Abstinence vs. Moderation: Can Moderation Work

Can moderation work?

This question has been the subject of much debate over the past several years. Let’s derive an answer by taking a closer look at two key words: recovery and addict.

· The Substance Abuse and Mental Health Services Administration (SAMHSA) defines recovery from alcohol and drug problems as “a process of change through which an individual achieves abstinence and improved health, wellness, and quality of life.”

· Most medical professionals agree that a person’s inability to control the intake of alcohol or drugs, or in other words the inability to moderate, is what defines them as an addict.

Almost every substance abuse treatment expert will tell you that when addiction is the problem (not occasional substance abuse or even regular drug or alcohol abuse) that the most effective way to overcome it is abstinence. In fact, several studies have found that most failed remission attempts are based on moderation and that abstinence proves more successful (Burman, 1997; Maisto, Clifford, Longabaugh, & Beattie, 2002).

The life and death of Audrey Kishline sheds much light on the moderation vs. abstinence debate. Kishline founded Moderation Management, a self-help group that says problem drinkers don’t have to give up alcohol. As Dateline NBC explains, it turns out she was kidding herself --- with deadly circumstances.

Audrey created Moderation Management for people she believed were just like her: problem drinkers who simply needed to reduce their drinking. There were ground rules. After an initial month long period of abstinence, women were allowed up to 9 drinks a week and men could have 14. Members were asked to go 3 or 4 days a week without any alcohol. And there was a zero tolerance policy about drinking and driving.

However, the founder of Moderation Management was failing at her own program --- drinking upwards of 30 drinks/week. She hid her secret binge drinking for 5 years. But in January of 2000 she decided to come clean and posted an online message to MM members: “I have made the decision recently to change my recovery goal to one of abstinence rather than moderation.”

Two months later driving in an alcoholic blackout she struck a car head-on, killing a 12-year old girl and her father. Kishline, who built a career and a support group based on the notion that she could control her drinking, had a blood alcohol level more than three times the legal limit.

Sentenced to four and a half years in prison, Kishline was released a year early. She had gone 3 1/2 years in prison without drinking and was forbidden to drink for two more years as she was on parole. But one night she couldn’t resist the temptation to drink and walked into a liquor store. A worried friend she called that evening contacted her parole officer. Audrey was sent back to jail. Her sentence was just 42 days but her life with her family was ruined.

Dateline correspondent Dennis Murphy asked Kishline, “Do you still believe a person can be a moderate controlled drinker?

Kishline: As long as they’re not truly an alcoholic.

Murphy: But what’s that line?

Kishline: Nobody knows where it is.

On December 19, 2014 Kishline died in her mother’s home. Though it has not been confirmed by her family, two respected professionals in the addiction field have stated publicly that her death was a suicide.

Our deepest sympathies go out to Kishline’s family, the victims’ family and all who were impacted by this tragedy. The entire addiction community grieves when one of our own is unable to beat this disease.

Our hope is that this story is explains more fully why, for the true addict, there is no moderation. There is only abstinence. And that’s the philosophy at Kiva Recovery. Through our holistic treatment approach, we’re committing to helping addicts achieve long-term abstinence and improved health, wellness, and quality of life.

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David Bohl is Executive Director of Kiva Recovery, the trusted resource in addiction treatment. Focusing on the individual and the strengths within each of us, Kiva’s treatment approach aims to replace addiction with solution-focused, growth-oriented strategies focusing on Lifelong Recovery through Holistic Health, Positive Character Building through Continuous Character Growth, and Life Satisfaction through Contentment. The Kiva Recovery treatment center is located in Vernon Hills. To learn more, please visit www.KivaRecovery.com.