Alcohol use is a major source of morbidity and mortality globally. Numerous adverse health outcomes have been linked to alcohol use, including liver disease, road injuries, violence, cancer, cardiovascular disease, suicide, domestic violence and family breakdown. Alcohol use is responsible for approximately three million deaths per year across the globe. Different paradigms have been employed in the treatment of alcohol use disorder, including abstinence-based and harm-reduction models. Radical acceptance, which has been successfully applied elsewhere in mental health treatment, has not gained purchase in the treatment of addictions. We used a set of corpus linguistics techniques to analyze a dataset of approximately 10,000 posts in an online forum for self-identified severe alcoholics. The forum we studied explicitly claims a radical acceptance approach to alcohol use disorder. The forum is “for people who accept their lifestyle choice and don't want to be interrupted . . ." We combined quantitative methods (keyword and collocation analysis) and qualitative methods (concordancing) to conduct a discourse analysis of the linguistic and rhetorical practices employed in the forum. We found that although the forum purports to embrace acceptance and eschew change, in fact, the discursive practices in the forum reveal a highly ambivalent relation with both acceptance and change. We found that acceptance and change are in dialectical tension that mirrors the structure agency dialectic described in critical realism. We suggest there may be merit in considering employing a radical acceptance paradigm in addictions treatment.
This is the author’s version of a work that was accepted for publication in International Journal of Drug Policy. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in International Journal of Drug Policy, 109, 2022 DOI: 10.1016/j.drugpo.2022.103862