Alcoholandyourhealth
Research-based information fromthe
National InstitutesofHealth
U.S.DEPARTMENTOFHEALTH ANDHUMANSERVICES
“Sometimeswedothingsoutofhabitandwedon’treallystoptothinkaboutit.Thismademethinkaboutmychoices.”
“Itemphasized thatdrinkingisnotbadinandofitself—it’showmuchyou’redoingitandhowit’saffecting yourlife.”
“Ithoughtthestrategiesforcuttingdownwerereallygood.
Itgivesyoutoolstohelpyourself.”
Thesearecomments fromsocialdrinkerswhoreviewed Rethinking Drinkingrcall301–443–3860.
Foranonlineversionofthisbookletwithinteractivefeaturesandadditionalresources,visit RethinkingDrinking.niaaa.nih.gov
RethinkingDrinking
Doyouenjoyadrinknowandthen?Manyofusdo, oftenwhensocializingwithfriendsandfamily.Drinkingcanbebeneficialorharmful, dependingonyourageandhealthstatus,thesituation,and,ofcourse,howmuchyoudrink.
Doyouthinkyoumaydrinktoomuchattimes?Doyouthink“everyone”drinksalot?Seebelowforresultsfromanationwidesurveyof43,000 adultsbytheNationalInstitutesofHealthon alcohol useanditsconsequences.
AlcoholusebyadultsintheUnitedStates*
7in10adults always drink at low-risklevels
or
donotdrink atall
37%alwaysdrinkatlow-risk levels
35%don’tdrinkatall
28% drink at heavyor at-risk levels
3in10adults drink atlevels thatputthematriskfor alcoholism,
liverdisease,and otherproblems
*AlthoughtheminimumlegaldrinkingageintheU.S.is21,thissurveyincludedpeopleaged18orolder.
Foranyone whodrinks,Rethinking Drinkingoffersvaluable,research-basedinformation.
Thefirstpart,How muchistoomuch?,answersthesequestionsandmore:
•What’s“low-risk”drinkingversus“at-risk”or“heavy”drinking?
•Whyisbeingableto“holdyourliquor”aconcern?
•Whataresignsthatdrinkingiscausingharm?
Manyheavydrinkersdonothavealcohol-relatedproblems yetandcanreducetheirriskofharmby cuttingback.Forthenearly18millionAmericanswhohavealcoholismorrelatedproblems,however,it’ssafesttoquit.
Thesecondpartofthisbooklet,Thinkingaboutachange?,offerstips,tools,andresourcesforpeoplewhochoosetocutdown orquit. Successislikelyforthosewhopersistintheirefforts.Evenforthosewithalcoholism,studies showthatmostdorecover,oftenwithoutprofessionaltreatment.
Whatdo youthinkabouttaking alookatyourdrinkinghabitsandhowtheymay affectyourhealth? RethinkingDrinkingcanhelpyougetstarted.
1
HOWMUCHISTOOMUCH?
Whatcounts as a drink?
Manypeoplearesurprisedtolearnwhatcountsasadrink.In theUnitedStates,
a“standard”drinkisanydrinkthatcontainsabout0.6fluidouncesor14gramsof“pure”alcohol.Althoughthedrinkspicturedbelowaredifferentsizes,eachcontainsapproximatelythesameamountofalcoholandcountsasasingledrink.
12flozof
regularbeer
8–9flozof maltliquor (shownin a
12ozglass)
5flozof
tablewine
1.5flozshotof
80-proofspirits
(“hardliquor”—
whiskey,gin,rum,
vodka,tequila,etc.)
about5%
alcohol
about7%
alcohol
about12%
alcohol
about40%
alcohol
Thepercentof“pure”alcohol,expressedhereasalcoholbyvolume(alc/vol),variesbybeverage.
Howmany drinks are in common containers?
