Can Some Problem Drinkers Keep Drinking?

A New Movement Says Moderation Is the Key For Some People Rather Abstinence

(CBS)  For decades, the conventional wisdom has dictated that problem drinkers must quit drinking altogether in order to be successful.

But what if you don't want to stop?

In Alcoholics Anonymous and other 12-step programs, abstinence from alcohol is key. But another movement says quitting isn't absolutely necessary. It is through this alternative that former problem drinker "Katie" found a workable solution.

"It ate me up. I really didn't like who I was. I really didn't like this — this person I was turning into, and I was terrified I was gonna turn out like my father," Katie told The Saturday Early Show co-anchor Tracy Smith.

Katie, a young wife and mother, was terrified because drinking took her father's life and she worried that her two or three glasses of wine a night might turn into something that could eventually take hers.

"Is this my destiny?" She said. "When — when am I going to become, you know, this fall-down alcoholic that my father was? When is all this going to happen to me? And it was a very scary time. And I really — I hated myself."

Katie, who agreed to speak with The Early Show if her last name and where she lived wasn't revealed, tried Alcoholics Anonymous, which meant abstinence.

"Total abstinence. That's right," Katie said. "And admission that you were powerless over alcohol. And that you could never drink again and if you keep slipping it's because you haven't hit your bottom. It absolutely worked for me for a long period of time. Well, I started questioning and obsessing over whether or not I was truly an alcoholic."

Katie wondered if she could drink socially again. She found others who felt the same way on the Internet and then contacted Drink Wise, whose basic philosophy is that some problem drinkers can moderate their drinking habits and do not have to completely abstain. Through Drink Wise, Katie found Moderation Management or MM. MM began in the late '90s to help people who don't want to quit drinking altogether.

Though primarily an online support group, MM has meetings in certain cities, such as New York. A woman named Anna ran the meeting that Smith observed, but almost everyone else preferred their identities remain hidden.

Like Katie, the people at this meeting don't see themselves as alcoholics, but they do recognize they have a problem.

"I try to plan my drinking," a group member named Carl said, "and that's been working well for me."

Anna said MM works because not everyone has to stop drinking all together.

"Because most of us don't have that degree of problem, and we don't want to give up having champagne at weddings or a glass of wine with dinner," she said.

Moderation Management has specific steps to help problem drinkers get in control, including a 30-day period of abstinence. You also plan in advance how many drinks you'll have each week, and then count each and every cocktail and the maximum per day and per week should never be exceeded.

"If you're unable to modify your use, if you're not able to stick to your limits, that might mean you're more dependent than you think, and abstinence may well be the best way to go," Dr. Mark Willenbring said.

Dr. Willenbring says studies show that only 5 percent to 10 percent of people who are truly addicted to alcohol can successfully moderate their drinking. That means more than 90 percent fail, including one very public failure. Audrey Kishline, the woman who founded Moderation Management in 1994 was sentenced to prison six years later for killing two people in a drunken driving accident.

"For some people who become addicted, there are changes in the brain that are permanent," Dr. Willenbring said. "And they can never go back to being a moderate drinker."

But Dr. Willenbring recommends that everyone should keep track of their drinking, and if a problem develops, seek help.

"The important thing is for people to engage in treatment of some kind, so I would encourage people to be persistent, look on the web, ask around," he said. "There are other options out there absolutely."

Today, using the principals of Moderation Management, Katie has successfully limited her drinking to a couple glasses of wine, a few nights a week.

"Last time I had a glass of wine was about five days ago," Katie said.

She said she only feels temptation to pour herself a second and third glass of wine when she has had two drinking days in a row. When the urge comes up, she said she abstains and doesn't worry that she will become an alcoholic like her father.

"Alcohol is a very small part of my life," she said. "It's something that I can truly take or leave."

[sabre_truth]

I appreciate seeing a story which brings attention to the fact that AA is not the only solution for people with drinking problems. However, one omission of which I am aware could bias audiences view on Moderation Management. MM's founder, Audrey Kishline, was reported to have left MM and joined AA with the attempt to abstain before she resumed heavy drinking leading up to her killing two people in a drunk driving accident. The message of having to "hit bottom" many hear in AA is a dangerous and often deadly one. Also omitted was the fact that there are a number of alternatives to AA which are abstinence-based. For example, SMART Recovery practices a highly structured program based on sound psychological principles related to cognitive-behavioral therapy. And LifeRing Secular Recovery supports a less structured, individualized approach along with online and in-person support. I myself attended AA for a couple months until its irrational religiously based methods became more a source of stress than of help. I wish more people realized just how dogmatic and self-abnegating AA can be, and that are other programs that don't tell you to "stop your stinking thinking", but instead emphasize the central importance of rational thought in a program of recovery and mental health in general.

