Controlled Drinking Verses Abstinence
In the United States of America, the idea of controlled drinking has aroused a lot of controversy concerning its effectiveness as a strategy of treating alcohol dependence. The controversy surrounding the issue has spread to the other parts of the world and has so far divided the treatment of alcoholism into two parts: abstinence and non-abstinence (Day 64).the term controlled drinking (CD) can be described in two aspects, that is, qualitatively and quantitatively. The control could be on the number of bottles one take or alternatively on the sequence of drinking by the person.
Some scholars have proposed that the two aspects be considered when giving definition of CD. Alcohol dependence has increasingly been used in the recent past to assess the quality of life. This assessment method is in agreement with the definition of health according to the world health organization. The definition states that health refers to the well being of human kind and not merely on the absence of disease.
The controversy surrounding the controlled drinking is further heightened by the fact that there is no agreed consensus on the best criteria to use in the treating alcohol dependence. Some of the major stakeholders in this debate include the European medicine agency and the national institute on alcohol abuse and alcoholism (Aasved 143). The institute considered controlled drinking as the reduction in the days in which an individual is engaged in heavy drinking, while the agency considers CD as a goal for reducing harm caused by the alcohol.
Various studies carried out in the past have all contributed to increased debate between complete abstinence and controlled drinking. Proponents of controlled drinking argue that it is not practical to subject an alcohol addict to total abstinence and expect to succeed. They state that it treatment should involve gradual withdrawal through controlled drinking. According to Vaillant (1995), controlled drinking has helped many people resolve their dependence on alcohol (294)
Some scholars have tried to establish whether there are groups of people who would benefit more from CD than others. Married, young people and those who are confident of the outcome are more likely to benefit from CD (“Alcohol abstinence vs. moderation”).it has been argued that when people select CD on their own then it would have more effective outcome. Other scholars base their arguments on the idea of neural sensitization and argue that abstinence is the only treatment that would help in treating alcoholism.
Some quotas have argued that many alcoholics would not be able to have a complete abstinence and therefore controlled drinking would be a better idea (Vaillant 296). The proponent of abstinence have been quick to respond to this argument saying that controlled drinking would only be effective with the people who drink moderately and not with the heavy drinkers. They also argue that controlled drinking may stop alcoholics from seeking the much-needed help they require at that moment.
Even though studies show that controlled drinking has helped many people gain control of their life back, many of those who opted for controlled drinking have also found themselves back in alcohol addiction. Many drinkers may sustain the habit for a long period of time, but in the end the energy fades and the drinker slips back to addiction (“Alcohol abstinence vs. moderation”). This is even worse because the alcoholic who fails at controlled drinking will find it very difficult to regain abstinence (Aasved 145). The proponents of abstinence argue that alcoholism is an incurable disease, which means that it can only be treated by a abstaining completely from it.
Controlled drinking is therefore not considered an option. The view is upheld by rehabilitation programs such as the alcoholic anonymous, which regard abstinence as the idea promoted by the disease theory of addiction. The group argues that those who attend rehab programs have tried controlled drinking but have not succeeded, this evidence of failure on the part of controlled drinking is viewed by the abstinence proponents as an indication of past, present and future failure of controlled drinking .
In the US, the main goal of therapists who treat alcoholism and the official stand of the alcoholics anonymous are to ensure a complete abstinence. The term controlled drinking is therefore rejected by the American therapists. These therapists claim that accepting such goal in treatment of alcoholism is detrimental and only make the alcoholics to delay from going for the right solution to their problems (Anderson). However, other countries like the Britain and other commonwealth nations, the idea of controlled drinking is widely accepted and available to the alcoholics.
The proponents of controlled drinking also argue that CD would still be used as a motivator for the people who wish to change their drinking behavior. Many alcoholics find it hard to completely stop drinking, even thought the damage is evident in their life and marriages. Controlled drinking, mediated on by a qualified therapist is bound to propel the alcoholic towards a better life (Aasved 144). The efforts to reduce intake may fail and the person would realize that they are addicted to alcoholism and then make steps towards recovery from the problem.
The two approaches to treating alcoholism; abstinence and controlled drinking only raise debate and controversy when one is depicted to be better than the other is. It should be noted that controlled drinking (moderation) is more effective when used by people who have not reached dangerous drinking habits and only need to practice how to maintain their drinking limits. On the other hand, alcoholic anonymous (abstinence) is more effective for the people whose alcoholism level cannot be reduced or need to be stopped immediately.
It is obvious that the main aim of treating alcoholism is to help people improve their quality of life. It should help people improve on their functioning. Too much alcohol interferes with the normal functioning of human beings. It therefore makes sense to say that abstinence should not be the only option in the treatment of alcoholism (Pond, Wilkinson, and Simpson 460) Controlled drinking is good for the health of humans and the fact that it promotes behavior change makes it much better than its critics may think.
Abstinence on the other hand is also good since it has proven to be the most effective approach with many alcoholics (Anderson). Both approaches have very important roles to play in the treatment of alcoholism (Pond, Wilkinson, and Simpson 460). In cases of harm reduction, the individual is never interested in abstinence but a reduction in the alcohol intake. With the above factors in mind, it would proper to say that the therapists should always consider both approaches in treating alcoholism and only settle on one when they have considered all the factors.
Aasved, Mikal J. The Biology of Gambling. Springfield, Ill: Charles C. Thomas, 2003. Print
Alcohol abstinence vs. moderation. Harvard health publications.2014.Internet resource. Available at http://www.health.harvard.edu/family_health_guide/alcohol-abstinence-vs-moderation
Anderson, Kenneth. Moderate Drinking, Harm Reduction, and Abstinence Outcomes. HAMS Harm reduction.2012.internet resource. Available at http://www.hamsnetwork.org/outcomes.pdf
Day, Ed. Clinical Topics in Addiction. London: RCPsych, 2007. Print
Pond, R A, D A Wilkinson, and R I Simpson. “Abstinence or Controlled Drinking?” CMAJ: Canadian Medical Association Journal 150.4 (1994): 460–461. Print. Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1486285/pdf/cmaj00284-0014b.pdf
Vaillant, George E. The Natural History of Alcoholism Revisited. Cambridge, Mass: Harvard University Press, 1995. Print