Learn more about what alcohol moderation is and who might be best suited for this type of alcohol treatment which involves controlling drinking without quitting entirely.
TL;DR: Alcohol moderation is the practice of limiting drinking according to self-defined goals and boundaries. Some people moderate “successfully,” meaning they consistently stick to their boundaries enough so that alcohol doesn’t cause as much harm as it once had. For others, moderation is a tiring process that causes more complexity than it’s worth, or introduces too many slippery slopes back into the harm you were trying to reduce in the first place. Genetics, severity of current alcohol use, lifestyle, environment, physical health, emotional health, and social wellbeing are all factors to keep in mind when choosing the right approach for yourself.
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As a counselor offering alcohol moderation therapy, the question I get most is some iteration of: “Is it possible for me to cut back alcohol without quitting entirely?”
To fully understand this question, let’s break it down into its parts:
“Is it possible for me” = You want to know if you have the ability to make choices in your relationship to alcohol—to respond to drinking urges instead of react to them.
“To cut back on alcohol” = The desire and willingness to challenge your current strategies and make space for something else.
“Without quitting entirely” = You don’t want to lose that part of yourself that sought what alcohol once offered—things like excitement, bonding, letting loose, and relaxing.
Taking this all together, the question we’re really working with is: “How do I create a life where I choose to de-stress and bond without relying solely on alcohol?”
This is one that we spend a ton of time exploring in therapy based on your unique circumstances, history, relationships, and personality—but this guide should be able to get you started on some self-reflection.
What Is Drinking in Moderation?
Drinking in moderation is the practice of limiting alcohol intake according to self-defined goals and boundaries.
Vague, I know, but moderation really does look different from person to person. Alcohol moderation may look like:
A set of rules: No more than seven drinks in a week. At least three alcohol-free days per week. No drinking on weekdays.
Periodic breaks from alcohol: Dry January, Sober October, or taking a day or week off.
Mindful drinking: The practice of being present as you’re consuming alcohol, doing your best to notice sensations, emotions, and thoughts that inform your decision of when to stop drinking.
Someone’s practice may include one or all of these, but at the heart, moderation is an effort to reduce the harm of alcohol through intention-setting, awareness, and challenges for growth.
Drinking Moderation Quiz:
This isn’t an official assessment or anything—just a tool for checking in with yourself. Walk through these statements and check any that you strongly relate to:
__ I have a family history of alcohol use disorder.
__ I need more drinks than I used to in order to feel the effects of alcohol.
__ My closest friends are heavy drinkers.
__ Much of my leisure life is linked to drinking or bars.
__ It’s hard to stop after 1-2 drinks.
__ Emotions are hard for me to express and talk about.
__ I often make impulsive decisions.
__ I notice that I often crave alcohol at a certain time or place.
__ If others are drinking, I have a hard time not drinking too.
__ I live with a medical condition or chronic pain that feels largely unmanaged.
Again, this checklist isn’t meant to diagnose an alcohol use disorder, or prescribe abstinence or moderation. But if you add up your checkmarks, it can provide an idea of how difficult moderation might be for you at this time, on a scale of 1 to 10.
If you’ve scored high, don’t worry—there’s nothing at all wrong with you. It just means alcohol has been your primary problem-solver up until this point, and it may be helpful to take a close look at your support circle, lifestyle environment, and available coping strategies to decide the best changes for you right now.
Does Alcohol Moderation Work?
Because alcohol moderation varies so much in its definition and techniques, it’s impossible to provide a success rate percentage. There are some specific programs with a standardized protocol that may report more specific outcomes, but in general, someone’s success with moderation is going to depend on a number of highly personalized and nuanced factors.
A 2020 meta-analysis summarized the study results of abstinence-oriented versus controlled drinking (aka moderation) treatment, and concluded that controlled drinking may be a viable alternative for some individuals, especially when combined with mental health counseling. Abstinence-oriented treatment appeared to have better results in the immediate short-term, but based on follow-up data, controlled drinking appeared to be, as the researchers reported, “non-inferior.”
The authors are careful to clarify that there is a need for more rigorous randomized-controlled trials—aka, better research—to confirm findings. But the outcomes here suggest that abstinence isn’t the only viable tool in treatment, and that goal-led controlled drinking may be something to study further.
Deciding if moderation works for you is a question to explore with yourself and your support circle. One way to decide if moderation is working for you is to document some specific, measurable goals and track those every day. Every 3 months, check your progress and honestly evaluate:
Are you satisfied with your ability to stick to your drinking goals most of the time?