[sabre_truth]

I appreciate seeing a story which brings attention to the fact that AA is not the only solution for people with drinking problems. However, one omission of which I am aware could bias audiences view on Moderation Management. MM's founder, Audrey Kishline, was reported to have left MM and joined AA with the attempt to abstain before she resumed heavy drinking leading up to her killing two people in a drunk driving accident. The message of having to "hit bottom" many hear in AA is a dangerous and often deadly one. Also omitted was the fact that there are a number of alternatives to AA which are abstinence-based. For example, SMART Recovery practices a highly structured program based on sound psychological principles related to cognitive-behavioral therapy. And LifeRing Secular Recovery supports a less structured, individualized approach along with online and in-person support. I myself attended AA for a couple months until its irrational religiously based methods became more a source of stress than of help. I wish more people realized just how dogmatic and self-abnegating AA can be, and that are other programs that don't tell you to "stop your stinking thinking", but instead emphasize the central importance of rational thought in a program of recovery and mental health in general.

[Syndicate]

NO. After the first drink your decisson making skills go Bye bye. Aw $*** were outta beer. Whos going to the store? As they say One is to many and a thousand is never enough.

[brewster56]

If you have to count the amount you drink...guess what...you have a problem....Audrey Kishline is a perfect example of how moderation doesn't work...I thought CBS was a bit more responsible in their reporting. I guess I was wrong....If you have a drinking problem..seek help...but moderation is certainly not the answer...I know that first hand.
Shame on you

[brewster56]

Watching your report and reading some of the comments, I realize how alcoholics spend so much time rationalizing their behavior instead of working on themselves. Audrey Kishline is a great example of moderate drinking behavior. AA is not a "religious group", it's a support group. Unfortunately, the disease of alcoholism is one of self, and most people look for the justification and not the solution. I personally thought your piece was irresponsible reporting and showed a tainted view. If you have to count the drinks you have, or plan out how many you are going to have, you have a problem.

[brewster56]

Watching your report and reading some of the comments, I realize how alcoholics spend so much time rationalizing their behavior instead of working on themselves. Audrey Kishline is a great example of moderate drinking behavior. AA is not a "religious group", it's a support group. Unfortunately, the disease of alcoholism is one of self, and most people look for the justification and not the solution. I personally thought your piece was irresponsible reporting and showed a tainted view. If you have to count the drinks you have, or plan out how many you are going to have, you have a problem.

[donna115]

I thought the story was very informative. Not every person with a drinking problem is an alcoholic. Moderation does work. It can be difficult at times so having a place to talk like MM is wonderful. Knowing that you are not alone and that other people are struggling with the same issues helps. If you find that you cannot moderate, then abstaining is always something that you can turn to. MM helps with that as well. I think it's great having choices.

[brewster56]

Watching your report and reading some of the comments, I realize how alcoholics spend so much time rationalizing their behavior instead of working on themselves. Audrey Kishline is a great example of moderate drinking behavior. AA is not a "religious group", it's a support group. Unfortunately, the disease of alcoholism is one of self, and most people look for the justification and not the solution. I personally thought your piece was irresponsible reporting and showed a tainted view. If you have to count the drinks you have, or plan out how many you are going to have, you have a problem.

[shingles1]

If you have to even worry about it, you have a problem. People without a problem don't spend their time worrying about their drinking and/or trying to control, moderate or limit it.

[seiserling]

This report shows just how irresponsible "journalism" has become. As any recovering alcoholic will testify to, the vast majority of newly sober, and in some cases not so newly sober, alcoholics & drug addicts are always looking for a softer easier way of getting out of the 1st step of Alcoholics Anonymous, which is to admit our powerlessness over alcohol and/or drugs.

To publish a story that, I am sure, will provide these individuals with "proof" that their drinking can be moderated through MM and other "easier softer ways" instead of devoting themselves to a program that has been proven to work for over 72 years, which current boast an active Worldwide membership of over 2 million people.

I am a recovering Alcoholic with 23 years of continuous sobriety, and we have a very simple saying, "It works if you work it." Do non-alcoholics end up in AA? In my experience no, but I guess it could happen. Could I at this point moderate my drinking? I guess that is also a possibility, but what am I missing and what would I be risking? A taste of wine, beer, or liquor for potentially losing my career, my family, my friends, my life,... and possibly the lives of those families on the roads at the same time I decide to head home after my "controlled" drinking binge. Today I choose not to, which I have done every day for the last 23 years....