Belowistheapproximatenumberofstandarddrinksindifferentsizedcontainersof
regularbeer / maltliquor / tablewine / 80-proofspiritsor“hardliquor”12floz=1
16floz=1
22floz=2
40floz=3 / 12floz=1½
16floz=2
22floz=2½
40floz=4½ / 750ml(aregular winebottle)=5 / ashot(1.5ozglass/50 mlbottle)=1
amixeddrinkorcocktail=1ormore
200ml(a“halfpint”)=4½
375ml(a“pint”or“halfbottle”)=8½
750ml(a“fifth”)=17
Theexamplesshownon thispageserveasastartingpointforcomparison.Fordifferenttypesofbeer,wine,ormaltliquor,thealcoholcontentcanvarygreatly.Somedifferencesaresmallerthanyoumightexpect,however.Manylightbeers,forexample,havealmostasmuch alcoholasregularbeer—about85%asmuch,or4.2%versus5.0%alcoholbyvolume(alc/vol),onaverage.
Althoughthestandarddrinksizesarehelpful forfollowinghealthguidelines,theymaynotreflectcustomaryservingsizes.Amixeddrink,forexample,cancontainone,two,ormorestandarddrinks,dependingon thetypeofspiritsandtherecipe.
2RethinkingDrinking.niaaa.nih.gov
What’s your drinking pattern?
Usingthedrinksizesonpage2,answerthequestionsbelow:
1.Onanydayinthepastyear,haveyoueverhad
•ForMEN:morethan4drinks?yesno
•ForWOMEN: morethan3drinks?yesno
2.Thinkabout yourtypicalweek:
•onaverage,howmanydaysaweekdoyoudrinkalcohol?(a)
•onatypical drinkingday,howmany drinksdoyouhave?X (b) (multiplyaxb)
weeklyaverage=
Sometimeseven a littleis too much
Evenmoderate levelsofdrinking(upto2drinksperdayformenor1forwomen) canbetoomuchinsomecircumstances.It’s safesttoavoidalcoholifyouare
•planning todriveavehicleoroperatemachinery
•takingmedicationsthatinteractwithalcohol
•managingamedicalcondition thatcanbemadeworsebydrinking
•pregnantortryingtobecomepregnant
Canyou“holdyourliquor”?
ifso,youmaybeatgreaterrisk.Forsomepeople,ittakesquiteafewdrinkstogetabuzzorfeelrelaxed.Oftentheyareunawarethatbeingableto“holdyourliquor”isn’tprotectionfromalcohol problems,butinsteadareason forcaution.Theytendtodrinkmore,socializewithpeoplewhodrinkalot,
anddevelopatolerancetoalcohol.Asaresult,theyhaveanincreasedriskfor developingalcoholism.Thehigher alcohollevelscanalsocauseliver,heart,andbraindamagethatcangounnoticeduntilit’stoolate.Andalldrinkersneedto
beawarethatevenmoderateamountsofalcoholcansignificantlyimpair driving performance,evenwhentheydon’tfeelabuzzfromdrinking.
3
What’s “low-risk” drinking?
Amajornationwidesurvey of43,000U.S.adultsbytheNationalInstitutesofHealthshowsthatonlyabout2in100peoplewhodrinkwithinboththe“single-day”andweeklylimitsbelowhavealcoholism oralcohol abuse.Howdo these“low-risk”levelscomparewithyourdrinkingpatternfrompage3?
Low-riskdrinkinglimits
Onany single DAY
Per
Week
Men
nomorethan
4
drinksonanyday
**AND**
nomorethan
14
drinksperweek
Women
nomorethan
3
drinksonanyday
**AND**
nomorethan
7
drinksperweek
Tostaylowrisk,keepwithinBOTHthesingle-dayAND weeklylimits.
“Lowrisk”isnot“norisk.”Evenwithintheselimits, drinkers canhaveproblemsiftheydrinktooquickly,havehealthproblems,orareolder(bothmenandwomenover65 aregenerallyadvisedtohavenomorethan3drinkson any day and7perweek).Basedonyourhealthandhowalcohol affectsyou,youmayneedtodrinklessornotatall.
