Can You Moderate Your Drinking, or Do You Have to Stop Drinking Completely?

A common struggle for my clients with addictions, alcoholism in particular, is trying to figure out if they need to give up alcohol entirely or if they can moderate their drinking. For most, the option of being able to still drink in certain situations or within certain parameters is far less daunting than the idea of never drinking again. This makes sense given how much of our lives, both personally and professionally, involve or even revolve around drinking. Unlike those addicted to other substances, it’s virtually impossible to eliminate exposure to alcohol and the social situations alcohol is part of.

Part of the answer to whether or not someone can moderate depends on the severity of the drinking problem. For my clients with moderate to severe versions of alcoholism (now called Alcohol Use Disorder), moderation usually doesn’t work. Once addiction has reached this state, it’s extremely unlikely that anything other than total abstinence will work. If someone has attempted many times to moderate their drinking, it’s also unlikely that “this time” it’s going to be effective. I also rule out this approach for folks who find they lose control of their drinking even after one drink.

Who Can Moderation Work For?

So who can moderation work for? For people who aren’t physiologically dependent on alcohol (meaning they can go periods without drinking and not experience symptoms of withdrawal like tremors, nausea, and vomiting), moderation is sometimes possible. If someone has never tried in any way to moderate their drinking, it’s possible this could work and is worth a shot. I’m always willing to try the moderation approach with my clients provided the risks aren’t severe. Usually, the first step we work on is concretely defining what “moderate” looks like for them: how many drinks, how often, and in what circumstances.

A crucial piece in defining moderation is making sure our parameters don’t allow for enough alcohol that judgement is impaired. For example, stopping after two standard drinks is doable for most people as they aren’t impaired enough by two drinks that their decision making suffers. But setting a limit of 5 drinks, for example, is very likely to fail. After 5 drinks everyone makes poorer decisions and is likely to be unable to make rational decisions after this point. Erring on the side of lower limits on drinks is always the safest, most effective way to go.

An example of clearly defined moderation may look something like this:

·       No alcohol except on Saturdays and Sundays

·       No more than two standard drinks a day

·       No drinking when alone

Obviously, the parameters of moderation depend on the person and their circumstances and lifestyle. But once we make a clear and concrete moderation commitment, we then see if the client is able to stick with it. If they can and can maintain this, we live happily ever after. If they aren’t able to stay within the boundaries of moderation, we don’t see this as failure. It is simply clear data that tells us moderation won’t work, and the only option is abstinence.

How Do You Figure Out Which Approach to Take?

The first step in determining which approach, abstinence or moderation, will work for you is talking with a professional. If we work together, my initial step is to get a clear history of your relationship with alcohol and how it has impacted your life and relationships, what you’ve already tried, and what your goals are. Though I can never truly predict who this will work for and who it won’t, I have enough data points after 30 years of working with clients with addictions that I can at least tell you whether I think it’s worth trying.

For more information, visit my Alcohol Counseling page.

Feel free to contact me with any questions.