Should everyone with a drinking issue go cold sober? You’ll hear that anything less is a half-measure and that you’re lying to yourself if you think you can cut back or drink safely.
Margaret Fetting, a psychologist with 25 years of experience in Santa Monica treating patients with alcohol and drug problems, doesn’t push abstinence for everyone or forever. Indulging in pleasurable use, she says, is natural and healthy — up to a point. Each of us needs to understand our patterns and learn ways to minimize damage.
According to the Centers for Disease Control and Prevention (CDC), one in six American adults goes on binges, drinking about 8 drinks at a time, typically four times a month — and most of them aren’t dependent on alcohol. Problem drinkers are much more common than alcoholics, and they tend to resist groups in which they’ll be defined as an alcoholic. If that sounds like you, you might look instead for a “moderation” group with either in-person or phone meetings.
Depending on your pattern, Fetting, who is also the author of two professional manuals on substance abuse and addiction, offers the following advice:
Voluntary nonuser. Some people refuse to use any drug, including alcohol and prescriptions. Fetting believes that they need to follow medical advice and take prescribed medications.
Mindful. You make your health a priority, and use substances carefully. Her advice: Be careful about mixing substances and learn your body’s limits.
Experimental. Most people experiment with alcohol and drugs at some point, typically as teens or in their twenties. Some people experiment after long periods of abstinence, she notes. She urges experimenters to talk to others about their experiences so they can learn to accurately measure the risks.
Social. You enjoy the experience of drinking with others, and feel confident that you know when to stop. While you may drink alone, it’s not a habit. The problem: Most people see themselves as social users, and they may need friends or family to tell them when their habit is harmful. After all, binge drinking is common, but binge drinkers are 14 times more likely to drink and drive, the CDC reports.
Misuser. You have bad memories of overuse you regret. You can learn from your mistakes. Also seek out safe situations when you won’t need to drive, or have a designated driver you can count on.
Regular misuser. If you repeatedly misuse drugs and alcohol, you mind may be full of monologues of worry. Fettig suggests a “leave of temporary abstinence” and thinking about whether you’re using substances to run away from problems. You could also consider a moderation group.
Problem. Some people get to the point where they use substances to cope with daily life. It’s not for fun, but survival. You may not have a physical addiction and you may refuse to quit. You’re a good candidate for a moderation group, which can keep your problem from getting worse.
Shadow. It’s possible to live like anyone else, paying the bills and meeting other people’s expectations, but use a party drug — or overuse a prescribed drug — every day of the year. Fetting advises looking at the reasons for your habit and seeking professional help, including medications that can counter cravings when you try to cut down.
Watchful. You might decide you have a problem, explore the causes, and go through a long period of abstinence before beginning to drink again. Keep a close eye on it; Fetting observes that you will most likely need to be careful for the rest of your life.
Discontinued user. Abstinence is a choice, which may or may not last a lifetime.
Addiction. The words “addict,” “substance abuser,” or “alcoholic” are often used loosely; professionals evaluate each person according to a checklist of symptoms. The bad signs include increased tolerance (needing more of the drug for the same effect), preoccupation (spending time thinking about how to get it), and irresponsibility (letting drug use interfere with your job or other obligations and goals). Like other chronic diseases, addiction often produces cycles of relapse and remission. So you may get better for a while, but without treatment or action to recovery, addictions progress and can lead to disability or premature death, the American Society of Addiction Medicine notes. When you have become out of control, Fetting says, you need immediate professional help.
February 19, 2016
Janet O’Dell, RN