What’s “heavy” or “at-risk” drinking?
Forhealthyadultsingeneral,drinkingmorethanthesingle-dayorweekly amountsshownaboveisconsidered “at-risk”or“heavy”drinking.About1in4peoplewhodrinkthismuchalreadyhasalcoholismoralcoholabuse,andtherestareatgreaterriskfordeveloping theseandotherproblems.
Itmakesadifferencebothhowmuchyoudrinkonanydayandhowoftenyouhave
a“heavydrinkingday”—that is,morethan4drinksinaday formenormorethan3drinksforwomen.Themoredrinksinadayandthemoreheavydrinkingdaysovertime,thegreaterthechancesforproblems(see“What’stheharm?” on thenextpage).
W Whyarewomen’slow-risklimitsdifferentfrom men’s?
Researchshowsthatwomenstarttohavealcohol-relatedproblemsatlowerdrinkinglevelsthanmendo.Onereasonisthat,onaverage,womenweighlessthanmen.Inaddition, alcoholdispersesinbodywater,andpoundforpound, womenhavelesswaterintheirbodiesthanmendo.Soafteramanandwomanofthesameweightdrinkthesameamountofalcohol, thewoman’sbloodalcoholconcentrationwilltendtobehigher,puttingheratgreaterriskforharm.
4RethinkingDrinking.niaaa.nih.gov
Howmuch do U.S. adults drink?
Themajority—7outof10—either abstainoralwaysdrinkwithinlow-risklimits.Whichgroup areyouin?
DrinkingpatternsinU.S.adults
drinkmorethanboththesingle-day
limitsandtheweeklylimitshighestrisk
drinkmorethaneitherthesingle-day
limitsortheweeklylimitsincreasedrisk
37%alwaysdrinkwithinlow-risklimitsLowrisk
35%neverdrinkalcohol—
What’s the harm?
Notalldrinkingisharmful.Youmayhaveheardthatregularlighttomoderatedrinking
(from½drinkaday up to1drinkaday forwomenand2formen)canevenbegoodfortheheart.Withat-riskorheavydrinking,however,anypotentialbenefitsareoutweighedbygreaterrisks.
Injuries.Drinkingtoomuch increasesyourchancesofbeinginjuredorevenkilled.Alcoholisafactor,forexample,inabout60%offatalburninjuries,drownings,andhomicides; 50%ofseveretraumainjuriesandsexualassaults;and40%offatalmotorvehiclecrashes,suicides,andfatalfalls.
Healthproblems. Heavydrinkershaveagreaterriskofliverdisease, heartdisease, sleepdisorders,depression,stroke,bleedingfromthestomach,sexuallytransmittedinfectionsfromunsafesex,andseveraltypesofcancer.Theymayalsohaveproblemsmanagingdiabetes,highbloodpressure,andotherconditions.
Birthdefects. Drinkingduringpregnancycancausebraindamageandotherseriousproblemsinthebaby.Becauseitisnotyetknownwhetheranyamountofalcoholissafeforadevelopingbaby,womenwhoarepregnantormaybecomepregnantshouldnotdrink.
Alcoholusedisorders. Generallyknownasalcoholismandalcoholabuse,alcohol usedisordersaremedical conditions thatdoctorscandiagnosewhenapatient’s drinkingcausesdistressorharm.IntheUnitedStates, about18millionpeoplehaveanalcohol usedisorder.Seethenextpageforsymptoms.
5
Whatare symptoms of an alcohol use disorder?
