Is Moderate Drinking Possible for People With Alcohol Use Disorder?

People with alcohol use disorder who try to quit drinking often ask whether they have to stop consuming alcohol forever—or if they can learn to drink in moderation. Until recently, experts saw no room for social drinking or “just one.” However, programs such as Moderation Management (MM) now allow for a certain level of controlled drinking and have helped many learn to drink safely. However, these programs are not meant for everyone.

“Moderate consumption” is limited to one to two alcoholic drinks per day for healthy men and one alcoholic drink per day for healthy women. One drink is equivalent to 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of distilled spirits.

Moderation Management Programs

Those who commit to an MM program must undergo a 30-day period of abstinence during which they learn strategies for identifying and controlling triggers, adopting healthy behaviors and activities to replace drinking, and managing moderate drinking in the future. Participants are asked to take a realistic look at their drinking patterns and reasons.

The MM approach has been found most successful for those who have a problem with drinking but do not meet the criteria and have not been diagnosed with moderate or severe alcohol use disorder.

Drawbacks of Moderating Drinking

Many people with an alcohol use disorder find that moderation doesn’t work for them, and abstinence becomes their only option. Here are reasons why moderate drinking may not be suitable:

• Withdrawal symptoms can occur when reducing alcohol intake.
• The downsides of drinking, like hangovers, blackouts, upset stomach, and remorse, are often overlooked.
• Once drinking starts, it’s challenging to predict or control how much alcohol will be consumed.

Withdrawal Symptoms

If you have an alcohol use disorder and try to cut down or quit drinking, you may experience several withdrawal symptoms:

Psychological symptoms include:

• Anxiety
• Bad dreams
• Depression
• Difficulty thinking clearly
• Fatigue
• Jumpiness or nervousness
• Irritability or becoming easily excited
• Insomnia
• Rapid emotional changes
• Shakiness

Physical symptoms include:

• Clammy skin
• Elevated blood pressure
• Hand tremors
• Headache
• Insomnia
• Loss of appetite
• Nausea and vomiting
• Paleness
• Rapid heart rate (palpitations)
• Sweating, especially on your palms or face

Tips for Moderating Drinking

According to the National Institute on Alcohol Abuse and Alcoholism, small changes can make a big difference for someone whose alcohol use is problematic but not yet officially diagnosed.

Track Your Intake

Whether you carry a physical card in your wallet or use your smartphone, track your drinks to get a better handle on your consumption. Similarly, make sure your drinks are standard sizes (12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of distilled spirits). This is easier to do at home, but you can try communicating your needs to the bartender or waiter.

Set Attainable Goals

Designate a few days as no-drinking days. Take some time to decide which days are OK to have a drink and which days are off-limits.

Inquire About Medication

The medication naltrexone (commonly sold under the brand names Revia, Depade, and Vivitrol) has been found to help people learn how to drink in moderation by blocking the pleasurable effects of alcohol. This reduces cravings for alcohol when used consistently (i.e., each and every time the person drinks).

In the Sinclair method, the participant takes Revia or Vivitrol one hour before drinking. These medications minimize the endorphin release in the brain that usually accompanies drinking. Because this makes drinking less pleasurable, people are less likely to crave alcohol.

At the end of four to six months of treatment with the Sinclair Method, 80% of people who had been overusing alcohol were drinking moderately or abstaining entirely.

Seek Healthy Alternatives

One of the best things about moderating your alcohol use is filling newfound time with fun hobbies and activities. By doing so, you may even identify triggers that cause you to drink—for example, certain social situations, stress from work, or even boredom. 

Plan Your “No” Script

Drinking in moderation means you’ll likely need to turn down a drink now and again. Planning exactly how you’ll say no—in a quick, polite, and convincing way—can make it easier for you to stick with your convictions and avoid a spiral of uncomfortable excuses.

Talk Through Urges (aka Urge Surfing)

Whether via self-talk or a conversation with a trusted friend, family member, or healthcare professional, it’s important to talk about your urges and remind yourself why you chose to moderate your drinking in the first place. Accepting, embracing, and then distracting yourself from these feelings in a healthy way will help you fight the urge to drink.

Replace Alcohol

Plan the non-alcoholic beverages you’ll order or make instead of alcoholic versions. Enjoyable, non-alcoholic alternatives include virgin mojitos, kombucha, mocktails, and soda with fresh fruit or lime juice.

Try Other Relaxation Techniques

If you’ve been using alcohol as a way to unwind, try these healthful alternatives:

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. National Institute on Alcohol Abuse and Alcoholism. Drinking levels defined.

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3. Mirijello A, D’Angelo C, Ferrulli A, et al. Identification and management of alcohol withdrawal syndrome. Drugs. 2015;75(4):353-65. doi:10.1007/s40265-015-0358-1

4. National Institutes of Health. U.S. Department of Health and Human Services. Rethinking your drinking.

5. Umhau JC. Conquering the craving: Treatment to curb alcohol use disorder. J Christ Nurs. 2019;36(3):148-156. doi:10.1097/CNJ.0000000000000624

6. Sinclair JD. Evidence about the use of naltrexone and for different ways of using it in the treatment of alcoholism. Alcohol & Alcoholism. 2001;36(1):2-10. doi:10.1093/alcalc/36.1.2

7. Cavicchioli M, Movalli M, Maffei C. The clinical efficacy of mindfulness-based treatments for alcohol and drugs use disorders: A meta-analytic review of randomized and nonrandomized controlled trials. Eur Addict Res. 2018;24(3):137-162. doi:10.1159/000490762

8. Edwards MK, Loprinzi PD. Experimental effects of brief, single bouts of walking and meditation on mood profile in young adults. Health Promot Perspect. 2018;8(3):171-178. doi:10.15171/hpp.2018.23

By Buddy T

Buddy T is a writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Because he is a member of a support group that stresses the importance of anonymity at the public level, he does not use his photograph or his real name on this website.

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