[seiserling]

...I truly hope and pray that you and your families do not encounter a "mediating alcoholic/drug addict" on the day they rediscover that they do need to pursue abstinence and AA/NA as the result of a fatal car crash.

CBS shame on you.

[khaki4]

Years ago the Veterans Administration attempted the %u201Cmoderation management%u201D approach and it failed miserably. It seems to me that is more logical to believe I%u2019m an alcoholic and be wrong than to die attempting to prove I%u2019m not.

[gmcnally2]

Maybe they should change the name from MM to 'Functional Alcoholics'

We all make choices, not everything is black and white. Everyone is different. Do what works for you, do not worry about what others think or labels.

[johntarleton-2009]

I was married to an alcoholic for 13 years. It was miserable. His drinking affected more people than just him, and now my kids have to see him and his alcoholic live in girlfriend drink.

I feel sorry for someone who has a problem with alcohol.

I am proud when someone can control the habit. I don't agree with moderation control if you have a true addiction. I believe, that if you have to plan when you can and can't drink, that you have a true addiction. If this is the only way you can control your intake, I am glad for you. I just believe that you are just a step away from being out of control.

[roysmith5]

There is a book that convinced me there is a way to be able to eliminate craving and to control my drinking. It was written by a former alcoholic who has obviously been there.
The book is at www.northernlightshealth.com
The web site says,
"I am not driven to drink or helpless and without hope. I can easily control it because I can remove the internal requirement to drink. I can turn it off like a switch, or I can turn it down to a tolerable level that puts me in control. I can have a drink or two and easily stop; or I can easily choose to drink nothing. I am completely comfortable and without the constant effort and vigil that used to be required to try to control the desire for drink."
The book is short and easy to read. It totally worked for me.
I found it online at www.northernlightshealth.com

[choklyteyes]

The practice of medicine IS the practice of harm reduction. It is a fundamental principle of medical care that the patient has the right to disagree, to be non-compliant, to choose a path or a goal other than the one we might desire for them. The physician%u2019s job is to do everything possible to help such a patient do the best he can, to minimize harm since, at least temporarily, it cannot be eliminated. Only in addiction medicine is it insisted that patients and staff hew to a %u2018philosophy%u2019 of %u2018total abstinence%u2019 rather than support appropriately individualized goals.

To refuse to work with a patient because he or she will not accept our goals for them, to not inform patients of legitimate treatment alternatives when such exist, to refuse to try legitimate alternative treatments when a particular approach has repeatedly failed because to do so would violate some %u2018philosophy%u2019 of treatment, all such behavior constitutes sub-standard medical care. This is true whether it takes place on an alcohol rehabilitation unit or an asthma ward.

[choklyteyes]

My comment was actually an excerpt from an article I read...thought it pretty well summed it up.

[dook1033]

And even further information regarding the founder of MM:

Kishline's lawyer, John Crowley, announced, "The accident and the subsequent intensive alcohol treatment she has undergone have made Kishline realize that moderation management is nothing but alcoholics covering up their problem."

[sammybear3]

I drink for 13 years. When to AA for 13 years, loved it. Now I've been drinking for 5 years, plan on drinking for a finite time, will quit again someday. I like drinking but don't fret too much about it. No OCB. I think less is better, the first drink is the best and each one after that is not as enjoyable. I hate getting drunk. I enjoy the effect of a little bit. I stick mainly to red wine, about an average of two drinks a day with counting four to a bottle. Take it easy.

[goodidstaken]

I'd just like to respond to some a few comments left by others.

"If you have to count the amount you drink...guess what...you have a problem...."

Well, if you're counting your drinks, moderating, not letting alcohol consumption effect your life negatively (health, relationships, etc.), then what is the problem exactly?

Problems drinking is not as black an white as many like to make it out to be. Yes, many have serious problems, and abstinence may be the only answer. I think though there are a larger number of people that overconsume alcohol, but don't fit the alcoholic mold of driving drunk, drinking to high levels of intoxication, being abusive or irresponsible, waking up with hangovers, or other stereotypes, and for the most part get by in life pretty well without ever going toward some kind of "bottom". These people may be able to find support in MM. It's not for everybody though.

