One Drink, One Drunk

Can ex-alcoholics eventually drink in moderation without succumbing to their old addiction? One survey of more than 3,000 people reveals that only 29 percent of Americans think they can. This perception dovetails with the Alcoholics Anonymous (AA) slogan, “One drink, one drunk.” AA’s familiar 12-step program encourages members to admit that they are powerless over alcohol. Treatment programs premised on the 12 steps boast recovery rates as high as 85 percent. But here’s the rub: as many as two thirds of drinkers drop out within three months of joining AA, and AA helps only about a fifth of people abstain completely from alcohol. Claims that some people with a history of alcoholism can safely engage in “controlled drinking” have generated a firestorm of controversy. Yet a 2001– 2002 National Institute on Alcohol Abuse and Alcoholism survey of more than 40,000 adults revealed that 18 percent of one-time alcoholics could drink in moderation without abusing alcohol, challenging the popular assumption that abstinence is a necessary goal for all alcoholics.

Further, researchers have found that behavioral self-control training programs, in which moderate drinking is the goal, are at least as effective as those that use the 12-step method. In these restraint-centered programs, therapists train people to monitor their drinking, set limits for their alcohol consumption, control their rate of drinking and reward their progress. These programs also teach coping skills that help participants “wait out” the urge to drink and to avoid situations that tempt them to drink. Such tactics do not work for everyone. Studies suggest that if individuals are severely dependent on alcohol, have a long history of unhealthy drinking, and experience physical and psychological problems from drinking, they are probably best off seeking treatment programs that advocate abstinence. Nevertheless controlled drinking is probably a feasible goal for some ex-alcoholics. Indeed, problem drinkers may seek help earlier if they know that complete abstinence from alcohol is not the only alternative. Indeed, controlled drinking may be especially worth considering for patients for whom abstinence-oriented programs have repeatedly failed to work.

Source of Information : Scientific American Mind March-April 2010