Seeifyourecognizeanyofthesesymptomsinyourself.Inthepastyear,haveyou
hadtimeswhenyouendedupdrinkingmore,orlonger, thanyouintended?
morethanoncewantedtocutdownorstopdrinking,ortriedto,butcouldn’t?
morethanoncegottenintosituationswhileorafterdrinkingthatincreased yourchancesofgetting hurt(suchasdriving,swimming,usingmachinery,walkinginadangerousarea,orhavingunsafesex)?
hadtodrinkmuchmorethanyouoncedidtogettheeffectyouwant?orfound
thatyourusualnumberofdrinkshadmuchlesseffectthanbefore?
continuedtodrinkeventhoughitwasmakingyoufeeldepressedor anxiousor
addingtoanotherhealthproblem?orafterhavinghadamemoryblackout?
spentalotoftimedrinking?orbeingsickorgettingoverotheraftereffects?
continuedtodrinkeventhoughitwascausingtroublewithyourfamilyor
friends?
foundthatdrinking—or beingsickfromdrinking—ofteninterferedwithtakingcareofyourhomeorfamily?orcausedjobtroubles?orschoolproblems?
givenuporcutbackon activitiesthatwereimportantorinterestingtoyou,orgaveyoupleasure,inordertodrink?
morethanoncegottenarrested,beenheldatapolicestation,orhadother
legalproblems because ofyourdrinking?
foundthatwhentheeffectsofalcoholwerewearingoff,youhadwithdrawal symptoms,suchastroublesleeping,shakiness,restlessness,nausea,sweating,aracingheart,oraseizure?orsensedthingsthatwerenotthere?
Ifyoudon’thavesymptoms, thenstayingwithin thelow-riskdrinkinglimitsonpage4willreduceyourchancesofhaving problemsinthefuture.
Ifyoudohaveanysymptoms, thenalcoholmayalreadybeacauseforconcern.Themoresymptomsyouhave,themoreurgenttheneedforchange.Ahealthprofessional canlookatthenumber,pattern,andseverity ofsymptoms toseewhetheranalcoholusedisorder ispresentandhelpyoudecidethebestcourseofaction.
Thinkingaboutachange?Thenextsectionmayhelp.
Note:These questionsarebasedonsymptoms foralcoholusedisordersintheAmericanPsychiatricAssociation’sDiagnosticandStatistical Manual(DSM)ofMentalDisorders,FourthEdition.TheDSMisthemostcommonlyusedsystemin theUnitedStatesfordiagnosingmentalhealthdisorders.
6RethinkingDrinking.niaaa.nih.gov
ThinkingAboutAChange?
ThinkingAboutAChange?
It’s up to you
It’suptoyouastowhetherandwhentochangeyourdrinking.Otherpeoplemaybeabletohelp,butintheendit’syourdecision.Weighingyourprosandconscanhelp.
Pros:Whataresomereasonswhyyoumightwanttomake achange?
toimprovemyhealth
toimprovemyrelationships toavoid hangovers
todobetteratworkorschool
toloseweightorgetfit
tosavemoney
toavoidmoreseriousproblems
tomeetmyownpersonalstandards
Cons:Whataresomepossiblereasonswhyyoumightnotwanttochange?
Compareyourprosandcons.Put extracheckmarksbythemostimportantone(s).Isthereadifferencebetweenwhereyouareandwhereyouwanttobe?
Ready. . . or not?
Areyoureadytochangeyourdrinking?Ifso,seethenextsectionsforsupport.Butdon’tbesurprisedifyoucontinuetohavemixedfeelings.Youmayneedtore-makeyourdecisionseveraltimesbeforebecomingcomfortable withit.
Ifyou’renotreadytochangeyet,considerthesesuggestionsinthemeantime:
•Keeptrackofhowoftenandhowmuch you’redrinking.
•Noticehowdrinkingaffectsyou.
•Makeorre-makealistofprosandconsaboutchanging.
•Dealwithotherpriorities thatmay beinthewayofchanging.
•Askforsupportfromyourdoctor,afriend, orsomeoneelseyoutrust.
Don’twaitfor acrisisorto“hitbottom.”
Whensomeoneisdrinkingtoomuch, making achangeearlierislikelytobemoresuccessfulandlessdestructivetoindividualsandtheirfamilies.
