Moderation Management

In past blog posts, I have outlined Alcoholics Anonymous, 12-Step programs in general, SMART Recovery, and Women for Sobriety, and I will be reviewing other recovery programs in future posts.

The ultimate goal in most recovery programs is abstinence from alcohol or drugs. This is the goal of most people in recovery, and it is a healthy choice for most people who are serious about putting an end to problematic substance use.

There are, however, a couple of programs whose goal is to help people to drink in moderation. One of these is Moderation Management (MM).

MM is a secular, non-profit, non-12-step program whose premise is that "moderation is a reasonable, practical, and attainable recovery goal for many problem drinkers."

As its name implies, Moderation Management does not require participants to stop drinking entirely. While the program does accommodate abstinence, it is up to the participant to make the choice of moderation or abstinence.

Unlike many other recovery programs, the MM philosophy is that abstinence can only be achieved through reduction and moderation, and that, while abstinence may be the final goal, eliminating the habit shouldn't be the first aim.

MM's guiding values and assumptions are stated on its website, as follows.

Guiding Values
  • Members take personal responsibility for their own recovery from a drinking problem.
  • People helping people is the strength of the organization.
  • People who help others to recovery also help themselves.
  • Self-esteem and self-management are essential to recovery.
  • Members treat each other with respect and dignity.

Assumptions of MM
  • People should be offered a choice of behavioral change goals.
  • Harmful drinking habits should be addressed at a very early stage, before problems become severe.
  • People can make informed choices about moderation or abstinence goals based upon educational information and the experiences shared at self-help groups.
  • Harm reduction is a worthwhile goal, especially when the total elimination of harm or risk is not a realistic option.
  • People should not be forced to change in ways they do not choose willingly.
  • Moderation is a natural part of the process from harmful drinking, whether moderation or abstinence becomes the final goal. Most individuals who are able to maintain total abstinence first attempted to reduce their drinking, unsuccessfully. Moderation programs shorten the process of "discovering" if moderation is a workable solution by providing concrete guidelines about the limits of moderate alcohol consumption.

The MM program's focus is on changing drinking habits so that drinking isn't harmful. The program includes nine steps, which do not have to be followed in any particular order, so long as the participant is progressing toward the goal of moderation or abstinence.

Nine Steps Toward Moderation
  1. Attend meetings or online groups and learn about the program of Moderation Management.
  2. Abstain from alcoholic beverages for 30 days and complete steps three through six during this time.
  3. Examine how drinking has affected your life.
  4. Write down your life priorities.
  5. Take a look at how much, how often, and under which circumstances you have been drinking.
  6. Learn the MM guidelines and limits for moderate drinking.
  7. Set moderate drinking limits and start weekly "small steps" toward balance and moderation in other areas of your life.
  8. Review your progress and update your goals.
  9. Continue to make positive lifestyle changes and attend meetings whenever you need ongoing support or would like to help newcomers.

Participants in the program have to pay close attention to their drinking over a period of time. In order to do this, MM suggests a drinking diary that tracks your drinking behavior, including the date, number of drinks, and type of drink, as well as the amount of time spent drinking, the occasion, and your feelings at the time that you were drinking.

The goal, of course, is moderate drinking, although a lot of participants will want to move on from moderation to quitting entirely.

Moderate drinking refers to maintaining specific limits on the amount of drinking that you do, as well as on the number of days per week in which you drink. These limits are specified within the program or on the MM website.

A moderate drinker:
  • Usually does not exceed the 0.055% blood alcohol concentration drinking limit.
  • Usually has something to eat before, during, or soon after drinking.
  • Usually does not drink for longer than an hour or two on any particular occasion.
  • Considers an occasional drink to be a small, though enjoyable, part of life.
  • Has hobbies, interests, and other ways to relax and enjoy life, that do not involve alcohol.
  • Usually has friends who are moderate drinkers or non-drinkers.
  • Feels comfortable with his or her use of alcohol, does not drink secretly, or spend a lot of time thinking about drinking or planning to drink.

Moderate drinking is not for everyone and, in my opinion, it could be a terrible choice for someone who has successfully stopped drinking. If you've managed to stop drinking, don't go backwards.

The MM website includes an Alcohol Dependence Data Questionnaire that can be used to help determine whether the Moderation Management program. Those who score within the "high dependence" category will do better with an abstinence program, while those with "medium dependence" are recommended to include other therapy along with t
he MM program, to deal with alcohol and non-alcohol issues that may complicate their situation. Those in the "low dependence" category might find success through the MM program.

If you are a candidate for moderation management, you should still examine the pros and cons for both moderation and abstinence. Abstinence offers the advantage of taking you away from the drinking problem, as well as a simpler and clearer goal to work toward.

The Moderation Management program is more likely to be successful if your dependence on alcohol is on the low side or if you enter the program early. Moderation is not for everyone.

A good summary of the Moderation Management program can be found on its Guide to Moderation Management Steps of Change (PDF).

Although offline group meetings are available only where Moderation Management is active, the program also offers online meetings, an online forum, a Facebook group, and a chat room available 24/7. Phone meetings may be available, and MM has a Listserve, which is an email communication program.

Some MM groups are open to the public, while others are for MM members only. Group leaders are non-professionals who use the MM programs. Group members may discuss a variety of topics during a meeting, although most will focus on elements of the MM program.

See: Moderation Management