Abstinence Based Treatment: A Sheep in Wolf’s Clothing

Abstinence is a pretty terrifying word. Even the noise the vowels and consonants make as they bang together as it rolls out of the mouth, are sharp edged and nippy. It sounds unkind, austere and like something that nuns and monks do which is hugely uncomfortable and unnatural.

Even the actual meaning doesn’t make it any friendlier and the dictionary defines it as: ‘the fact or practice of restraining oneself from indulging in something’. Ultimately this sounds painful. This is doing without something pleasurable, it is sack cloth and ashes and chanting at dawn on an empty stomach in a cold, bare hall. Abstinence is not a cuddly word.

And addicts and alcoholics like indulgence – that is what we do. How do you NOT do it?

Shock and awe

Most people when encountering this notion for the first time step back, aghast with their hands up in defence: ‘What? No booze, no pot, no pills, no cheeky little line of Charlie at the weekend? Really is that possible? And can you really be happy with none of the above. Do people actually even do this? Surely not!’ Maybe though, for some, the whole notion of going from one extreme makes total and absolute sense.

A grown up word

Drinking and using drugs addictively is not necessarily a hobby in the same realm as collecting dolls or toy trains. This is a grown up disease and successfully treating it means pulling up your big girl/boy pants and taking mature evasive action. Abstinence saves lives, messy, flawed beautifully imperfect lives. Important lives – every single one, even when the owner of said life has given up on the value of it.

Combine the word Abstinence with the word Treatment and you get a new level of clinical and impersonal. This is a bit of a paradox really and there are lots of those in the world of recovery. On one hand this is an actual medical diagnosis and on the other, healthy emotional intimacy is a fundamental prerequisite of recovery. We expect a life support machine to do its job and that is exactly what the concept of abstinence based treatment does.

What does abstinence based treatment mean?

The Minnesota Model

Abstinence based treatment is also known as the Minnesota Model. This is closely linked to Alcoholics Anonymous and combines the principles of the first 5 Steps with other medical and psychological practices. This includes educating the sufferer about their disease.

This method was created in 1949 and was utilized by a small non-profit organisation called the Hazelden Foundation which is now the famous Hazelden Betty Ford Foundation. Their success in treating alcoholism and addiction this way meant that the idea caught on, like wild fire.

Abstinence based addiction treatment is based on 10 fundamental beliefs:

  1. Alcoholism/addiction is a primary disease that can be described and diagnosed. It is also nobody’s fault.
  2. Alcoholism/addiction is a chronic and progressive disease. It always gets worse until drinking and drugging ceases.
  3. There is no cure, but the disease may be arrested.
  4. The nature of the alcoholic/addict’s initial motivation for seeking help does not determine to outcome of treatment.
  5. The treatment of the disease includes physical, psychological, social and spiritual dimensions.
  6. Successful treatment requires an environment in which the alcoholic/addict is treated with dignity and respect.
  7. All addicts/alcoholics are susceptible to the abuse of all mind and mood altering drugs. It is not really about the drug of choice but about the issue of chemical dependency.
  8. Chemical dependency is best treated by a multi-disciplinary team. Members of the team should develop close, less formal relationships with their clients. All activities are integrated within a customised treatment plan developed for each client.
  9. The best way to implement this treatment plan is through a dedicated case manager who is usually the same sex as the client. This should have an atmosphere of mutual identification and support and be safe environment for emotional self- disclosure.
  10. The most effective treatment is combined with an introduction to the appropriate 12 step fellowship. Here the client learns the value of step work, meetings, support, and confrontation.

Kindness and love in disguise

So abstinence may not be a flowery, feel good word but is the kindest thing that any addict or alcoholic can do for themselves. It is a sheep in wolf’s clothing. A gun toting gangster with a heart of gold. A bad ass concept for bad ass users and drinkers with a simple principle of self-love at its core. Abstinence shows you value your life.

And the fact is, are you really ‘giving up something pleasurable?’ Basically you give up the substance and the consequences (these two things are soul mates since the beginning of time) to gain a world of hope and possibility. As deals go, it’s a pretty good one. A winner, really.

Abstinent staff

If you are attending a rehab that advocates abstinence based treatment it’s pretty important that these have staff who are also living this way. Many addicts and alcoholics find wrapping their noggins around this notion pretty problematic. It is so opposite to the way that most of us have lived our lives. We just take what we want, right?

This immersive type of treatment sounds, to the more paranoid among us, like a kind of brainwashing but that healthy emotional intimacy which we need to recover is more easily established between people who share something in common. And being shown what to do is always far more powerful than being told what to do. It doesn’t matter if you are teaching Indonesian 4 years old the ABC or addicts how to live.

Seasons rehabilitation centres pride themselves on being run by recovering addicts for recovering addicts. Everyone from the founder and general manager to the therapists, program coordinators and support workers are in recovery and abstain from mind or mood altering substances. They are examples to the clients of what is possible.

The alternative

The alternative to abstinence based treatment is harm reduction. This undoubtedly has a place in the big picture of drug and alcohol treatment and is often the first port of call for people who want help with their problem use of substances. It is also consequently acts as a sort of the gateway to abstinence based recovery.

There are many different programs that advocate drinking in moderation or taking substitution medication but how successful are these really? How much do they improve the quality of people’s lives? This is a pretty difficult thing to quantify and statistics can be wholly unreliable in terms of creating a big picture view.

Moderation management and Audrey Kishline

An interesting and wholly telling anecdote can be seen in the story of Audrey Kishline. She founded one of the styles of harm reduction which was in vogue in the mid 90’s called Moderation Management. Kishline was a self-confessed problem drinker who had an issue with the disease model and other principles taught by AA.

She created Moderation Management as an alternative to abstinence treatment, with the idea that drinkers could continue consuming alcohol in moderation. To cut a long and controversial story short as her drinking progressed she left the support group she founded and returned to AA.

Give it a go – What have you got to lose?

Seasons rehab centres are all abstinence based because over 20 years’ experience and evidence has shown this to be the best way to help addicts and alcoholics get well. We believe in the sheep in wolf’s clothing. So if you are sick of losing self-respect, self-worth, self-esteem, confidence, money, family, relationships and jobs to the jaws of your addiction, it’s time to talk to the experts.


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