8RethinkingDrinking.niaaa.nih.gov
To cut down or to quit . . .
Ifyou’reconsideringchanging yourdrinking,you’llneed todecidewhethertocutdownortoquit.It’s agoodideatodiscussdifferentoptionswithadoctor,afriend,orsomeoneelseyoutrust.Quittingisstronglyadvisedifyou
• trycuttingdown butcannotstaywithin thelimitsyouset
• havehadanalcohol usedisorderornowhavesymptoms(seepage6)
• haveaphysical ormentalcondition thatiscausedorworsenedbydrinking
• aretaking amedicationthatinteractswithalcohol
• areormaybecomepregnant
Ifyoudonothaveanyoftheseconditions,talkwithyourdoctortodeterminewhetheryoushould cutdown orquit basedonfactorssuchas
• familyhistoryofalcoholproblems
• yourage
• whether you’vehaddrinking-relatedinjuries
•symptoms suchassleepdisordersandsexualdysfunction
Ifyouchoosetocutdown,seethelow-riskdrinkinglimits onpage4.
Planningfor change
Evenwhenyouhavecommittedtochange,youstillmayhavemixedfeelingsattimes.Makingawritten“changeplan”willhelpyoutosolidifyyourgoals,why youwanttoreachthem,andhowyouplantodoit.Asampleformisprovidedonpage 14,oryoucanfilloutoneonlineattheRethinkingDrinkingWebsite.
Reinforceyourdecision withreminders.
Enlisttechnologytohelp.Changecanbehard,soithelpstohaveconcreteremindersofwhyandhowyou’vedecidedtodo it.Somestandardoptionsincludecarryingachangeplaninyourwalletorpostingstickynotesathome.Ifyouhaveacomputerormobile phone,considerthesehigh-tech ideas:
• Fillouta“changeplan” onlineattheRethinkingDrinkingWebsite,emailittoyourpersonal(non-work)account,andreviewitweekly.
• Storeyourgoals,reasons, orstrategiesinyourmobilephoneinshorttextmessagesornotepadentriesthatyoucanretrieveeasilywhenanurgehits.
• Setupautomatedmobilephoneoremailcalendaralertsthatdeliverreminderswhenyouchoose,suchasafewhoursbeforeyouusuallygo out.
• Createpasswordsthataremotivatingphrasesincode,whichyou’lltypeeach timeyoulogin,suchas1Day@aTime,1stThings1st!,or0Pain=0Gain.
9
Strategiesfor cuttingdown
Smallchangescanmakeabigdifferenceinreducingyourchancesofhaving alcohol-relatedproblems.Here aresomestrategiestotry.Checkoffperhapstwoorthreetotryinthenextweekortwo,thenaddsomeothersasneeded. Ifyouhaven’tmadeprogressafter2to3months,considerquittingdrinkingaltogether, seekingprofessionalhelp,orboth.
Keeptrack.
Keeptrackofhowmuchyoudrink.Findawaythatworksforyou,suchasa3x5”cardinyourwallet(seepage15forsamples),checkmarksonakitchencalendar,ornotesinamobilephonenotepadorpersonaldigital assistant. Makingnoteof eachdrinkbeforeyoudrinkitmayhelpyouslowdown whenneeded.
Countandmeasure.
Knowthe“standard”drinksizessoyoucancountyourdrinksaccurately(seepage2).Measuredrinksathome.Awayfromhome,itcanbehardtokeeptrack,especiallywithmixeddrinks.Attimesyoumaybegettingmore alcoholthan
youthink.With wine,youmayneedtoaskthehostorservernotto“topoff”a partiallyfilledglass.
Setgoals.
