Addiction recovery is not a one size fits all approach. This is a significant fact, not just among addicts, but among industry professionals who are often torn by personal theories and methodologies.
One of the more controversial conversations that arise is the debate between moderation and total abstinence in recovery. The heart of that debate boils down to a question regarding self-discipline. While some field professionals believe that moderation is possible with the right determination, others strongly point to total abstinence as the only option for lifelong success.
Moderation — harm reduction
Moderation, also known as harm reduction, is the practice of gradually reducing use over time. This method is most often adopted by recovering alcoholics who self-manage their intake in lieu of quitting cold turkey. It is not, however, a viable option for recovering drug addicts, wherein the risk of an overdose after one episode is reasonably high.
While this method might seem like a realistic approach, it is fundamentally flawed. First, the practice of moderation relies on the addict’s judgment and self-control. Without the proper and often extensive therapy, there is no reason to believe that a recovering addict will be able to suddenly monitor their addictive behaviors.
Secondly, the data collected in support of harm reduction is based on self-reporting. This is problematic because the sources of this information, the addicts themselves, can lie about their behavior.
Total abstinence in recovery means completely avoiding the offending substance. Abstinence is considered to be the most traditional form of recovery and was originally adopted from the Minnesota Model to fit the 12-step program for Alcoholics Anonymous. It demands a great deal of self-discipline — a skill that many addicts have to learn in treatment. However, with hard work and dedication, it is the most effective in achieving and maintaining sobriety.
Abstinence — what to expect
Let’s talk about the period of recovery known as Post-Acute Withdrawal Syndrome (PAWS). This phase, which can last several weeks or months, is a notably difficult hurdle to overcome. Abstinence is a big goal. It demands a lot on the part of the recovering addict, and it quite literally describes a life devoid of substance use.
PAWS challenges that goal with difficult symptoms like urges, anxiety, and sleep deprivation. The temptation to use is still present, but very much like a phantom. This can be excruciating for recovering addicts who want to reach sobriety. However, PAWS, though characterized by phantom symptoms, is the body’s natural way of re-establishing equilibrium. Total abstinence is a necessary component of that process.
Roots and habits of addiction
Some recovering addicts choose to abandon moderation and abstinence altogether. Instead, they eliminate their substance of choice in favor of a new one. It is a coping method with catastrophic potential. Addictive behavior has a root. And that root can grow very deep, depending on the circumstances, genetic predisposition, and severity of the addiction.
Even when an addict has given up their substance, they have not, without proper treatment, eradicated the root of the problem. Thus, picking up a new substance is merely picking up a new habit with incredible potential for addiction.
Moreover, substance use of any kind hinders the brain’s ability to recover from a previous addiction. A brain that has been altered by chronic drug use needs time to heal, and that means total abstinence.
Why is it important to practice abstinence?
Why is abstinence important? It’s simple — it’s the safest and surest way to avoid relapse. Recovering from an addiction is an incredible feat. It takes determination and grit. And that journey, though different for each individual, is decidedly easier when unnecessary hurdles are removed.
Total abstinence means eliminating temptation from the path, whether that is the substance itself or the people who encourage the problem. Once those temptations have been removed, abstinence becomes a positive habit and sobriety eventually becomes second nature.