If Nothing Changes, Nothing Changes: Why Are We Still Pushing Abstinence When It Fails 90% of the Time?
Key Takeaways
Abstinence-based alcohol treatment sees around a 90% relapse rate in the first 12 months
The Sinclair Method (TSM) offers a medical, harm-reduction approach with a 78% success rate
TSM is backed by 35 years of research and 125 clinical trials, yet remains underutilised
Outdated thinking and a lack of awareness keep abstinence-based approaches dominant
It’s time to rethink how we treat Alcohol Use Disorder (AUD) with science-led alternatives
Doing the Same Thing, Expecting Different Results
We’ve all heard the quote attributed to Einstein: “Insanity is doing the same thing over and over again and expecting different results.” When it comes to treating Alcohol Use Disorder, this rings painfully true.
Abstinence-based treatments have been the go-to approach for decades. Whether it’s rehab, 12-step groups, or cold-turkey efforts, the method is simple: stop drinking and never drink again. But here’s the problem—up to 90% of people relapse within the first year.
And still, this remains the primary model offered to people in crisis.
The Sinclair Method: An Evidence-Based Alternative
What if we told you there’s a scientifically validated method that actually works for the majority of people, yet it’s rarely talked about? The Sinclair Method (TSM) flips the traditional model on its head. Rather than focusing on abstinence from day one, it uses a pharmacological approach to reduce the desire to drink over time.
Involves taking naltrexone, a prescription medication, one hour before drinking
Over time, this rewires the brain’s reward system through a process called Pharmacological Extinction
Allows people to gradually regain control over their drinking without needing to go cold turkey
Backed by 35 years of research and 125 clinical trials, TSM has demonstrated a 78% long-term success rate. That's a figure abstinence-based models can only dream of.
Learn more about the science and effectiveness of this approach in our post on whether The Sinclair Method works.
So, Why Isn’t It Being Used?
Despite the overwhelming evidence, TSM remains a fringe method in the mainstream recovery world. But why?
Cultural bias towards abstinence as the "only true recovery"
Lack of training for healthcare providers on medication-assisted treatments
Stigma around taking a pill and continuing to drink while seeking help
Limited public awareness—many people have simply never heard of it
Resistance to change in institutions and treatment providers
In short, old habits die hard. The recovery industry, much like the condition it treats, can be stubborn.
Let’s Embrace What Works
Abstinence isn’t a bad choice—it’s just not the right choice for everyone. For many, the pressure to quit completely can feel overwhelming or even trigger shame when they “fail”. That’s where The Sinclair Method offers hope: a pathway based on empowerment, patience, and science.
If we genuinely care about helping people overcome AUD, we must be willing to evolve. That starts by asking hard questions and recognising when a system is broken.
We’re Here to Help You Rethink It
At Rethink Drink, we support individuals who are ready to explore a more compassionate and evidence-based approach to alcohol recovery. If you're curious about TSM or want to understand if it’s right for you:
Visit our FAQ page for common questions about the process
Book a free screening call to speak with a member of our team in confidence
If nothing changes, nothing changes. Let’s start changing the conversation—and the outcomes.