Originally Posted by
Jimboagust 
Thanks for the responses. In answer to your question, Dee74, I've been struggling with drinking for about three years, it was getting progressively worse, leading to myriad health problems (psychological and physical). I tried moderating quite a few times but it didn't take, for whatever reason(s). I finally made a commitment to sobriety a little over five months ago, so I'm obviously relatively new to this. The benefits of not drinking have been immense, as they assuredly are for everyone who is drinking at such self-destructive levels. I still struggle a great deal with the ambiguities and confusion regarding this decision, though. I'm extremely skeptical about the disease theory of addiction, and do honestly believe that many people can go from destructive abuse of substances to consuming them moderately. On the other hand, there's obviously a lot of people who cannot do so (for reasons no one, including scientists, seems to quite understand). The question for me, and a lot of addicts, is whether or not its worth the risk to really explore which group we actually fall into. I'm 99% certain I could have a glass of whiskey tonight and that would be it, but I'm not sure what the case would be a week (or a month, or a year) from now.
I found this thread interesting since it was pushing against some of the standard presumptions about addictive behavior. I found your replies very interesting and helpful. Thanks again.
Statistically, I think you will find some people can go from alcohol abuse to moderation, but statistics are like that. You can cherry pick data to find whatever answer you are looking for given enough raw data. I also don't see a lot of value in the AA definition of alcoholism or the word in general, because as you have mentioned, it is circular. Denying some people can moderate by excluding them as being possible addicts is silly.
There is a lot of alcoholism related material that isn't 100% abstinence only on this site:
HAMS: Harm Reduction for Alcohol
I guess the way I look at it though, moderation for one person might be functional alcoholism for others. If the goal is simply harm reduction (eg. not drinking and driving, going to work in the morning), you might be a reasonably productive member of society but still hurting yourself and your own future. Are you looking to better your life, or simply get by as a functioning member of society?
An important question for me is what do I get out of alcohol and is it worth it? Is my quality of life better sober or drinking? Can I honestly justify drinking at all and risk harm based on my past behaviors?
Even the moderation adherents who insist that 100% abstinence isn't the only way will admit that for some, it is the only safe choice, and for someone who succeeds being 100% sober, it is the best choice to stay sober. The risk of relapse to abuse or worsening dependance is too great once you've already been a substance abuser. Depending on the level of abuse, success rates and outcomes of moderation vary, and "success" can be kind of like just making the grade curve for passing an exam. You're not excelling, but you aren't failing either (and presumably not dead).
These two documents linked of the HAMS site have some eye opening data:
Moderate Drinking, Harm Reduction, and Abstinence Outcomes PDF Aug 1, 2012
Choosing a Goal: Safer Drinking, Reduced Drinking, Or Quitting Altogether PDF March 7, 2012
I guess, on the one hand, you can read the stats in the "outcomes" study and say "Yeah! some people were able to moderate!". Truthfully though, most people couldn't, 5 people died, and who is to say that moderation is an ideal better than abstinence? Even the group of subjects with the lowest measure of alcohol dependance only had a somewhere less than 25% success rate at moderation. The rest of the subjects with higher dependance quickly approached a 0% success rate at moderation. I don't see those as particularly good odds.