Abstinence vs. Moderation

Many clients seeking services for addiction are often ambivalent about whether or not they have to completely quit, forever, or if they will ever be able to use moderately.  This is a frequent conundrum for those in early recovery, and something that we at Realize Recovery often explore with clients uncertain in which direction they want to go.  Pressures from loved ones, work, the legal system and societal beliefs from a predominantly 12-Step philosophy often play a role in the push for complete abstinence.  

Uncertainty about which direction to choose is normal at the early stages of recovery and can remain for years to come.  If you are considering which path may be best for you, it can be helpful to first identify what your main goals are with your substance for the near future.  It is often recommended for those with their minds set on moderation to experience a period of complete abstinence in order to have something to compare abstinence with.  If one has been using some form of mind altering substance for years on end, it will be hard to gauge if moderation or abstinence is right, when abstinence has not been experienced since childhood, or years in the past.  Taking a break from all substances for at least 30 days (if possible) gives one the opportunity to compare how they feel being sober, versus having a mood altering substance affecting their perception.  I have often worked with people set on moderating, only to go a month or two abstinent and then report that they have never felt better and have no desire to return to using their substance of choice.  

Why Moderation?

            Moderation can be helpful for those that are unwilling to abstain and are fearful of a life without their substance.  Considering moderation may still be a scary decision for the person who has been using heavily for a long period of time and would be considered a harm reduction approach.  Harm reduction seeks to reduce the harm in a person’s life caused by the substance.  If one is used to drinking 12 beers a day and now drinks 6, that would be reducing the harm in the individual’s life and a step in the direction towards moderation.  This can open the door to change for someone who is resistant to stopping their addiction, while helping them gain momentum in a value driven direction. 

            Moderation can also work for a lot of people who do not see any consequences from their substance use and therefore have little desire or internal motivation to change.  For those with comorbid disorders, or dual-diagnosis,moderation may work once the individual has worked on their mental health and feel they are in a good place as substances are often used to self-medicate.  Individuals who are dual-diagnosis may have used their substance as their primary coping mechanism and in some cases may be able to drink moderately upon receiving the mental health they need. 

            For behavioral addictions such as shopping, eating and in some cases sex, moderation is a necessity and therefore points to the ability for individuals to be able to learn how to have a different relationship with their addiction.  

Why Abstinence?

            For those struggling with a severe addiction, the easiest and safest way to avoid negative consequences is to abstain.  It can be much easier for many people to set their mind to complete abstinence instead of dealing with all the decisions on when it is okay to use, how much, under what circumstances etc.  Research has shown that the number aspect for those maintaining long-term sobriety is a commitment to complete abstinence.  This makes a lot of sense as it takes out the guesswork and allows the mind to simply focus on one thing–abstinence under all circumstances. 

            Certain substances can also be deadly and pose dangers legally and professionally, and one may find it easier to abstain instead of risking severe long term consequences for short, fleeting euphoria, with no long term payment comparable to the degree of possible long term consequences. 

Is there a Right Way?

            There are no absolutes in the world of relativity, and therefore there are no right or wrong answers to this question.  Each individual is free to decide which path they choose, as each individual gets to experience the positive or negative consequences of their choices.  Thinking back to past experiences with both approaches and getting honest with oneself is often the first step to take.  Regardless of what has happened in the past, know that those patterns do not have to carry on moving forward.  

            Realize Recovery works with all clients regardless of which approach they prefer and can help you or your loved one sift through the pros and cons of each approach based on their unique experiences.  There are interventions and methodologies that can be implemented to test and experiment with moderation if one so chooses to take that route.  We are not here to tell anyone what to believe or how to live their life, rather we work within your values and help each individual to come to the best conclusions for themselves.  

Coping with Uncertainty

Coping with Uncertainty realize recovery

Living in a world filled with uncertainty can be stressful. Most of us feel our best when we are in a routine; when our routine is uprooted, we feel anxiety and stress. The world at large has recently been “un-routinized” due to the spread of coronavirus. Research shows that people respond to uncertainty differently and those with a higher tolerance for uncertainty are less likely to experience anxiety, low mood, and negative thoughts and feelings. Here are some suggestions for coping with uncertainty and changes in daily routine.

  • Focus on what you can control:  As much as possible, avoid dwelling on things out of your control. While you cannot control the governmental regulations and policies, you can control how much time, energy and attention you put on these matters. Try putting your attention on what you can do to improve yourself, uplift friends and family, and your community. Begin a new daily routine and do your best to stick to it.
  • Remember past successes:  No good or bad thing lasts forever. Reflect on times in your life when adversity came and how you were able to overcome. When fear and anxiety begin to manifest, redirect your attention and remind yourself that you’ve coped with adversity in the past and can do the same now.
  • Stay Productive:  Our minds can only focus on one thing at a time, so by engaging in activities, we can find a reprieve from intruding negative thoughts. With coronavirus quarantines, think about light projects around the house that have been put off in the past and begin working to accomplish those. Watch home workout videos on YouTube and engage in physical exercise at home. This will improve your immune system, release endorphins and help improve sleep.
  • Minimize exposure to news and social media:  When we feel stressed about something, we want answers and information. Constantly checking the news or social media outlets for updates will only increase your sense of uncertainty. Try limiting your exposure and plan one or two times throughout the day to check for updates. It is especially important to avoid news outlets before bedtime.
  • Engage in consistent self-care:  During times of uncertainty, we often forget to take a moment and do something enjoyable for ourselves. During quarantine, consider taking a relaxing bath, sleeping in, take an afternoon nap, order delivery food and watch a movie, ask for a massage from a significant other, etc. However you choose to practice self-care, the important thing to remember is that the activity should be something safe and enjoyable for you.
  • Practice relaxation and mindfulness techniques:  When we are anxious and stressed, we are kick-starting our fight-or-flight response, which sends a cascade of hormones into our system. This response is designed to increase our heart rate, alter blood flow, and decrease activation of our brain’s frontal lobes, where our higher, rational decision-making happens. There are apps you can download, such as Headspace, and plenty of guided exercises on YouTube. 
  • Seek Professional Help:  Despite following these suggestions you may find a heavy burden still exists. Working with a counselor can help you find individual ways to better cope with stress, uncertainty and how to develop a healthy routine.

While we cannot avoid the unexpected, by building our stress tolerance, we can better cope with uncertainty.