Let's Not Raise a Glass to 'Moderation Management'

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Maybe human intelligence is a zero sum game. The rules seem to demand that each manifestation of brains be matched by an equivalent idiocy.

So if science has mapped the human genome, where may we find a compensating feat of imbecility to restore the balance?

I nominate the idea of moderation management, an admittedly obscure but nonetheless impressive and truly insidious piece of dumbness.

Moderation management is the notion that alcoholics (or "problem drinkers") can continue drinking as long as they are careful and stick to a kind of homeopathic weekly ration of drinks (nine for women; 14 for men).

This is like saying that teen-age pregnancy is perfectly all right, as long as the girls stay pregnant for only three or four months at a time. It's part of a larger revolution against common sense. We have a habit of reinventing the wheel as a triangle. Managed moderation puts the drunk on the road to recovery in a vehicle with trapezoid wheels.

The stupidity in this case lies in the cluelessness, the aggressive point-missing, an alienation from the thing being addressed. Amazingly, the director of the famous Smithers Addiction Treatment and Research Center in New York City expressed support for managed moderation. Smithers eased him out not long ago. An outfit called Addiction Alternatives, based on Los Angeles, has been attracting drinkers who hope that their problem can be thus disciplined.

The argument is that many problem drinkers can be helped with this approach — people who think the total abstinence route taken by Alcoholics Anonymous is (in the cagey phrase) "not for them."

I am certain the approach is not only futile for problem drinkers but also dangerous. Inside the alcoholic's brain two characters are arguing. One of them blusters and pettifogs and rationalizes, in the voice of denial: "I don't really have a problem... I can stop any time I want to... I only drink because (fill in the blank)."

The other character doesn't say much, but he massively disconcerts the denier, who keeps trying to stuff a sock in his mouth; the second one simply mutters, "You're an idiot. You know perfectly well you're an alcoholic, and you've got to stop before you kill yourself."

One of the two will win the argument. If the denier wins, it's a disaster, not only for the alcoholic but also for his or her family.

The idiocy of moderation management is that it cheers on the denier. It empowers him in folly. It spiffs up his rationalization. It is a pseudo-solution. Managed moderation is the pettifogger's debate coach.

It is the second voice that needs encouragement — the one that faces facts and deals with them. Every alcoholic knows, in some region of the brain, the truth about what he is. But every alcoholic will do almost anything to avoid facing the truth. Moderation management gives the addict a hiding place. It poisonously helps him along in the avoidance, gives him a strategy (14 drinks... wellllll, maybe 16 or 17 this week... or, just this once, maybe, oh, 42) and moral cover (it's all right, you see, I'm in this program...) to continue doing the one thing he must not do.

"It's a gray area," says one problem drinker experimenting with managed moderation. Right. Alcoholism loves gray areas. It thrives in the ambiguous zones.

But alcoholism is not a gray area. It is binary, black-and-white, either/or. It is defeated by clarity and self-knowledge, not by a sneaking, temporizing, dishonest litigation with the sauce.