Abstinence only model calling cutting back “failing”. A Harm Reduction Article.

[Joey]

I've cut down my drinking. So why do people think I tried to stop – and failed? | Adrian Chiles

Drinking doesn’t have to be all or nothing, yet our model for alcohol misuse assumes abstinence is the only answer, writes Guardian columnist Adrian Chiles

www.theguardian.com

Drinking doesn’t have to be all or nothing, yet our model for alcohol misuse assumes abstinence is the only answer

Achap with a dog stopped me on the street this week. He sidled up and said: “Rumour has it you’re off the sauce.” He was referring to a TV programme I made a couple of years ago, in which I talked about my need to reduce the vast amount of alcohol I was drinking; it was getting on for 100 units a week. My conclusion in the film was never that I needed to stop drinking; I just needed to try to cut down. Accordingly, I said to this fellow with the dog that, in fact, I hadn’t stopped drinking; I had just cut down a lot. He smiled a kindly smile and went on his way. I knew exactly what he was thinking: poor chap, he has obviously been unable to knock the drinking on the head and now he is deluding himself that he has it under control. Shame; he needs help.

I realised, once James Morris, a psychologist specialising in addiction, had explained the concept to me, that I am more of a believer in the “continuum” model. This has all drinkers on a spectrum: from those who hardly drink at all to those who hardly stop drinking. The more you drink, the more of a problem of some kind you are likely to have; there is no cutoff point. And, I would argue, abstinence is not necessarily your only option. Despite everything you have heard, with the right support most people can moderate. If you really can’t – and there are certainly those for whom that is true – then so be it, but it is worth a try.


It is hard in lots of ways. You will have to deal with those – invariably loved ones who were concerned about your drinking – thinking your attempts to cut down will be fruitless, and that you are deluding yourself. Then there will be your drinking buddies, annoyed and even hurt that you are not downing your usual quantities with them. You will be accused of being antisocial and, at this time of year, judged guilty of being “un-Christmassy” to boot. Most exasperating of all, if you do manage to cut right down in the long term, there will be people who will conclude that your success only indicates you didn’t have that much of a problem in the first place. I hate that.

 

[Joey]

This is a good article detailing someone journey as he has cut back significantly, and the many stigmas he runs into for doing so and not quitting completely according to AA ideology.

 

[SunriseChampion]

Interestingly, as a binge drinker I find drinking in moderation 1000x* harder than not drinking at all so I consider being able to do any drug in moderation far more of an accomplishment and virtue than abstinence.

In fact, abstinence is for people who can't control their impulses and is probably a sign of psychological failing.


*--Absolutely made-up ratio....probably close to the actual number.

In fact....the central European cultures I come from would see abstinence as a failure to control impulse as well. I wouldn't have the same reaction from people in my life. My mum used to worry about my binge drinking.....she'd worry almost as much if I stopped drinking altogether.

I think my whole family would....including the married-in ones.

I can see it now: "Wtf is wrong with him? Is he ok?"

They'd think I was suffering from some terminal illness or something.

 

[S.J.B.]

Great topic! Stanton Peele was always a big advocate of this attitude, you should look him up if you haven't heard of him.

 

[Jabberwocky]

I don’t think not being able to cut back and needing to be abstinent is necessarily a psychological failing as @SunriseChampion suggests and AA makes it’s core message.

Some substances are incredibly moreish to some people while those same people can take other substances without problem. That suggests the issue might be physiological rather than psychological - though likely some combination.

For example I can keep 100 valium in my medicine cabinet for months and months and use them strictly for emergency use only. I have a stockpile of about 800 dexamfetamine pills because I have no urge to take them except when I need to relieve ADHD symptoms and get work done. Yet whenever I get hold of a back of meth or, in the past, coke - i hoover the contents right up until I’m redlining and stay there until it’s all gone.

So I believe I need to be abstinent from some substances and not others. The problem though is that while I don’t have a problem abusing alcohol, for example, it does seem to often cause me to suddenly think some coke or meth would be a good idea.

Do occasional lowered inhibitions count as a psychological weakness?

 

[SunriseChampion]

Some substances are incredibly moreish to some people while those same people can take other substances without problem. That suggests the issue might be physiological rather than psychological - though likely some combination.

This is a fair point.

When I quit smoking, I did so cold turkey and completely for about 8 months. Have since started smoking again when I drink with absolute zero compunction to do so when I'm not drinking. Can't say moderation was harder to attain than abstinence in this case, personally, as just one example.

... i hoover the contents right up until I’m redlining and stay there until it’s all gone.

This made me lol. Keep it real.

So I believe I need to be abstinent from some substances and not others. The problem though is that while I don’t have a problem abusing alcohol, for example, it does seem to often cause me to suddenly think some coke or meth would be a good idea.

Yeah, same....well, not so much with the meth but coke sure does seem like a good idea when offered to me after ten pints. Or maybe not so much a good idea as a benign addition to the evening.

Do occasional lowered inhibitions count as a psychological weakness?

I don't know. Maybe?

They probably do with me, considering my inhibitory malfunctions are probably completely caused by alcohol-induced brain restructuring.


I think I may have used terminology that was a bit broad and blunt and applied it a bit too generally.

Personally, for me, I find it much harder to do some things (not just drugs, by the by) in moderation than not at all.

That being said, as it pertains to alcohol, I fully stand by what I said: abstinence is for those who can't control their impulses.


Actually, you know what.....wouldn't an ocassional psychological failing still be, well, a psychological failing?


I think the moderation v abstinence idea is quite drug dependendent.

 

[Jabberwocky]

I guess what I get a bit agitated about is any suggestion that substance abuse is a moral weakness. I know that is not what @SunriseChampion said at all, however the term ‘weakness’ when applied to drug use always seems to be judgemental and to suggest the person using the drugs is somehow inferior (in willpower, psychological adjustment, or morality) than non drug users.

While all those things may well be true in the case of some individual users (I myself am quite morally bankrupt) I think it puts the phenomenon of drug use and dependency in to small a box to offer anything verify useful to recovery and also tends to stigmatise users and give non-users a valid reason to look down on them.

 

[SunriseChampion]

I provided my alcohol use as an example of a drug-related psychological weakness, so as a judgment call on myself. I stand by that.

To be clear....I don't hate myself or my alcohol use. It's just not bad enough.

I used the term psychological weakness only in the context of drug use and don't see anything wrong with it.

I agree with the optics of such terminology when discussing drug use with certain non-users though. I think in the context of a forum frequented by drug users where various levels of use and abuse are readily admitted to, making a distinction between being able to moderate and not is fine.
I wouldn't personally use the same term when discussing the issue with non-drug users because I know how judgmental and intellectually stunted those conversations can be from personal experience.

I didn't mean to pass judgment on anyone which is why I used myself as an example of the very psychological weakness I was talking about.

 

[Deru]

When I originally started on my journey into sobriety after some extremely dark times, NA/CA/HA was so essential to me. The community support and building support systems I never had, probably, at least initially, saved my life. I've been torn about the complete abstinence portion of it, but at this point, for me, I have come to accept it has to be that way.

I guess what I get a bit agitated about is any suggestion that substance abuse is a moral weakness

What else could substance abuse be considered, if we're using the normal definition of moral weakness? Or are you suggesting the moral principles regarding substance (ab)use, themselves, are problematic?