Alcohol Moderation Management: Programs and Steps to Control Drinking

What is Alcohol Moderation Management?

Alcohol moderation management is a form of harm reduction for those struggling with the consequences of alcohol use and who do not have an alcoholism issue. 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 helpful 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 tool meant to motivate 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 misuse from a different angle. These programs let the person reflect on their behavior and come up with their own system. Research shows that working on moderation can help a person seek help before they continue further down a harmful path. The goal is to help people create goals and personal drinking limits, and it’s meant for individuals who have not yet developed a pervasive pattern of alcohol misuse.²

Alcohol Moderation Management Steps and 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.

MM breaks down the process of quitting drinking using this step-by-step approach:³

• Start keeping a diary. Record the times of day that you drink. This will help you become more aware of your habits and patterns. At the top of a full-size sheet of paper, write: Date / # of Drinks / What drink / Time Spent Drinking / The Occasion / Feelings at the Time. Keeping a record of your drinking can help you identify various triggers, such as time of day or certain individuals. While you are keeping the journal, you don’t have to change anything, simply observe and reflect on your behaviors.
• Observe moderate drinkers. Look at people who practice moderate drinking. Observe when they stop and how they step away from drinking. This can help you learn strategies that you can adopt in your own life. Once you understand what moderate drinking looks like, do an honest check-in and ask yourself whether moderation or completely staying away from alcohol is the better option for you.
• Create a list. Think back through the times when your alcohol use has caused problems. Listing these out is not meant to cause you pain, but to help you get a grasp on the extent of your troubles with alcohol. Write down what happened and how it made you feel. Think back through how drinking has played a role in your physical health, emotional health, relationships, work life, family, and legal issues. After writing a list of problems that are tied to your alcohol use, you are ready to create a list of the benefits you can imagine experiencing when you start drinking in moderation. This may include positive changes to your physical, emotional, and mental health, your finances, your spiritual life, and your social life. You can display this list somewhere in your house to remind you of your goals.
• Take a conscious step away from alcohol for 30 days. The beginning of a moderation program begins with a commitment to 30 days or more of not drinking. During this time, you will learn to say “no” to cravings for alcohol and tune into how your body is feeling. You can take a step back and observe how people act when they have consumed too much and possibly reflect on how you do not want to do the same. Allow your body to experience what it feels like not to have alcohol. If you don’t feel ready to go a full 30 days without drinking, you can start slow. Maybe start with a few days, work up to a week, and see how you feel. Only attempt something like this with the clearance of a medical professional, since some people with significant physiological alcohol dependence may be at risk of dangerous withdrawal complications like seizures.
• Learn skills to avoid drinking. As you embark on your 30 days of abstinence, you can’t just try to power through without a plan. You have to learn what to do instead of drinking. If you are with your friends or family, who know that you are a heavy drinker, they may question why you’re not drinking. It’s best to let them know ahead of time so they can support you in your attempts to cut down on drinking. You might also come prepared to any social gathering with responses ready to offer anyone who asks why you aren’t drinking. It will become very apparent who supports your new, healthy lifestyle and who does not.
• Create your own set of rules. Come up with a list of personal rules that you will follow when practicing moderate drinking. Keep this list precise, realistic, and short. Write down your drink limits. List out strategies that you can use while drinking moderately. Keep in mind this list can change as you evolve. Have a copy of your rules with you and update it as necessary.
• After 30 days of abstinence, you can try drinking in moderation. As you ease back into drinking, it should be done mindfully. Now that you are aware of your limits and triggers, you should be prepared to have a better handle on your urges and cravings for alcohol. Pay close attention to your drinking following abstinence, and continue taking detailed notes in your diary.
• If you relapse or over-drink, do an honest check-in with yourself. It is normal and human to slip back into drinking. Don’t beat yourself up over it. Instead, be curious about what led you to drink heavily again and come up with a way to deal with this situation in the future without alcohol.

Abstinence Vs. Moderation Management: Success and 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 misuse 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. 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?

An alcohol use disorder can only be diagnosed by a healthcare professional, who use the criteria in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) to diagnose this condition. You can use the criteria to assess your drinking habits but should consult a healthcare professional to formally diagnose you. The criteria includes:⁶

• Using alcohol in larger amounts or over a longer period than intended.
• Making unsuccessful efforts to cut down or control alcohol use.
• Spending a great deal of time trying to obtain, use, or recover from alcohol.
• Experiencing cravings for alcohol.
• Failing to fulfill responsibilities at work, home, school, or family life due to alcohol use.
• Continuing to use alcohol despite consequences (including persistent or recurrent social or interpersonal problems) caused by alcohol use.
• Giving up social, occupational, and recreational activities because of alcohol use.
• Using alcohol in situations that could be potentially dangerous.
• Using alcohol despite it causing or worsening physical or mental health conditions.
• Developing a tolerance to alcohol, meaning you need increasing amounts of alcohol to achieve intoxication or the desired effect.
• Experiencing alcohol withdrawal when use stops or is drastically reduced.

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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Take our free, 5-minute substance use self-assessment below if you think you or someone you love might be struggling with substance use. The evaluation consists of 11 yes or no questions that are intended to be used as an informational tool to assess the severity and probability of a substance use disorder. The test is free, confidential, and no personal information is needed to receive the result.

Alcohol 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 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, U.S. citizens, middle-class, and mildly dependent on alcohol. Before starting an MM group, the average number of drinks among MM members was 35 drinks 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 for 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.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 can help them shift their heavy drinking habits to moderation. For others, attending a group meeting online or in person can lead to the realization that they need additional support at an alcohol treatment center.¹