[steinberger1]

I have in my practice seen many people resolve their drinking problems by moderating, and many more finally abstaining from alcohol after trying moderation. There is more success in helping people find their own path through the initial ambivalence to change, than in forcing goals that they initially reject and so stimulate resistance (often mislabled as denial).
MM regards people as successful if they no longer have a problem with alcohol, whether they abstain or moderate.
And as to Kishline's lawyer's comments - what would one expect from a lawyer trying to get their client the lightest sentence. I knew Audrey and she was dishonest with us and herself. She could have checked herself into a hospital or called someone from MM. She faked her success and now blames MM for her mistakes. Please feel compassion for her. MM didn't work for her, but works for others. Kishline still seeks the same attention she tried to get by running MM singlehandedly rather than sharing the work with others.
Reader - IF YOU ARE IN TROUBLE WITH ALCOHOL OR DRUGS and need a supplement to your 12-Step work or an alternative to that approach, please go to www.smartrecovery.org, and check our a science based program for a change.

[steinberger1]

I have in my practice seen many people resolve their drinking problems by moderating, and many more finally abstaining from alcohol after trying moderation. There is more success in helping people find their own path through the initial ambivalence to change, than in forcing goals that they initially reject and so stimulate resistance (often mislabled as denial).
MM regards people as successful if they no longer have a problem with alcohol, whether they abstain or moderate.
And as to Kishline's lawyer's comments - what would one expect from a lawyer trying to get their client the lightest sentence. I knew Audrey and she was dishonest with us and herself. She could have checked herself into a hospital or called someone from MM. She faked her success and now blames MM for her mistakes. Please feel compassion for her. MM didn't work for her, but works for others. Kishline still seeks the same attention she tried to get by running MM singlehandedly rather than sharing the work with others.
Reader - IF YOU ARE IN TROUBLE WITH ALCOHOL OR DRUGS and need a supplement to your 12-Step work or an alternative to that approach, please go to www.smartrecovery.org, and check our a science based program for a change.

[steinberger1]

I have in my practice seen many people resolve their drinking problems by moderating, and many more finally abstaining from alcohol after trying moderation. There is more success in helping people find their own path through the initial ambivalence to change, than in forcing goals that they initially reject and so stimulate resistance (often mislabled as denial).
MM regards people as successful if they no longer have a problem with alcohol, whether they abstain or moderate.
And as to Kishline's lawyer's comments - what would one expect from a lawyer trying to get their client the lightest sentence. I knew Audrey and she was dishonest with us and herself. She could have checked herself into a hospital or called someone from MM. She faked her success and now blames MM for her mistakes. Please feel compassion for her. MM didn't work for her, but works for others. Kishline still seeks the same attention she tried to get by running MM singlehandedly rather than sharing the work with others.
Reader - IF YOU ARE IN TROUBLE WITH ALCOHOL OR DRUGS and need a supplement to your 12-Step work or an alternative to that approach, please go to www.smartrecovery.org, and check our a science based program for a change.

[porkchoptze]

My name is Ken Anderson aka Pork Chop Tze. My face is the one you see next to Ana's in the live MM meeting which CBS filmed.

I have been to AA. Never was my drinking so out of control and dangerous as it was during the time I attended AA. I had to leave AA to save my life.

I got involved with MM and started working on practicing Harm Reduction. MM gave much wonderful support to me.

There was, however, some tension--since the goal of MM is to moderate within limits rather than to practice Harm Reduction forever.

So in between the time of the filming for CBS and now I have set up my own organization which focuses strongly on Harm Reduction.

http://hamshrn.org

Not everyone succeeds with AA--in fact 95% of new members drop out within the first year.

Not everyone moderates perfectly either.

But anyone can learn to practice Harm Reduction.

And thanks MM for the great support I got while I was active there.

[porkchoptze]

My name is Ken Anderson aka Pork Chop Tze. My face is the one you see next to Ana's in the live MM meeting which CBS filmed.

I have been to AA. Never was my drinking so out of control and dangerous as it was during the time I attended AA. I had to leave AA to save my life.

I got involved with MM and started working on practicing Harm Reduction. MM gave much wonderful support to me.

There was, however, some tension--since the goal of MM is to moderate within limits rather than to practice Harm Reduction forever.

So in between the time of the filming for CBS and now I have set up my own organization which focuses strongly on Harm Reduction.

http://hamshrn.org

Not everyone succeeds with AA--in fact 95% of new members drop out within the first year.

Not everyone moderates perfectly either.

But anyone can learn to practice Harm Reduction.

And thanks MM for the great support I got while I was active there.

[helcat62]

Thank you for airing this story; I'm sorry I missed it. MM helped me moderate my own drinking, and I know it has similarly helped many others.

