Can Alcoholics Recover and Drink in Moderation?

For decades the research, both formal studies and informal observations, has shown that some alcoholics could return to moderate or controlled drinking, and that many do. However, Alcoholics Anonymous and other powerful recovery programs have defined an alcoholic as a person who can never again drink in moderation. This has placed them in the curious position of maintaining that someone who returns to moderate drinking wasn't an alcoholic - not matter how obvious the evidence to the contrary.

While their traditional conceptions and definitions have caused the AA/12 Step organizations to reject the mounting evidence, they haven't been alone. The treatment "industry" also has a vested interest in keeping definitions and solutions narrowly defined and simple. There is, in their lexicon, only one "disease" and one "cure." Since 95% of providers are wedded to the 12 Step model, and have nothing else to offer, suggestions that other outcomes are possible are very unwelcome. In the United States even those programs describing themselves as "alternatives to the AA/12-Step models" generally adhere to abstinence-only outcome criteria.

But individuals and providers alike would be better served by the different picture painted by an analysis of data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Based on a sample of 43,000 U.S. adults, the study found that more than one-third (35.9 percent) of those with alcohol dependence (alcoholism) that began more than one year ago were in full recovery a year later (according to the National Institute on Alcohol Abuse and Alcoholism).

The fully recovered individuals include roughly equal proportions of abstainers (18.2 percent) and low-risk drinkers (17.7 percent), while one-quarter (25.0 percent) of individuals with alcohol dependence are still dependent and 27.3 percent are in partial remission (that is, exhibit some symptoms of alcohol dependence or alcohol abuse). About twelve percent (11.8%) are drinkers with no symptoms but whose borderline problematic consumption increases their chances of relapse (for men, more than 14 drinks per week or more than four drinks on any day; for women, more than 7 drinks per week or more than three drinks on any day).

One of the many problems with the "disease" model of alcoholism is its adherence to the supposed progressive nature of the condition. Again, political correctness to the contrary, just as everyone knows someone with an alcohol problem, we all know someone whose alcohol abuse stopped for no apparent reason. This isn't unusual and occurs with "alcoholics" more often than any real disease - often enough to be the rule rather than the exception. Alcoholism may occasionally be progressive, but it’s far more apt to be regressive.

What's a person suffering from alcohol related problems to do? What are spouses or families or employers to do? Certainly people lose patience waiting for someone to sober up and it would be good to be able to jump start some progress. The real news is that there are many different ways to achieve different solutions and if you are looking for outside help, for yourself or someone else, look for help that offers a variety of possible outcomes.

Just as you don't want to be stuck with a stigmatizing label, don't sign up for a "lifelong disease" you may not have, onerous treatment that you don't need, or definitions that diminish you and your life. Getting the right assistance will help you sort through current problems more quickly, deal with them more effectively, and correct them more efficiently than you are apt to manage on your own. If you can find it, that's help worth having, but be careful not to sacrifice too much of yourself in the process.