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Article: Reducing drinking may be easier than abstinence initially

Traditionally alcoholism rehabilitation is expected to commence and end with abstinence.  Abstinence is often the goal for those who suffer alcoholism. But difficult to attain at the beginning, as the withdrawal symptoms can be so severe that people are unable to cope.  Rather than attempt full on abstinence from the get-go, some individuals choose to aim for reduced or controlled levels of drinking.  However, slowly reducing levels of intake should not be confused with controlled drinking. Research has indicated that controlled drinking is not as effective as abstinence in the long term, even if it appear easier in the beginning (Pendery, Maltzman & West, 1982).  In the majority of cases people tend to return to destructive drinking habits rather than adopt controlled drinking long term, although some ultimately decide that abstinence is the best option following treatment (Pendery, Maltzman & West, 1982). 

However, as mentioned above, abstinence can often be a difficult goal to attain straight away, and in some cases it may be useful for an individual to first attempt to cut down their drinking prior to entering a program.  But the issue is that people are rarely afforded the opportunity to enter an alcoholism rehabilitation program unless they have attained abstinence beforehand.  It is understandable why treatment centres adopt this policy as it makes it safer for staff and residents but in some cases it means that people who need help and support are excluded from a program, which could result in further damage. 

A recent housing project for homeless individuals has developed a new policy which appears to be working to good effect.  Rather than abstinence being a prerequisite for housing, the project allows individuals to drink in their apartments, and they report that during two years alcohol consumption by residents has dropped by 35% which is a significant improvement (Science Daily, 2012). 

It may be that the mere offer of support and non-judgment has given these individuals the opportunity to address their drinking, which they might never have had the opportunity to do if they had been constantly rejected from housing on the basis of their alcoholism.  Often unless an individual has already stopped their drinking, they will find it extremely difficult to find housing and support, and it appears that this could be a massive barrier to people seeking help and could ultimately be causing more damage to such individuals. 

Alcoholism is a multi-faceted problem and it is naturally going to take a variety of approaches in order to maximise effectiveness.  It is unjust to turn away people who seek help, merely because they are taking smaller steps than others, it is the fact that they are taking the steps at all that should count.

Pendery, ML., Maltzman, IM & West.  LJ.  (1982).  Controlled drinking by alcoholics? New findings and a reevaluation of a major affirmative study.  Science, 217, 169-175.  DOI:10.1126/science.7089552

Science Daily.  (2012).  Homeless Heavy Drinkers Imbibe Less When Housing Allows Alcohol, Study Finds.  Sourced: http://www.sciencedaily.com/releases/2012/01/120119163239.htm

DryOutNow.com provides highly practical help for people with alcohol problems, their friends and relatives. DryOutNow.com also provides free resources for healthcare professionals such as medical information and alcohol treatment guidelines.

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