Abstinence

This page discusses some of the issues surrounding a goal of abstinence. You should read this page if you are considering abstinence as your goal. In fact, you should read this page anyway, even if you are considering another goal.

Abstinence
What do we mean by abstinence?  Basically, it means not consuming any alcohol whatever.  Abstinence can be for a specified, or unspecified, period or it can be total abstinence – ie life long.

For many treatment professionals, abstinence from alcohol is viewed as the only acceptable outcome to treatment. Why is that? Well, how we view any problem obviously influences the solutions or treatments that we believe possible and/or acceptable. In the case of alcohol or drinking problems, many believe that it is a disease. However, in order to understand why that should mean abstinence is the only option, we need to understand what is actually meant by suggesting alcoholism is a disease. There is a brief description of the disease model below but for a fuller discussion of the model, the evidence and the implications go to disease model.

Disease Model Assumptions
The disease model makes some basic assumptions about the nature of alcoholism, in particular it claims that alcoholics:- Suffer from an abnormal and uncontrollable craving that leads them to drink and that, once they begin drinking, they have no control over their consumption

If we accept these assumptions then it is easy to see why we would believe that alcoholics cannot drink in safety. Add to this, the belief that the disease is progressive (ie it continually gets worse), that is without treatment it will progress. In fact some suggest that even after treatment and abstinence it continues to worsen, so that if the alcoholic were to drink again after 10 years abstinent, instead of their drinking problem being just as bad as when they stopped, it would in fact be 10 years worse than it was.

Therefore, it is also thought to be irreversible (once an alcoholic always an alcoholic). If we believe all these claims then the only possible conclusion that we can come to is that the only safe outcome the alcoholic or drug addict to abstain for the rest of their lives.

Abstinence vs Sobriety
AA, while they believe that the alcoholic needs to stop drinking and stay stopped for life (or for a day at a time), make a distinction between abstinence and sobriety. They view abstinence as an absence of alcohol, whereas they see sobriety as a state of being.

Sobriety for AA is a state of both mind and spiritual well-being that is achieved by the AA member working through the twelve-step program. Working through this program entails a self-examination and change in attitudes and behaviour, that is facilitated by relationships with the group and a higher power. So, whereas abstinence is negative, or a removal of alcohol, sobriety is gaining a positive outlook and behavioural pattern that enhances the life of the alcoholic.

Other organisations also point out that if the (former) drinker is unhappy in abstinence then they will not maintain it, hence, like AA they suggest that lifestyle changes are required. However, while this may be a positive it also points up one of the major problems of abstaining as a goal, major lifestyle changes.