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Moderation Management

A. Tom Horvath, Ph.D., ABPP, Kaushik Misra, Ph.D., Amy K. Epner, Ph.D., and Galen Morgan Cooper, Ph.D. , edited by C. E. Zupanick, Psy.D.

Moderation Management

Like SMART Recovery, Moderation Management (MM) bases its program on evidence-based treatment approaches. These are approaches that help people moderate or abstain from alcohol. MM was founded in 1993. MM is the only self-empowering support group that accepts moderation as a positive outcome. This is in contrast to other programs that emphasize abstinence. Overeaters Anonymous identifies itself as an abstinence organization. However, it appears to be more comparable to MM on this issue. In OA, participants abstain from overeating or abstain from certain types of food. In MM, participants abstain from over-drinking. There are few local meetings of this organization, but there is an active website. A free "Drinker's Checkup" is also available at the website. There is also a step-by-step moderate drinking educational course, for a nominal fee.

In 2000, the organization suffered from bad publicity. Its founder, Audrey Kishline, had a head-on collision on the freeway. Kishline's blood alcohol level was .26. This is more than 3 times the legal limit. She entered the freeway going the wrong way and killed two people. The news media offered numerous commentaries at the time. Some suggested that this episode demonstrated that moderation was not a suitable approach for drinking problems. Ironically, the majority of media coverage failed to note that about two months before the crash Kishline publicly quit MM and joined AA. She did not criticize the value of moderation approaches. She simply decided an abstinence approach was preferable for her. It would not be reasonable to blame AA for her behavior. Nor would it be reasonable to blame MM. Although MM remains somewhat controversial, there is now overwhelming evidence that many individuals once diagnosed as alcohol dependent later engage in moderate drinking (NIAAA, 2012). The US federal government has established a Rethinking Drinking website that offers information very similar to the MM site. 

Moderation training is also termed controlled drinking. It is one of the most extensively researched methods for coping with alcohol problems. People who are not good candidates for this approach are individuals who have moderate to severe forms of alcohol use disorder, and that have other major life problems. Of course, claiming to moderate but not accomplishing it is not moderation! For many, a sincere but failed attempt at moderation can be the catalyst to adopt an abstinence approach. By failing to offer support for moderation, we cause individuals to wait until they are ready for abstinence. In the meanwhile, they are accumulating many problems. During that wait, which can be lengthy, enormous harm can occur. The Rethinking Drinking website addresses this issue directly.