In particular, trees can identify splitting variables that are idiosyncratic to the particular data set more often than classical methods that focus on main effects (Hastie et al., 2009; Zhang and Singer, 2010). Due to the performed internal and external validation of our analyses, our results can be considered stable in similar samples of patients. The COMBINE Study evaluated the benefits of combining pharmacotherapy treatment (naltrexone, acamprosate) and behavioral interventions (Medication Management (MM) (Pettinati et al., 2004), Combined Behavioral Intervention (CBI), (Miller, 2004)) in alcohol dependent patients. The PREDICT Study adopted the methodologies, assessment and behavioral interventions used in the COMBINE Study to allow for direct comparisons of the findings between the two studies (Mann et al., 2009). It is important to know when seeking treatment for substance use that there are options.

New strategies have to be developed in recovery and these are acquired by confronting obstacles and overcoming them. It is lack of an ability to cope with life that attracted such people to alcohol abuse in the first place. Just removing alcohol is not going to be enough to allow the individual to find happiness and comfort in life. The journey to changing your relationship with alcohol is about progress, not perfection. Whether you’re working towards sobriety or moderate alcohol intake, the most important thing is to keep going. Every day presents a new opportunity to define your goals and make progress towards them.

Moderation vs. Abstinence: Should You Cut Back or Quit Drinking Completely?

Dr. Stanton Peele, recognized as one of the world’s leading addiction experts, developed the Life Process Program after decades of research, writing, and treatment about and for people with addictions. His work has been published in leading professional journals and popular publications around the globe. Regardless of your path, working with a physician and therapist can provide answers, reassurance, and guidance throughout the process. You also don’t need to have a clear understanding of your goal to start making progress.

This literature – most of which has been conducted in the U.S. – suggests a strong link between abstinence goals and treatment entry. For example, in one study testing the predictive validity of a measure of treatment readiness among non-treatment-seeking people who use drugs, the authors found that the only item in their measure that significantly predicted future treatment entry was motivation to quit using (Neff & Zule, 2002). The study was especially notable because most other treatment readiness measures have been validated on treatment-seeking samples (see Freyer et al., 2004). This finding supplements the numerous studies that identify lack of readiness for abstinence as the top reason for non-engagement in SUD treatment, even among those who recognize a need for treatment (e.g., Chen, Strain, Crum, & Mojtabai, 2013; SAMHSA, 2019a). AA was established in 1935 as a nonprofessional mutual aid group for people who desire abstinence from alcohol, and its 12 Steps became integrated in SUD treatment programs in the 1940s and 1950s with the emergence of the Minnesota Model of treatment (White & Kurtz, 2008).

1. Review aims

The harm reduction movement, and the wider shift toward addressing public health impacts of drug use, had both specific and diffuse effects on SUD treatment research. In 1990, Marlatt was introduced to the philosophy of harm reduction during a controlled drinking vs abstinence trip to the Netherlands (Marlatt, 1998). He adopted the language and framework of harm reduction in his own research, and in 1998 published a seminal book on harm reduction strategies for a range of substances and behaviors (Marlatt, 1998).

But with patience, persistence and these strategies at hand – you’re better equipped than ever before on this journey towards healthier living minus harmful drinking habits. When it comes to choosing between total abstinence or limiting your intake, the answer isn’t black and white. Several factors influence this decision, including societal perception, cultural factors, psychological impact, and health implications. You may feel pressured by society’s view of what is acceptable drinking behaviour or fear being ostracised due to cultural norms surrounding alcohol use. Psychologically, you might be dealing with a range of emotions from guilt over past incidents to anxiety about future relapses.

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