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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
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Addiction: Is Moderate Alcohol and Drug Use Possible?

Allan N. Schwartz, LCSW, Ph.D. Updated: May 8th 2006

There was an article in the Sunday edition of the New York Times this weekend (May 7th, 2006) noting that those who treat the addictions are opting for moderate use of drugs and alcohol instead of complete sobriety. The reasons give for this change in thinking is the simple fact that there is an extremely high rate of relapse as exemplified by Senator Ted Kennedy's son who crashed his car under the influence of both alcohol and opiate drugs.

In my opinion, this is a great mistake in thinking. The problem with aiming or allowing for moderate drug and alcohol use for those plagued by addiction is that these unfortunate people are not able to regulate the amounts used once they get started. It is not a case where one or two pills or drinks will satiate their desire. Instead, users crave ever larger amounts, particularly of opiate drugs. In fact, the euphoric feeling that is sought requires larger dosages because, as dependence increases as the pleasurable feelings decrease at the lower dosages.

Furthermore, I am unaware of any drug addiction counselors who advocate for modest use of these substances. Everyone I know continues to help and encourage their clients to work towards sobriety and within a twelve step context used by such groups as Alcoholics or Narcotics Anonymous.

What do you think about this critical issue? We encourage you to write about your opinions.

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at dransphd@aol.com for details.

Reader Comments
Discuss this issue below or in our forums.

some people cannot moderate. that's why they're in treatment. - - Sep 21st 2010

"one's too many and twenty aren't enough."

Abstinence is old school religious propaganda - - Mar 24th 2009

Totally quitting is stressful.  It means you can never trust yourself and is a tool fueling State programming. Hard drugs are the exception. If you are gen-x or younger, do not be brainwashed by these zealots. You have more power than you think and if you deal w// the underlying causes you can reclaim and enjoy your life. Look to the mediterranean and european countries like Spain.  Be happy and yourself.

Editor's Note: Frankly, I think this is bad advice - dangerous even.  Lots of people do not agree with AA and want to reject the twelve steps in theory and practice these days. It's become fashionable to do so around here anyway.  Just becuase you view twelve step programs with great suspicion, however, does not mean that it is intelligent to do the opposite of everything they suggest.  To the contrary, abstainance is a very useful goal for a person struggling with alcohol addiction to aspire to (provided that cold turkey is not used as a means of arriving there!).  There are habit chains that lead a person to drink more than is wise, and there is no better way to not find yourself at the bottom of those chains than to remove alcohol from your life.  It's not a good idea to say that controlled drinking is an impossible goal for former alcoholics - there is a lot of variation across people and some people (not all) may be able to do it safely after a period of time spent sober.  However, abstainance remains the only safe goal for actively substance abusing people to aspire to in the short and medium terms.  And if you don't want to participate in a "religious" group like AA in order to get yourself sober, it isn't necessary - there are secular alternatives to AA .  

Maybe not so cut and dry - - Jan 15th 2009

I have been addicted. I have hit bottom. I know that feeling of not being about to stop, even when a drink or two, a hit or two, is all I "planned" on.

Today however, I am different. I can have a drink or two, and be completely satisfied. I do not believe that addiction is simply this cut and dry at all. I have seen lots of other cases such as mine. When people were 100% text book addict, and recovered.

I am not a recovering addict. I am recovered. I kind of almost feel it's a conditioned responds. That after being taught, have it pounded into our mind that we have a condition in which we will never recover. This mean we can't enjoy a glass of champagne at our children's wedding. This means that we are never allowed to have wine with dinner, because if you do, you can't stop. So we simply listen, either way, we don't stop or we just don't start. Like i said, classical conditioning.

I am going to school right now, with my goal being to be an addiction counselor. But there is no way I can tell people you will never be better, because I know that you can be.

Don't get me wrong, i would say it's almost impossible to do it alone. I would say that people need treatment, time to heal, time to recover, you don't hit bottom over night, you don't get better over night, but to say it's life long, and not fixable is to extreme for me.

 

Trying to do "moderate" alcohol and drug use is playing with fire - Nena - Oct 29th 2006
I am a recovering alcoholic. I can drink only one drink at a time.... For only maybe two weeks. Then I will have TWO drinks and say "I'll stop there." Then a few weeks later it'll go to three and then I'll be drinking the entire bottle of wine and then going onto harder stuff. I choose not to play with fate and will continue to just abstain from alcohol. I am able to go to a bar and not drink and be the designated driver. However, if I am at all stressed out, I won't go to a bar because I know that I'd be tempted to drink. Actually the ONLY time I will go to a bar is if my favorite band is playing. Other than that bars annoy me because I get so irritated with people and the social anxiety makes me miserable.

First drink.. - - Aug 23rd 2006
I agree that it is the first drink that gets you drunk. I have always found it easier to not drink than to limit. This does not mean that I have always succeeded in not drinking but I have ALWAYS failed to stop once started. I have had exactly the same problem with cocaine, although I am now managing to abstain completely. A return to social drinking is not possible for me and I suspect for most people. Relapse rates just illustrate the difficulty of stopping completely but should not mean that it should not be the aim. RT

It's the first drink that gets you drunk - - Aug 9th 2006
I am a 27 year old recovering alcoholic. the first drink is what always got me drunk, b/c when i put alcohol into my body i cannot determine or control when i will stop. sometimes it was only one. others three, sometimes all i could get my hands on. it depends on how much my alcoholism had progressed determined how much i drank. i find it hard for nonalcoholic and nonaddicts to understand the mental obsession that comes before the drink or drug and then the physical alllergy that creates a craving for more, no matter how unmanageable it can be. Thank you

right to express opinion - Andy - Aug 6th 2006
A refusal to publish "hostile" comments could mean anything you want it to mean. Why is there such a fear of open debate on this issue. Surely it is perfectly reasonable for people to express strongly held opinions for or against conflicting approaches to addiction treatment.

one glass or two - - May 9th 2006
I think that anyone who has a drug or alcohol issue should really abstane from all because how much is to much when you really get into it? Is it the one glass of wine or is it two? or mabe three? where is that line. I think if someone's idea is off already then how can they really say the appropriate line and stick with it. There would always be a time that would come up where you'd think just one more and that would be continueing your addiction. Just my thought I have known people with addictions and the small amount always ends up a bigger amount again over and over like a cycle. So I think if a person is to be better then all should stop completly other wise its just to tempting.

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