Should I quit? Sobriety and moderation

Are you considering whether sobriety is something you should try? Recognizing whether you need or want to quit drinking isn’t easy and looks different for everyone. The stereotypical picture of the newly-sober person is someone who hits “rock bottom” and has no other choice but to give it up – for health, interpersonal, or perhaps legal reasons. It could be anything, but we typically envision something serious.

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Many people do hit “rock bottom” before stopping. Rock bottom may be losing your family or job, or it could just be one instance of going too far, doing something you deeply regretted while drunk. A lot of people drink heavily but “functionally” in a sense, going about their jobs and personal lives while compartmentalizing any pain alcohol might be causing. They might not hit rock bottom as we typically see it, but accumulate enough regrets over time that they want a change. Another person drinking somewhat heavily might just want to try out a healthier lifestyle, perhaps driven by the “sober curious” wellness trend.

Whatever your reason(s) are, it’s a good idea to speak with a doctor or mental health counselor before deciding to quit. They won’t (and can’t) force you to stop drinking just because you start the conversation. But they can provide you with additional tools and guidance, should you choose to proceed. If you’re experiencing any additional mental health conditions – depression, bipolar disorder, anxiety, or anything else – it’s important that you assess any risks and get all the information you need so that if you decide to quit, you can transition safely to sobriety.

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It can help when contemplating giving up alcohol to read some articles and maybe a book or two about alcohol sobriety to see what it entails and whether it’s something you feel ready and able to pursue. I personally enjoyed This Naked Mind by Annie Grace and Alcohol Explained by William Porter early on in my sobriety. They reminded me why I was doing this and alerted me to some of the physical health benefits that hadn’t weighed as heavily into my decision to quit, but certainly helped keep me going. There are more and more books out there in this area, especially with the sober curious and mindful drinking movements gaining popularity. You can find a few book lists linked to on the Resources page of this blog.

While there are clearly people who need to refrain completely from alcohol use, that’s not everyone’s experience. If you feel it’s worth giving sobriety a try, you might not have to tell yourself you’ll never drink again. That all-or-nothing approach is a huge commitment and can intimidate and discourage people from taking what might just be a well-needed break. At first, I told myself I wouldn’t be drinking again “for the foreseeable future” and gave myself the flexibility to change that decision, should I want to.

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In my case, I felt pretty sure I couldn’t start up again moderately, or I’d slowly revert to the same compulsive drinking patterns in which I’d been ingrained. I’m a night owl, so for me, that meant things like telling myself it was okay to stay up and have another glass or two of wine after I returned from drinking events – even on weeknights. I always went to bed much later than intended and felt miserable the next day. And that’s on the light end of things. For people with use problems, when there’s a will there’s a way, and the will is to drink more. It’s a behavioral problem, and we’ll always behave. It’s very hard and takes a lot of dedicated work to shift behavior patterns.

But not everyone has that level of compulsivity, and many people can shift to moderate drinking after a pattern of heavy drinking, or after a period of sobriety. If continuing to drink at lower levels poses no serious risk to you or others, it might be worth trying moderation before making the decision to quit entirely. You can limit yourself to a certain number of drinks per night, or per week, or in certain social settings – in some way tracking and limiting your consumption. Try a glass of water or something other than alcohol between drinks. That can be a good test of your willpower.

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If you do try that, pay attention to how difficult it feels. If it’s no trouble, then maybe you can continue and don’t really need to give up alcohol completely. If it’s prohibitively difficult – if, even after several attempts, you find yourself making excuses to push past the limit, or you can’t get your mind off the drink you’re not having – you might want to consider giving up alcohol.

Apart from cravings for those with chemical dependence, navigating social situations can be one of the hardest things to get used to in sobriety (and warrants a separate blog post). This is one of the first excuses many people state for why they couldn’t quit drinking. There’s the social awkwardness and anxiety, the fear of missing out on things, and, though people don’t typically state it, the threat to a social identity they’ve formed that involves alcohol.

