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Half of Addiction Counselors Say It’s OK for Some Patients to Drink Occasionally

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A survey of addiction counselors finds almost half say it is acceptable for at least some of their patients to drink from time to time. The survey included 913 members of the National Association of Alcoholism and Drug Addiction Counselors.

About half of the counselors said they would not object if some of their clients who abuse alcohol wanted to limit their drinking, but not totally abstain, PsychCentral.com reports. That is double the number of counselors in a 1994 survey who said moderate drinking was acceptable for some clients.

The new survey found about half of counselors said moderate drug use was acceptable as an intermediate goal, while one-third said it was adequate as a final goal.

“Individuals with alcohol and drug problems who avoid treatment because they are ambivalent about abstinence should know that — depending on the severity of their condition, the finality of their outcome goal, and their drug of choice — their interest in moderating their consumption will be acceptable to many addiction professionals working in outpatient and independent practice settings,” the researchers from Bowling Green State University noted in a press release.

Counselors were less accepting of occasional substance use for clients diagnosed with alcohol or drug dependence, which is considered more severe than alcohol or drug abuse. At least three-fourths of the counselors said they would not approve of limited or moderate consumption for these clients.

“In light of this study, we suggest that clients ask about their counselor’s openness to limited or moderate consumption as an outcome goal, and that agencies acknowledge their policy regarding negotiation of outcome goals as part of informed consent,” said researcher Harold Rosenberg, PhD.

The study was published in Psychology of Addictive Behaviors.

15 Responses to this article

  1. Avatar of Romeo A. Blackmar
    Romeo A. Blackmar / November 14, 2012 at 10:38 am

    Thank God my substance abuse counselor didn’t subscribe to this belief. Had I been told I could continue to drink on a limited basis, I more than likely would have ended up in a treatment facility, jail, badly injured or dead. This kind of advice given by professionals in the field of addiction/substance abuse is very dangerous and could lead to more accidents, more pain and suffering for the the addict and their families.

  2. Richard Solomon / November 11, 2012 at 11:30 am

    With more than 30 years of experience in the field of addiction treatment I am VERY concerned about the implications of counselor who condone periodic drinking by those who meet the criteria for dependence. It is by definition a condition in which an individual CANNOT control his/her intake. Telling these individuals that it is okay for them to drink occasionally is at best foolish. At worst, it is colluding with their denial and potentially destructive. Do NOT forget that some people DIE from consequences of their addictions!! Anyone who takes this stance in regards to his/her clients is being irresponsible, in my opinion.

  3. perryrants / November 9, 2012 at 5:16 pm

    just don’t call it recreational drinking!

  4. perryrants / November 9, 2012 at 5:15 pm

    as abuser has not lost “control” of their drinking and/or drug use, then moderation is ok.

  5. Avatar of Jamie Matter
    Jamie Matter / November 9, 2012 at 3:39 pm

    The result allows for a lot of interpretation. One possibility: counselors would prefer the client to try the experiment of controlled drinking or using and report back in treatment, rather than driving the client away from treatment by a rigid atttude. In many cases, the clients will do it anyway, so why not keep them engaged in treatment? If it works, good. If it doesn’t (as is frequently the case), then they’re still engaed in treatment and can work on new goals.

  6. Avatar of Jean
    Jean / November 9, 2012 at 11:37 am

    This is certainly a very slippery slope as well as controversal. For those of us who have worked with addiction for years I imagine have seen both those who can occasionally have a drink and those who cannot. However, all current neuroscience studies show how difficult it is to break a habit, control addiction, create stability — whatever you want to call it — once your memory has been imprinted with that behavior. Truly addicted people would definitely be playing with fire if they tried controlled drinking from my 25 yrs opf experience. I have rarely seen a person be able to sustain once they started “controlled” drinking. Choices and decisions is what it is all about.