Decidehowmanydaysaweekyouwanttodrinkandhowmanydrinksyou’llhaveonthosedays.It’sagoodideatohavesomedayswhenyoudon’tdrink.Drinkerswiththelowestratesofalcoholusedisordersstaywithintheselimits(alsoshownonpage4):Formen,nomorethan4drinkson any day and 14 perweek;andforwomen,no morethan3drinksonanydayand7perweek.Bothmenandwomenoverage65 generallyareadvisedtohavenomorethan3drinksonanydayand7perweek.Dependingonyourhealthstatus,yourdoctormayadviseyoutodrinklessornotatall.
Paceandspace.
Whenyoudodrink,paceyourself.Sipslowly.Havenomorethanonestandard drinkwithalcoholperhour.Have“drinkspacers”—makeeveryotherdrinka nonalcoholicone,suchaswater,soda,orjuice.
Includefood.
Don’tdrinkonanempty stomach.Havesomefoodsothealcoholwillbeabsorbedintoyoursystemmoreslowly.
10RethinkingDrinking.niaaa.nih.gov
Findalternatives.
Ifdrinkinghasoccupied alotofyourtime,thenfillfreetimebydevelopingnew,healthyactivities,hobbies,andrelationships orrenewingonesyou’vemissed.
Ifyouhavecounted onalcoholtobemore comfortable insocialsituations,managemoods,orcopewithproblems,thenseekother,healthywaystodealwiththoseareasofyourlife.
Avoid“triggers.”
Whattriggersyoururgetodrink?Ifcertainpeopleorplacesmakeyoudrinkevenwhenyoudon’twantto,trytoavoidthem.Ifcertainactivities,timesofday,orfeelingstrigger theurge,plansomethingelsetodoinsteadofdrinking.Ifdrinkingathomeisaproblem, keeplittleorno alcohol there.
Plantohandleurges.
Whenyoucannotavoidatriggerandanurgehits,considertheseoptions:Remindyourselfofyourreasonsforchanging(itcanhelptocarrytheminwritingorstoretheminanelectronicmessageyoucanaccesseasily).or talk thingsthrough withsomeoneyoutrust.orgetinvolvedwithahealthy,distractingactivity,suchasphysical exerciseorahobbythatdoesn’tinvolvedrinking.or,insteadoffightingthefeeling,acceptitandrideitoutwithoutgivingin,knowingthatitwillsooncrestlikeawaveandpass.
Knowyour“no.”
You’relikelytobeofferedadrinkattimeswhenyoudon’twantone.Havea polite,convincing“no,thanks”ready.Thefasteryoucansaynototheseoffers,thelesslikelyyouaretogivein.Ifyouhesitate,itallowsyoutimetothinkofexcusestogo along.
Toolstohelpyoumanageurgestodrinkandbuilddrinkrefusalskillsareavailableon
theRethinkingDrinkingWebsite.
Ifyouwanttoquitdrinking—
Thefourstrategieson thispageareespeciallyhelpful.Butifyouthinkyoumaybedependentonalcoholanddecidetostopdrinkingcompletely,don’tgoitalone.Suddenwithdrawalfromheavydrinkingcanbelifethreatening.Seekmedical helptoplanasaferecovery.
11
Supportfor quitting
Thesuggestionsinthissectionwillbemostusefulforpeoplewhohavebecomedependentonalcohol,andthusmayfinditdifficulttoquit withoutsomehelp.Severalproventreatmentapproachesareavailable.onesizedoesn’tfitall,however.It’s a goodideatodo somehomework on theInternetoratthelibrarytofindsocialandprofessionalsupportoptionsthatappealtoyou,asyouaremorelikelytostickwiththem(seealsoResourcesontheinsidebackcover).Chancesareexcellentthatyou’llpulltogether anapproachthatworksforyou.
