Alcoholics can learn to drink less

Most of us tend to drink too much - women as well as men. Alcohol’s long been important in male culture, of course, but now it’s just as common for women to drink socially or alone.

This may be for personal enjoyment, or to soothe the pressures of careers and relationships. But drinking too much has huge downsides, and so many people would like to cut down. Or wish their partner would. Both can be surprisingly difficult to achieve.

That’s because heavy drinking, long before physical dependence, develops into an irresistible habit. This is driven not just by the taste and effects of the alcohol, but also by the whole ritual of “having a drink”. And behaviours like that can be really hard to change.

Mostly we’re told that the only successful way forward is total abstinence. But there is another approach. Psychological techniques such as cognitive behavioural therapy (CBT) can be very effective at helping people to manage their drinking.

CBT helps heavy drinkers to reduce their intake to safe limits and maintain it there or abstain if that suits them better. Typically they first abstain for a short period then re-introduce alcohol and evaluate its effects, monitor their drinking, set limits for themselves, manage risky drinking behaviours, and above all, recognise and avoid the triggers of over-indulgence.

ADDRESS HARMFUL HABITS EARLY

This approach works best for heavy drinkers who have not yet become severely dependent. For them abstinence might still be the best approach because recovering from dependency is much more difficult. It’s also often costly — perhaps involving rehab, for example. So harmful drinking habits are best addressed early before the problems become too severe.

In fact, public health would be greatly improved by early intervention strategies for alcohol.

They are cheaper, quicker, and more successful than traditional abstinence-only approaches. But, unfortunately, there aren’t many “moderate drinking” programmes around. Worse still, most problem drinkers tend to actively avoid traditional treatment, because they don’t want to be labelled as alcoholics. Or told that lifetime abstinence is the only way forward.

Fortunately, CBT feels far less threatening, and so heavy drinkers are more likely to enrol before their problems become too difficult. 

Is reducing your drinking through CBT a reasonable option for you? If you’re physically-dependent on alcohol, then probably not. Similarly too if you have a medical or psychological condition that would be made worse by drinking, even in moderation. If you have any doubts, seek professional advice.

It will still require effort and commitment. And it’s possible that even with the help of CBT, you may find you can’t simply moderate your drinking. Then you should consider using CBT to manage total abstinence. Or join an abstinence-only group such as AA.

You won’t master the skills of moderation overnight, but most heavy drinkers find they drink significantly less within six months. So if you’re worried about your drinking, talk to a CBT counsellor as a first step towards a healthier life.

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