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A lot of us drink in social settings to avoid feeling awkward and anxious while we adjust to the environment. Having been in a host of social situations without alcohol, I’ve been paying close attention to those group dynamics. To me, it seems that with patience and time, people seem to adjust and that initial awkwardness subsides – for both those drinking and those not drinking. But it’s hard when you first quit to get to that point of calm and ease without the aid of alcohol, especially if your anxiety is particularly strong. Having a seltzer or soda in hand (or hidden in a coozie) certainly helps.

In one of my SMART Recovery meetings, someone said, “If you pull a carrot out of the ground, you can’t put it back in. That carrot has seen things.” That’s an apt representation of how I felt when I first realized I was probably “one of those people” who needed to give up alcohol for good. I saw who I was becoming and couldn’t unsee it. That moment occurred well before I gave it up – years before, actually. But if you really have a use problem, part of you probably knows it. It’s pretty common to have a voice inside you pointing out that your drinking looks different from everyone else’s. You might feel like you’re not always in control, that something else keeps taking the reins.

And at that point – or years later, if you’re like me – you’ll stop trying to put the carrot back in the ground.

-Dana G

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Terminology surrounding alcohol use

What’s the difference between alcohol use, misuse, abuse, and dependence? And between moderate and heavy consumption, binge drinking, and Alcohol Use Disorder (AUD)? We hear these highly related terms a lot, often used casually and unspecifically. That makes it tough if you’re trying to understand the distinctions and find out if your relationship with alcohol is safe and healthy or problematic.

It helps to remember that alcohol-related behaviors and conditions don’t exist on their own. Each of us has unique developmental differences, life experiences, personalities, social and cultural influences, motivations, traumas, and mental health challenges that contribute to how we approach and interact with alcohol. It’s not always easy to pinpoint whether alcohol is a problem in your life, and whether adjusting your relationship with alcohol or something else will help you overcome whatever struggles you might be facing. 

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It can become even more confusing when you read up on these terms. Some of the information you find online is contradictory. You may exhibit some, but not all the behaviors linked to risky alcohol use, or feel like you sit somewhere in between two levels of consumption. The important thing to remember is that alcohol use lies on a spectrum. No definition or diagnosis is perfect. They are simply there to help you start to make sense of your relationship with alcohol, to get some idea of what constitutes healthy vs. unhealthy drinking behavior. You don’t have to identify with anything perfectly, or at all.

Ask yourself how you feel about your drinking. Does alcohol make you feel good about yourself and your connections to other people? Is that consistent, or is there turbulence in your life fueled by alcohol? Are there patterns of repercussions that are impacting you negatively (injuries, unintended behavior, embarrassment, work or legal challenges)? Does alcohol augment positive aspects of your personality or negative ones? Asking yourself questions like these can be more clarifying than reading behavioral and diagnostic terms.

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However, language is important for helping us describe our world, to categorize and communicate, and at times, to heal. For that reason, here are some of the many terms often used in recovery settings to define alcohol consumption.

