wpainterw

P.S. When I put up this thread I was afraid it might cause a melt down discussion of alternative recovery methods. I guess that, if you're an alcoholic and have achieved sobriety (by one method or another!) you don't tend to melt down as much. Then again, there are some folks who may not be alcoholics and melt down anyway, particularly if they're politicians. And politics has always been mixed with whiskey since the Union began. Do you recall the "Board of Education" in a Capitol hideaway just after the passing of the Roosevelt years? I think that Harry Truman was there "educating" or "being educated" when they told him the news of F.D.R.'s death. Why am I going on this way? Maybe because I have so many memories, good and bad. I've lost a ton of weight. Should I have a milkshake today (In New England that's a frappe or a float)?I guess up here a "milkshake" is what you get out of a cow that's been jogging...

W.

FreeOwl

I'm sure it can happen.

Studies probably verify this because it can happen for some people.

But, not sure whether it can happen for everyone.

Pretty sure not.



(PS, the smileys were picked by my daughter who was reading this just now...)

Soberpotamus

Hehe

Soberpotamus

SoberCAH

Life and sobriety are kind of funny.

When I was drinking, I was always stumbling over 20 question tests to determine whether I was an alcoholic (I usually scored ~17 yes answers and ~3 no answers (i.e. lies)).

But now that I have been sober, I never run across these sobriety surveys that I hear or read about from time to time.

FreeOwl

here's what I keep going back to with these things;

Maybe I COULD be a 'moderate drinker' with just the right program, the right attention to all of the elements of life in balance, the right mix of physical, emotional, spiritual and mental health.

Maybe, if I have a really good adjusted program of living that overrides the program I learned over the years since my early teen years living with alcohol - maybe THEN I could successfully be a 'moderate drinker'....

BUT WHY???

I've gone over 6 months now and increasingly I see the good outweighing the bad. Apart from occasional pangs of "gee, maybe a beer would be nice right now" or a slight tug of something like jealousy at others' participation in a cocktail - I really don't miss alcohol. And what's more, I'm living healthier and more focused on the really important things in my life without it.

What is the real benefit I think I'd get from being able to 'moderately' dull my senses?

When I honestly look at that question and the realistic answer - I personally begin to see that even 'moderate' drinkers are pouring a toxin down their throats as a means to attain an altered state. Even if it's only a 'slightly' altered state - it is an altered state. It's more calories, it's a dulling of the senses, it's a falsehood. I'm grateful that I actually don't really WANT that.

ChiefBromden

Where normally I like to keep an open mind and look at the science - even when that science goes against my confirmation bias - the problem with alcoholism and moderation is that being on the fence can be lethal.

Sure, people who partied heavily as students often "grow out of it" when they get jobs, families... But while technically they were binge drinkers, I doubt we would class them all as alcoholics.

Many here state that it wouldn't work for them, and I join their ranks. Moderation is not an option for me. For people new to recovery, articles like this might send them in the wrong direction, especially with percentages like 75. No, that can not be accurate. I do not buy it.

Could it work for a certain type of binge drinker? Would it cause less harm than continually failing at abstinence? I think Dr. David Nutt is thinking in that direction, but I could be wrong.

Hmmm. Maybe we should spend more effort in making it clear that being both sober and happy is absolutely possible. It surely beats failing in moderation.

Soberpotamus

This is a good description of what I appeared to be in college. I was a binge drinker, and at first glance appeared to be drinking just like lots of other college binge drinkers who did eventually "grow out of it." But I kept on drinking. I knew I needed to mature out though, and I tried a couple of times... age 25, 27, 30. Just couldn't make it stick until a few years later.

So I think it's scary that there seems to be no outward differentiation between binge drinkers who grow out of it, and those who go on to become alcoholics.

There are even those who'd tell me I'm not a true alcoholic because I continued to binge drink and was never a daily drinker. But binge drinkers who wake up in ER, get a DUI, and set their hair on fire during blackouts, in my opinion, are alcoholics.

I tried Moderation Management for a year. I was counting my drinks with the rest of them. It was pitiful. Calling it a failed experiment would be an understatement.

Serenidad

The only way for me is 100% abstinence! I don't even need to read all the debates & posts here. I have my opinions about AA after many years of attending (and almost 6 years of sobriety) and don't go there anymore. For the people who go to AA and like it...great! I will never totally burn that bridge.

I DO believe that many people recover on there own if they WANT to. Several people in my family quit on their own years ago and are happy productive members of society.

BOTTOM LINE: for ME, if I want to drink more than I want to stay sober I will drink. No program, book, class, doctor, therapist, on-line forum etc. can fix that. There is no magic pill. If you really WANT to stop you can stop. My 2 cents. Not worth much. Ha

Sent from my iPhone using SoberRecovery

jdooner

Yes it was knee jerk - guilty as charged. I don't believe in moderation for an addict, it has nothing to do with 12 step vs. a rational or cognitive treatment approach.

TalenCrowhaven

For me, the defiinition of an alcoholic = One who cannot moderate their drinking in the long term, ever.

If you're not an alcoholic (regardless of being a moderate or heavy drinker at one time), you can moderate.