Socialsupport
Onepotentialchallengewhenpeoplestopdrinkingisrebuilding alifewithoutalcohol.Itmaybeimportantto
•educatefamilyandfriends
•developnewinterestsandsocialgroups
•findrewardingwaystospendyourtimethatdon’tinvolvealcohol
•askforhelpfromothers
Whenaskingforsupportfromfriendsorsignificant others,bespecific.Thiscould
include
•notoffering youalcohol
•notusing alcoholaround you
•givingwordsofsupportandwithholdingcriticism
•notaskingyoutotakeonnewdemandsrightnow
•going toagrouplikeAl-Anon
ConsiderjoiningAlcoholicsAnonymousoranothermutualsupportgroup(seeResources).Recoveringpeoplewhoattendgroupsregularly dobetterthanthosewhodonot.Groupscanvarywidely,soshoparound foronethat’scomfortable. You’llgetmoreoutofitif youbecomeactivelyinvolvedbyhavingasponsorandreachingouttoothermembersforassistance.
Feelingdepressedoranxious?
It’scommonforpeoplewithalcohol problemstofeeldepressedoranxious.Mild symptomsmaygoawayifyoucutdownorstopdrinking.Seeadoctorormentalhealthprofessionalifsymptomspersistorgetworse.Ifyou’rehavingsuicidalthoughts, callyourhealthcareproviderorgotothenearestemergencyroomright away.Effectivetreatment isavailabletohelpyouthroughthisdifficulttime.
12RethinkingDrinking.niaaa.nih.gov
Professionalsupport
Advancesinthetreatmentofalcoholismmeanthatpatientsnowhavemorechoicesandhealthprofessionalshavemoretoolstohelp.
Medicationstotreatalcoholism.Newermedicationscanmakeiteasiertoquitdrinkingbyoffsettingchangesinthebraincausedbyalcoholism. Theseoptions(naltrexone,topiramate, andacamprosate) don’tmakeyousickifyoudrink,asdoesanolder medication(disulfiram).Noneofthesemedicationsareaddictive,soit’sfinetocombinethemwithsupportgroupsoralcohol counseling.
Amajorclinicaltrialrecentlyshowed thatpatientscannowreceiveeffectivealcohol treatmentfromtheirprimarycaredoctorsormentalhealthpractitionersbycombiningthenewermedicationswithaseriesofbrief officevisitsforsupport.SeeResourcesformoreinformation.
Alcoholcounseling.“Talktherapy”alsoworkswell.Thereareseveralcounseling approachesthatareaboutequallyeffective—12step,cognitive-behavioral,motivationalenhancement,oracombination.Gettinghelpinitselfappearstobemoreimportantthantheparticularapproachused,aslong asitoffersempathy,avoids heavyconfrontation,strengthensmotivation,andprovidesconcretewaystochangedrinkingbehavior.
Specialized,intensivetreatmentprograms.Somepeoplewillneedmoreintensiveprograms. SeeResourcesforatreatmentlocator.Ifyouneedareferraltoaprogram, askyourdoctor.
Don’tgiveup.
Changinghabitssuchassmoking, overeating,ordrinkingtoomuch cantake
alot ofeffort, andyoumaynotsucceedwiththefirsttry.Setbacksarecommon,butyoulearnmoreeachtime.Eachtrybrings youclosertoyourgoal.
Whatevercourseyouchoose,giveitafairtrial.Ifoneapproachdoesn’twork,trysomethingelse.Andifasetbackhappens,getback on trackasquicklyaspossible.
Inthelong run, yourchancesforsuccessaregood.Researchshowsthatmostheavydrinkers,eventhosewithalcoholism,eithercutbacksignificantlyorquit.
Fortoolstohelpyoumake andmaintainachange,visitthe RethinkingDrinkingWebsite.
13
Readyto begin?
Ifso,startbyfillingoutthechangeplanbeloworonlineattheRethinkingDrinking
Website,whereyoucanprintitoutoremailittoyourself. Ifyouarecuttingdown
asopposedtoquitting,youcanusethedrinkingtrackercardsonthenexttwopages.