Are you noticing an overall trend toward holding your drinking boundaries more often?
Do the pros of continuing to drink at your current level outweigh the cons?
Can an Alcoholic Learn to Drink in Moderation?
This answer is going to vary from person-to-person, and requires some exploration of what an “alcoholic” is, exactly.
In the mental health field, we use the diagnosis of “alcohol use disorder,” which is defined by a set of criteria that measures the severity of alcohol dependence and consequences of use. This criteria measures alcohol abuse on a spectrum of mild, moderate, and severe. So, in diagnosing alcohol use disorders, there is no binary of “alcoholic” or “non-alcoholic”—it’s a severity score.
Some might identify as an alcoholic if they have a strong family history of alcohol abuse or dependence. Different genetics can predispose one to a greater risk of alcohol use disorders, and for some, this susceptibility translates to an identity of “alcoholic.” (To clarify: Genetics determine risk of alcoholism, but it’s not the end-all-be-all. Environment plays a big role, too.)
"For some, moderation allows them to turn the knob of change—to peer into the crack of their fears and slowly open the door and trust that what lies beyond the door is survivable. Then tolerable. Then, even desirable."
While the term “alcoholic” might suggest that someone either has it or doesn’t, alcoholism doesn’t fit neatly into a checkbox. It’s a spectrum of severity that is influenced by many different factors including genetics, social environment, behavioral triggers and responses, neurodivergence, trauma, and so much more.
Interestingly, the 2020 meta-analysis cited earlier supports the idea that goal-driven controlled drinking may work for some individuals that identify with more severe drinking patterns. The authors write, “Our results do not confirm the conventional wisdom that [controlled drinking] is only acceptable in non-dependent patients.” Again, the researchers emphasize: “Controlled drinking, particularly if supported by specific psychotherapy, appears to be a viable option where an abstinence-oriented approach is not applicable.”
If you identify as an alcoholic, alcohol dependent, or someone with a high alcohol abuse severity, it may be particularly helpful to work with a substance use professional who can help you arrive at the most supportive goals—whether you decide that’s abstinence, moderation, or somewhere in between.
How Many Drinks Per Week is Considered “Alcoholic”?
To reiterate, there is no universal definition for “alcoholic,” and the number of drinks you consume per week is only one factor of many when assessing alcohol use disorders.
For example, one screening tool used by addiction professionals is the AUDIT—the Alcohol Use Disorders Identification Test. This test asks a few questions about how much and how often you drink—but also includes questions about how you feel about your drinking, its impact on your responsibilities, and any concerns conveyed by others. That’s because alcoholism is more complicated than the number of drinks you consume, though that’s still important.
Citing the Dietary Guidelines for Americans, the CDC provides guidelines for moderate alcohol consumption for adults who choose to drink:
No more than one drink per day for women (7 per week total)
No more than two drinks per day for men (14 per week total)
Certain individuals should abstain from alcohol altogether (e.g. due to a health issue, pregnancy, medication, or being underage).
As the WHO recently reported, alcohol doesn’t seem to be “healthy” in any amount, but adhering to these moderation guidelines can help reduce risk and harm.
Is Alcohol Moderation Just an Excuse to Keep Drinking?
One concern some professionals have with moderation strategies is its potential to collude with denial, avoidance, and addiction. In other words, that moderation is an excuse to just keep drinking, to deny that one has a drinking problem, or to avoid doing the difficult internal work that abstinence clears space for.
That sometimes is true. Sometimes we aren’t ready to let go of what we feel alcohol brings to life (relief, comradery, excitement, etc.). Sometimes there’s incredible shame in admitting that our relationship to alcohol has become problematic. Sometimes we don’t have enough support or coping skills to do the difficult internal work.
All of these feelings are a natural part of the process. In therapy with my clients, we often address these fears after a foundation of trust, safety, and alternative coping strategies is established. We never want to avoid, deny, or bypass these important fears.
The question becomes: Do we need to be completely abstinent to begin the process of addressing those fears that stand between us and the life we really want to live?
No, alcohol moderation isn’t for everyone. Alcohol dependence is a serious and very lethal issue that compels us to take an honest look at how our decisions affect those around us, especially when we know that one drink of alcohol fells that first domino before abuse, violence, or intoxicated driving. There are many people who swear by abstinence because moderation didn’t work for them. They tried, and it wasn’t for them.
For other people, moderation allows them to turn the knob of change—to peer into the crack of their fears and slowly open the door and trust that what lies beyond the door is survivable. Then tolerable. Then, even desirable.