Does Moderation Management Work In Alcohol Treatment?

Marthann Masterson-Weaber started drinking when she was 14 years old and kept on drinking even after alcohol killed both of her parents. "My mother was 37, and my father died just a few years later. He was 41," says Marthann Masterson-Weaber, a recovering alcoholic.

In her 40's, Masterson-Weaber was divorced, raising a teenage son, running a catering business and drinking day and night. "I had hit my bottom basically, and I had faced the fact that I was in fact an alcoholic."

Marthann tried to slow down her drinking on her own. Her plan was to stay off alcohol for 30 days, then allow herself an occasional drink. But out with a colleague after a tough day at work, she fell off the wagon hard. "So I said, well, I’ll have one too, thinking that you know, I could control it for 30 days, surely I could just have one. But that’s not the way it happened."

Now a growing number of treatment programs are using moderation to help people who abuse alcohol if they're not yet addicted. "Those are people who are drinking excessively but are not actually dependant on alcohol," says John Morgenstern at Mount Sinai Medical Center in New York. "And at least some of those people, we know from research, can control their drinking by cutting back."

Moderation Management is a nine-step program that promotes abstinence for the first 30 days. It limits the number of drinks allowed, nine per week for women, and 14 for men.

But last March, Audrey Kishline, the program's founder, got behind the wheel of her pickup and plowed head-on into a car, killing a man and his 12-year-old daughter. Her blood alcohol level was more than three times the legal limit.

Despite the tragedy, Marc Kern of Moderation Management defends the program. He says Kishline's guilty plea to charges of vehicular homicide has highlighted the need to better tailor treatment to individuals..

"The professional community, the medical community is coming to realize that as we turn to the 21st century, we need a much more comprehensive spectrum of interventions for people with alcohol problems," says Marc Kern of Moderation Management.

Kishline's conviction created a backlash. The head of the renowned Smithers Addiction Treatment and Research Center was forced to resign last month after he publicly endorsed moderation.

Dr. Nicholas Pace has been treating alcoholics for more than 25 years. He believes moderation is dangerous because the line between alcohol abuse and alcohol dependence is fuzzy at best:

"I don't believe in moderation management," says Dr. Nicholas Pace, co-founder of New York Council on Alcoholism. "I think if somebody has a problem with alcohol they shouldn't drink. If alcohol is interfering with your job, if it's interfering with your interpersonal relations, if it's interfering with your health you shouldn't drink."

Ten years ago today after failing at moderation, Marthann Masterson-Weaber checked into a treatment center tat promotes abstinence. She still meets with a support group every day. Now at the age of 53, Marthann has remarried, and is writing a book. She is working to repair some of the damage her drinking did to her relationship with her son who now has a son himself:

"I can't help but thinking that he lost something," says Marthann. "So today I really try to be there. I try to be the best grandmother I can be."

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