Moderating Alcohol Use
If you or your loved ones have concerns about your alcohol use, you need not feel ashamed.
If you are struggling with alcohol, it is not a moral failing. Alcohol is deeply engrained and ubiquitous in our culture, a powerful substance that provides pleasure, social lubrication, and other benefits for a large portion of our population. Some folks are genetically vulnerable to developing alcohol problems. Some are gradually drawn into problematic patterns of use over time. Others drink in response to trauma, high stress, or emotional factors. In all cases, there are underlying needs and dynamics driving the behavior, and therapy is a place to explore what those are.
Working with me to address your alcohol use
I blend traditional talk therapy with practical, action-oriented approaches to helping clients address alcohol concerns. The latter may include between-session writing exercises, workbooks, and setting specific behavioral goals, for example. The degree to which we will use the action-oriented approaches depends on your personal preferences and circumstances.
My approach to supporting clients with alcohol concerns is especially informed by Harm Reduction, Moderation Management, and Motivational Interviewing. In a nutshell, my emphasis is on minimizing harm, respecting clients' agency and pace, and acknowledging that one size does not fit all.
If you are struggling with alcohol, it is not a moral failing. Alcohol is deeply engrained and ubiquitous in our culture, a powerful substance that provides pleasure, social lubrication, and other benefits for a large portion of our population. Some folks are genetically vulnerable to developing alcohol problems. Some are gradually drawn into problematic patterns of use over time. Others drink in response to trauma, high stress, or emotional factors. In all cases, there are underlying needs and dynamics driving the behavior, and therapy is a place to explore what those are.
Working with me to address your alcohol use
I blend traditional talk therapy with practical, action-oriented approaches to helping clients address alcohol concerns. The latter may include between-session writing exercises, workbooks, and setting specific behavioral goals, for example. The degree to which we will use the action-oriented approaches depends on your personal preferences and circumstances.
My approach to supporting clients with alcohol concerns is especially informed by Harm Reduction, Moderation Management, and Motivational Interviewing. In a nutshell, my emphasis is on minimizing harm, respecting clients' agency and pace, and acknowledging that one size does not fit all.
Alcohol use patterns exist on a spectrum
What constitutes an alcohol problem? It's not useful to divide drinkers into polarities of "alcoholics" and "non-alcoholics", because it obscures the huge numbers of alcohol consumers who are not physically dependent, but nevertheless experience negative consequences.
The latest edition of the DSM (the text for diagnosing mental illness and substance disorders in the U.S.) underscored this by changing the defining criteria for alcohol-related disorders. While the previous edition (DSM-4) had separate criteria for "alcohol abuse" and "alcohol dependence," the DSM-5 brings the two together under the term "Alcohol Use Disorder (AUD)". AUD recognizes that it's more useful to talk about substance use behavior in terms of a continuum with many shades of grey between individuals who do not use substances at all, and those whose lives and health are profoundly damaged by substance use.
Anyone who regularly drinks alcohol, no matter where on this spectrum, has to monitor how their patterns of use affect their lives and their mental & emotional health to weigh the costs and benefits. Obviously, this becomes more urgent for heavy and high-risk drinkers.
What constitutes an alcohol problem? It's not useful to divide drinkers into polarities of "alcoholics" and "non-alcoholics", because it obscures the huge numbers of alcohol consumers who are not physically dependent, but nevertheless experience negative consequences.
The latest edition of the DSM (the text for diagnosing mental illness and substance disorders in the U.S.) underscored this by changing the defining criteria for alcohol-related disorders. While the previous edition (DSM-4) had separate criteria for "alcohol abuse" and "alcohol dependence," the DSM-5 brings the two together under the term "Alcohol Use Disorder (AUD)". AUD recognizes that it's more useful to talk about substance use behavior in terms of a continuum with many shades of grey between individuals who do not use substances at all, and those whose lives and health are profoundly damaged by substance use.
Anyone who regularly drinks alcohol, no matter where on this spectrum, has to monitor how their patterns of use affect their lives and their mental & emotional health to weigh the costs and benefits. Obviously, this becomes more urgent for heavy and high-risk drinkers.
What is"moderate" or "healthy" use of alcohol?
From a harm reduction perspective, each person must define for herself what constitutes an acceptable amount and frequency of alcohol consumption. However, it can be a helpful to start with a discussion of how health experts define moderate use.
Formal definitions of moderate alcohol use
Health researchers have proposed specific definitions and guidelines for "moderate" alcohol use, based on their findings. Statistics suggest that the risk of developing alcohol dependence increases when a person exceeds certain daily and/or weekly amounts, which differ by sex. At highest risk for developing alcohol dependence are those who exceed both the daily and weekly limits.
Most researchers define "moderate drinking" with the following parameters:
A deeper cost/ benefit analysis:
Adding to this generic conceptualization of what constitutes healthier or safer drinking patterns, it is meaningful to take stock of your unique relationship with alcohol and the consequences you experience. This goes beyond looking at the risk of developing alcohol dependency, and considers other issues related to quality of life, personal goals and values, and safety.
Additional Resources:
The HAMS website provides "support for safer drinking, reduced drinking, or quitting"
Information about support group alternatives to Alcoholics Anonymous
From a harm reduction perspective, each person must define for herself what constitutes an acceptable amount and frequency of alcohol consumption. However, it can be a helpful to start with a discussion of how health experts define moderate use.
Formal definitions of moderate alcohol use
Health researchers have proposed specific definitions and guidelines for "moderate" alcohol use, based on their findings. Statistics suggest that the risk of developing alcohol dependence increases when a person exceeds certain daily and/or weekly amounts, which differ by sex. At highest risk for developing alcohol dependence are those who exceed both the daily and weekly limits.
Most researchers define "moderate drinking" with the following parameters:
- For women, no more than 1-2 drinks in a day, and no more than 7 drinks in a week
- For men, no more than 2-3 drinks in a day, and no more than 14 drinks in a week
A deeper cost/ benefit analysis:
Adding to this generic conceptualization of what constitutes healthier or safer drinking patterns, it is meaningful to take stock of your unique relationship with alcohol and the consequences you experience. This goes beyond looking at the risk of developing alcohol dependency, and considers other issues related to quality of life, personal goals and values, and safety.
- relationship consequences (extent to which alcohol is negatively impacting or limiting one's relationships)
- psychological consequences (using alcohol to cope with emotions or trauma)
- health consequences (e.g., liver function; weight; nutrition)
- quality of life consequences (e.g., blackouts; time spent coping with hangovers)
- emotional consequences (impact of alcohol on one's emotional stability, self respect, and self confidence)
- daily life consequences (impact of alcohol on one's ability to manage every day personal, occupational, and family responsibilities)
- legal consequences (DUIs and other problems)
- genetic factors (the level of risk one's genes may carry, i.e. family history of alcohol problems)
- financial consequences (amount of money being spent on alcohol, and related costs like taxis)
- cultural/ religious variables (the extent to which alcohol is acceptable within one's religious/cultural/moral framework)
Additional Resources:
The HAMS website provides "support for safer drinking, reduced drinking, or quitting"
Information about support group alternatives to Alcoholics Anonymous