Moderation Management: A Mutual-Help Organization for Problem Drinkers Who Are Not Alcohol-Dependent

Moderation Management (MM) is a mutual-help organization for problem drinkers who are not alcohol-dependent. MM members pursue a goal of moderate drinking as defined by specific guidelines for frequency and quantity of alcohol consumption. MM's program for change is based primarily on cognitive restructuring and behavioral self-control enhancement and has no inherent spiritual component. MM's definition of the ?nondependent? problem drinker is based on the individual's ability to adhere to MM guidelines, which include an initial 30-day abstinence period followed by limits on daily consumption. MM's members, on average, are less alcohol-dependent and have higher social capital than individuals who participate in Alcoholics Anonymous or seek inpatient alcohol treatment. Although no longitudinal studies to date have examined the efficacy of MM, there are positive outcome data for similar cognitive and brief behavioral interventions delivered by health care professionals. Critics of MM claim the organization feeds denial among dependent drinkers and thereby delays abstinence-oriented treatment, but its defenders point out that MM may prevent some problem drinkers from progressing to a more deteriorated state such that abstinence would be necessary. Randomized trials examining whether MM is more effective than no treatment, or if it is comparable to existing evidence-based ambulatory treatments, are needed to resolve this debate. That many MM members have never sought help before suggests the organization has some public health value by widening the range of attractive options available to people with alcohol use disorders.