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Moderating Alcohol Abuse: An AA Alternative Approach In Outpatient Alcoholism Treatment

By Dr. Ed Wilson and Dr. Mary Ellen Barnes

The Answer Isn’t the One You Expected to Hear…

Did you know that the real research has shown that many “alcoholics” actually return to moderate drinking every year? If you think about your own friends and acquaintances you’ll probably remember any number of them who went through periods of alcohol and drug abuse, but who got over it.

You’re not alone in your impressions. For decades the research, both formal studies and informal observations, has shown that some alcoholics can return to moderate or controlled drinking, and that many do.

However, Alcoholics Anonymous and other powerful recovery programs have defined an alcoholic as a person who can never again drink in moderation. This has placed them in the curious position of maintaining that someone who returns to moderate drinking wasn’t an alcoholic – no matter how obvious the evidence to the contrary.

Abstinence Isn’t Always the Only Answer

While traditional AA/12-Step conceptions and definitions have caused these organizations to reject the mounting evidence, they haven’t been alone. The treatment “industry” – one founded almost exclusively by people seeking to spread the 12-Step gospel – recognizes only one “disease” and one “cure.” Since they don’t have meaningful solutions for most of us, suggestions that other outcomes are possible are very unwelcome.

But everyone would be better served by the different picture painted by an analysis of data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Based on a sample of 43,000 U.S. adult alcoholics, the study found that more than one-third of those with alcohol dependence that began more than one year ago were in full recovery a year later (according to the National Institute on Alcohol Abuse and Alcoholism).

About one fifth of the fully recovered individuals abstained, another fifth moderated their drinking back to healthy levels, one-quarter were still dependent, another quarter were in partial remission, and a tenth had moderated but showed symptoms of possible future relapse.

Alcoholism is Rarely a “Progressive Disease.”

One of the many problems with the “disease” model of alcoholism is its adherence to the supposed progressive nature of the condition. Trouble is, it usually isn’t. More often it’s static with people maintaining the same level of consumption – healthy, abusive, dependent, and so on – for decades. And, political correctness to the contrary, we all know someone whose alcohol abuse just stopped for no apparent reason.

It turns out that remission isn’t unusual and occurs with “alcoholics” more often than with any actual terminal disease. Alcoholism may occasionally be progressive, but it’s far more often static, and at least as apt to be regressive.

“Bottoming Out” is Dumb!

Another part of the mythology says that people don’t “recover” until they have “bottomed out.” Most drinkers are never going to get to that desperate, homeless, penniless condition so often described. That doesn’t mean that their lives aren’t filled with negative consequences. But the myth keeps people from getting help with problems before they reach extremes, and keeps family members from suggesting help before the condition gets completely out of hand – which it may never do.

What should people with alcohol problems, their spouses, families, or employers do? Obviously it would be good to be able to intervene early and jumpstart some progress. The real news is that by doing so you allow for a variety of possible outcomes.

Get Real Help, Not a Life-Long Label.

Just as you don’t want to be stuck with a stigmatizing label, don’t sign up for a “progressive terminal disease” you don’t have. You can also afford to skip onerous treatment that you don’t need, and outcomes that diminish you and your life.

Getting the right assistance will help you sort through current problems more quickly, deal with them more effectively, and correct them more efficiently than you are apt to manage on your own and that’s help worth having. Just don’t sacrifice too much of yourself to a cult mentality in the process.

If you are ready to get real help, call us today at 888-541-6350. We would be happy to talk with you about helping you get through your current problems in the fastest possible time.

By |2016-11-14T06:14:14+00:00May 11th, 2010|Alcohol Treatment|9 Comments


  1. ramzi Haddad July 2, 2010 at 4:08 pm

    Please advice me if you have any centres in Canada
    I would be interested to join the program.

  2. Cindi Pollack November 15, 2010 at 4:26 pm

    I am interested in finding a program for my 19 year old daughter, who is an excellent student and cheerleader at her college and does not have an alcohol dependency…it is her lack of moderation (she ended up in the hospital several times over the last 2 years at college and is now taking a leave of absence to address this). Do you have any programs in the MD/DC/VA area? Please let me know!

    Cindi Pollack

  3. Rita Messbarger December 8, 2011 at 5:03 pm

    I am interested in establishing alcohol moderation management. I live in south Texas.

  4. Dr. Mary Ellen Barnes & Dr. Ed Wilson December 8, 2011 at 7:24 pm

    I do not know of any programs in your area. I would recommend the St Jude’s Retreat program in upatate NY. It is residential but is an excellent program for young people.

  5. Theresa April 18, 2013 at 9:43 am

    Where can I get help in Long Island, NY.

  6. Dr. Mary Ellen Barnes & Dr. Ed Wilson April 18, 2013 at 10:59 am

    There are very few non 12 step programs anywhere in the country. There are a few in southern California, where we are located, there is one in upstate NY, one in Iowa and one in Florida. With the exception of us, in California and the program in Florida, all the rest are residential and are 4 – 6 week programs.

  7. taylor April 25, 2015 at 8:38 am

    This is an excellent article. I wish that there was more like it.

    12 step programs like AA are actually religion in disguise and the focus on abstinence and with duration of abstinence for seniority I believe fosters an abstinence -binge cycle that harms people.

  8. marc pellicane May 22, 2015 at 8:49 am

    I started attending MM meetings about 2 months ago and stopped going to AA after a long time. I never agreed with AA but I went along with it because I thought it was the only way and that I was a loser. I feel liberated the last few months and have accomplished more in these months than I have had in a long time.

  9. […] ‘About one fifth of the fully recovered individuals abstained, another fifth moderated their drinking back to healthy levels, one-quarter were still dependent, another quarter were in partial remission, and a tenth had moderated but showed symptoms of possible future relapse.’ (3) […]

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