Brad Pitt knows something about alcohol addiction recovery that most don’t - CNN

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Brad Pitt’s recent revelation that he’s drinking again in “a more restrained manner,” after seven years of sobriety following heavy drinking, sparked intense pushback. The actor’s past behavior aside, the larger controversy was in challenging the long-held idea that someone who struggled with alcohol in the past can’t ever drink normally — that recovery is defined solely by sobriety.

The controversy Pitt stepped into comes down to old versus relatively new approaches to dealing with drinking problems. What makes someone “recovered” from alcohol addiction has seen “an evolution in health care,” said Dr. Smita Das, addiction psychiatrist in the Addiction Medicine Dual Diagnosis Clinic at Stanford University in California.

Relevant medical fields in recent years have widely embraced the idea of a spectrum of recovery, including sobriety and non-abstinence, but some clinicians, abstinence support organizations (most notably Alcoholics Anonymous), and patients with alcohol issues haven’t caught up to the science — or are downright opposing it.

Pitt simply gave voice to the expanded understanding of recovery from what is commonly called alcohol addiction or alcoholism, but has been officially known as alcohol use disorder, or AUD, since 2013, according to the DSM-5. That’s the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders — the authoritative handbook of mental disorders published by the American Psychiatric Association and used by mental health professionals in the United States.

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The body of research on non-abstinent recovery has been growing as well. A small study in February examined how low to moderate drinking can be part of successful recovery for some. Compared with the abstinent group in that study, those who continued to drink felt more confident they could limit their intake. Participants who drank also felt that positive life changes and supportive relationships bolstered their efforts to maintain recovery.

In a larger 2025 study about non-abstinent recovery, about 1,900 participants reported drinking in the past month — and their health and functioning were similar to those of abstinent participants, though they were slightly more likely to be experiencing psychological distress.

Redefining alcohol use disorder and recovery

Alcohol use disorder is defined by the DSM-5 as “frequent or heavy alcohol drinking that becomes difficult to control and leads to problems such as in relationships, work, school, family, or other areas.”

Someone can have mild, moderate or severe AUD depending on how many criteria they’ve experienced in the past year. This definition was a broader move away from previous DSMs’ binary diagnoses of alcohol abuse and alcohol dependence. The “abuse” diagnosis required that a patient was experiencing severe or dangerous consequences such as alcohol-related legal problems or failure to fulfill major obligations. The “dependence” diagnosis referred to serious but less severe issues, such as abandoned interests and repeatedly failed attempts to quit drinking.

The DSM-5 definition of AUD supports the idea that sobriety “is a part of the definition of recovery, but it is not the whole thing,” Das said — since patients can also reach remission by reducing drinking and whatever criteria that led to their diagnosis.

Researchers with the US National Institute on Alcohol Abuse and Alcoholism, or NIAAA, published a paper on a new definition of recovery from AUD in 2022 — calling it a process or outcome in which someone pursues or achieves both remission from AUD and cessation of heavy drinking.

Remission requires that a patient have no AUD criteria besides craving. Someone who hasn’t had any criteria for up to three months is in initial remission — three months to one year is early remission, one to five years is sustained, and more than five years is stable. For men, cessation of heavy drinking means having no more than four standard drinks on a single day or 14 drinks weekly, and for women, maximum three drinks on one day or seven drinks weekly, the authors wrote.

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