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 “problem drinkers” 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’s 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. Since it is run by lay people, 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 MM
- Members take personal responsibility for their own recovery from a drinking problem.
- People helping people is the strength of the organization.
- People who help others to recover also help themselves.
- Self-esteem and self-management are essential to recovery.
- Members treat each other with respect and dignity.
Assumptions of MM
- Problem drinkers should be offered a choice of behavioral change goals.
- Harmful drinking habits should be addressed at an early stage, before problems become severe.
- Problem drinkers can make informed choices about moderation or abstinence goals based upon educational information and the experiences shared at self-help groups.
- Harm reduction is a worthwhile goal, especially when the total elimination of harm or risk is not a realistic option.
- People should not be forced to change in ways they do not choose willingly.
- Moderation 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 “discovering” 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 was 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’s increasingly defensive views, Schaler severed ties with her and MM.
In January 2000, Kishline acknowledged publicly that despite her belief in MM’s philosophy and methods, it wasn’t 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 “driving 100 mph in a blackout.” 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 ½ 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, “The current status of the addiction field is based 97% on this black-and-white idea that you’re either an addict or you’re not, and if you’re an addict, the only path is abstinence.” MM and AA may appear to be diametrically opposed on the issue of whether moderation or abstinence is the best approach, but that is not necessarily the case. “I 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 — they realize they can’t moderate and end up going to AA or another abstinence group. But there’s at least a sense of ‘I gave it a try,’ and a lot of people need to do that before they’re willing to accept that they need to abstain.”3
Alternative to AA
Instead of the 12-step program embraced by AA 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’s 2 million members worldwide, it is a viable option for some people struggling with drinking. MM is listed under 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’s website currently lists support groups in Brazil, Germany, Ireland, England, Scotland and Thailand, with emerging groups in Canada and Belgium.3
- What is Moderation Management? Moderation Management website. http://www.moderation.org/whatisMM.shtml Accessed June 14, 2016.
- Walker R. Remembering Audrey Kishline, the Founder of Moderation Management. The Fix. https://www.thefix.com/content/remembering-audrey-kishline Jan. 7, 2015. Accessed June 14, 2016.
- Girvan A. The next AA? Welcome to Moderation Management, where abstinence from alcohol isn’t the answer. The Guardian. https://www.theguardian.com/society/2015/mar/16/the-next-aa-moderation-management-abstinence-alcohol-isnt-the-answer March 16, 2015. Accessed June 14, 2016.