Controlled drinking and controlled drug use as outcome goals in British treatment services

Abstract

We mailed a questionnaire to the directors of a nationwide sample of substance abuse service agencies in England, Wales, and Scotland (response rate 70%; 436 of 623 potential respondents) to assess the acceptance and availability of both controlled drinking and controlled drug use, and to examine whether acceptance was associated with clients’ severity (abuse versus dependence) and ultimate goal choice (non-abstinence as intermediate versus final outcome goal). Chi-square analyses revealed a statistically significant association of acceptance ratings with client severity/goal choice conditions. Specifically, larger majorities of agency administrators rated controlled drinking and controlled drug use as somewhat or completely acceptable for clients described as abusing versus dependent on their key substance, and non-abstinence was rated as acceptable less often for dependent drinkers and dependent drug users who select non-abstinence as their final outcome goal. Consistent with several decades of research on treatment outcome, natural recovery, and harm reduction, there is widespread and ongoing support for controlled or moderate consumption as an outcome goal by clients presenting to British treatment services with alcohol and drug problems, but such support is moderated by the clients’ severity and ultimate goal choice.

• Controlled drinking
• controlled drug use
• harm reduction