Problem Drinking – Can You Just Cut Back?
Some call this Moderation Management, Controlled Drinking and a host of other names.
I’ve had several clients in my Sausalito office that say they are drinking too much, drinking too often, some even say they are “mildly” addicted but also say they just want to cut back, not quit, but have been unable to do it on their own.
Can just cutting back work?
Yes, for a few. The concept itself is controversial to some. Many experts still say that just cutting back won’t work – that there must be total abstinence. AA certainly feels that way. Many people who drink too much are resistant to getting help, entering treatment and to complete abstinence but are willing, even eager, to try cutting back. Moderation is a goal, a test, that is worthy and workable for many and for many it is a start. In fact, Moderation could be a help where there is clearly a treatment gap, as often only people with severe alcohol addiction and consequences get treatment. However, Moderation certainly doesn’t work for everyone and there is no way to determine who can learn to control their drinking vs. those who must give it up completely. There isn’t enough data and only one research test on Moderation thus far, which isn’t nearly enough.
In my experience, some can stop for 45-60 days, clean out their systems and test themselves to see if they can stop at one drink every other night. Others will plan to start out with two drinks or less every other night, planning to get to one drink every other night and never make it. Some can’t get through even one week of cutting back of any kind.
Oddly, many of these same clients resist keeping track of exactly how much they were drinking each day. Others would track, but not the size (ounces) of their drinks.
Some refused to buy an inexpensive Breathalyzer to keep in their car and use it, even though admitting to regularly driving after drinking.
I say that if you can’t handle the above methods of cutting back, then it is unlikely that you can Moderate or manage your drinking.
Figure out why you are really drinking to excess.
This is critical and your therapist can certainly help. What are you medicating? What feeling are you trying to get rid of? It didn’t start off being a habit, obviously. Is it now a compulsion?
First, is your drinking really a problem?
You may be having a drinking problem if you have one or more of these….
Try to hide the amount you are drinking or feel the need to lie or down play it
Have friends or family who are concerned
Need to drink to relax or de-stress with alcohol instead of other, healthier methods
Regularly drink more than you intended to, or told yourself or others that you were going to
Feel guilty, embarrassed or ashamed about your drinking
You have to drink every day, and cannot manage every other day or twice a week
Use more than one or two drinks daily
Regularly cannot stop at one drink
Occasionally black out or forget what you did while you were drinking and how much you drank
Drink and drive thinking nothing will happen
What does Moderation look like?
It looks like a lot of small changes, instituted immediately.
Your therapist can help you with these but cannot manufacture motivation.
It must come from within, but your clinician can help you to strengthen it. You must give Moderation an honest trial. If you haven’t made good progress in cutting down after 2 or 3 months, then you should seriously consider completely giving up drinking and seeking abstinence via professional help.
- Keep exact track of what you drink, when, how much and with whom by writing it down in your phone, your calendar or on paper. The real amount and size of your drinks generally mean success or failure.
- Make yourself a weekly goal and memorialize it. Exactly which day, or days, this week are you planning to drink. Look at your social calendar and decide accordingly. It is very important to have days you do not drink at all. People who do this are the most successful.
- Spread out your drinks. Stop chain drinking one alcoholic drink after another. Alcohol is very dehydrating. You need to drink a full glass of water between each alcoholic drink. Sparkling water with a twist of lemon or lime is not only refreshing but for those embarrassed not to be drinking with others, it looks like a number of potential alcoholic drinks. Having juice or juice mixed with sparkling water tends to lessen the taste for more alcohol. Learn to sip your drink slowly to actually savor and taste it.
- Act like an Italian. In Italy, it is considered rude to offer a drink to a guest without some bread based food or appetizer to go with it. The idea is that the food “absorbs” some of the alcohol. Research shows it does slow the absorption.
- What triggers you? It is critical to seriously examine this.
Do you think you require a few drinks to wind down from a stressful job? What else relaxes you? Perhaps exercise, meditation, a walk, hobbies or new, health conscious friends may help.
Showering & changing clothes immediately upon coming home helps many to feel the transition from work to home and refreshes them.
Change your routine if you have gotten in a habit of stopping at a bar, having a drink with a partner even before dinner, etc. If drinking at home is your habit, stop keeping alcohol at home. It doesn’t HAVE to be there.
6. Practice the habit of simply saying NO. There is no stigma to not drinking. As we become more health conscious, many people choose not to drink at all. Others don’t drink for diet or health reasons. In 2014 almost 30 million Americans were said to have diabetes and cannot drink. If you look around you at the people who are not drinking, instead of those who are, you may be very surprised.
7. Distract yourself. There are many activities that you just can’t drink and do, like sports, exercise, a yoga class, playing outside with your youngsters or your dog, knitting, etc.
It’s helpful to realize that your strong urge for most things, certainly alcohol, will peak and then dissipate if you allow it to. Many people are never taught as children to just feel their feelings and then let them dissipate. You must work hard to hold onto an urge or a thought. Just attempt it when you are trying to meditate – the thoughts will come but they won’t linger. More will come, but again, you can’t hold them.
8. Take a month off. Yes, a full month each year. It’s a common practice for many to skip all alcohol during the month of January. Why not try it?
Some people claim that they have so much social anxiety that they can’t function well in social or work gatherings, talk to strangers etc., or even manage their moods. If this is your “excuse” for drinking too much, too often, then seek a therapist or medical doctor who can help you more effectively.
What does it take to be serious about truly working Moderation requirements?
Alcohol use can cause serious health complications, affecting virtually every organ in your body, including your brain and certainly your appearance – your looks. Over drinking can also damage your heart, liver and emotional stability, your family, finances, your relationships, your reputation and career, and can lead to serious alcohol abuse and addiction. Usually one, or more, of these issues leads a drinker to Moderation or stopping drinking altogether.
What if Moderation doesn’t work?
My website: www.valentinotherapy.com has an Alcohol Self-Test from Johns Hopkins that is geared to whether you need treatment in a program.
People with severe problems, such as those who keep on drinking even after they lose jobs, damage relationships or get DUIs, need treatment to stop drinking completely.
Success works when you have people you can count on for support, because it’s so easy to fall back into old patterns. There are many groups and programs that may interest you. Therapy offers support and helps you discover and deal with what you are medicating with alcohol, whether it is stress, depression, childhood or family issues, etc. You can address these and be free of them and the over-use of alcohol. You deserve it.
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