Recovering alcoholics see regular folks enjoying a glass of wine with dinner, a few times per week, and think, "Maybe one day I could do that." But, says a new study out of the University of Gothenburg, that probably won’t happen. For alcoholics, its easier to give up booze entirely than to try to manage it.
The study looks at the approaches of care providers in Sweden. Specifically, it studies the difference between two approaches. One is that people with alcohol dependence can learn to control their drinking. The other says that they should quit entirely, because any amount of drinking will set them back onto the wrong path. Previous studies have shown that the most important factor in quitting is that the care provider and the recovering alcoholic both share the same view on how to quit and that the actual method itself is less important.
The new study sets out to determine how much of an effect the method has. Can drinking be managed? Or is it better to just abstain? Here’s the spoiler, from study author Kristina Berglund: "Our study shows that, regardless of agreement on goals and methods, in the end it is more difficult to stick to controlled drinking than to give it up entirely."
The study followed 201 patients, split between the two goals—abstinence, and low-risk drinking—for two and a half years. In cases of alcohol use disorders, relapse is common, with rates of up to 70% of patients drinking again in the first 12 months.
But while "low-risk drinking is a viable option for at least some problem drinkers and alcohol-dependent individuals," the short follow-up period of most studies doesn’t capture the full picture.
What the Gothenburg researchers found is that the main factor in success is whether the subject chooses abstinence or controlled drinking. It makes little or no difference whether or not the care provider and the recovering alcoholic agree on the method. However, one limit of the study is that the patients self-selected their own treatment program. That is, most of those with abstinence as a goal chose the program that promoted abstinence, and vice versa. Despite this, the numbers were surprising, with 88% of abstinence-oriented patients reporting continued success 2.5 years after the trial began, vs. just 54% of patients with the goal of low-risk drinking.
So, it seems that the common 12-step approach is still a good one, in terms of its goals at least. For an alcoholic, quitting entirely is a lot easier than trying to manage your drinking. Which, given that most alcoholics have problems stopping after just one drink, is probably not much of a surprise.
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