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thinking about drinking after rehab.
September 23, 2017

Can Previous Addicts Drink Responsibly After Rehab?

thinking about drinking after rehab.

It’s a controversial question, and the answer may be life-changing. Get it here:

Once an alcoholic completes treatment and enters recovery, sooner or later he or she will begin to contemplate drinking again. After all, drinking as much a part of their lives for some time and the residual memories are slow to fade. Tack on a few more months of effective sobriety and the thought of being able to have a drink now and then may become even more tantalizing. But what’s the real story here? What about drinking in moderation? Isn’t that possible? Can previous addicts drink responsibly after rehab?

ABSTINENCE OR MODERATION?

Addiction experts and most 12-Step group programs, including Alcoholics Anonymous, have long espoused that the only truly effective way to overcome addiction following detoxification and treatment is total abstinence. There have been some cases in which previous alcoholics and drug addicts have been able to resume drinking in moderation—but these are more the exception than the norm, and do not describe most addicts in recovery.

The controversy surrounding the moderation management theory, or the ability to engage in controlled drinking, has its supporters and detractors. Indeed, some propose giving abstinence and moderation equal weight as possibilities for alcoholics in recovery, at least to consider that there’s no single right way to deal with drinking post-rehab.

Yet, consider what happens to the body and mind because of addiction. Not only is addiction accompanied by significant physiological changes, but the brain also undergoes changes as well. Alcohol addiction is not problem drinking, it’s a complete and radical metamorphosis from the normal functioning of body and mind to behavior that’s controlled and dominated by alcohol.

WHAT SCIENCE SAYS ABOUT ADDICTION

It doesn’t matter if you’re a man or a woman, young or old, rich or poor, drinking too much over a prolonged period, engaging in repeated binge drinking, combining alcohol consumption with other drug use and having other medical and/or psychological conditions present will pose serious risks that are physiological, psychological and emotional in nature. Chronic drinkers are more likely to become dependent on alcohol, a condition diagnosable as alcohol use disorder (AUD), more commonly referred to as alcohol addiction. AUD is divided into the sub-classifications of mild, moderate and severe.

How does alcohol affect the body? Alcohol affects every person’s body—although the effects and severity become progressively worse the more alcohol that is consumed and the longer the length of time over which the substance is ingested. Briefly, alcohol can cause minor to serious effects on the brain, heart, liver, pancreas, immune system and increase risk of various cancers.

Research shows that most alcoholics with cognitive impairment may experience at least some improvement within one year of continuous abstinence, although others may require much longer to heal. Fortunately, a wide variety of treatment methods exist that tailored to the individual to help him or her both stop drinking and recover from the brain damage caused by alcohol.

WHY CAN’T AN ALCOHOLIC JUST DRINK LESS?

Consider the symptoms of alcohol addiction as a logical answer to the question of whether it’s possible for a previous addict to drink responsibly after rehab. These symptoms include:

  • Craving or compulsion to drink
  • Losing control over how much and how often you drink
  • Continuing to drink regardless of increasingly negative consequences, such as the onset or worsening of physical and/or mental illness, job loss, family problems, arrests for driving while intoxicated (DWI) or driving under the influence (DUI), legal problems.

An alcoholic can no more turn away a drink without detoxification and treatment than he or she can will him or herself to be smarter. The brain, hijacked by chronic drinking, simply won’t allow it. Despite repeatedly vowing not to drink, the presence of cues – the sight, sound, smell of alcohol, proximity to others drinking, and the physical and psychological pull to down that drink prove impossible to ignore. Being in recovery is no panacea, either. Even after months of sobriety, giving in to the urge to drink can precipitate a full relapse back into addiction.

The difference between a problem drinker and a previous addict is that the problem drinker may, over time, be able to learn to drink responsibly, whereas the addict in recovery is seldom able to ever resume drinking, even on a casual or social basis.

HOW EFFECTIVE IS ALCOHOL REHAB AT CURBING THE COMPULSION TO DRINK?

A key question that anyone contemplating going into treatment to overcome alcoholism may have is how effective rehab is at reducing or curbing the urge to drink. The simple answer is that it depends on many factors. These include any co-occurring mental health disorder such as depression or anxiety, any other concurrent medical conditions, polydrug use (using illicit and prescription drugs along with alcohol), a family history of alcoholism, socioeconomic factors, any previous treatment for alcoholism, number of relapses, motivation for sobriety, and much more.

In addition to detoxification and formal treatment, consisting of a comprehensive approach that includes individual psychological counseling, group therapy, various treatment modalities such as cognitive-behavioral therapy (CBT), educational lectures, psychosocial engagement, lifestyle changes and participation in 12-Step or self-help groups, those who work at maintaining their sobriety will have a greater likelihood of doing so. However, relapse is a definite risk, especially in the first year following treatment. In fact, multiple relapses may occur. This does not mean that treatment was ineffective, just that the addict may need more counseling and longer time taking part in different treatment methods.

Continued participation in self-help groups following rehab is considered by addiction experts to be a fundamental part of ongoing alcohol recovery, as is the development and cultivation of a staunch support system that includes family members and friends supportive of the addict’s recovery. This support system provides the recovering addict with resources and allies, helping him or she resists the sometimes-overwhelming cravings and urges that can surface post-rehab.

It should be noted that even after years of abstinence, relapse can occur, possibly with a single drink. The alcoholic’s motivation to get clean and sober should never be coupled with the intention of one-day drinking again. That’s inviting a return to addiction that the addict worked so hard to overcome in the first place.

In summary, most previous addicts shouldn’t expect that they’ll be able to once again drink responsibly. The major goal of treatment is to give recovering addicts the best likelihood to function optimally in society and reach their potential to realize their dreams. Drinking responsibly doesn’t generally fit this scenario.

 

Sources:

Addiction Research and Theory, “Obstacles to the adoption of low risk drinking goals in the treatment of alcohol problems in the United States: a commentary.” Retrieved August 31, 2017 

Alcohol and Alcoholism, “Initial preference for drinking goal in the treatment of alcohol problems: I. Baseline differences between abstinence and non-abstinence groups.” Retrieved August 31, 2017

American Counseling Association, “Alcohol Use Disorder Practice Brief.” Retrieved August 31, 2017

Current Opinion in Psychiatry, “Controlled drinking: more than just a controversy.” Retrieved August 31, 2017

Psychiatric Services, “Alcohol and drug abuse: A research-based analysis of the Moderation Management controversy.” Retrieved August 31, 2017

Psychology Today, “Social Drinkers, Problem Drinkers and Alcoholics.” Retrieved August 31, 2017

The Fix, “What You Really Don’t Know About Recovery.” Retrieved August 31, 2017

WebMD, “Can Alcoholics Learn to Drink Less?” Retrieved August 31, 2017