Thirty-two states now have legally authorized SSPs, a number which has doubled since 2014 (Fernández-Viña et al., 2020). Regarding SUD treatment, there has been a significant increase in availability of medication for opioid use disorder, especially buprenorphine, over the past two decades (opioid agonist therapies including buprenorphine are often placed under the “umbrella” of harm reduction treatments; Alderks, 2013). Nonabstinence goals have become more widely accepted in SUD treatment in much of Europe, and evidence suggests that acceptance of controlled drinking has increased among U.S. treatment providers since the 1980s and https://ecosoberhouse.com/ 1990s (Rosenberg, Grant, & Davis, 2020). Importantly, there has also been increasing acceptance of non-abstinence outcomes as a metric for assessing treatment effectiveness in SUD research, even at the highest levels of scientific leadership (Volkow, 2020). Many advocates of harm reduction believe the SUD treatment field is at a turning point in acceptance of nonabstinence approaches. Indeed, a prominent harm reduction psychotherapist and researcher, Rothschild, argues that the harm reduction approach represents a “third wave of addiction treatment” which follows, and is replacing, the moral and disease models (Rothschild, 2015a).

How Many Drinks a Day Is Considered an Alcoholic?

According to this systematic review and NMA, in terms of improving PDA, our findings provided further clarification about the abstinence efficacy of MET and CT protocols, which was significantly better than the efficacy of TAU with relatively higher evidence quality. Among the active interventions for PDA with high or moderate certainty comparisons, the four psychotherapies (MET, CT, MT, and RT) showed better effects than ART, CBT, and TSF, while MET and CT showed better effects than MT and RT, which suggests MET and CT as prior considerations in abstinence improvement. Additionally, TAU+SP was more efficacious than TAU for changing DDD in the high-quality direct comparison, although they had no other connection in the evidence network. This study supplemented a network comparison of intervention compliance to assess the patient’s ability to adhere to a specific intervention, using the risk ratio (RR) as the ES. Separate meta-analyses by intervention type (psychotherapies alone or combined) or time point (short-, medium-, and long-term) were planned to assess the robustness of the results; sensitivity analyses were planned that excluded studies with high ROBs; however, these were not completed owing to sparsity of data.

1. Nonabstinence psychosocial treatment models

This mental clarity also enhances productivity at work or in pursuing personal hobbies because there’s no longer a hangover holding you back. It’s during this period that peer support becomes invaluable; it helps to know that others are experiencing similar struggles or have overcome them already. Dr. alcohol abstinence vs moderation Stanton Peele, recognized as one of the world’s leading addiction experts, developed the Life Process Program after decades of research, writing, and treatment about and for people with addictions. His work has been published in leading professional journals and popular publications around the globe.

The Effects of Drinking Goal on Treatment Outcome for Alcoholism

The current review highlights a notable gap in research empirically evaluating the effectiveness of nonabstinence approaches for DUD treatment. While multiple harm reduction-focused treatments for AUD have strong empirical support, there is very little research testing models of nonabstinence treatment for drug use. Despite compatibility with harm reduction in established SUD treatment models such as MI and RP, there is a dearth of evidence testing these as standalone treatments for helping patients achieve nonabstinence goals; this is especially true regarding DUD (vs. AUD).

Additionally, some groups target individuals with co-occurring psychiatric disorders (Little, Hodari, Lavender, & Berg, 2008). Important features common to these groups include low program barriers (e.g., drop-in groups, few rules) and inclusiveness of clients with difficult presentations (Little & Franskoviak, 2010). While there have been calls for abstinence-focused treatment settings to relax punitive policies around substance use during treatment (Marlatt et al., 2001; White et al., 2005), there may also be specific benefits provided by nonabstinence treatment in retaining individuals who continue to use (or return to use) during treatment. For example, offering nonabstinence treatment may provide a clearer path forward for those who are ambivalent about or unable to achieve abstinence, while such individuals would be more likely to drop out of abstinence-focused treatment.

Consider the health benefits

• As the IP had a successful outcome, six months after treatment, their possibilities for CD might be better than for persons with SUD in general.
• Our second goal was to examine differences in quality of life betweenabstainers and non-abstainers controlling for length of time in recovery.
• There is no “one size fits all” approach to changing your relationship with alcohol, and all pathways are unique.
• Indeed, a prominent harm reduction psychotherapist and researcher, Rothschild, argues that the harm reduction approach represents a “third wave of addiction treatment” which follows, and is replacing, the moral and disease models (Rothschild, 2015a).
• Patients differ on the continuum between not wanting to change their drinking at all to seeking complete and long-term abstinence from alcohol.
• Given low treatment engagement and high rates of health-related harms among individuals who use drugs, combined with evidence of nonabstinence goals among a substantial portion of treatment-seekers, testing nonabstinence treatment for drug use is a clear next step for the field.

What Are the 4 Types of Drinkers?

Drinks per Drinking Day

Current Study