There’s been a lot of talk lately in the world of recovery about the techniques of moderation management, as well as other “alternative” treatment methods that aim to educate alcoholics and addicts on how to safely drink and/or use again. The practitioners of these methods clearly seem aware of how thin the ice is on which they are skating. They claim (with remarkably little reassurance) to teach their approach of controlled drinking only to people they deem “problem drinkers”. They concede that those who meet full-blown alcohol dependence criteria are probably better off with abstinence-based treatment. But what if their “alcohol dependence criteria” leads to a misdiagnosis? Even in just ten percent of those being tested? Isn’t it possible they’ll wind up trying to teach a “real alcoholic” how to drink again?
With such cases in mind, we think it’s important that the advocates of Moderation Management ask themselves a further question: are their methods really worth the risk? The evidence to the contrary is overwhelming and all too convincing. When controlled drinking fails, the end result is often jail, insanity, or death, or perhaps simply the dull desperate ache of an unfulfilled life. And that doesn’t even include the countless number of devastated loved ones whose own lives wind up just as damaged as the alcoholics’ themselves.
We don’t try and teach diabetics how to eat sugar or, more relevantly, gambling addicts who’ve burned through their entire savings how to happily visit Las Vegas, do we? Of course not. We accept they have a problem, and get to work trying to help them learn to live healthy, fulfilling lives without the substances, or behaviors, that have caused them such damage. Apparently, though, the very idea of suggesting abstinence from drugs and/or alcohol, even for just one day at a time, must seem too extreme for moderation managers, or at least a fate to be avoided if at all possible. As if a happy, healthy, and fulfilling life weren’t attainable without being able to have a drink or two occasionally.
The Big Book of Alcoholics Anonymous, written almost 80 years ago, contains an oft-quoted passage: “If anyone who is showing inability to control their drinking can do the right-about-face and drink like a gentleman, our hats are off to him.” Although drinking like a gentleman may be an antiquated concept, learning to control our drinking obviously still holds a strong appeal. But for those real alcoholics out there, trying to do so remains as great a risk as ever.