Different strokes for different folks


August 21, 2016

Research over the last decade has shed a lot of light on alcohol use disorder (AUD):

  • Among dependent drinkers, low-risk drinking (17.7%) was about as likely a recovery outcome as abstinence (18.2%) [1]
  • The worse your drinking problem, the less likely you will be able to drink at low-risk levels. [1]
  • The Centers for Disease Control and Prevention (CDC) found that only 10.2% of excessive drinkers were dependent. [2]
  • NIAAA developed an 11-question self-test to gauge your problem severity:

https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders

So AUD is on a spectrum – not just alcoholic or not. And there are multiple paths to recovery, though moderation is less likely for those with more severe AUD.

People often ask me the secret to moderation. There isn’t just one; rather, there are many strategies out there, and none works for everyone. You have to try several and see what works. People often adopt some combination of rules/tools like these:

  • keep out of house when abstaining
  • no drinking at home
  • no drinking alone
  • no drinking on weekdays
  • no drinking to relieve stress
  • no shopping after noon
  • buy expensive wine/whiskey/whatever (e.g., trade in box-o-wine for the good stuff, and savor it)
  • alternate between alcoholic and non-alcoholic drinks
  • keep adding ice chips to wine to stretch it out
  • touch the wine to your tongue – barely sip

Finding the combination of rules that works for you takes trial and error.

I found MM in 2002, and it has made a huge difference in my health and productivity. I did the 30 within a month of subscribing to the listserv, and started drinking moderately thereafter. I got pregnant several months later, so I had a nine month abs period, followed by several months of minimal drinking. After I stopped nursing, my drinking gradually increased — “the creep.” I did 30’s every January, which helped me reset, and in fall 2008, I started doing 30’s every few months to keep the creep at bay. It worked so well, and I enjoyed the abs months so much, I increased the frequency to every other month. I enjoy the benefits of abstaining, but it’s not a long wait until I get to enjoy cider, beer, or wine again.

Since I switch so often between modes, I know exactly what benefits each provides me. My brain works better when I abstain, but the thought of never having the treats I love makes me panic. I know I will fail. But I realize now I don’t need to be 100% abstinent. I can be almost abstinent, as are the 30% of adults who drink one drink per week or less [3]. Gradually converging toward abstinence, but still indulging on occasion — that’s where *my* best quality of life lies, I have become convinced. Maybe next year I’ll do two months abs, one month moderation; maybe six weeks abs, two weeks moderation. Dunno yet.

The less booze I drink, the better I sleep. The better I sleep, the better I think, work, etc. My metabolism, hormones, emotional equilibrium, attention — they all benefit from quality sleep. Someone at a face-to-face meeting had a fitness device that tracked sleep movements, among many other things. She said she could tell just by looking at the graphs of her sleep movements which evenings she drank alcohol. Her sleep was much more fitful.

If you do a 30, or whatever period of abstinence, it’s a good idea to start back up slowly. SBRS’s Post 30 THIRTY explains how to dip your toes in the water, rather than dive back into your old drinking pattern. Also, keep a drinking diary, as the MM Steps of Change recommends. This will force you to drink more mindfully, and help you get into touch with what each drink is doing for you, so you can see more clearly that the returns diminish quickly after the first few drinks.

So if you aren’t ready to quit drinking yet, but would like to cut back, read the MM Steps of Change and think about which of these strategies might work for you.

References:

  1.  Dawson DA1, Grant BF, Stinson FS, Chou PS, Huang B, Ruan WJ. Recovery from DSM-IV alcohol dependence: United States, 2001-2002. Addiction. 2005 Mar;100(3):281-92.
  1.  Marissa B. Esser, MPH; Sarra L. Hedden, PhD; Dafna Kanny, PhD; Robert D. Brewer, MD, MSPH; Joseph C. Gfroerer, BA; Timothy S. Naimi, MD, MPH Prevalence of Alcohol Dependence Among US Adult Drinkers, 2009–2011
  1. Washington Post “Think you drink a lot? This chart will tell you.”

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