Moderation Management

Moderation Management (MM) is a secular non-profit organization providing peer-run non-coercive support groups for anyone who would like to reduce their alcohol consumption. MM was founded in 1994 to create an alternative to Alcoholics Anonymous and similar addiction recovery groups for non-dependent problem drinkers who do not necessarily want to stop drinking, but moderate their amount of alcohol consumed to reduce its detrimental consequences.

History
Moderation Management was founded by Audrey Kishline, a problem drinker, who did not identify with the disease theory of alcoholism (as presented in Alcoholics Anonymous and other addiction recovery twelve-step programs) finding that it eroded her self-confidence. Kishline never experienced withdrawal symptoms and was able to hold a job and stay in school while drinking. Kishline found that she could moderate her drinking with the help of cognitive-behavioral therapy principles and in 1994 founded Moderation Management as an organization for non-dependent problem drinkers to help maintain moderate alcohol use. MM maintains, however, that it is not for all problem drinkers; that there are some drinkers for whom abstinence will be the only solution.

In January 2000 Kishline posted a message to an official MM email list stating that she had concluded her best drinking goal was abstinence and that she would begin attending Alcoholics Anonymous, SMART Recovery and Women For Sobriety meetings while continuing to support MM for others. Having never ceased her excessive drinking, in March 2000 she drove her truck the wrong way down a highway, and hit another vehicle head-on killing its two passengers (a father and his 12 year old daughter). MM continued to grow during Kishline's time in prison. She was released in August 2003 after serving 3½ years of her 4½ year sentence.

In 1998, MM member Larry Froistad posted a murder confession on an official MM email list. Froistad had deliberately set his house on fire in 1995 while his five year old daughter was sleeping, but had successfully made it look like an accident. During the course of the investigation evidence emerged that he may have molested his daughter. Out of the approximately 200 members on the email list only three reported the confession to legal authorities. The incident has been studied as an online version of the bystander effect.

Kishline had asked many professionals for advice while she was establishing the fellowship, including psychologist Jeffrey A. Schaler, who had written the foreword for the first edition of the book, Moderate Drinking, used in the organization and served on the original board of trustees for MM. Schaler and MM split ways over whether or not there was a medical distinction between problem drinkers and alcoholics, the latter having a disease and the former having a habit, and over the MM's failure to condemn Larry Froistad following his murder confession. Schaler's foreword was replaced with one by Historian Ernest Kurtz in subsequent editions.

Methodology
MM allows members to set their own drinking goals as they feel appropriate. MM encourages members to follow particular drinking guidelines, limits, goal setting techniques, and a nine-step cognitive-behavioral change program.

A Moderate Drinker
 * Considers an occasional drink to be a small, though enjoyable, part of life.
 * Has hobbies, interests, and other ways to relax and enjoy life that do not include alcohol.
 * Usually has friends who are moderate drinkers or nondrinkers.
 * Generally has something to eat before, during, or soon after drinking.
 * Usually does not drink for longer than an hour or two on any particular occasion.
 * Usually does not drink faster than one drink per half-hour.
 * Usually does not exceed the .055% BAC moderate drinking limit.
 * Feels comfortable with his or her use of alcohol (never drinks secretly and does not spend a lot of time thinking about drinking or planning to drink).

The MM Limits
 * Strictly obey local laws regarding drinking and driving.
 * Do not drink in situations that would endanger yourself or others.
 * Do not drink every day. MM suggests that you abstain from drinking alcohol at least 3 or 4 days per week.
 * Women, who drink more than 3 drinks on any day, and more than 9 drinks per week, may be drinking at harmful levels.
 * Men, who drink more than 4 drinks on any day, and more than 14 drinks per week, may be drinking at harmful levels.

Nine Steps Toward Moderation and Positive Lifestyle Changes
 * 1) Attend meetings or on-line groups and learn about the program of Moderation Management.
 * 2) Abstain from alcoholic beverages for 30 days and complete steps three through six during this time.
 * 3) Examine how drinking has affected your life.
 * 4) Write down your life priorities.
 * 5) Take a look at how much, how often, and under what circumstances you had been drinking.
 * 6) Learn the MM guidelines and limits for moderate drinking.
 * 7) Set moderate drinking limits and start weekly "small steps" toward balance and moderation in other areas of your life.
 * 8) Review your progress and update your goals.
 * 9) Continue to make positive lifestyle changes and attend meetings whenever you need ongoing support or would like to help newcomers.

The MM limits and guidelines were derived from the work of Dr. Martha Sanchez-Craig. MM members are encouraged, but do not need to follow, the suggested guidelines, limits and steps. MM does not view non-dependent problem drinkers as alcoholics, but rather people with a bad, but controllable, habit. MM does not state that surrender or spirituality is needed to end or control the habit. MM literature makes a similar distinction to Alcoholics Anonymous literature that there are problem drinkers who can return to controlled drinking and alcoholics who can not.

MM groups give members a chance to identify with other problem drinkers and learn from the successes and failures of each other. Mutual support and encouragement is provided. Face-to-face meetings last about an hour, whereas online meetings are ongoing. "Crosstalk," members interrupting each other to provide feedback during meetings, is allowed. Mental health professionals are allowed to help start MM meetings, but ultimate control must be left to the participants. A content analysis of online MM meetings found the most common types of communication by members were self-disclosure, provision of information and advice, and provision of emotional support. Similar studies of depression and eating disorder support groups have found the same patterns.

Membership
The vast majority of face-to-face MM meetings occur in the United States. Active membership is estimated at about 500 people at any given moment, but with a larger number coming in to contact with the organization through the Internet. Most MM members are white (96%), employed (81%), educated (72% have at least a college education) and on average are more secular than the rest of the population (32% identify as atheists or agnostics, only 16% regularly attend religious services). MM attracts an equal number of men and women (49% are female) and a large number of people under 35 years of age (24%), with a much larger percentage (76%) of people who are over 35 years of age.

MM members mostly describe themselves as being non-dependent problem drinkers. In general, MM members report having a mild history of substance-abuse problems before joining, with 40% having consumed four or fewer drinks per drinking day and less than 10% experienced serious withdrawal symptoms or comorbid drug abuse.