Chapter 1: Moderation and the Debate

Responsible Drinking Chaper 1: Moderation and the Debate

Core message: unless you are alcohol dependent moderation is very likely to work BUT there is one key ingredient PAY SERIOUS/FULL ATTENTION to the issue

Notes

Recovery of individuals who have been severely dependent on alcohol predominantly involve abstinence and Recoveries of individuals who have not been severely dependent on alcohol predominantly involve reduced drinking.

• Have you noticed you drink more than your friends?

• There is a belief that alcohol problem inevitably progress.

• In the USA the concept of different treatments for different alcohol levels doesn't exist.

• The clinical diagnosis of alcoholism is called alcohol dependence.

• There are 32 million non-dependent problem drinkers on the USA (16% of the population).

• 5% of the USA population are alcoholics (a large number if you ask me: 15 million people!)

• 93% treatments are 12 step based.

• It makes sense to establish early intervention models aimed at alcohol problems in the less severe stages. There is a large body of science based evidence to support moderation.

• Brief interventions are the approach with the strongest evidence of effectiveness.

• James Prochaska defines stages (not steps) for effective change. Theory that change occurs in stages, detailed in the book CHANGING FOR GOOD
 by Prochaska, Norcross, and DiClemente 
The stages are conceptualized as:

1. Pre-contemplation: I don’t have a problem.

2. Contemplation: I might have a problem.


3. Preparation: I do have a problem. What would I have to do to change?

4. Action: I’m acting to make some changes.

5. Maintenance: You mean I have to do this forever?

6. Recycling: Learning from Relapse.

• What AA promotes is largely a moral cure. Confrontation based. Although the "Big Book" suggests a trial of control drinking if a person is not convinced that he or she is an alcoholic.