Drinking in Moderation: A Harm-Reduction Approach

What Is Moderation?

Do you have some concerns about your drinking but aren’t willing to give up alcohol completely? Have you thought about moderating your drinking? What does this mean exactly?

It might be easier to start by defining heavy drinking. The National Institute on Alcohol Abuse & Alcoholism (NIAAA) defines heavy drinking as:

  • For men, consuming more than 4 drinks on any day or more than 14 drinks per week
  • For women, consuming more than 3 drinks on any day or more than 7 drinks per week

In defining moderate drinking, the NIAAA follows the USDA’s “Dietary Guidelines for Americans 2020-2025,” recommending a maximum of two drinks a day for men and one for women. NIAAA also notes that some folks should avoid alcohol entirely, including those who:

  • Plan to drive or operate machinery, or participate in activities that require skill, coordination, and alertness
  • Take certain over-the-counter or prescription medications
  • Have certain medical conditions
  • Are recovering from alcohol use disorder or are unable to control the amount that they drink
  • Are younger than age 21
  • Are pregnant or may become pregnant

Moderation Management, a support network and behavior change program, offers similar metrics for moderation. They also note that the moderate drinker does not drink more than 3-4 days per week.

Other common guidelines for moderation may include:

  • Monitoring your blood alcohol concentration drinking limit. You can estimate your BAC here.
  • Drinking at a slow/moderate pace (usually not more than one drink per half hour)
  • Limiting the total time spent drinking (no longer than a couple of hours on any specific occasion)
  • Avoiding drinking to the point of blacking out, hangovers, etc.
  • Avoiding other negative consequences associated with drinking (e.g., impacts to your health, work, relationships)
  • Avoiding drinking in a manner that leads to feelings of guilt or regret
  • Eating before, during, and/or after drinking
  • Drinking on occasion and maintaining the ability to socialize/have fun without alcohol
  • Creating ways of relaxing/winding down that do not involve alcohol
  • Developing/maintaining sober hobbies/interests 
  • Cultivating/maintaining social connections with those who are moderate drinkers or don’t drink at all
  • Avoiding drinking in secret or hiding your drinking
  • Avoiding drinking in a way that leads to other people complaining about your use
  • Spending most of your time thinking about things besides drinking/alcohol
  • Feeling comfortable with the role that alcohol plays in your life 

Why Moderation?

As noted above, some folks approach moderation because they observe  some difficulties with their drinking but aren’t ready to quit completely. Maybe they’ve noticed some negative consequences associated with drinking , such as health issues, hangovers, relationship troubles, or blackouts. Recognizing these consequences, they realize that it would be helpful to dial back the frequency or amount of their alcohol use, but sobriety just doesn’t feel possible or sustainable. If they can moderate, they will likely experience fewer negative consequences associated with their use. In this way, moderation serves as a form of harm reduction, an approach focused on reducing any harm associated with alcohol use.

How to Moderate

Moderation Management offers a step-by-step approach for moderating your drinking. While the organization notes that folks don’t necessarily need to undertake these steps in order, they do advise that folks spend some time on each of them:

1. Start keeping a diary of your drinking, to help learn how your problems with drinking occur.

2. Look at the limits of drinking for moderate drinkers, and some of the practices and attitudes that go with moderate drinking, to get a clear picture of the moderation objective.

3. With that clear picture of what moderation looks like, consider whether moderation or abstinence seems the better objective for you. Also score your problem severity with a self-test, and consider other factors, to see whether moderation would be workable for you.

4. Make an extensive list of the problems drinking has caused you, and the benefits you expect from moderation, to strengthen your resolve.

5. Start on a period of abstinence of 30 days or more, to experience the positives of non-drinking. During this period away from alcohol you can work through some steps to help you achieve moderation.

  • Learn skills for avoiding drinking on occasions when you choose not to drink.
  • Learn skills to control drinking on occasions when you do drink.
  • Identify the key triggers that lead you to over-drink, and develop means to neutralize those triggers.
  • Develop your own personal rules that will keep your drinking moderate.
  • Identify and start new spare-time activities that will displace drinking in your life.

6. At the end of your period of abstinence, you can start drinking again cautiously, being mindful of your limits and personal rules for drinking. Maintain a high degree of attention to your drinking during this period, including keeping a diary.

7. If and when you have slips, do a post-mortem to see what went wrong, and change your personal drinking guidelines if necessary.

Some folks might attempt to moderate their drinking and continue to struggle with limits and reducing their use. For some, once they start drinking, they have trouble stopping. Or they repeatedly surpass the limits they’ve decided are important to uphold. For folks who continue to struggle with moderation, abstinence might ultimately be a more effective approach. A therapist who specializes in substance use disorders can help you explore your relationship to alcohol, your goals around drinking, and how to moderate (and troubleshoot) if that’s the path you choose.


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