Definition of Abstinence in Addiction Treatment

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There are times when no alcohol is the best choice. Image © Kriss Szkurlatowski, Freeimages

Definition of Abstinence

Abstinence is a term used in the addictions field to describe the process of abstaining -- meaning avoiding, or not engaging in -- certain potentially addictive substances or behaviors. If an individual does not engage in the addictive behavior at all, either indefinitely or for a short period of time, that person is said to be abstinent or abstaining, for example, "He was abstinent from alcohol for 6 months."

Abstinence can also be a goal, for example, "She intends to abstain from sexual activity until she is married," or a philosophy, for example, "AA is an abstinence-based approach to recovery from alcoholism."

Controversy About Abstinence

Alcoholics Anonymous was the first program focused specifically on treating addiction, and abstinence was the cornerstone of the approach. Therefore, abstinence has a long history of being an entrenched concept required for recovery.

Abstinence is a rigid, all-or-nothing approach, so it is considered by some factions of the addictions field to be unworkable for many people who want to overcome addictive behavior. This has set up a dichotomy between approaches to treatment that require abstinence, and those that do not. People are often pressured to take sides, and state whether they believe in abstinence or harm reduction as if the approaches are mutually exclusive.

For example, 12-step programs require abstinence, whereas motivational interviewing does not. Abstinence from alcohol involves completely avoiding intake of any alcohol and contrasts with controlled drinking that might help an alcohol addict to become a moderate and non-problematic drinker. Methadone maintenance treatment may or may not require abstinence from heroin or other opiate drugs, but as an opiate drug itself, people on methadone are often perceived not to be abstinent, and may therefore find themselves excluded from abstinence based programs.

Problems With Abstinence From Normal Behaviors

With the growing recognition of behavioral addictions, abstinence-based approaches are increasingly seen as unworkable. For example, everyone needs to eat, so abstinence from food is not possible -- although some who are particularly attached to abstinence-based approaches hold that certain foods should be completely avoided. Exercise addiction, sex addiction, and shopping addiction are very difficult to treat with abstinence-based approaches.

However, even among advocates of moderation and controlled approaches, it is acknowledged that abstinence has its place for certain people who are prone to relapse, for whom any addictive behavior would be harmful, or for certain stages in the process of recovery. And some addictive behaviors, such as sexually abusive behavior or the use of inhalants, are so harmful that controlled behavior is not possible or advisable under any circumstances, and complete abstinence is necessary.

Pronunciation: ab-stin-enss

Also Known As: alcohol free, drug free, non-smoker, self restraint, moderation, self regulation, dry drunk

Common Misspellings: abstinance, abstinece

Examples: As he had severe health problems as a result of his drinking, Joel decided to strive for complete abstinence from alcohol and drugs when he finally quit.

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