  • Alcohol use: This simply refers to the behavior of consuming alcohol. People “use” alcohol at different levels – not at all, moderately, or heavily. 
  • Moderate alcohol use: The numbers can feel a little stringent, especially because they don’t take into account how varied our body composition can be. But this is defined as up to three drinks on any single day and up to seven drinks per week for women. For men, it’s up to four drinks on any single day and up to 14 drinks per week.
  • Heavy alcohol use: This is defined in terms of the frequency of binge drinking. Doing so on five or more days within a month is classified by the Substance Abuse and Mental Health Services Administration (SAMHSA) as heavy alcohol use. This blog is mostly catered to people who have consumed alcohol at this level and are interested in navigating sobriety, because that was my experience – so naturally, that’s where I’m writing from.
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  • Alcohol misuse: This is an umbrella term referring to a range of behaviors that increase a person’s risk of adverse health and social consequences. These behaviors include risky, or excessive alcohol use (which encompasses binge drinking), as well as alcohol abuse and alcohol dependence – two terms that have been replaced in the medical literature and are now encompassed under the broader diagnosis of Alcohol Use Disorder (AUD). 
  • Risky (excessive) alcohol use: This refers to heavy alcohol use, binge drinking, and any drinking by pregnant women or people younger than the age of 21 (CDC). It is based on the amount of alcohol that increases the risk of poor health outcomes such as high blood pressure, heart disease, stroke, liver disease, and certain cancers – along with an increased risk of developing Alcohol Use Disorder (AUD).
  • Binge drinking: If you come from a hard-partying college in the U.S. like I did, you probably need no introduction to what binge drinking is. But here’s how SAMHSA defines it: five or more alcoholic drinks for males, and four or more alcoholic drinks for females consumed within a couple of hours on at least one day within a month. That’s the level that typically (again, dependent on body composition) brings blood alcohol concentration (BAC) levels to 0.08 g/dL.
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That’s a good start, but it doesn’t tell us what’s normal and at what level heavy alcohol use becomes a “disorder.” How do you know if you really have a problem? And how serious is it? While the below can only be diagnosed by a medical professional, looking at the criteria for Alcohol Use Disorder (AUD) can help you to start thinking clearly about your alcohol consumption and relationship with alcohol on a larger scale.

Again, don’t jump to any conclusions about yourself! Though frequent binge drinking is quite common (one in six adults binge drinks around four times per month), not everyone who does so develops AUD. The statistics show that among people who have one heavy drinking day per month, two in 10 have AUD, and among those who have one heavy drinking day per week, three in 10 have AUD. The risk is higher for those who have two or more heavy drinking days per week, among whom five in 10 have AUD.

  • Alcohol Use Disorder (AUD): The Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) distinguished between alcohol abuse and alcohol dependence based on the number of diagnostic criteria met under each of those categories. But the new edition of this diagnostic resource – the DSM-V – removes that distinction and instead has one diagnosis, called Alcohol Use Disorder, classified by severity (mild, moderate, severe) depending on how many of 11 criteria are met. Most of us are brought up to believe that you either are or are not an “alcoholic.” But the current definitions seem to imply that here is really a spectrum of alcohol-related problems, rather than this binary concept of alcoholism. Because of this, I won’t be referring to “alcoholism” in my blog.

In general, AUD involves continuing to drink despite recurrent social, interpersonal, and/or legal problems that result from alcohol use. Behaviorally, it usually involves frequent binge drinking, but may or may not reach the level of chemical dependence. A person may start to narrow in on social events and friendships that involve drinking, require increasing amounts of alcohol to achieve the same effect, and be subjectively aware of cravings and the compulsion to drink, continuing to do so even if it’s making them feel depressed or anxious.

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At more severe levels, they’ll experience physical and emotional withdrawal symptoms like tremors, nausea, sweating, and insomnia shortly after they stop drinking, and drink to relieve or avoid those symptoms. If they decide to quit, the intensity of withdrawal symptoms may push them to lapse back into drinking behavior.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) provides several questions that can help when considering whether if you might be suffering from AUD. If you have severe AUD and might experience withdrawal symptoms upon quitting drinking, outside help is advised during the recovery process. You should work with your doctor to determine what’s best for you, but that additional help might include detoxification, medical treatment, or professional rehab – in addition to the counseling and group support that, in my opinion, are helpful to anyone moving from misuse to sobriety. The SAMHSA helpline is available 24/7 to help you locate a range of recovery resources.

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To summarize things, the risks of alcohol use are typically gauged by the amount consumed, considering the number of drinks, frequency, and other behaviors surrounding drinking and its impacts. Alcohol misuse is an umbrella term that describes a broad spectrum of behaviors and conditions – including risky (excessive) alcohol use and AUD – that increase a person’s risk of adverse health and social consequences.

I hope these definitions will be of some value as you consider whether you feel in control of your drinking behavior. Remember that none of the above come with the label of “alcoholic,” but refer only to behaviors. And problem behavior always exists on a spectrum. It’s important that we try to shake off some of the stigma surrounding how we talk about alcohol use and sobriety so we can begin to think clearly about it!

-Dana G

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