What is Moderation Management? Moderation Management (MM) is a support group for people with alcohol issues that offers an alternative to Alcoholics Anonymous (AA). Its basic premise is that abstinence-focused programs are not a one-size-fits-all approach. MM embraces an ideological delineation between \u201cproblem drinkers\u201d who have issues related to excessive drinking and those who are fully dependent on alcohol and have a disease. MM provides drinkers with the option of progressively moderating drinking habits instead of complete abstinence. One of MM\u2019s core tenets is that people should be free to choose how they address their addiction. Although the program primarily revolves around members offering one another practical tips for drinking in moderation, the group does not discourage people from using AA and other abstinence-based treatments. In fact, it states that 30% of MM members end up going to abstinence-based programs. MM shies away from discussing serious psychological issues in-depth, advising members to seek help from professional therapists to address underlying mental health or emotional issues.1 The Values That Guide Moderation Management \tMembers take personal responsibility for their own recovery from a drinking problem. \tPeople helping people is the strength of the organization. \tPeople who help others to recover also help themselves. \tSelf-esteem and self-management are essential to recovery. \tMembers treat each other with respect and dignity. Assumptions of MM \tProblem drinkers should have a choice of behavioral change goals. \tAddress harmful drinking habits at an early stage, before problems become severe. \tProblem drinkers can make informed choices about moderation or abstinence goals based upon educational information and the experiences shared at self-help groups. \tHarm reduction is a worthwhile goal, especially when the total elimination of harm or risk is not a realistic option. \tPeople should not force others to change in ways they do not choose willingly. \tModeration is a natural part of the process from harmful drinking, whether moderation or abstinence becomes the final goal. Most individuals who are able to maintain total abstinence first attempted to reduce their drinking (unsuccessfully). Moderation programs shorten the process of \u201cdiscovering\u201d if moderation is a workable solution by providing concrete guidelines about the limits of moderate alcohol consumption.1 Founding and Controversy In 1994, Audrey Kishline founded MM in response to her belief that she was not an alcoholic and an abstinence program was not the right approach for her. She stated that she simply had some problems related to drinking. In December 1995, Kishline published Moderate Drinking: The Moderation Management Guide for People Who Want to Reduce Their Drinking. The forward to the book is written by Jeffrey A. Schaler, PhD. The group gained visibility when Kishline appeared on Oprah and an article was published in Time magazine. However, MM faced an increasing level of criticism, prompting Kishline to publicly reinforce her message that MM was not meant for alcoholics. In 1996, uncomfortable with Kishline\u2019s increasingly defensive views, Schaler severed ties with her and MM. In January 2000, Kishline acknowledged publicly that despite her belief in MM\u2019s philosophy and methods, it wasn\u2019t working for her. She started attending AA, SMART Recovery and Women for Sobriety meetings while continuing to support MM for others. A few months later, tragedy struck when Kishline drove her truck the wrong way down an interstate in Washington. Her blood-alcohol content was more than three times the legal limit, and she admitted to \u201cdriving 100 mph in a blackout.\u201d The accident took the lives of a 38-year-old man and his 12-year-old daughter. Kishline was found guilty of vehicular manslaughter. She was released from prison in August 2003 after serving 3 \u00bd years. Soon thereafter, she violated her probation, which mandated sobriety, and was sentenced to 42 days in jail. In 2014, after years of battling alcohol abuse and plagued by personal demons, Kishline took her own life.2 To Abstain or Not to Abstain According to Marc Kern, director of MM, \u201cThe current status of the addiction field is based 97% on this black-and-white idea that you\u2019re either an addict or you\u2019re not, and if you\u2019re an addict, the only path is abstinence.\u201d MM and AA may appear to diametrically oppose the issue of whether moderation or abstinence is the best approach, but that is not necessarily the case. \u201cI often think of MM not as a treatment program, but as a strategy tool. We will help people strategize about a party coming up, for example. And for some people, going through MM is almost like a diagnostic tool \u2014 they realize they can\u2019t moderate and end up going to AA or another abstinence group. But there\u2019s at least a sense of \u2018I gave it a try,\u2019 and a lot of people need to do that before they\u2019re willing to accept that they need to abstain.\u201d3 Alternative to AA Instead of the 12-step program embraced by\u00a0AA and other addiction programs, the group utilizes a nine-step approach. This includes abstaining from alcoholic beverages for 30 days. In recent years, MM has emerged from the shadows and attracted a modest number of members. While MM is never likely to attain a number close to AA\u2019s 2 million members worldwide, it is a viable option for some people struggling with drinking. Find MM under the mutual-support groups on the Rethinking Drinking website (National Institutes of Alcohol Abuse and Alcoholism), right under AA. While the majority of meetings are in the U.S., the organization\u2019s website currently lists support groups in Brazil, Germany, Ireland, England, Scotland and Thailand, with emerging groups in Canada and Belgium.3 References \tWhat is Moderation Management? Moderation Management website.\u00a0http:\/\/www.moderation.org\/whatisMM.shtml\u00a0Accessed June 14, 2016. \tWalker R. Remembering Audrey Kishline, the Founder of Moderation Management. The Fix.\u00a0https:\/\/www.thefix.com\/content\/remembering-audrey-kishline\u00a0Jan. 7, 2015. Accessed June 14, 2016. \tGirvan A. The next AA? Welcome to Moderation Management, where abstinence from alcohol isn\u2019t the answer. The Guardian.\u00a0https:\/\/www.theguardian.com\/society\/2015\/mar\/16\/the-next-aa-moderation-management-abstinence-alcohol-isnt-the-answer\u00a0March 16, 2015. Accessed June 14, 2016.