Moderation vs Abstinence for Alcohol/Substances? 

Do you ever find yourself thinking “Am I drinking too much?” “Why am I smoking pot way more than I used to?” “I used to party on occasion, now I’m doing it all the time” “Why are my friends and family giving me grief about my use?”

In my work as a clinical psychologist, I will often have clients who are starting to question their relationship with alcohol or substances.  These clients might be experiencing consequences that are slowly building over time or may come in the form of an immediate wake up call.  Long term consequences might include health consequences, significant time and energy spent consuming and recovering or struggles to engage with daily activities or responsibilities.  A person might regularly experience the sincere desire to quit or cut back but find themselves continually giving into temptation.  Immediate consequences can come in the form of an accident, injury or legal consequence.  These might be isolated incidents or could be the result of tempting fate over and over.

One of my first steps in working with clients questioning their alcohol or substance use is to do a thorough evaluation to try to determine the severity of the issue.  Formally speaking, a client’s alcohol or substance issue might be diagnosed “Mild, Moderate or Severe.”  More generally though I explore with clients to reflect on their own concerns and results of their use.  Once I have gathered some information about the situation, I will often reflect to a client my perspective on how “strong” the condition appears to be.  Though the results of a diagnostic screening may indicate varying degrees of severity, it is still fundamentally up to the client to decide how they want to proceed.  I try not to get ahead of clients with a heavy handed and authoritarian direction.  My goal is to work with a client to establish a collaborative relationship and agreed upon goals.  

To establish a goal or direction clients are often trying to decide if they can cut back and moderate, or if they might want to abstain from use.  As a professional I can often make recommendations but ultimately it is up to each individual client to decide what direction they want to take.  A client might consider moderation when their drinking or use is getting excessive but not necessarily causing profound consequences in their life.  This person may find that with some new perspectives, skill development and alternative coping skills, that they can get their amounts and frequency of use into a more comfortable range.  However, others may find that they are less successful in cutting back and find they still end up consuming more than intended.  In these cases, they may consider learning to step away from their use. 

Whichever direction you are considering, asking for help can be difficult but ultimately rewarding.  I have worked for many years with clients across the struggle spectrum.  I strive to be non-judgmental, supportive and respectful for every client with whom I work.  Through my many years of experience, I feel confident I can provide assistance to help you find your healthy relationship with alcohol and substances.  If you feel that you might have a problem or are looking to get a professional perspective, please reach out to me.  Call 619-414-0042 or send me a message and we can set up a free 15 minute consultation.  

All the Best,

Dr. Chad K. Cox PsyD 
Licensed Psychologist PSY23320 
San Diego, CA


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