Sobriety | Research & Encyclopedia Articles

The term sobriety is not defined in current medical or psychiatric literature. The term abstinence is found more often and is generally agreed upon as the treatment goal for severe alcoholics. Abstinence is defined as nonuse of the substance to which a person was addicted.

The term "sobriety" is used by members of ALCOHOLICS ANONYMOUS (AA) and NARCOTICS ANONYMOUS (NA), and also by members of other Twelve-Step groups and recovery groups not affiliated with AA. In AA and NA, "sobriety" is often preceded by the adjectives "stable" or "serene." Abstinence—the condition of being sober—is a necessary but insufficient condition for sobriety. Sobriety means something different from the initial abstinence so often achieved by alcoholics and other drug addicts. This initial abstinence is recognized as a time of vulnerability to RELAPSE, often referred to as a "dry drunk" or "white knuckle sobriety."

According to AA beliefs, recovery from ALCOHOLISM and other addictions calls for more than just abstinence. The addict's central nervous system must undergo a substantial readaptation. This means that the CRAVING, drug-seeking, dysphoria (unhappiness), and negative cognitions that characterize early abstinence must not only diminish but must also be replaced by more normal positive behavior. This readaptation requires time and substitute activities. The activities most associated with successful readaptation are found in TREATMENT programs and in AA or NA.

Sobriety, as used by most recovering people in AA and NA, refers to abstinence plus a program of activity designed to make the abstinence comfortable and to improve functioning in relationships and in other aspects of life. The program of recovery that leads to stable sobriety usually includes: (1) attending AA and/or NA meetings; (2) "working" the Twelve Steps and continuing to use steps 10, 11, and 12 for the maintenance of sobriety; (3) working with a sponsor who acts as a mentor in maintaining sobriety; (4) belonging to a home group and engaging in service activities that help others with their sobriety; and (5) other activities that enhance or support sobriety (e.g., exercise, hobbies, and psychotherapy). A program of recovery recognizes that any activity has potential to either enhance or interfere with the recovering individual's sobriety. In addition, Twelve-Step programs emphasize the importance of basing sobriety on positive beliefs and ideals. "Shotgun sobriety" is defined in AA as a type of sobriety based only on fear of drinking. "Long-term sobriety must be based on spiritual principles, not on fear of alcohol."

Secular Organization for Sobriety (SOS), Women for Sobriety (WFS), Life Ring Secular Recovery (LSR), and similar recovery groups for substance abusers also define sobriety in terms of abstinence from drugs and alcohol. A Life Ring pamphlet states, "Please look elsewhere for support if your intention is to keep drinking or using, but not so much, or to stop drinking but continue using, or stop using but continue drinking. The successful LifeRing participant practices the Sobriety Priority, meaning that nothing is allowed to interfere with staying abstinent from alcohol and drugs."

One complication of the term "sobriety" has been the difficulty of defining it in the context of the so-called "process addictions" or "behavioral addictions," terms that have been used to distinguish addictions to such activities or behaviors as gambling, shopping, overeating, sexual acting-out, etc. from substance addictions in the strict sense. Unlike alcoholics and drug abusers, people with behavioral addictions cannot always define "sobriety" as simple abstinence. A compulsive overeater, for example, must learn to consume food in moderation, not avoid it. Persons addicted to compulsive spending or shopping cannot simply abstain from making purchases. Members of Sex Addicts Anonymous (SAA) rarely define sexual sobriety as "complete abstinence from sex," although at times recovering persons may practice complete abstinence (celibacy) for a period of time in order to gain perspective on their life. In this Twelve-Step group, sexual sobriety is most often defined as "a contract that the sexual addict makes between him/herself and their 12-step recovery support and/or their therapist/clergy. These contracts… are always written and involve clearly defined concrete behaviors from which the sexual addict has committed to abstain in order to define their sobriety." Comparable abstinence contracts are used by recovering binge eaters, compulsive spenders, relationship addicts, etc.

One benefit of attempts to redefine sobriety in the context of behavioral addictions is that they have called attention to the problem of substitute addictions, which are addictions that develop when a recovering alcoholic or drug abuser substitutes food, tobacco, or certain activities (including exercise) for their drug of choice. Many members of Twelve-Step groups have found that sobriety requires a re-examination of addictive beliefs and attitudes in general as well as abstinence from alcohol or specific drugs.

One question that has arisen in recent years is whether some alcoholics can achieve sobriety through spontaneous recovery. G. G. May (1988) uses the term "deliverance" for this phenomenon and defines it as "healing [that] takes the form of empowerment that enables people to modify addictive behavior." Some researchers suggest that spontaneous remission and recovery is more common among alcoholics than was once believed, and that it is connected to growth and maturity in the course of the adult life cycle. G. E. Vaillant (1983) found that most alcoholics in his study outgrew their drinking problem, more often than not without going into treatment or joining AA. Stanton Peele (1992) is perhaps the best-known proponent of the viewthat "… some people who appear completely out of control of their actions at one point significantly change their outlooks and abilityto regulate their behavior later in life." He likens spontaneous recovery of sobriety to the ability of some smokers to suddenly quit using tobacco.

Despite these problems of precise definition, the concept of sobriety (abstinence or its equivalent for nonchemical addictions, plus a program of activity designed to make abstinence comfortable) is a useful one for health-care professionals.

Addiction: Concepts and Definitions

ALCOHOLICS ANONYMOUS WORLD SERVICES. (1976). Alco holics anonymous. New York: Author.

AMERICAN PSYCHIATRIC ASSOCIATION. (1989). A.P.A. task force: treatment of psychiatric disorders. Washington, DC: Author.

AUGUSTINE FELLOWSHIP, SEX AND LOVE ADDICTS ANONYMOUS. (1986). Sex and Love Addicts Anonymous. Boston: Fellowship-Wide Services, Inc.

LIFE RING SECULAR RECOVERY. (2000). Sobriety is our priority. New York: Life Ring Secular Recovery Ser vice Center.

LUDWIG, A. M. (1986). Cognitive Processes Associated with "Spontaneous" Recovery from Alcoholism. Jour nal of Studies on Alcohol, 47, 53-58.

MAY, G. G. (1988). Addiction & grace: love and spiri tuality in the healing of addictions. New York: HarperCollins.

PEELE, S. (1992). Why is everybody always pickin' on me? A response to comments. Addictive Behaviors, 17, (1) 83-93.

STONE, E.M. (ED.). (1988). American psychiatric glos sary. Washington, DC: American Psychiatric Press.

VAILLANT, G. E. (1983). The Natural history of alcohol ism. Cambridge, MA: Harvard University Press.

WILFORD, B.B. (ED.). (1990). Syllabus for the review course in addiction medicine. Washington, DC: Amer ican Society of Addiction Medicine.

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