the same as alcohol abstinence. Those who suffer from drinking problems, in general, do not respond well to a one-size-fits-all approach to treatment because every person is different and has a distinctive relationship with alcohol. For some people, a zero-tolerance policy, such as abstinence, keeps them sober and on track. Abstinence involves a person not drinking or using other mind-altering substances whatsoever. For others, moderate drinking may be a valuable approach in preventing further harm in the form of driving drunk, risky sexual activities, violence, or other potential alcohol-related problems.1
Moderation—sometimes called controlled drinking—is a useful tool in motivating people to reduce alcohol use or give it up all together. So, instead of forcing someone into abstinence or a treatment program, or shaming them for their alcohol use, moderation programs tackle alcohol abuse from a different angle. They let the person reflect on their behavior and come up with their own system. Research shows that working on moderation can help a person to seek help before they continue further down a harmful path. The goal is to help people create goals and personal drinking limits who have not yet developed a pervasive pattern of alcohol abuse.2
Moderate drinking is designed specifically for people who do not have an alcohol use disorder, as previously mentioned.1 People with severe alcohol use disorders may find it difficult to attempt to reduce harm with drinking moderation and may have a better chance of recovery at a professional treatment center. If you aren’t sure what your level of alcohol dependence is, you can take a questionnaire like the one available on the moderation.org website, called “Alcohol Dependence Questionnaire.” If your dependence score is 20 or above, moderation may not be the right choice for you. If you have a lower score, a harm reduction approach could entail trying moderate drinking in conjunction with therapy, but always consult with a medical or mental health professional before beginning any form of treatment.3
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Moderation Management Steps & Process
Different people may be drawn to trying a moderation approach for a variety of reasons. For example, most college students don’t want to give up drinking altogether. But if they have a problem with alcohol, taking a harm reduction approach could be a constructive way to help them take a look at the negative consequences of their behavior and motivate them to make positive changes. Most people who seek out moderation management (MM) have already tried and been unsuccessful at stopping drinking or cutting down on their use.
Abstinence Vs. Moderation Management: Success & Outcomes
Abstinence is not the only solution for recovering from alcohol use disorders, but it is one of the most studied and successful methods for recovering from alcohol use disorders. Though programs like Alcoholics Anonymous and other well-known programs meant to aid in the recovery from alcohol use disorders and alcohol abuse require or encourage full abstinence, these are not the only solutions known to help people quit or control drinking.
Controlled drinking receives its fair share of pushback from people who believe in common programs that attract problem drinkers. For example, organizations that promote abstinence-only approaches may find moderation to be too loose in its approach to recovery. Groups such as Alcoholics Anonymous (AA) or professional 12-step treatment programs may not support the idea of moderate drinking in a controlled environment.4
However, research shows that when a person has a strong belief in their ability to drink moderately and reach the goals they set for themselves, they will work harder to reach these goals. This is in line with social cognitive theory, which states that people view themselves as more capable of reaching goals if they themselves were in charge of creating them. Moderation helps people become mindful and aware of their own harmful drinking patterns, creating rules around drinking, and continuously reflecting on their progress. For many in moderation programs, they eventually chose goals of abstinence after practicing moderation first.4 According to research studies, web-based approaches of moderation management help people reduce their drinking, especially in the short-term.4
When Is My Drinking an Issue?
According to the DSM-5, your drinking habits may cause you to qualify for an alcohol use disorder if you experience some or all of the following signs:6
- You often use alcohol in larger amounts or over a longer period than intended.
- You have made unsuccessful efforts to cut down or control alcohol use.
- You spend a great deal of time trying to obtain, use, or recover from alcohol.
- You experience cravings for alcohol.
- Your alcohol use often results in a failure to fulfill responsibilities at work, home, school, or family life.
- You’ve continued using alcohol despite consequences (including persistent or recurrent social or interpersonal problems) caused by persistent alcohol use.
- You’ve given up social, occupational, and recreational activities because of alcohol use.
- You use alcohol in situations that could be potentially hazardous, or your alcohol use places you in situations that could be or are dangerous.
- You use alcohol despite knowledge of having a persistent problem with alcohol use.
- You develop a tolerance to alcohol. In other words, you need increasing amounts of alcohol to achieve intoxication or the desired effect.
- You experience alcohol withdrawal.
If you are struggling with some of the following signs above, be sure to contact your physician or seek help at a substance abuse treatment facility.
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Moderation Management Programs
In 1990, the Institute of Medicine noted that people who had a problem with drinking but were not dependent on alcohol were an underserved group. In response, different face-to-face and web-based interventions were created, including:6
- Moderation Management (MM): MM operates as a mutual support group that believes that drinking is a habit that can be changed in a group setting. Initially, MM was designed to be conducted in a face-to-face setting, but now online groups are popular as well. According to studies, the majority of MM members are female, white, college-educated, US citizens, middle-class, and mildly dependent on alcohol. Before starting an MM group, the average number of drinks among MM members was 35 per week. As more and more of the average person’s daily life shifts to online networks, MM may hold increasing appeal for those who have a preference interacting online. For people who are curious about whether to practice moderation or abstinence, attending an MM meeting may be a good place to start. Drinking in a controlled environment can be helpful in helping a person learn where their edge is and whether they need further treatment.6
- Moderate Drinking.com (MD): Similar to MM, ModerateDrinking.com focuses on self-control and balance. You can visit the website to monitor behavior, set goals, and chart your journey. The site also offers trainings on identifying triggers to drink, how to develop alternatives to drinking, how to deal with relapse, and how to motivate yourself to practice moderation or abstinence. You can enter your self-monitoring data in a daily log and receive feedback on your progress.6
The goal of a moderation program is to support a person’s journey toward understanding their drinking behavior and create a safe environment for them to explore how to drink moderately.
Drinking moderately is not for everyone, but if you think that you want to try a moderation program, an online search can help you locate a meeting in your area or you can sign up for a virtual or telephone meeting. For some, it is exactly the program they need to shift their heavy drinking habits to moderation. For others, they attend a group meeting online or in person and realize that they need additional support at an alcohol treatment center.1
- Marlatt, G. A. & Witkiewitz, K. (2002). Harm reduction approaches to alcohol use: Health promotion, prevention, and treatment. Addictive Behaviors, 27(6), 867–886.
- Harvard Medical School. (2009). Alcohol abstinence vs. moderation.
- org. (n.d.). Guide to Moderation Management Steps of Change.
- Kosok, A. (2006). The Moderation Management Programme in 2004: What type of drinker seeks controlled drinking? International Journal of Drug Policy, 17(4), 295–303.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Hester, R. K., Delaney, H. D., & Campbell, W. (2011). com and Moderation Management: Outcomes of a randomized clinical trial with non-dependent problem drinkers. Journal of Consulting and Clinical Psychology, 79(2), 215–224.