The non-alcoholic’s guide to drinking less alcohol

(CNN)If you’re reading this, you may think you drink a little too much, yet you wouldn’t describe yourself as an “alcoholic.”

Maybe you’re a parent who comes home after a stressful day at work and takes a drink to decompress and deal with the kids, another with dinner and then another to top off the evening before dozing off.
Or maybe you’re a college student who studies hard all week and then downs a six-pack at the first post-exam opportunity. You might celebrate special occasions, like a big birthday or even weekend dinners, with a couple bottles of wine.
    Whether drinking is a celebratory ritual or serves to ease stress, you may be drinking an amount at which health risks outweigh potential benefits.
    “Alcohol use and its associated problems exist on a spectrum,” said Dr. John Mariani, associate professor of clinical psychiatry at Columbia University Medical Center and director of Columbia University’s Substance Treatment and Research Service. “There are people who don’t meet the criteria even for mild alcohol use disorder (a disorder characterized by a loss of control over drinking) but are drinking more than what would be considered healthy.”

    The problems with drinking too much

    Including some alcohol in your diet may lower your risk of a heart attack and type 2 diabetes. But even at low levels, alcohol may interfere with sleep, cloud judgment, contribute to weight gain and negatively interact with some medications.
    We’ve also known that just one drink per day slightly increases a woman’s risk of breast cancer.
    The more you drink, the greater the risks.
    According to the National Institute on Alcohol Abuse and Alcoholism, people who drink heavily — for men, that’s defined as more than four drinks on any day or more than 14 drinks per week, and for women more than three drinks on any day or more than seven drinks per week — have a greater risk of injuries, having children with birth defects and health problems including liver disease, heart disease, depression, stroke and several types of cancer.
    Drinking too much can also make it difficult to manage existing health conditions such as diabetes and high blood pressure.
    “Even in cases where one’s alcohol intake doesn’t necessarily meet the definition of what we colloquially refer to as an ‘alcoholic’ (i.e. someone who is considered ‘addicted’), excessive consumption can increase health risks,” Mariani said.

    How to know if you’re drinking too much

    Mariani stresses that rather than thinking about being “an alcoholic or not” — which he says is an imprecise term — it’s more important to consider how alcohol may be impacting your life.
    Red flags include situations in which you don’t remember where you parked the car after drinking, embarrassing yourself at a party or waking up unable to remember where you were.
    Other behaviors include sending inappropriate emails when drinking, having sex with people you wouldn’t otherwise choose, using other substances in conjunction with alcohol or getting a DWI. “These behaviors are objectionable to your value system, and you don’t like them,” he said.
    But even if you don’t engage in inappropriate behavior, you still might be drinking an unhealthy amount. One might use alcohol “almost medically — for anxiety, as an anesthetic,” Mariani explained. Here, the consequence is that you are missing beneficial opportunities to help manage the stress, such as going to the gym, reading a book or building a hobby. “The consequences are not bad things per se but an absence of good things that are not happening, because drinking is taking up that time. No one is going to lose their job if they have three drinks in a night, but it takes up time and space that doesn’t allow other things to happen.”
    For some, learning about a test result during a doctor’s visit or that you’ve gained an unhealthy amount of weight can be reason enough to cut back. “A person may go to the doctor one time and have elevated liver function tests, which is enough of a motivation,” Mariani said.

    A guide to drinking less

    Whatever the motivation may be, there are ways to cut back on your alcohol consumption. Below are some tips worth trying, according to experts.
    1. Journal your drinks. Doing so can be a powerful tool in understanding how much you’re drinking and can bring awareness of patterns, according to Ginger Hultin, a registered dietitian and spokeswoman for the Academy of Nutrition and Dietetics.
    “A lot of my clients will say ‘Well, I don’t drink that much,’ but then when they track their intake on MyFitnessPal or another app, they start to see patterns like drinking many more days per week than they thought or having more drinks on a given night than they expected,” she said.
    The simple act of recording what you drink may help you naturally drink less. “It changes the behavior somewhat: Maybe you’ll have three drinks instead of five if you know you have to write it down,” Mariani said.
    It’s also important to know whether you are accurately estimating the amount of alcohol you consume. “A person may record three drinks, but is it three standard drinks — each containing 1.5 ounces of alcohol — or is it bigger?” Knowing what counts as “one standard drink” can help you accurately determine your intake.
    2. Set limits. Try slowly decreasing the number of drinks you consume, depending on where you are starting. “Cutting back means having two drinks instead of three or one instead of two,” Hultin said.
    Observe whether drinking less corrects any existing problems. The amount of alcohol that can disrupt sleep or lower inhibitions to eat unhealthy foods, for example, is different for each person, according to Hultin.
    3. Designate abstinence days. You might decide that Mondays and Fridays are “no alcohol” days. This can help to “prove that I can do it,” Mariani said.
    4. Keep alcohol out of the house. Out of sight often means out of mind. If this is unrealistic, try to keep a healthy physical distance from it, such as putting it on a high shelf.
    5. Alternate drinks in social settings. “Limit your quantity by alternating (alcoholic) drinks with sparkling water,” Hultin said. This can keep you hydrated and will help you pace yourself.
    Ordering a non-alcoholic cocktail in a restaurant or just adding a lime or other garnish can make a non-alcoholic drink feel more special. “It can also help mask the fact that you’re not drinking as much as others if you have social pressures,” Hultin added.
    6. Eat while you drink. “Eating before or with an alcoholic beverage can help slow the absorption of alcohol, and it can also make you feel more full, so you may drink less,” she said.
    7. Avoid temptations and triggers. “Some people find it better to avoid situations where they would typically drink,” Hultin said. Instead, spend time doing things you enjoy like going on a hike or attending events where alcohol isn’t the main attraction.
    If you can’t avoid a specific event or situation where you might feel the urge to drink, have a plan in place to prevent going back to old patterns. If a certain time of day triggers the urge, plan to do something else during that time, like calling a friend, going to the gym or taking a bath.

    When to seek additional help

    If these behavioral tips haven’t helped you achieve the desired result, you might consider seeking the help of a cognitive behavioral therapist with expertise in substance abuse problems.
    “Typically, these patterns have developed over a decade or two … and so it’s important to recognize these patterns and to try and create a new relationship with alcohol,” Mariani said. “A lot of this is about being more mindful about what is going on. It takes a lot of work and commitment.”

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    Medication is another option for some. For example, naltrexone or topiramate are medicines that people tend to drink less on, as they interfere with how rewarding the alcohol feels, Mariani said, though he cautions that they “work for some people and not for others.”
    Lastly, surround yourself with friends or family members who are supportive of your goals, and go easy on yourself if you slip. “When you have failures or don’t achieve your goals, the temptation is to give up,” Mariani said. “But it’s important to recognize that changing a behavior pattern takes time … and just being in the process of change is good.”

    Read more: http://www.cnn.com/2017/11/03/health/less-alcohol-food-drayer/index.html