Experts discuss moderation versus abstinence in problem drinking

When Brad Pitt revealed to Esquire that, after seven sober years, he’d started drinking again (reportedly, in a more “restrained manner”), he was met with public scepticism. Don’t we know it never ends well when problem drinkers quit but then attempt moderation?

But it’s not as black and white as you might think. Following a break from alcohol, some problem drinkers can drink moderately, says Dr Chris Davis, an addiction specialist at Sydney’s St Vincent Hospital.

“Traditionally, abstinence has been seen as the only approach to problem drinking, and in some recovery circles, like AA [Alcoholics Anonymous], it still is. But it’s not borne out by research,” he says.

“A 2021 US study of 4500 people with alcohol use disorder who’d had a period of sobriety found that 18 per cent who’d returned to drinking were drinking at low-risk levels of less than 10 drinks a week. But a lot depends on the kind of drinker you are and how long you’ve been drinking for.”

Davis is also clinical co-founder of the Clean Slate Clinic in Sydney, which supports people to detox safely at home but doesn’t require abstinence as the only goal.

“Being told you can never drink alcohol again is a barrier to treatment – and only one in five people who need treatment get it,” he says.

There’s a spectrum of problem drinkers. Those with mild to moderate alcohol use disorder (AUD) at one end, and those at the other, more severe end who are physically dependent on alcohol, Davis explains.

There are many clues someone has AUD with symptoms including drinking more than you mean to, needing to drink more to get the same effect, drinking while driving, and continuing to drink even when it’s causing problems with your physical or mental health, work or relationships.

According to Davis, you only need to have experienced two of these symptoms in a 12-month period to qualify for AUD.

“But being physically dependent on alcohol means that alcohol has also caused physical and neurological changes, so that going without alcohol can cause symptoms like shaking, sweating and anxiety,” he says.

This distinction is important.

“If you’re physically dependent [on alcohol], it’s not safe to go cold turkey, and you’re likely to need medication to detox. People who become physically dependent on alcohol are also less likely to succeed at moderation if they restart after being abstinent,” adds Davis.

The less time you spent as a heavy drinker the better.

“Drinking for two years, rather than 20, means the habit will be less ingrained. Having as long a break as possible from alcohol is good too – the longer the break, the more likely you are to stick with moderation. There’s also what’s called ‘recovery capital’ – having strong relationships, financial security and a roof over your head gives you a much better chance.”

Establishing rules around drinking helps too, rather than a vague “I’m going to drink less”, says Dr Nicole Lee, chief executive of Hello Sunday Morning, an organisation which provides free support to help people change their relationship with alcohol.

“Setting rules is a big talking point on Hello Sunday Morning’s Daybreak program – around 56 per cent of people come for help to reduce their drinking rather than give up alcohol entirely.”

Rules some program followers have set themselves include not drinking alone, not drinking at home unless entertaining, never drinking more than two glasses of wine in one sitting and never getting drunk.

Other rules Lee suggests include knowing exactly what a standard drink looks like and how to pour one, and not keeping alcohol in your home.

“If you feel like a drink after a bad day, it means you’ll have to go out and get it, so you’re more likely to find another way to soothe yourself. And avoid drinking if you feel lonely or upset,” says Lee.

“It also helps to share your rules with friends – it helps keep you accountable and means friends are less likely to pressure you to drink.”

Of course, sometimes rules aren’t enough.

In 2023, Melbourne-based Karina Joyce ended a long-time daily wine habit. It began as a test to see if she could last a month, but once she learnt more about alcohol’s impact on the body, she decided to quit indefinitely.

“I realised how dangerous and insidious alcohol is. It went from being my best friend to a poison that created a cycle of craving, shame and regret,” says Joyce, 58, the founder and chief executive of NoLo Life, an organisation aiming to make it easier for people to choose not to drink or to drink less.

But in 2024, tired of having sugary carbonated drinks when she went out, she began drinking alcohol occasionally. By 2026, she was drinking daily again.

“I was also drinking to cope with stress, rather than enjoyment or socialising,” she says.

Today, she’s back to full-time abstinence.

“Like me, I think a lot of people try moderation but eventually switch to abstinence because of the work involved with monitoring drinks and sticking to rules.

“Giving up this time has been harder because I’m realising the role it played as my ‘off’ switch in times of overwhelm, helping me loosen up at social events and blocking out unwanted emotions. I’m learning new ways of managing those situations, but it’s worth it not to be constantly thinking about the option of drinking,” says Joyce.

“I recognise that the low alcohol option works for others, but for me, it didn’t, so I choose ‘no’.”

Having any kind of break from alcohol is smart idea, even if you don’t think you have a problem, says Davis.

“You learn so much about your relationship with alcohol, and it’s great for your health – so many things improve including insulin resistance, blood pressure and markers for cancer.”

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