“The professional community, the medical community is coming to realize that… We need a much more comprehensive spectrum of interventions for people with alcohol problems.”
~ Marc Kern, Moderation Management
Most programs of recovery from alcoholism stress the need for the patient to be completely abstinent from any and all intoxicating substances if that recovery is to be successful.
But there is a school of thought that purports that perhaps substance abusers who can’t achieve total abstinence can still return to a safer, more productive life by learning how to manage their consumption.
“Get your loved one the help they need. Our substance use disorder program accepts many health insurance plans, this is our residential program.”
What Is Moderation Management?
Like Alcoholics Anonymous, Moderation Management is a non-profit organization made up of fellowship support groups for people who have a problem with alcohol. However, there are some key differences:
- MM is made up of people who want to achieve “controlled drinking”, rather than complete abstinence from alcohol.
- Many MM members do not identify the concept of alcoholism as a disease.
- Active membership is small – usually no more than 500 people at any given time. Because of that, the vast majority of MM meetings are held online.
- Most MM members self-report having little-to-no substance abuse problems before joining.
- MM believes moderation IS possible and recommends limits weekly limits of nine drinks per week for women and 14 drinks per week for a man.
Instead of the ubiquitous “Twelve Steps” of AA, MM members are guided by the “Nine Steps Toward Moderation Positive Lifestyle Changes”:
- Attend meetings or online groups and learn about the program of Moderation Management.
- Abstain from alcoholic beverages for 30 days and complete steps three through six during this time.
- Examine how drinking has affected your life.
- Write down your life priorities.
- Take a look at how much, how often, and under what circumstances you had been drinking.
- Learn the MM guidelines and limits for moderate drinking.
- Set moderate drinking limits and start weekly “small steps” toward balance and moderation in other areas of your life.
- Review your progress and update your goals.
- Continue to make positive lifestyle changes and attend meetings whenever you need ongoing support all would like to help newcomers.
Now, some rehab programs are moving to moderation-based approaches instead of demanding complete abstinence.
Purported Positives of Moderation Management
The organization states that there are “four times as many” problem drinkers in America as there are alcoholics and that MM offers an alternative to the AA model of supportive recovery.
- MM says it is perfect for people who have a drinking problem but who are not dependent on alcohol.
- MM believes that it can be preferred by certain demographics because AA and the disease model of addiction refer to being “powerless” over alcohol. This can be difficult for women or minorities who already feel victimized and powerless.
- For those people who have difficulty achieving abstinence, MM states it may be easier for them to cut down their drinking and lessen the harm that alcohol does to their life.
- Attempting to control one’s drinking does not preclude later participating in an abstinence-based recovery program. When some people find that they are unable to limit their consumption, they admit the severity of their problem and move on to AA and alcohol rehab.
“We treat both addiction and co-occurring disorders and accept many health insurance plans. Take a look at our inpatient program.”
The Negatives of Moderation Management
But what the experts say?
Dr. Nicholas Pace, the co-founder of the New York Council on Alcoholism, says, “I don’t believe in moderation management. 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 relationships, if it’s interfering with your help, you shouldn’t drink.”
The disease concept of addiction that is except by most physicians, mental health professionals, and scientists does not allow for moderate drinking. In fact, the modern definition of addiction is an inability to choose when and how much is consumed.
There is one more characteristic of addiction that is crucial – continued usage in spite of negative consequences.
People typically don’t check into an alcohol rehab or begin attending AA or MM meetings for no reason – they do so because their alcohol use has resulted in some negative to their life – a DUI, blackouts, problems at work, concerns from a loved one, etc.
So an MM member has experienced negative consequences because of their drinking, yet they are still looking for a way that allows them to KEEP drinking. That kind of thinking is indicative of another hallmark of addiction – denial.
The Real Dangers of Moderation Management
But it’s not only mistaken – it can be dangerous. To show just how dangerous, one has to look no further than the tragically ironic story of Audrey Kishline, the woman who founded Moderation Management in 1994.
In 2000, Kishline posted a message to the Moderation Management website admitting that her drinking was out of control, and more to the point, it had never been IN control at all. She stated she was discontinuing her attempts at moderation and was going to start attending abstinence-based meetings.
In March of that year, Kishline got drunk, and with a BAC that was three times the legal limit, drove her truck the wrong way down a Washington State highway. She had a head-on collision with another vehicle, killing a 38-year-old father and his 12-year-old daughter. Kishline spent three-and-a-years in prison.
While she was in prison, Kishline was visited by the woman who was the surviving widow and mother, who had come there to practice forgiveness. Against all odds, the two women became friends and in 2007, published a dual memoir, Face to Face.
Kishline, who went back to her maiden name of Conn, continued to struggle with guilt, as well as anxiety and depression. Even though she attended meetings for several different 12-Step fellowship programs, she relapsed numerous times. At one point, she was returned to prison for drinking, because it was a violation of her parole.
On December 19, 2015, Conn lost her battle with her demons. She committed suicide in her mother’s home.
“We accept many health insurance plans. Get your life back in order, take a look at our residential program.”
What we can learn from this sad story is that moderation doesn’t go far enough. A person who is abusing any substance – alcohol, inhalants, illicit drugs, or prescription medications – has to do whatever it takes to ensure their continued sobriety—starting with total abstinence.
There can be no controlling, bargaining, or reasoning with the disease of addiction.