Is moderation for everyone? No. But join MM for a while, and you will find many people who have chosen abstenence without choosing to say that they are "powerless." There is a misconception in this country that AA and total abstinence are the only things that work, but a look at success rates will show you that AA is one of the LEAST successful methods of dealing with a drinking problem. In fact, Audrey Kishline was an active member of AA, not MM, when she had her car accident.

I have spent many years working in social services, and I've seen more 12 step "victims" than I have successes. I think it's sad that more professionals don't know about the alternatives to AA, including MM, rational recovery and SMART recovery. Just once, I would like to see someone publish the true statistics/success rates for AA and other programs - perhaps it would explode once and for all the myth that AA is the only alternative for problem drinkers.

[truthteller5]

Thank you for your report on MM. I have only one criticism. By failing to explain the differences between an alcohol dependent (alcoholic) person and an alcohol abuser (problem drinker)it is impossible to fully understand how MM can help. People with alcohol dependence generally will not be successful with moderation, but those abusing alcohol can certainly make the choice to moderate. Unfortunately,the biggest problem in America is not believing in moderation of anything!

[dkuber-2009]

Straight from the book, Alcoholics Anonymous:

"Here are some of the methods we have tried: Drinking beer only, limiting the number of drinks, never drinking alone, never drinking in the morning, drinking only at home, never having it in the house, never drinking during business hours, drinking only at parties, switching from scotch to brandy, drinking only natural wines, agreeing to resign if ever drunk on the job, taking a trip, not taking a trip, swearing off forever (with and without a solemn oath), taking more physical exercise, reading inspirational books, going to health farms and sanitariums, accepting voluntary commitment to asylums we could increase the list ad infinitum."

You can read more at: http://www.aa.org/bigbookonline/en_tableofcnt.cfm

Click on the chapter, More About Alcoholism. This was written in 1939 and is as applicable today as it ever was.

I hear so often that people feel like members of AA were trying to FORCE them to believe or accept certain ideas. This is NOT how AA works. So many people are FORCED to come to AA by the legal system or counselors, and this is NOT AA forcing them.

Our only purpose in AA is to share what happened to us, what AA has done for us, and how you can get the same results, IF YOU WANT THEM. We say "if you want to drink, that's your business, if you want to stop, we can help."

Debi
Sober by God's Grace and
AA's 12 Steps since 11-25-90

[dkuber-2009]

p.s. The televised story included a piece about Audrey Kishline. Too bad they eliminated that from this online story. Including it helped to add balance and another perspective to the piece.

[denmancharle]

In the aa book it says by every form of self-deception and expermentation,thay will try to prove themself exception to th erule, therefor nonalcohol.And it says that Most alcoholics have to be pretty badly Mangled befor they really commence to solve their problems.So i get a dwi does this mean i am alcoholic? I had four befor i was eighteen and the courts sentence me to aa and I was not ready alcohol was not the problem it was the answer to my problem which was everybody else so i though. Lets just say it got bad and i got mangled. I have benn sober for six and half years does aa work it does for me and it will for you also when you want it to.

[zipply]

I'm well over five years abstinent now... and this never would happened through AA... because I never would have gone to AA... because of the scary and dreary stigma attached to that organization, and because of the bombastic attitude of many within. Instead, I "tried" moderation first, through the MM program, but ultimately concluded, with my own free will, to walk away from drinking. I didn't need to be "powerless" and I didn't have to have a "sponsor." End result: Somebody who doesn't drink and doesn't want to (and is happy with both of these freedoms). Path by which I got there: MM... and very much NOT EVER would it have been via AA. There are other choices out there, folks. Look into them.

[javiansmo]

I discovered MM in 2001 when I realized that I didn't like the direction my drinking pattern was taking. I learned about the concepts of moderation, self-management, personal responsibility and balance and how to apply them to all aspects of my life, not just my alcohol intake which, by most standards, would have been considered heavy at that time. I learned that I have choices at every turn and that I am responsible for every choice that I make, including going to the fridge, grabbing the beer, popping the cap and bending my elbow. I learned about making choices that were in my best interest long-term and in keeping with my values and my life priorities.

In December of 2003 I decided that I was most comfortable emotionally, physically and otherwise when I didn't drink and have been abstinent since - not because somone told me I have to be but because I choose to be and because I like it.

I have since completed an addiction counselling certificate and get great satisfaction out of offering people a menu of options and supporting their inherent wisdom and inner strength, their right to make choices that they feel are in their best interest at any given time. By believing in the people I work with, valuing them, accepting them where there are at, they begin to believe in and value themselves and become capable of great things.

Thank you MM for all that you have taught me.

Janet Pal