Is Moderating Drinking Possible for Alcoholics?

One of the most common questions people who struggle with alcohol use and try to quit drinking ask is whether they really have to stop forever. Can they learn how to drink in moderation? Can they become social drinkers? Is it true that they can never have another drink?

For years, the answer was assumed to be no, there is no room for “just one drink” for anyone with a drinking problem. Today, there are programs like Moderation Management, which do allow for a certain level of controlled drinking and have helped many learn to drink safely. However, these programs are not meant for everyone.

Moderation Management

Those who commit to a Moderation Management (MM) program must undergo a 30-day period of abstinence during which they learn strategies for identifying and controlling triggers, adopting other healthy behaviors and activities to replace drinking, and managing future moderate drinking behaviors. MM asks participants to take a realistic look at their drinking patterns and reasons for drinking.

Moderate drinking is possible for some people who previously had an issue with alcohol, even for those who have joined Alcoholics Anonymous, although it's likely these individuals didn't have an official alcohol use disorder (commonly referred to as "alcoholism"). They may have been "problem drinkers," "heavy drinkers," or "binge drinkers."

Drawbacks With Moderating Drinking

Many people who struggle with heavy or unhealthy alcohol use or alcohol use disorder and who try moderate drinking come to realize that abstinence is the only option. Here are a few reasons why moderate drinking may not work for people with an alcohol use disorder:

• You may experience withdrawal symptoms when trying to reduce alcohol.
• You may quickly forget the downside of drinking, including the hangovers, blackouts, upset stomach, and remorse the day after.
• Once you start drinking, you may not be able to predict or control how much alcohol you'll end up consuming.

Withdrawal Symptoms

If you have an alcohol use disorder, you may experience a variety of withdrawal symptoms if you try to reduce or quit drinking, including:

Psychological

• Anxiety
• Bad dreams
• Depression
• Difficulty thinking clearly
• Fatigue
• Feeling jumpy or nervous
• Irritability or becoming excited easily
• Insomnia
• Rapid emotional changes
• Shakiness

Physical

• Clammy skin
• Elevated blood pressure
• Headache
• Insomnia
• Loss of appetite
• Nausea and vomiting
• Paleness
• Rapid heart rate (palpitations)
• Sweating, especially on the palms of your hands or your face
• Tremor of your hands

Tips for Moderating Drinking

If you are not living with alcohol use disorder, small changes can make a big difference when it comes to moderating your alcohol intake and reducing your risk of having a problem with alcohol according to the National Institute on Alcohol Abuse and Alcoholism.

Track Your Intake

Whether you carry a physical card in your wallet or use your smartphone, try tracking your drinks to get a better handle on your consumption. Similarly, make sure the drinks you are counting are standard sizes (12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of distilled spirits). Of course, this is easier to do at home—but you can try communicating your needs to the bartender or waiter.

Set Attainable Goals

When you’re looking to drink in moderation, it’s a good idea to designate a few days as no-drinking days. Take some time to decide which days are OK to have a drink and which days are off-limits.

Inquire About Medication

The medication naltrexone (commonly sold under the brand names Revia, Depade, or Vivitrol) has been found to help people learn how to drink in moderation by blocking the pleasurable effects of alcohol and thereby reducing further cravings for more alcohol when used consistently (i.e., each and every time the person drinks).

The Sinclair method is an approach that involves taking either Revia or Vivitrol before people drink. These medications minimize the endorphin release in the brain that usually accompanies drinking. Because this makes drinking less pleasurable, people are less likely to crave alcohol. With the Sinclair Method, Revia or Vivitrol must be taken one hour before drinking alcohol.

Seek Healthy Alternatives

One of the best things about moderating your alcohol use is filling those times spent drinking or obtaining alcohol with fun hobbies and activities. By doing so, you may even identify any triggers that cause you to drink—for example, certain social situations, stress from work, or even boredom. 

Plan Your “No” Script

Drinking in moderation means you’ll likely need to turn down a drink now and again. Planning exactly how you’ll say no—in a quick, polite, and convincing way—can make it easier for you to stick with your convictions and avoid a spiral of uncomfortable excuses.

Talk Through Urges

Whether via self-talk or a conversation with a trusted friend, family member, or healthcare professional, it’s important to talk about your urges and remind yourself why you chose to moderate your drinking in the first place. Learning to accept these feelings, and finding healthy ways to distract yourself from them, will also go a long way toward helping you to handle any urges to drink.

Replace Alcohol

Instead of drinking alcohol, plan out the non-alcoholic beverages you can order or make instead. Enjoyable, non-alcoholic alternatives include soda and fresh lime juice, virgin mojitos, soda with fresh fruit, kombucha, or mocktails. 

Try Other Relaxation Techniques

If you've been using alcohol as a way to unwind, there are plenty of healthier alternatives that can help ease your mind and body. Consider strategies such as:

• Deep breathing
• Exercise
• Meditation
• Mindfulness
• Progressive muscle relaxation
• Spending time outdoors
• Yoga