Half of Counselors Don't Always Advise Abstinence

Nearly half of addiction counselors say they don’t always advise total abstinence for clients with substance problems, a new study shows. Researchers surveyed 913 members of the National Association of Alcoholism and Drug Addiction Counselors across the US, and found that around 50% of them believe it’s acceptable for certain patients with alcohol problems to have an occasional drink. This represents a dramatic rise since a similar study, released in 1994, showed just 25% of addiction therapists said they didn’t always push total abstinence. As for drug problems, about half the counselors in the new study also believe moderate drug use can be an acceptable intermediate goal, with one third able to accept it as a final goal—about the same as in a similar survey 10 years ago.

“Individuals with alcohol and drug problems who avoid treatment because they are ambivalent about abstinence should know that—depending on the severity of their condition, the finality of their outcome goal, and their drug of choice—their interest in moderating their consumption will be acceptable to many addiction professionals working in outpatient and independent practice settings,” write study co-authors Alan K. Davis, MA, and Harold Rosenberg, PhD, of the Department of Psychology at Bowling Green State University. “Our study did not examine whether those who want to moderate their drinking or drug use had better or worse outcomes than those who attempt to abstain immediately and completely, and research has found that episodes of lapse and relapse are common among clients no matter what outcome goal they pursue,” notes Rosenberg.“In light of this study, we suggest that clients ask about their counselor’s openness to limited or moderate consumption as an outcome goal, and that agencies acknowledge their policy regarding negotiation of outcome goals as part of informed consent.”