The Question of Moderation: Is It Okay for Your Loved One to Drink Small Amounts of Alcohol?
An Allies in Recovery member hears her loved one expressing a desire to reintroduce small amounts of alcohol into his life. He’s been through program after program for the past year or so, and he’s been back home for just a few months. It’s hard not to panic when he talks about wanting to try moderation… Read the full blog post for our CRAFT-informed answers.
“My loved one completed a 30-day stay in residential treatment in mid-January for alcohol use disorder. This past year has been full of ups and downs, with him being in and out of treatment. He has been doing fairly well being home since January as far as drinking is concerned. He had one slip that I am aware of since returning home. Over the last week he has been talking about how he would like to try and reintroduce alcohol into his life in a very limited amount. This of course has set every alarm in my brain off. I am very concerned this is the start of a relapse back into full on alcohol use. I would love some advice on the best way to handle this situation using the CRAFT method.”
Using CRAFT to shepherd your loved one into recovery
CRAFT is based on social learning theory. The family uses CRAFT to shepherd a loved one into a position of recovery. The family helps to maintain the change by rewarding non-use and stepping back when they see use. They allow natural consequences, and they remove themselves from the equation as best they can.
If your loved one ends up needing to drink again to prove to himself that the problems of alcoholism are real and beyond his ability to control, this is part of his path. You may not have a choice in the matter.
Getting sober is easier than staying sober. Staying sober usually involves a daily focus on staying sober. You continue to use CRAFT around your loved one to help prevent a relapse, but ultimately, it’s going to be his choice.
Your use of CRAFT – such as rewarding your loved one for non-use and helping to create an environment where he’s not using (like introducing and encouraging other activities that don’t involve alcohol), will be key as he works through his decision to try moderation or not. A moderation plan will also be key – read on below for more on making a plan.
Efforts to moderate use often fail – but they can be learned from
We argue in our CRAFT e-Learning Module #1 that efforts to moderate often fail, but that these failures can help teach abstinence from substance use; it is the social feedback described in social learning theory. Please revisit our CRAFT e-Learning Module #1, and see the set-up I describe below – options for when you take action, and planning together beforehand. These perspectives may help you see the potential merits of going along with a call to moderate.
Moderation – the practice of learning to consciously limit the amount one consumes of alcohol or drugs – just may work for those with less severe addiction problems, some research suggests. Check out this book by Miller and Muñoz for a closer look at both the research on moderation, and suggestions for how to plan around it.
The line between severe and less severe problem use depends on several things, including the amount your loved one ingests, the reasons for their use, the context in which they use, and their biology.
For everyone who crosses that line into more severe use and for whom abstinence from alcohol is likely the answer, moderating at some earlier point was probably part of the picture.
Agreeing to go along with your husband’s attempt at moderation may be okay for now, because even if it doesn’t work, he will learn that he really can’t continue drinking or drug use as easily as he thought; and, he may even have the thought that this drinking or drug problem is bigger than he realized. These are good thoughts for your loved one to have on his own! Trying moderation can lead to these thoughts. But…
Years of alcohol use? Moderation is not likely to succeed
Given his many years of alcohol use, there is not a strong likelihood that he will be successful. This means you step away a little and let this play out. This won’t be easy for you. You will need to watch for signs of danger and be willing to step in various ways. Perhaps a call to the police if he is drinking and driving, calling police to the home if he is drunk, unresponsive, and/or potentially a danger to himself or others.
You’d be intervening like the above, if/when he steps over the line. Remember, as we outline in our CRAFT e-Learning Module #1, his efforts at moderation may be an essential part of his learning process. This ultimately could bring him to a clearer realization about his need for total abstinence.
Make a moderation plan together, and consider medication assisted treatment
If your loved one wants to moderate, then he should be willing to put in place a proper moderation plan that includes a recovery coach and a therapist who is on board and knows what they are doing. This by necessity must be a tight plan, for the chances are good that your loved one will overdo things and put himself in jeopardy again. He would also need to agree to a plan for if/when he does overdo it: detoxification, more residential or intensive level of services, and other measures as he and his coach/ therapist see fit.
If he is going to try to moderate, I would also suggest he get on Naltrexone (Vivitrol is the monthly shot). Naltrexone is a medication assisted treatment that discourages drinking as it blocks the euphoria of alcohol. You drink less because the alcohol isn’t giving you the same good feelings, and your brain’s endorphin system learns to become less interested in alcohol. Here’s the site for The Sinclair Method, which outlines this approach and claims a very high success rate. For our Alliesinrecovery.net members, we have discussed the Sinclair method in a handful of other posts as well.
Once all of this is in place, then your loved one could be in a stronger position to try moderation. Can you work this out, in partnership with him? What I am suggesting is somewhat unorthodox in mainstream treatment right now, but it agrees with what people in recovery have known forever: if you think you can go back out there safely, go ahead and do some more experimenting. No one can stop you. At least there is a safety net in place and you’re not going into it “blind.”
Take the time to process this and care for yourself, too
You have been navigating so much with your loved one’s use over the years. You undoubtedly still have so much to unravel, process, and heal within yourself. Your concerns about trust, the alarms going off in your head, and all that you are carrying right now is 100% legitimate. It is also a cue to redouble your efforts to dedicate real time to caring for yourself.
Seek out and lean on the supports that help you process, accept, and own whatever you are feeling. Accepting full responsibility for our own feelings, so that we don’t end up asking (directly or indirectly) our loved ones to be responsible for them is a key part of practicing CRAFT.
You have done an incredible job weathering the storms with your husband’s use and you should give yourself credit for all that you have accomplished, held together, and learned. In the past year especially, you have experienced so many ups and downs, but you have also both come a long way. It is very heartening that your husband completed the residential treatment successfully. This is huge, and we are glad to hear of his willingness to look at his use in different ways over the past year.
A relapse won’t erase what you have learned so far
A relapse does not erase the lessons you have learned along the way. You become savvier and better equipped to take swift action as needed. You become better aware of your own reactions, tendencies, strengths, and weaknesses. Meanwhile, relapses can also be opportunities for a loved one to come to a greater understanding about their relationship with the substances involved, and to ultimately arrive at a decision about their need to embrace abstinence. This can all be vital and valuable information, for everyone involved.
Whether or not moderation will work for your husband, this is for him to discover. Considering the approach I’ve outlined above should help you see how to adopt a strong yet flexible stance during his experiment with moderation. It is key to put those protective measures in place, and to be as open as you can in discussing the “plans” with your husband. Use the many resources on the Allies site, along with whatever else is available to you right now to support and fortify yourself.
Thank you for reaching out. You are not alone. We are all here for you.
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