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절주가 아닌 단주를 지지하는 경험적 이유와 과학적 증거

Empirical Reasons and Scientific Evidence that do not Support Controlled Drinking but Alcohol Abstinence

중독정신의학 2019년 23권 2호 p.51 ~ 58
김한오 ( Kim Han-Oh ) - 계요병원 중독센터


Objectives : It has long been advocated that abstinence is the only way to realistically and effectively cope with alcoholism. In opposition to controlled drinking (moderation), the valid reasons for abstinence were reviewed.

Methods : A search was conducted through PubMed using the keywords abstinence and/or moderation. And related books were also sought.

Results :Alcoholics should not practice moderation but abstinence instead for the following reasons. 1) The core concept of the definition of addiction is ‘loss of control.’ 2) Disruption of orbitofronto-striatal functional connectivity underlying perseveration in alcoholics makes them rigid and incapable of controlling drinking. 3) To prevent brain damage caused by repeated excitotoxicity. 4) Long-term follow up studies on alcoholics’ drinking have revealed the inevitable failure of moderation. 5) Due to the reinstatement phenomenon. 6) Moderation is a step towards another relapse. 7) As addicts attach to alcohol, detachment from alcohol makes them form a healthy attachment. 8) For the sake of their loved ones. 9) Abstinence is safer and simpler than moderation. 10) Moderate drinkers do not stand for alcoholics.

Conclusion : Moderation is a fit for a few addicts but abstinence is a better fit for the majority of addicts. Although abstinence should be an imperative goal of alcoholics, it should not be forced but instead chosen.


알코올사용장;, 익명의 알코올중독자들; 단주; 절주
Alcohol use disorder; Alcoholics anonymous; Alcohol abstinence; Controlled drinking.
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