Can Alcoholics Recover and Drink in Moderation?
November 5th, 2007 | Email this to your FriendsWritten by Edward W. Wilson, Ph.D., MAC
Click here to contact Edward and/or see his GoodTherapy.org Profile
For decades the research, both formal studies and informal observations, has shown that some alcoholics could 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 - not matter how obvious the evidence to the contrary.
While their traditional conceptions and definitions have caused the AA/12 Step organizations to reject the mounting evidence, they haven’t been alone. The treatment “industry” also has a vested interest in keeping definitions and solutions narrowly defined and simple. There is, in their lexicon, only one “disease” and one “cure.” Since 95% of providers are wedded to the 12 Step model, and have nothing else to offer, suggestions that other outcomes are possible are very unwelcome. In the United States even those programs describing themselves as “alternatives to the AA/12-Step models” generally adhere to abstinence-only outcome criteria.
But individuals and providers alike 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. adults, the study found that more than one-third (35.9 percent) of those with alcohol dependence (alcoholism) that began more than one year ago were in full recovery a year later (according to the National Institute on Alcohol Abuse and Alcoholism).
The fully recovered individuals include roughly equal proportions of abstainers (18.2 percent) and low-risk drinkers (17.7 percent), while one-quarter (25.0 percent) of individuals with alcohol dependence are still dependent and 27.3 percent are in partial remission (that is, exhibit some symptoms of alcohol dependence or alcohol abuse). About twelve percent (11.8%) are drinkers with no symptoms but whose borderline problematic consumption increases their chances of relapse (for men, more than 14 drinks per week or more than four drinks on any day; for women, more than 7 drinks per week or more than three drinks on any day).
One of the many problems with the “disease” model of alcoholism is its adherence to the supposed progressive nature of the condition. Again, political correctness to the contrary, just as everyone knows someone with an alcohol problem, we all know someone whose alcohol abuse stopped for no apparent reason. This isn’t unusual and occurs with “alcoholics” more often than any real disease - often enough to be the rule rather than the exception. Alcoholism may occasionally be progressive, but it’s far more apt to be regressive.
What’s a person suffering from alcohol related problems to do? What are spouses or families or employers to do? Certainly people lose patience waiting for someone to sober up and it would be good to be able to jump start some progress. The real news is that there are many different ways to achieve different solutions and if you are looking for outside help, for yourself or someone else, look for help that offers a variety of possible outcomes.
Just as you don’t want to be stuck with a stigmatizing label, don’t sign up for a “lifelong disease” you may not have, onerous treatment that you don’t need, or definitions 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. If you can find it, that’s help worth having, but be careful not to sacrifice too much of yourself in the process.
©Copyright 2007 Edward W. Wilson, Ph.D., MAC All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Edward and/or see his GoodTherapy.org Profile
December 4th, 2007 at 7:54 am
This is a very interesting blog. I’ve never heard of an alcoholic who suddenly recovered with no explanation. Very interesting. It certainly gives me something to think about for awhile.
December 5th, 2007 at 7:55 am
I would really like to know where the study got these statistics. They certainly fly in the face of every other study ever done. Alcoholism as being regressive? That’s a hard pill to swallow, so to speak. I don’t think that one study that could very well be flawed can cause us to throw out everything every other study has told us.
December 6th, 2007 at 3:26 pm
While these statistics may not fit the norm, I don’t think we can totally throw them out, either. It may be that the study found a different way of looking at alcoholism and is perfectly valid and reliable. I think one point to consider is that 12 step programs do not work for everyone. I agree with the author when he says that we need to look for alternative treatments.
December 6th, 2007 at 8:58 pm
there are many studies (and observations) that show that people can “mature out” of both alcohol and drug use.
when you read the AA literature, it is pretty clear that AA was originally intended for hardcore users who had tried everything else.
and many of these “everything else” approaches work for people.
it really shouldn’t come as a surprise that the experience of alcohol abuse is very different for different people. after all, everything else is different - we don’t have the same marriages, the same work experience, the same taste for licorice or bowling - why should we all be the same with relation to alcohol use and abuse? and since we’re all at least a bit different, we all need different treatment. AA works for some, therapy works for others, willpower seems to do the trick for others yet. let a thousand treatments bloom!
December 10th, 2007 at 12:36 pm
I have an uncle who is an alcoholic. But, whenever he goes to the doctor and the doctor threatens to put my uncle on insulin, he doesn’t touch alcohol until he’s in the clear again. So, does that make him an alcoholic or not? His behavior would certainly indicate that he is while he is drinking. But, is the fact that he has such control over drinking indicative that he is not an alcoholic?