Addiction, as defined by the National Institute on Drug Abuse, is a “chronic, relapsing disorder characterised by compulsive drug seeking and use despite adverse consequences.” It further explains that addiction leads to functional changes in the brain circuits related to reward, stress, and self-control, which may persist even long after the person has stopped using the substance.

Addiction is undeniably a complex condition, and overcoming it often requires professional help and structured treatment. Most effective, evidence-based programmes for addiction recovery advocate for abstinence – which means complete cessation of drug or alcohol use. But what about moderation? Can it work in the context of recovery?

Find out what you need to know about abstinence vs. moderation in this article.

What Is Abstinence in Addiction Recovery?

Abstinence is the act of completely avoiding something, whether it’s alcohol, drugs, or any other addictive behaviour. In the context of addiction recovery, abstinence means entirely cutting out the addictive substance or behaviour and refraining from it entirely. In some cases, this even includes avoiding all drugs and alcohol, as substituting one addiction with another can be a real danger.

Abstinence is a central pillar of many recovery programmes, such as inpatient rehab and peer-support groups like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), both of which follow the 12-step model. The reasoning behind this approach is clear: many people who struggle with addiction find that even just one instance of use can trigger a relapse and lead them back down a destructive path.

You’ve probably heard the expression, “One drink is too many, and a thousand is never enough.” This encapsulates the idea that for those battling addiction, even one lapse can reignite compulsive behaviour, undoing progress in recovery.

What Is Moderation in Addiction Recovery?

Moderation, on the other hand, involves reducing the amount of the addictive substance or behaviour rather than cutting it out entirely.

For some people (particularly those whose addiction has not yet reached a severe level), this approach might seem more manageable. For example, someone who notices their drinking is becoming problematic may try to reduce their consumption before it has the chance to spiral out of control.

However, moderation is generally unsuitable for those with full-blown addictions, especially to dangerous substances like cocaine, opioids, heroin, or amphetamines. These substances have such powerful effects on the brain that moderation is not a realistic option. In some cases, however, replacement therapies – such as switching from heroin to methadone under medical supervision – can be an effective harm-reduction strategy.

Why Abstinence Is Often the Better Path

There are several reasons why abstinence is usually the safest and most effective route for addiction recovery:

  1. There is never a safe level of use: For many addictive substances, particularly alcohol, no amount is truly “safe.” The World Health Organisation (WHO) has stated that there is no safe level of alcohol consumption for health. Completely cutting out the substance removes the risk of harm from the start.
  2. Avoiding the slippery slope: Even small amounts of a substance can lead to cravings or the loss of control over usage. For those in recovery, this can be incredibly risky. The best way to prevent a return to addictive patterns is to avoid the substance altogether.
  3. Health improvements: Abstaining from harmful substances often brings about immediate and long-term health benefits, ranging from improved liver function to better mental clarity. For many, this can be a compelling reason to choose abstinence.

That said, one of the challenges of abstinence is that some people see a single relapse as a complete failure, which can be discouraging. It’s important to recognise that while avoiding relapse is crucial, a slip-up should be viewed as a setback, not the end of the road. Recovery is a journey, and occasional hurdles can be overcome.

When Abstinence Is Difficult: Food and Behavioural Addictions

While abstinence is often the best approach to substance addiction, it can be more challenging in cases of behavioural addictions, such as food addiction. Unlike drugs or alcohol, we cannot simply abstain from food altogether. People with food addictions may struggle with compulsive eating, which makes moderation necessary yet particularly difficult. Managing such addictions often requires a tailored approach that focuses on finding healthy boundaries and addressing the underlying emotional or psychological triggers.

Similarly, other behavioural addictions like sex or shopping may require careful management rather than total abstinence. However, the goal should always be to eliminate the harmful, compulsive aspects of the behaviour.

The Limits of Moderation in Addiction Recovery

There are supporters of moderation, especially when it comes to alcohol. Broadcaster Adrian Chiles, for example, has written about his experience with moderating his drinking. However, even he admits that for some, particularly those with severe alcohol dependencies, abstinence is the only viable option.

Moderation Management (MM), a self-help organisation, promotes moderation as an alternative to the abstinence model followed by AA. While it may work for problem drinkers who are not fully dependent, the evidence for its effectiveness is limited. Many experts argue that the moderation approach can actually prolong denial in people with serious addictions, delaying the point at which they seek the help they truly need.

Abstinence Vs. Moderation: Which Approach Is Best for You?

Choosing between abstinence vs. moderation depends on the nature and severity of the addiction. For those with milder issues or who have not yet developed a physical dependency, moderation might be an achievable goal with proper guidance. However, for anyone who has reached the stage of seeking addiction recovery, abstinence is typically the safest and most effective option.

This is particularly true for drugs like heroin, methamphetamines, and even alcohol when used at dangerous levels. Once someone is physically dependent on a substance, abstinence is the most reliable way to avoid the health risks and behavioural patterns that come with addiction.

Support and Therapy: Essential in Any Approach

Whether choosing abstinence or moderation, it is vital to seek the right support and therapeutic interventions. Inpatient rehab provides a controlled environment for those choosing abstinence, helping them through detox and addressing the psychological aspects of addiction. Outpatient services and group therapy can also provide critical ongoing support.

Techniques like cognitive behavioural therapy (CBT) can help individuals identify and change the thought patterns that lead to substance use or addictive behaviours. Support groups, counselling, and aftercare are essential in assisting people to stay on track, no matter which recovery path they choose.

So, although moderation may seem appealing, especially in less severe cases, abstinence is often the safer and more effective option – particularly for those who have struggled deeply with addiction.

Struggling in Recovery? Get in Touch

We hope you’ve found our article on abstinence vs. moderation insightful. If you’re finding it hard to stay on the path to recovery, you’re not alone – and help is available. At Ocean Recovery, we understand the complexities of addiction and the challenges of overcoming it, whether you’re pursuing abstinence or exploring other recovery approaches. Our dedicated team provides expert, personalised support to guide you through every stage of your journey, from detox to long-term aftercare.

With a range of therapeutic services, inpatient care, and tailored recovery programmes, we are committed to helping you regain control of your life. Don’t wait—reach out to Ocean Recovery today and take the next step towards lasting freedom from addiction. Your recovery starts with a single call.

John Gillen - Director at Ocean Recovery

John Gillen - Author - Last updated: October 14, 2024

John is one UK’s leading professionals in the addiction recovery industry. Pioneering new treatment techniques such as NAD+ and ongoing research into new therapy techniques such as systematic laser therapy, John is committed to providing the very best treatment for people throughout the UK and Europe. During his extremely busy schedule, John likes to regularly update our blog section with the latest news and trends in the industry to keep visitors to our site as well informed as possible on everything related to addiction treatment.