Yes or No
Prevalent theories regarding moderation and substance abuse are usually divided into two camps: yes, it’s possible, or no, it’s not. There are many mitigating factors.
Each individual’s unique characteristics, environment, and genetic makeup contribute to the possibility of substance abuse and addiction. While the National Institutes of Health report that “genes and environmental stressors on gene expression represent 40–to–60 percent of an individual’s addiction risk,” the majority of experts agree that addictive behavior is still affirmed by a combination of influences.
Most addiction scientists conclude that addiction is a brain disease, and continued research only strengthens the evidence. Addiction is defined as “a disorder that results in functional changes to brain circuits involved in reward, stress, and self-control.” Medical professionals at the National Institute on Drug Abuse, the Institute of Medicine, the American Psychiatric Association, and the American Medical Association are in accordance with this diagnosis.
A vast majority of researchers believe that moderate alcohol or drug use isn’t the best the decision for long-term wellness and sobriety. Addiction myths often include the point “if only you had enough willpower, you’d quit!” If willpower is all it took to break the cycle of substance abuse, there’d be fewer people suffering from it.
Yet again: each individual is unique. So, when the debate of yes vs. no comes up, there simply isn’t a clear valuation on which to speculate. For example:
- If someone isn’t dependent on alcohol, but binge drinks frequently, is she or he an alcoholic?
- If a person uses alcohol to excess, but develops a high tolerance for it, is he or she actually addicted?
- If someone again consumes drugs or alcohol after attaining sobriety in an inpatient rehabilitation facility, are they using in moderation or have they suffered a relapse?
- If a person doesn’t effectively manage a co-occurring disorder, such as a mental health issue, will it influence their ability to regulate moderate substance use?
- If someone still needs to develop strong coping mechanisms to address triggers such as loneliness, abuse, past trauma, negative influences, and other stressors, is moderate consumption a wise choice over abstinence?
These and many other subjective questions reinforce the concept that a future of abstinence is usually the most effective approach for an individual with compulsive behavioral issues that often lead to addiction. However, there are a couple of exceptions.
Controlled Drinking as a Means to Abstinence
As addiction science continues to evolve, new philosophies emerge. Within the past decade, the concept of controlled drinking emerged as a graduated path to eventual abstinence. This was—and in some circles, continues to be—a controversial method.
The University of Oxford released data from a Japanese study proposing that controlled drinking (CD) during and after treatment accomplishes a few key aspects:
- If someone is initially resistant to chemical-free treatment, incorporating CD can be a means to begin treatment. If such a treatment is found to be difficult, the therapeutic goal can be changed to abstinence.
- The researchers discovered success with “interventions for reducing alcohol consumption” for heavy drinkers.
- Using CD as part of initial treatment enabled therapists to track the success rate of behavioral self-control training.
There are also organizations utilizing other research to promote CD. They include:
These organizations aren’t necessarily saying moderation is better than abstinence. In many instances, the point of the information they provide is for people who have yet to develop compulsory use to stop, analyze their behavior, and consider reducing consumption.
Using One Substance to Treat Another
Once again, this is often a hotly-contested topic. But according to the National Institute on Drug Abuse, this common practice helps a number of people “establish normal brain functioning and decrease cravings.” Certain drugs also help block the effects of the substance or reduce its impact on the body.
Currently, medications are often used to treat the following addictions:
- Alcohol: naltrexone, Acamprosate, or disulfiram
- Opioids, including prescription pain relievers and heroin: methadone, buprenorphine, and naloxone
- Tobacco/nicotine: bupropion, varenicline, and over-the-counter remedies
Treatment drugs for cocaine and marijuana addictions are in development.
Typically, an addiction therapist prescribes treatment drugs not only to make physical withdrawal easier and reduce the likelihood of relapse, but also enable someone to be more open to behavioral therapy. Over time, the goal is to eliminate the treatment drug completely.
Using one type of drug to help someone’s addiction to another isn’t without risks. One of the most commonly known side effects is when a person develops a methadone addiction if it’s used to treat a heroin problem. This is why most specialists require a full treatment suite of options to enable an individual make efficient and lasting changes for a life without substances.
Willingway’s Approach to Treatment
Willingway’s philosophy of care is rooted in clinical research and extensive experience. Our addiction specialists believe substance abuse is a primary illness that affects the entire family system.
We also understand that addiction and alcoholism are diseases of the whole person, impacting the mind, body, emotions, and soul. To effectively treat someone, our practice is to strive for a chemically-free baseline, then provide an assessment and diagnosis. Each individualized treatment plan originates from this thoughtful and methodical approach to ensure a lifetime of wellness.
