Choosing and Managing Non‐Abstinent Recovery: Experiences of Adults in Untreated Recovery From Alcohol Use Disorder

INTRODUCTION: We sought to characterise non-abstinent recovery from alcohol use disorder (AUD), particularly to understand why some people choose non-abstinence instead of abstinence and to illuminate how they may continue drinking in a way consistent with recovery. METHODS: We conducted semi-structured interviews with 65 adults with resolved AUD and no history of treatment who were enrolled in a national United States study of recovery definitions and strategies. Using inductive and deductive coding, we identified and elaborated themes. RESULTS: Non-abstinent participants reported infrequent and low-level drinking, citing helpful internal resources, such as strong self-awareness of their limits and confidence in their ability to control their drinking. By contrast, individuals who chose abstinence were often not confident in their ability to stop drinking, and some recounted instances when they learned that, after years of abstinence, they could not safely control their drinking. In addition, individuals who chose moderated drinking appeared to have clear, self-imposed rules about when and how much they could drink. Close and supportive social relationships, as well as aging and changes of life circumstances and contexts, also helped curb excessive drinking and maintain non-abstinent recovery. Many participants described changing their recovery goal, sometimes multiple times, reflecting a dynamic process of recovery. DISCUSSION AND CONCLUSIONS: Beyond documenting the existence of non-abstinent recovery, our study identified why and how moderated drinking might be part of successful recovery for some people. Strict or enduring abstinence may not be necessary for all individuals seeking to recover from alcohol use disorder.