Definition of abstinence in addiction treatment

Abstinence is a term used in the field of addiction to describe the process of abstaining (meaning avoiding or not participating in) certain potentially addictive substances or behaviors. If a person does not engage in addictive behavior at all, whether it is indefinite or short-term, it can be said to be abstinent or abstinent, for example, “he has abstained from alcohol for 6 months”.

Abstinence can also be a goal, for example, “She intends to abstain from sex before marriage”, or a philosophy, for example, “AA is a method of abstinence based on abstinence”.

Controversy about abstinence

Alcohol Abstinence Anonymous (AA) is the first program specifically aimed at addiction treatment, and complete abstinence is the cornerstone of this method. Therefore, abstinence has a long history as a deep-rooted concept required for recovery. The people who developed the AA 12-step plan truly believe that alcoholism is a disease that people are born with and not developed due to exposure to alcohol. Therefore, any alcohol consumption is a complete failure for “alcoholics”.

Abstinence is a rigid, all-or-nothing approach, so much so that certain factions in the addiction field consider it to be unworkable for many people who want to overcome addictive behaviors.

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Some experts also believe that abstinence is unnecessary, and some people can switch from excessive drinking to moderate drinking.This establishes a dichotomy between treatments that require abstinence and treatments that do not require abstinence. People working in the field and people seeking help for addictive behaviors are often forced to stand aside and declare whether they believe in abstinence or harm reduction, as if these methods are mutually exclusive.

For example, the 12-step plan requires abstinence, while motivational interviews do not. Quitting alcohol includes completely avoiding any alcohol intake and is in contrast to controlled drinking, which may help alcohol addicts become mild and problem-free drinkers. This also means that if someone wants to overcome the problem of alcoholism, they must give up alcohol, and the process of giving up alcohol varies from unpleasant to life-threatening. In contrast, harm reduction methods allow people to gradually reduce the number of beverages they drink each day without the need for withdrawal syndrome.

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Similarly, methadone maintenance therapy may or may not require withdrawal of heroin or other opioids, but as the opioid itself, people who take methadone are generally considered not to have withdrawal, and therefore may find themselves excluded from withdrawal based Outside of the plan. This can be very frustrating for people who have tried to withdraw heroin many times but have relapsed. These people are most likely to stabilize on methadone before receiving psychotherapy.

Some professionals have more balanced and evidence-based treatment methods. Harm reduction methods may be the most effective for many people, and total abstinence may be the best solution for others.

For those who seriously harm their health due to alcohol and drug use, abstinence may be advisable, because further exposure to alcohol or drugs may be life-threatening, or abstinence may half the progress of the disease, if the person drinks alcohol, it may be endangered Life alcohol or drugs. In this case, the decision to abstain from sex is based on individuals and evidence, rather than a one-size-fits-all dogmatic philosophy.

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The problem of “normal” abstinence

As people become more aware of behavioral addiction, methods based on abstinence are increasingly seen as unworkable. For example, everyone needs to eat, so it is impossible to fast-although some people who are particularly attached to abstinence-based methods believe that certain foods should be avoided altogether.

Exercise addiction, sex addiction and shopping addiction are difficult to treat with abstinence-based methods.

However, even among the advocates of moderate and controlled methods, people admit that for some people who are prone to relapse, any addictive behavior is harmful, or that abstinence has a place in certain stages of the recovery process.

Total abstinence may be necessary

Some addictive behaviors, such as sexual abuse or the use of inhalants, are so harmful that it is impossible or not recommended to control behavior under any circumstances, and total abstinence is necessary.