What is abstinence from addiction? In addictions other than alcoholism, there is no greater source of confusion and conflict, for those who have the disease as well as for the professionals who treat them.
Abstinence as a Model
Abstinence from a specific addictive behavior means to abstain from it -- to not do it. Most addictions have at least some substance or some behavior that you can totally stop using or doing. We can call it an abstinence model.
Alcoholism is an unusual addiction. Most addictions do not have such a clear example for abstinence. The fact that alcohol is virtually never necessary in any way, means the alcoholic can count the days since his or her last drink and suggest that that is a measure of recovery.
For a drug addict, the illegal drugs work the same way. Those who are in both AA and NA may say they have been so many days “clean and sober”.
For prescription drug addicts, it isn’t quite as clear. What if there are certain drugs that are necessary. Maybe to fight real, chronic depression. Or psychosis. Or chronic pain. There may be drugs that they can abstain from, and also those that have to be taken moderately, only as needed.
Compulsive gamblers can abstain from gambling in casinos, or in card games, or in sports betting. But they may also need to be moderate in their risk-taking behaviors. Many of the compulsive gamblers we have seen own their own businesses. An abstinence model would suggest that they should stop doing that. A moderation model would say they need to monitor that and make sure they do it without any strong addictive behavior.
Excitement addicts can abstain from certain behaviors, but without necessarily avoiding excitement of any kind.
Eating addicts may want to abstain from foods high in sugar or fats, or particular foods that were strong binge foods for them. Bulimics may abstain from bingeing and from purging. But exceptions need to be made. Vomiting because you’re sick is just not the same as vomiting to get rid of food from a binge.
In any pattern of addiction, there will probably be some things that will fall within the abstinence model for that pattern. There will also be some things that must be done in moderation.
Abstinence vs. Moderation
OA uses the term abstinence to mean abstaining from compulsive eating. This is sort of a misnomer. Abstaining from compulsive eating would fall better under the moderation model, which we will discuss next.
Abstinence from certain substances or behaviors is where recovery from many addictive patterns begin. It gives you the freedom to begin a good recovery program. Many addicts consider their abstinence just as important as sobriety for the alcoholic.
We believe that a look at abstinence for all addictions can help even pure “alcohol only” addicts (if you can ﬁnd one) to understand the role of abstinence in the overall concept of recovery.
Individual addicts’ deﬁnitions of abstinence vary considerably, especially with those other than alcohol and other drug addiction. As long as individualized abstinence works, with no fooling, there is no need for someone to dictate a “one size fits all” definition.
If you can identify your problem as addiction to a particular substance, or to biochemical imbalances caused by a very specific behavior, you will ﬁnd the tool of abstinence to be a powerful ally in recovery.
Abstinence from Moodifiers
We have coined the word moodiﬁer to mean any externally or internally induced chemical imbalance that has the potential to cause the profound mood swings associated with addiction. This includes the body’s reaction to alcohol, cocaine, marijuana, heroin, and other drugs.
It seems much simpler to think about abstinence when talking about a drug like alcohol that is not needed for life, than from something like food, which you cannot avoid entirely. Many addicts do not have the “luxury” of being able totally to cease using the drug, other substance, or activity that seems so central to their addiction.
For example, many eating addicts are sensitive to high sugar foods, sweet fats, or salty fats, to some degree. This means that the biochemical imbalances caused by excessive amounts of these foods affect them signiﬁcantly. The greater these foods modify their judgment and mood, the more careful they should be to avoid large amounts of them. Excesses of other foods, like protein, also can produce abnormal mood swings or distortions of judgment.
Binge abstinence Bingeing (clearly overdoing it with drugs like alcohol or heroin, substances like food or certain foods, or activities like sex or gambling) should be included in a deﬁnition of abstinence, even if the excess is not directly associated with extreme mood and judgment distortions.
Purging/starving abstinence For eating addiction, purging (vomiting, using laxatives or other attempts to get rid of food) or starving (fasting, near fasting, or very low calorie diets) also can be moodiﬁers. Bingeing, purging, and starving should have no place in abstinence.
Between-meals abstinence By avoiding food between meals, eating addicts can experience the ability to be free of the obsession about whether to eat now, and if so what and how much. Most people do allow reasonable amounts of low-calorie beverages (like diet sodas and artiﬁcially sweetened coffee or tea) between meals. Some OA members talk about “3-0-1,” which means three moderate meals, nothing between, and one day at a time. If you need more meals, for example because you have had gastroplasty for weight control, you may need more, smaller meals, so it might be 5-0-1 or 6-0-1.
Rigid diet abstinence When asked about their abstinence, some eating addicts describe a rigid diet (which they may proudly call a “food plan”). This diet mentality is a setup to break their recovery and “fail.” An eating plan, formal or informal, is your guide to selecting a moderate meal, but abstinence will be hard to maintain if you think that any tiny deviation from that eating plan is a break in your recovery.
Activity abstinence Addicts can exclude certain deﬁnite activities if they consider them to be part of their addiction. Some examples are gambling, having sex with a prostitute, using credit cards, writing bad checks, shoplifting, hitting people, or exceeding the speed limit. These activities are similar to drinking alcohol in that you could decide to abstain from them and be able to count the days since your last such activity.
Addictive behavior Some behaviors are not so clear. You may need to abstain from a particular pattern, rather than a clear activity. If you want to avoid unhealthy sex, then you need to know what an unhealthy or addictive sexual pattern is, so you can recognize and abstain from it. You may exclude prostitution and adultery, but what about masturbation and sex between unmarried people? If you can clearly establish the pattern in your mind, then you can abstain from it. If you did a lot of your drinking in bars or lounges, then excluding that type of “bar behavior” might become part of your abstinence. That may not preclude meeting a prospective client in a hotel lounge, if you believe you have a good reason for being there. If you can identify with the feeling of a “feeding frenzy,” then you can recognize and take steps to avoid that sharklike approach to food in your abstinence. If you binged on excitement by taking unreasonable risks while driving or playing, you might want to avoid these patterns as part of your abstinence.
Often, these kinds of behaviors might be better handled with a moderation model (next chapter).
Alcohol abstinence All addicts should consider abstaining from the use of alcohol and other moodifiers (unless prescribed for a good medical reason), especially during early recovery. If you are not an acknowledged alcoholic, this may seem extreme. But here are some good reasons:
- Even if you have no history of alcohol or other drug abuse, there is such a strong tendency for addiction to mutate into another pattern that the chance of developing alcoholism/chemical dependency does not seem worth the risk.
- Alcohol is a powerful mind-altering drug, so it will be much more difﬁcult to maintain good judgment about your speciﬁc abstinence or other choices while drinking.
- Alcohol usually metabolizes into fat, not carbohydrates, and it interferes with carbohydrate metabolism, so it makes no sense for anyone with weight concerns to use it.
- Alcohol has a very poor nutritional value, increases appetite in many people, and may stimulate various kinds of cravings.
- We have seen few addicts of any sort who could drink alcohol, even occasionally, and still maintain long-term recovery from other addictions.
For most addicts, getting honest will help you ﬁnd the best compromise between abstinence and moderation, too lax or too rigid. It may include your own interpretation of many of the above suggestions.
Abstinence, see also: Addiction, Allergies, Dichotomous thinking, Diet mentality, Drugs, Excitement, Freedoms, Hitting bottom, Moderation, Moodifiers, Physical aspects, Powerlessness, Purging, Recovery, Sex, Step One.
Updated 1 Sep 2015
Addictionary 2 by Jan & Judy Wilson
is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.