When NOT To Take Another One

Alcohol abuse patients may require varied levels of abstinence after successful treatment

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Some people who abuse alcohol may avoid treatment because they fear they’ll never be able to drink again, even occasionally. Not all counselors agree that every case requires total abstinence.

A recent study surveyed professional substance use disorder counselors about some patients returning to moderate drinking after treatment.

The study’s findings showed the majority of counselors did not agree that total abstinence was necessary for every patient.

"Talk to a therapist about alcohol and drugs."

Co-authors, Alan Davis, MA, and Harold Rosenberg, PhD, from the Department of Psychology at Bowling Green State University in Ohio, led the investigations. For the study, 913 members of the National Association of Alcoholism and Drug Addiction Counselors participated in an on-line survey.

The surveys were designed to assess each counselor’s attitude concerning treatment plans for substance abuse and substance dependent patients. The average counselor had 17 years of experience treating substance use disorders, with 89-91 percent of their patients having been diagnosed with drug and/or alcohol abuse or dependence disorders.

Alcohol abuse is where a person's drinking gets out of hand, but it is not as severe as alcohol dependence, where a person's drinking is more compulsive and harder to control throughout their lifetime.

A total of 76 percent of the counselors oriented their therapy around 12-step program principles. The survey results for the counselor’s responses were as follows:

  • Alcohol abuse patients drinking as an intermediate goal was rated as completely acceptable by 20 percent, somewhat acceptable by 38 percent and completely unacceptable by 29 percent.
  • Alcohol dependent patients drinking as an intermediate goal was rated as completely acceptable by 10 percent, somewhat acceptable by 18 percent and completely unacceptable by 57 percent.
  • Alcohol abuse patients drinking as a final goal was rated as completely acceptable by 15 percent, somewhat acceptable by 36 percent and unacceptable by 36 percent.
  • Alcohol dependent patients drinking as a final goal was rated as completely acceptable by 7 percent, somewhat acceptable by 9 percent and unacceptable by 74 percent.

Counselors said the patient’s age, emotional state and type of substance they abused influenced whether or not they should ever drink or do drugs again.

Authors said, “Individuals with alcohol and drug problems who avoid treatment because they are ambivalent about abstinence should know that—depending on the severity of their condition, the finality of their outcome goal, and their drug of choice—their interest in moderating their consumption will be acceptable to many addiction professionals working in outpatient and independent practice settings.”

Dr. Rosenberg noted the limitations of their study such as actual patient outcomes from non-abstinence goals and relapse rates.

Authors recommended an open dialogue and full disclosure between patients and counselors regarding treatment and outcome goals.  This study was published in October in Psychology of Addictive Behaviors. No financial information was provided and no conflicts of interest were listed.

Reviewed by: 
Review Date: 
November 18, 2012
Last Updated:
November 26, 2012