Do I Have to Stop Drinking or Using Forever? Is Moderation an Option?

One of the things I hear fairly often from people who are considering therapy for concerns around alcohol or substance use is a fear that they’ll be told they have to stop altogether.

For some people, that can be frightening. They may have started to recognize that something isn’t quite right with their drinking or drug use, but they’re not necessarily ready to quit. Perhaps they’re wondering whether they could simply cut back, set some limits, or find a way to return to how things used to be.

I think this fear can become a significant barrier to reaching out for help. People sometimes decide to figure things out on their own rather than risk being told that abstinence is their only option.

The problem is that avoiding the conversation doesn’t necessarily make things better. Sometimes it means that problematic patterns continue, or even become more entrenched, until the consequences become more significant and changing those behaviours becomes more difficult.

So, is “stopping completely” the only answer? Not necessarily. But it’s a conversation worth having.

Who Gets to Decide What Your Recovery Looks Like?

When I work with someone experiencing difficulties with alcohol or substance use, my job isn’t to convince them to stop. It’s to help them be honest with themselves about the impact their use is having on their lives and to explore what they’d actually like their relationship with these substances to look like.

From there, we can work collaboratively to establish some specific goals.

For someone interested in moderation, that might mean identifying what cutting back actually looks like, establishing boundaries and agreeing on how we’ll recognize whether those boundaries are being maintained.

Importantly, we also need to talk about what it looks like when moderation isn’t working.

Are they repeatedly crossing limits they’ve established for themselves? Are they finding themselves slipping back into old patterns? Are the consequences continuing despite their efforts to cut back?

I believe it’s important to create an environment where someone feels comfortable being honest about these things, both with themselves and with me.

Ultimately, I believe people have the right to discover what their own recovery looks like. It’s not my job, or the job of any particular recovery program, to define that for them.

Can Moderation Actually Work?

One thing I hear quite often is something along the lines of, “I just wish I could go back to using like I used to,” or “I wish it could be fun again.”

When someone says this, I think it’s worth taking a closer look at what they’re actually hoping to return to.

Was it really as much fun as they remember? Would it be fun now? And is returning to that relationship with alcohol or other substances actually what they want?

Sometimes our memories of the past don’t fully reflect what our experience was really like.

If someone wants to explore moderation, there are practical ways we can approach that. For some people, keeping a drinking journal or substance-use log can be helpful. Tracking how much and how often they’re using can provide a clearer picture of what’s happening.

We might also establish specific boundaries around when and where someone chooses not to drink or use. For example, perhaps they decide they won’t use when they’re alone, in certain social situations, or at particular times of the day.

But I also think there’s another way to look at moderation.

Rather than focusing exclusively on how much someone is drinking or using, we can explore whether their efforts to change are bringing them closer to the person they want to be and the life they want to live.

Are their choices aligned with their values? Are they moving towards the things that matter to them, or further away?

And there’s another consideration. Sometimes the constant effort involved in trying to moderate can become exhausting. If someone is repeatedly struggling to maintain limits, it may be worth exploring whether abstinence might actually be easier than the ongoing negotiation of trying to control their use.

When Might Abstinence Be Worth Considering?

There are certainly circumstances where I would encourage someone to seriously consider abstinence.

For example, perhaps they’ve made multiple attempts to moderate, but those attempts haven’t produced the results they wanted. Maybe they’re consistently drinking or using more than they intended, or the consequences haven’t changed despite their efforts.

There may also be significant consequences affecting relationships, finances or employment. Perhaps someone is engaging in increasingly risky behaviours.

In these situations, I think it’s important to reflect what I’m seeing back to the client and make sure those concerns are heard and understood.

Sometimes we’ll sit down together and work through a pros-and-cons exercise, looking at the benefits and costs of continuing to use, as well as what discontinuing might mean.

The important thing is that these aren’t simply my reasons for why someone should stop. They’re an opportunity for the client to identify, in their own words, what’s happening and what they want for themselves.

There are also situations where continued use presents significant medical or safety risks. For example, people with physical alcohol dependence may need medical support to stop safely, as alcohol withdrawal can be dangerous.

Respecting someone’s autonomy doesn’t mean ignoring those risks. It means having honest conversations about them and helping people make informed decisions.

What If You’re Not Ready to Stop?

I think it’s important to recognize that change isn’t linear. For some people, getting to a place where they’re ready to make significant changes takes time.

My job isn’t to lecture someone or convince them to do something they’re not ready to do. It’s to sit beside them, try to understand their experience and create a space where we can explore change together.

Therapy can be a place where you try on different ideas, examine your relationship with substances and even talk about your fears around what life might look like if you were to change.

For some people, there’s a tremendous sense of loss associated with the idea of giving up alcohol or other substances. It might mean changing friendships, social routines, relationships or even how they see themselves.

My own recovery journey over the past ten-plus years has given me a personal appreciation for just how complicated change can be. I wouldn’t presume to know exactly what someone else is experiencing, but I understand something about the fear, uncertainty and sense of loss that can accompany the decision to change.

Sometimes therapy is where you begin to discover just how ready you are to make that change. And when you are ready, my role is to help you discover the tools and strategies to get where you want to go.

Considering Change?

If you’re questioning your relationship with alcohol or other substances, you don’t need to have a clear answer about what you want to do before reaching out.

A free consultation doesn’t commit you to anything. Sometimes people carry a tremendous weight around these issues, and simply making that first connection with someone who understands something about what they might be experiencing can be helpful in itself.

And even if I’m not the right therapist for you, I can certainly help you find someone who is.

Maybe the decision about what change looks like will come later. That’s okay, too.

You don’t have to decide whether you’re going to stop forever before you decide to ask for help.

About Dave Edwards

Dave Edwards is a Registered Psychotherapist (Qualifying) in Ontario with a Master of Arts in Counselling Psychology. He works with adults navigating concerns related to alcohol and substance use, anxiety, depression, relationships and life transitions.

Dave offers virtual psychotherapy across Ontario and in-person sessions in downtown Toronto.

Learn more about Dave and his approach to therapy: Visit edwardspsychotherapy.ca

Free 20-minute consultations are available.