  7. Dave Finch / November 8, 2012 at 1:32 pm

    This is a dialogue of which I would like to see much more. In the writing I am doing I argue that abstention can be too harsh a prescription for some substance dependent people who are just starting or just approaching the start of treatment. I am not a treatment profession and so would welcome further comment from those of you who are.

  8. Avatar of Floyd Frantz
    Floyd Frantz / November 8, 2012 at 1:17 am

    I like what the Big Book says about this, “if you don’t think you are a real alcoholic, then go to the bar and try some controlled drinking..try it several times”…if there is education and support along with with this decision it would be better than the client going it alone in a “relapse mode”, which is only going to make the person feel more shame. The only problem that I see is advising a person to try this if they were actually “dependent”.

  9. Avatar of John Wieglenda
    John Wieglenda / November 6, 2012 at 2:18 pm

    This was a vague question to ask counselors. Most of us treat individuals in Alcohol Abuse and Alcohol Dependence. The wording should have been “Do you approve of moderate use of Alcohol in individuals in Alcohol Abuse?” I agree that “low risk choice amounts” (2 drinks if daily or 3 less than daily, spaced an hour) would be appropriate for many but not all individuals in alcohol abuse. There are several other factors to consider including genetic history, tolerance and values. Someone needs to do better research, shame on them.

  10. Avatar of
    Jerry Otero / November 6, 2012 at 1:34 pm

    Thank you for your reporting of this very controversial issue. There are bound to be naysayers on both sides of the argument, but as a clinician working with addictive disorders, I say that the stakes are too high for us to continue to rely upon drug prevention/treatment rhetoric and propoganda. It’s time to use the evidence and practice wisdom of those in the field who know that “one size does not fit all”, to determine the most approriate course of action. It might be helpful to note that as reported by the Harvard Health Newsletters (follow the link) http://harvardpartnersinternational.staywellsolutionsonline.com/HealthNewsLetters/69,M0109c, the degree of dependence predicts which strategy works best. Assess, assess, assess.

  11. Avatar of Gail Chmielewski
    Gail Chmielewski / November 6, 2012 at 11:18 am

    I agree that this is a very dangerous message to send to clients. I can’t believe that that many counselors are clueless. Maybe they should look up what happened to Audrey Kishline the founder of “Moderation Management”. She is an alcoholic who decided she could teach herself and other alcoholics to be “social drinkers”. She ended up killing a father and daugher while driving drunk and spent prison time. The last I heard she advocates for total abstience and AA.

  12. Michael Morrison / November 5, 2012 at 4:49 pm

    This is a very dangerous message being sent to clients. Part of the diagnostic criteria for alcohol dependency includes an inability to consistently control the use of alcohol. So, if the client is diagnosed as alcohol dependent, giving the green light to drink occasionally seems wreckless at least. Alcohol abuse is a different diagnosis and harm reduction may be appropriate. I hope that the therapists questioned have been properly trained to recognize the difference.

  13. Avatar of James Hill
    James Hill / November 5, 2012 at 2:10 pm

    This needs to addressed very carefully. I think if you are going to separate abuse and dependence in this manner there should be separate treatment protocol’s for each catagories.

  14. jgogek / November 5, 2012 at 1:57 pm

    Please note that this survey differentiates the counselors’ responses on whether their clients suffer from abuse or dependence, two different substance use disorder diagnoses as laid out by the DSM-IV. For people with dependence, few counselors say some drinking is OK. However, for those with abuse — which is not addiction to alcohol but rather a person who drinks too much and gets into trouble because of it — half say some alcohol consumption is OK. The difference between abuse and dependence must be clearly recognized.

  15. Avatar of Roy DiVincenti, LAC, AADC
    Roy DiVincenti, LAC, AADC / November 5, 2012 at 1:12 pm

    I question how this survey was done, since they only used NAADAC members and did not also use members of ICRC which is equal to or has a possibly larger number of Lic. Addiction Counselors. I belive this survey is very misleading in the results given.

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