Changeplan
goal:
Iwant todrinknomorethan drink(s)onanydayand
nomorethan drink(s)perweek(seepage4forlow-risklimits) or
Iwant tostopdrinking
timing:Iwillstartonthisdate:
Reasons:Mymostimportantreasonstomake thesechangesare:
Strategies:Iwill usethesestrategies(seepages10–11):
People:Thepeoplewhocanhelpmeare(namesandhowtheycanhelp):
Signsofsuccess:Iwillknow myplanisworkingif:
Possibleroadblocks:SomethingsthatmightinterfereandhowI’llhandlethem:
14RethinkingDrinking.niaaa.nih.gov
Drinkingtrackercards
Ifyouwant tocutbackonyourdrinking,startbykeepingtrackofeverydrink.Belowaretwosampleforms youcancutoutorphotocopy andkeepwithyou.Eitheronecanhelpmakeyouawareofpatterns,akeystepinplanningforachange.The“4-weektracker”isasimplecalendarform.Ifyoumarkdowneachdrinkbeforeyouhaveit,
thiscanhelpyouslowdownifneeded. The“drinkinganalyzer”canhelpyouexaminethecausesandconsequences ofyourdrinkingpattern.Tryoneform,ortrybothtosee which ismore helpful.ThesearealsoavailableontheRethinkingDrinkingWebsite.
4-weektracker
GOAL:nomorethan drinksonanydayand perweek.
Week starting
Drinkinganalyzer
Date / Situation(people,place)or trigger(incident,feelings) / typeof drink(s) / Amount / Consequence(whathappened?)
15
Drinkingtrackercards(continued)
Thesearethesamecardsason thepreviouspage.Ifyoucutoneout,youwillhavethedrinkinganalyzerononesideandthe4-weektrackerontheother side.
Drinkinganalyzer
Date / Situation(people,place)or trigger(incident,feelings) / typeof drink(s) / Amount / Consequence(whathappened?)
4-weektracker
GOAL:nomorethan drinksonanydayand perweek.
Week starting
16RethinkingDrinking.niaaa.nih.gov
Resources
Professionalhelp
Yourregular doctor. Primarycareand mentalhealthpractitionerscanprovide effectivealcoholism treatment bycombining newmedicationswithbriefcounseling
visits. See“HelpingPatientsWhoDrinkToo
Much” at orcall
301–443–3860.
Specialistsinalcoholism.Forspecialty addictiontreatmentoptions,contactyour doctor,healthinsuranceplan,localhealth department,oremployeeassistanceprogram. Otherresourcesinclude
Medicalandnon-medical addictionspecialists
AmericanAcademyofAddiction
Psychiatry
401–524–3076
AmericanPsychological
Association
1–800–964–2000(askforyourstate’s referralnumber tofindpsychologists withaddiction specialties)
AmericanSocietyofAddiction
Medicine
301–656–3920(askforthephone
numberofyourstate’schapter)
NAADACSubstanceAbuse Professionals
1–800–548–0497
NationalAssociationofSocial
Workers (searchforsocialworkerswith addictionspecialties)
Treatmentfacilities
SubstanceAbuseTreatment FacilityLocator
1–800–662–HELP
Mutual-helpgroups
AlcoholicsAnonymous(AA)
212–870–3400orcheckyourlocal phonedirectoryunder“Alcoholism”
ModerationManagement
212–871–0974
SecularOrganizationsforSobriety
323–666–4295
SMARTRecovery
440–951–5357
WomenforSobriety
215–536–8026
Groupsforfamilyandfriends
Al-Anon/Alateen
1–888–425–2666formeetings
Adult ChildrenofAlcoholics
310–534–1815
Informationresources
NationalInstituteonAlcoholAbuse andAlcoholism
301–443–3860
NationalInstituteonDrug Abuse
301–443–1124
NationalInstituteofMentalHealth
1–866–615–6464
NationalClearinghouseforAlcohol andDrugInformation
1–800–729–6686
Foradditionalresources,visitRethinkingDrinking.niaaa.nih.gov
NATIONALINSTITUTEONALCOHOLABUSEANDALCOHOLISM
NIHPublicationNo.10-3770
RevisedApril2010