This is a decision which many alcoholics struggle with, and some try both approaches at different times. It is of course tempting for anyone who drinks alcohol problematically, to think that they can just regain control and drink more sensibly. And of course this is possible, but it is also very difficult. But then achieving total abstinence is not exactly easy either.

Realistically, there is no way of knowing if you are able to change your addiction into healthier patterns of use, or if you must become abstinent, the only way to know this is to find out. Many people go around this cycle many times – achieving a certain time of abstinence, then trying to drink socially or sensibly again, only for this to spiral out of control back into alcoholism. But there are those who do successfully manage their addiction and achieve healthier patterns of drinking.

The 12-step (AA or NA) philosophy is unequivocal on the matter – “abstinence is the only way”, but more modern approaches are adapting to the fact that there are other options. Similarly, if you are trying to achieve abstinence and you slip, or relapse, then the 12-step crowd would have you believe that you’ve failed, and that you need to start again from the beginning (back to step 1). But of course this just increases a person’s sense of shame and failure, which can itself make even more drinking or using a possibility.

It would seem far healthier to look at relapses as an opportunity to learn from mistakes, and try to do things differently next time.