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KMID : 0870520190230020051
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Journal of Korean Academy of Addiction Psychiatry
2019 Volume.23 No. 2 p.51 ~ p.58
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Empirical Reasons and Scientific Evidence that do not Support Controlled Drinking but Alcohol Abstinence
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Kim Han-Oh
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Abstract
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Objectives ： It has long been advocated that abstinence is the only way to realistically and effectively cope with alcoholism. In opposition to controlled drinking (moderation), the valid reasons for abstinence were reviewed.
Methods ： A search was conducted through PubMed using the keywords abstinence and/or moderation. And related books were also sought.
Results ：Alcoholics should not practice moderation but abstinence instead for the following reasons. 1) The core concept of the definition of addiction is ‘loss of control.’ 2) Disruption of orbitofronto-striatal functional connectivity underlying perseveration in alcoholics makes them rigid and incapable of controlling drinking. 3) To prevent brain damage caused by repeated excitotoxicity. 4) Long-term follow up studies on alcoholics’ drinking have revealed the inevitable failure of moderation. 5) Due to the reinstatement phenomenon. 6) Moderation is a step towards another relapse. 7) As addicts attach to alcohol, detachment from alcohol makes them form a healthy attachment. 8) For the sake of their loved ones. 9) Abstinence is safer and simpler than moderation. 10) Moderate drinkers do not stand for alcoholics.
Conclusion : Moderation is a fit for a few addicts but abstinence is a better fit for the majority of addicts. Although abstinence should be an imperative goal of alcoholics, it should not be forced but instead chosen.
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KEYWORD
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Alcohol use disorder, Alcoholics anonymous, Alcohol abstinence, Controlled drinking.
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