So, if you can moderate (shouldn't I be using the word "control" here instead?), you are not an alcoholic.

imo

wpainterw

This has quite a lot of appeal from the standpoint of simplicity and logic. However, if you're not sure whether you're one or the other, how do you find out which you are? The only way I know personally is to try moderation and if you fail at that then you're probably an alcoholic. But why did it take me 40 years to "try moderation" and fail again and again? It's been called "denial" and I have been told it's linked up with that beastly thing called the Addictive Voice, along with psychological and neurological changes in the body over time.

W.

Serper2014

I drank moderately for years and years and years..... then my circumstances in life changed and I became a heavy drinker, and then an alcoholic (over the course of about 10 months.) I stayed an alcoholic for 588 nights in a row. That was enough to change my brain. There is no going back to drinking in moderation for me. I'll never be able to drink in moderation again, which is fine with me because drinking in moderation sucks anyway.

Jimboagust

One of the most comprehensive works on this subject is "Recovery from Alcohol DSM-IV Alcohol Dependence: United States 2001-2002" (Dawson, et al; Alcohol Research and Health [29:2]; 2006; pp. 131-142). The authors do a good job of analyzing the data available from the NESARC study (mentioned in the NYT article) which showed around a 75% recovery rate for alcohol dependence. The issue at stake really revolves around the definition of "dependence":

Only 25.0 percent of all U.S. adults with PPY alcohol dependence were still dependent in the past year (Table 2). Another 27.3 percent were in partial remission—10.5 percent who met the criteria for alcohol abuse and 16.8 percent who reported a subclinical array of dependence symptoms. Nearly half of all people with PPY dependence met the criteria for full remission from alcohol dependence in the past year. This figure includes asymptomatic risk drinkers (11.8 percent), low-risk drinkers (17.7 percent), and abstainers (18.2 percent). Combining low-risk drinkers (NR) and abstainers (AR), more than one-third (35.9 percent) had a past-year status indicative of full recovery. Most of those classified as fully recovered reported an interval of 5 years or more since remission of dependence, resulting in an estimated stable recovery rate of 29.6 percent. (p. 135).

As you can see, the main issue is the diagnostic definitions for alcohol dependence and abuse. A sizable amount of those who no longer fit the criteria for alcohol dependence were nonetheless engaged in drinking which is abusive or potentially damaging to one's health.

These data from a nationally representative sample of U.S. adults revealed substantial levels of recovery from DSM–IV alcohol dependence. Confirming previous studies that have reported similar findings, they provide evidence that alcohol dependence— at least when defined in terms of the DSM–IV criteria—may not preclude a return to low-risk drinking for some individuals. Typically, these might consist of people with less severe disorders who mature out of their drinking problems without treatment (Cunningham et al. 2000). The variation in past-year status over time suggests that a typical course of recovery might consist of continued drinking, accompanied by symptoms of alcohol use disorders, that would persist for 5–10 years before resolving into asymptomatic risk drinking and, ultimately, into either low-risk drinking or abstinence. (p. 137).

The progression from alcohol dependence to moderation is obviously a long and difficult path for many. It is understandable that many alcoholics find it preferable to simply abstain completely. Furthermore, this data cannot adequately take into account the numbers of people who fail at moderation:

However, such an extrapolation of the data would be risky for several reasons. First, it does not account for selective survival. Chronic alcoholics may be more likely to die than those who recover (Dawson 2000), inflating estimates of recovery in the later intervals since onset of dependence as the deceased become increasingly underrepresented in the denominators of the recovery rates. Nor does such an extrapolation reflect the periodic relapses or shifts between AR and NR that have been observed in longitudinal studies (Skog & Duckert 1993; Vaillant 1995). (pp. 138-139).

This data obviously suggests that a great many people do "mature out" of alcohol dependence, though that can be a long and difficult process. Those who advocate for abstinence-based recovery are right in pointing out that there are numerous problems with the data, including an inability to account for those who fail at recovery by paying the price with their lives.

My own two cents: The greatest advantage to this research is that it is obviously pointing towards an understanding of alcohol abuse and dependence seen as a spectrum of disorders rather than a monolithic definition. Everyone's addiction is different. That being said, it seems clear that for a great many people abstinence remains the safest option.

I hope that helps.

wpainterw

Jimbaugust: Thanks. Very interesting. However I'm still interested in how the study was made. Were the respondents interviewed personally? Or did they merely respond to a written survey form request? Or a telephone interview? Surveys which are considered "Statistically Valid" have weaknesses in possibly failing to discount lying or self serving responses resulting from denial.

W.

Jimboagust

This analysis is based on data from the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), in which data were collected in personal interviews conducted with one randomly selected adult in each sample household.

You're absolute right. It doesn't specify how the "personal interview" took place, perhaps over the phone.

Even if we allow for the possibility that everyone on the surveys answered truthfully the recovery rate's are obviously much lower than the purported 75% (about 30% in full, stable recovery). Notice also that abstemious subjects compose the highest percentage of those in recovery. That being said, there is obviously a sizable percentage of people who are able to return to moderate drinking. The chances of this happening seem primarily determined by a) the level and duration of dependence on the substance, and b) whether or not the subject received any treatment for the dependence. The latter does indicate that there is some truth in the worry that those who go into traditional abstinence-only programs (e.g. AA) have a much harder time returning to any semblance of normal drinking and that they may relapse harder than those who attempt moderation by themselves. Why this is the case is difficult to assess. Perhaps it is because only those with a certain severity of alcohol dependence ever seek help from abstinence-only programs such as AA.

wpainterw

Jimboagust: Your analysis is very perceptive. I concur.

W.