The majority of addiction rehabilitation facilities encourage the philosophy of abstinence over moderation. Why is this? Numerous reasons, including the most important one: addiction isn’t a choice. Research indicates that most people with certain risk factors experience predictable neurological changes with each use, which only creates a stronger dependence. So let’s take a closer look at abstinence vs. moderation.
What’s Abstinence?
In public health and academic contexts, drug and alcohol abstinence refers to the voluntary decision to refrain from consuming substances, often as a lifestyle choice or as part of recovery from addiction. Abstinence can be pursued for various reasons, including personal health, religious beliefs, or legal and societal responsibilities.
There’s not a gray area—the definitions are clear:
- Drug abstinence: The act of not using any non-prescribed or recreational drugs, including illegal substances or the misuse of prescription medications.
- Alcohol abstinence: The decision to refrain entirely from consuming alcoholic beverages.
These definitions underscore the emphasis on total non-consumption of substances within specific time frames, particularly during treatment and recovery.
The Substance Abuse and Mental Health Services Administration (SAMHSA) indicates that this approach may require substantial lifestyle changes, including avoiding social situations where substances are present. In its 10 Guiding Principles of Recovery, SAMHSA states, “abstinence from the use of alcohol, illicit drugs, and non-prescribed medications is the goal for those with addictions.”
Abstinence is also the preferred medical method of maintaining health for people who have a genetic predisposition to alcohol use disorder (AUD) or substance use disorder (SUD). Research indicates that 40–60 percent of risk factors are biological, so many individuals with a family history of AUD, SUD, or dual diagnoses choose to abstain for their well-being.
What’s Moderation?
This concept involves using substances in a controlled, responsible manner without negative impacts such as impaired judgment, health issues, or dependence. In mild instances of AUD or SUD, moderation might include the following guidelines.
Defining Limits
Individuals set clear and specific limits on the amount of drugs or alcohol they consume. For example, a person might decide to restrict their consumption to one or two drinks in a single sitting, once a week.
Awareness and Monitoring
Moderation involves being mindful of one’s consumption patterns. This might include tracking the quantity and frequency of use and recognizing situations where limits are exceeded.
Strategies for Control
Addiction specialists might work with someone to develop techniques for:
- Planning. Establishing boundaries before attending social events where substances might be present.
- Avoiding triggers. Identifying and steering clear of environments or emotional states that lead to excessive use.
Some healthcare providers may support a moderate approach to substance use if their patient doesn’t have inherent risk factors such as:
- Genetic predisposition
- A dual diagnosis involving a mental or emotional health disorder
- Generational trauma or other forms of complicated grief or PTSD
- A long history of drug or alcohol misuse
Some recent studies indicate that in cases where total abstinence isn’t possible, especially as part of a monitored medication-assisted treatment protocol or “lower barrier care,” helping people transition from higher use to lower use still provides benefits.
However, Fair Oaks Recovery Center and other addiction treatment centers advocate for an abstinence approach to reduce the chances of relapse.
The Evidenced-Based Treatment Approach at Fair Oaks
What’s critical to remember about abstinence vs. moderation is how the brain reacts to chemical dependency. The National Institute on Drug Abuse states that “drugs can alter important brain areas that are necessary for life-sustaining functions and can drive the compulsive drug use that marks addiction” Additionally, The National Institute on Alcohol Abuse and Alcoholism notes the stages of the addiction cycle and how focused abstinence as part of an individualized treatment plan not only help the brain and body break chemical dependency but also to encourage a shift in behavior and emotional regulation.
Fair Oaks Recovery Center in Sacramento, California is a licensed Chemical Dependency Recovery Hospital, issued by the California Department of Public Health to addiction rehabilitation and dual diagnosis treatment facilities. Our program is designed to introduce new habits and wellness techniques you can use to conquer cravings, identify addiction triggers, prevent relapse, and manage co-occurring conditions such as anxiety and depression.
To do this, our board-certified professionals meet you where you are and develop an individualized continuum of care plan based on evidence-based treatment and holistic therapies. The cognitive behavioral therapy, dialectical behavioral therapy, motivational interviewing, and other techniques we use are proven to assist in the recovery process.
This safe, therapeutic healing environment provides incentives for abstinence and the tools necessary to build family and interpersonal relationships that set the foundation for long-term success. Talk to a member of our admissions team to learn more.