All things in moderation? Not when it comes to addiction

Is total abstinence too extreme? Is moderation a viable option in addiction treatment? We review here.

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Is total abstinence too extreme?

For decades now, the focus in drug addiction recovery has been the achievement of total abstinence. For those who have struggled due to addiction or alcoholism, one of their primary goals each and every day is to avoid drinking or getting high.

Although this approach has worked for thousands and thousands of people, some believe that total abstinence is too extreme. They say that viewing every drink or puff of marijuana as a “relapse” decreases a recovering addict’s confidence and sabotages their otherwise excellent efforts in recovery. Who’s right? Is moderation a viable option when it comes to overcoming an addiction?

Slippery Slope

Almost every substance abuse treatment expert will tell you that when addiction is the problem (not occasional substance abuse or even regular drug or alcohol abuse, but a full-blown addiction) then the ideal way to successfully overcome the chronic disorder is complete abstinence. Does this mean that it’s impossible for an addict to be able eventually, at some point in the years following treatment, to function in society despite the occasional drink or use of marijuana? No. But unfortunately, cases like controlled drinking program successes or healthy patterns of weed use are the exception and not the rule.


Mainly, cravings play a significant role in addiction. Even though the addict is no longer physically dependent upon the substance of choice, seeing the drug or hearing someone talk about using it is often enough to trigger a relapse and, ultimately, a return to addiction, especially in the first few years of recovery. And taking control of cravings to use alcohol or drugs can be very difficult.

Indulging that craving by attempting to have “just one” drink or a puff off a joint does not serve to ameliorate that craving. Rather, cravings grow stronger and now, under the influence, the rationalizations for having more become even more difficult to ignore. As addicts and alcoholics are all too aware, their disease progresses even when they are in recovery. That means no matter how long they’ve been clean, they still need to remain vigilant about “slipping”. Almost inevitably, that first drink back will lead to one more, which leads to a dozen, which leads to repeating the behavior the following day and the next-the slippery slope of drug use can quickly turn moderation back into an active addiction.

Addiction or Not?

The theory behind harm reduction techniques, like attempting to moderate one’s use of drugs or alcohol if they are not yet ready to enter treatment, is particularly seductive to addicts and alcoholics alike. After all, the reality is that few addicts who enter treatment are excited about the prospect. Many would prefer to limit the number of drinks they have in a session or otherwise attempt to control their drug or alcohol use, and most have tried to do so multiple times in hopes of avoiding having to give up their drug of choice and go to rehab, but without success. Drug rehab is almost always viewed as a last resort for addicts who have had to come face to face with the consequences of their inability to manage their drinking or drug use.

In fact, the inability to moderate one’s use of substances is one of the main signs of addiction and the need for treatment. If it is possible to suddenly stop all drug use and abuse and have just one drink at dinner every night and never any more than that, then treatment is unnecessary. Unfortunately, for addicts who have years of addictive use of substances in their past, having a “normal” relationship with drugs or alcohol is highly unlikely.

In addition, the potential benefits of being able to enjoy a drink every now and then are far outweighed by the risks of overdose, accident, and/or a return to active addiction. For every story of someone who once had a heroin addiction but now can drink occasionally on the weekends, there 25 other stories of people who were sober for years then attempted moderation and ultimately lost their life to overdose or an accident under the influence.

What Do You Think?

Is it possible to maintain moderation for the long-term in recovery after living with an addiction? Do you believe there’s a “cure” for alcoholism, and that once you’ve “graduated” from treatment it’s possible to return to a life of moderate drinking? Leave us a comment and share your thoughts.

About the author
Tim has an extensive background writing for television, film, radio, and other diverse forms of media including apps, blogs, and social media. His latest creation, for the Axis Recovery Community, is the character of SoberMan, a sober superhero whose mission is to spread the word via Facebook about the importance of recovery, one meme at a time.


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  1. Hello Andrew. I like the way you explain addiction, it is true that it’s a lifetime of trying not to go down the same road once you’ve been there. But, that also means that recovered addicts live a more conscientious life than most, since they are thought to assess every decision, make calculated choices, eliminate triggers…a lot of effort goes into sustaining that substance-free life!

  2. It’s an insidious road. I think once you’ve crossed the Rubicon, you’ve crossed the Rubicon and it’s impossible to go back. I also think this applies to all sorts of addicts, drugs, alcohol, sex, gambling, risk taking etc. There’s a body of research suggesting addiction prone people have abnormal brains.

    Most addicts want so much to believe they can moderate their use and conquer their addiction, but I think it’s like trying to override a deep physical desire programmed in their brains – like trying to override eating or sex drive. I’m sure any addict who says they can stop the abuse and use socially or acceptably would probably pass the strictest lie detector test out there. Because that’s how much they lust after their addiction – they will believe anything to get their hands on another bottle of scotch, bump of coke or shot of heroin. They are slaves to their addictions, much as if they were possessed by the devil in the exorcist. Moderation for an addict is a slippery slope leading to relapse after worsening relapse, and with every relapse they will reach a new low until there are no more chances to relapse.

  3. Tim,
    You propose a lot of good questions here. Being in recovery myself I often ponder these things as well. What I have found thus far is that addiction and recovery are not a “one size fits all” kind of thing. What applies to one may not apply to another. That is why you have to see what works best for you and your recovery. I personally was not an alcoholic, I was addicted to pills. So I know pills are never an option for me, but I can say I honestly can have one drink here and there. By here and there I mean one toast of champagne on New Years. But I have found what works best for me and that is what matters. I strongly encourage you to put yourself out there and find what works best for you as well. One thing that really helped me was entering a same sex half way house. It is the kind of addiction care and discipline that I need at this stage in recovery.
    Good luck everyone!

  4. I think that it is possible to maintain moderation after, for example, alcoholism. At the same time I say that, I should also mention that is is possible, but not for everybody. I, for example, used to be at the complete mercy of alcohol and blacking out 3-5 times a week. This was about ten years ago and today I am able to socially drink in moderation. However, my brother is a case that I honestly do not believe could use in moderation. He is an all or nothing type of person and it carried over into his alcoholism as well. I honestly think it just depends on the person and to a certain extent, the amount of insight that one has about their situation. He was more severe at his worst than I was, and maybe that has something to do with it too. I think that this moderation theory is very interesting, but definitely not for everyone. And I also believe if a person is trying it, it should be done under full doctor supervision.

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