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To Drink or Not to Drink? That is the Question.

Updated: Apr 27, 2021

If there’s a question that regularly presents itself to someone who is trying to change their relationship with alcohol, it’s ‘Should I moderate or abstain completely?’ And this might not be an easy question to answer, depending on your starting point.


It is worth stressing that you don’t have to be a raging ‘alcoholic’ to be drinking more than is good for your health. 24% of adults in England and Scotland regularly drink over the Chief Medical Officer’s low risk guidelines and the figures are equally as high, if not higher, in many other countries across the world. (1, 2)


There is still a widely held assumption that there are people that ‘can’t handle’ their drink, the ‘alcoholics’ and then everybody else. The reality is far more complicated and it might be more helpful to think of ourselves on some sort of spectrum.


You will know by now that historically, I was a big drinker, so it will come as no surprise that I have dabbled with moderation on more than one occasion. In the early days of attempting some sort of sobriety, I built up to being able to go for several days, weeks or even months at a time without drinking. But then as I reintroduced the alcohol as a reward for my success, the intake would gradually increase again. The thought of starting from the dreaded ‘day 1’ again would be something that I would need to psyche myself up for. And so around and around I went.


This is part of the reason that I don’t count consecutive sober days anymore and try to take a broader view.

Of course, there’s nothing like a sense of failure to make you want to pour yourself a large drink, and that I did. The other problem is that alcohol affects our brain chemistry and decision making. This explains why for some people, once you’ve had one drink it becomes difficult to stop there. The dreaded ‘off-switch’ is problematic as is the continuous thinking about moderating.


This drinking equivalent of being on a diet can take up a lot of thinking and can become very irritating. In fact, some people get so fed-up of the constant internal chatter of trying controlling their drinking that they do decide to abstain completely. A perusal of some sites on the internet, such as ‘One Year No Beer’, demonstrates exactly this.


What if you though, for whatever reason, don’t want to give up completely? Alcohol Reconsidered isn’t anti-alcohol and we recognise the social benefits we get from drinking, if not the physical health benefits.


Upon reflection though, one of the reasons that I always ended up drinking heavily again was because my baseline was pretty high, so to stick to 14 units a week was initially unrealistic. Secondly, I wasn’t particularly clear about what I was aiming for in the longer term. I wasn’t very clear in my own mind about what I was trying to achieve, apart from proving to myself that I could ‘moderate’ my drinking if I needed to.


Which begs the question, do we spend enough time thinking about what we are aiming for in the long term? Is the reason that so many people ‘fail’ with moderation because the aims that they set for themselves are unrealistic?


Back at the time I would have judged my attempts at moderation as ‘failures’, though looking back now what they did do was force me to find other strategies for dealing with stress and boredom that are arguably necessary for longer term success.


Would moderation be a more successful strategy if they viewed it as an ongoing process rather than a short-term strategy?


Which brings us on to the word itself. We use the word ‘moderation’ at the time, but do we have a good understanding of what it means? Might it mean different things to different people at different times?

If we look a definition of moderation as ‘The quality of being reasonable and not being extreme’ (3) then perhaps a reasonable target would be to be able follow the Chief Medical Officer’s guidelines of ‘safest’ drinking guidelines. That means no more than 14 units a week on a regular basis, spread out over several days. If you’re a big drinker and you know how little 14 units is (approximately a bottle and a half a week), that might seem like a depressingly small amount. Would it not be a sensible idea to aim to reduce your drinking over time if this an unrealistic starting point?


The debate as to whether to moderate or abstain has been continuing for some length of time in the addiction field. Research seems to suggest that moderation may be a successful strategy for those who have not crossed the thin line of alcohol dependence and for those who have not experienced any severe negative consequences of their drinking.


Moderation it would seem may be less successful for dependent drinkers. The research also seems to suggest that as the severity of alcohol dependence increases, the likelihood of being able to drink moderately for an extended period decreases. (4) Perhaps I am the exception to the rule?


Whether you decide to moderate or abstain completely is obviously down to you and perhaps a good place to start is really considering why you drink and to really think about what is achievable. What is true is that if your drinking is affecting your life, your health and/or relationships, it is worth exploring your options and making some weekly, and most importantly, realistic targets.


What do you think? Please feel free to leave your thoughts below.


Lesley


(Disclaimer: At the risk of sounding like a stuck record, this blog and ‘Alcohol Reconsidered’ are not substitutions for medical advice. Stopping drinking suddenly can result in death, and we definitely don’t want that, so please consult with a professional before making any changes to your lifestyle. The authors accept no liability with regard to this.)


References:

1) Burton, R. et al. (2016). The Public Health Burden of Alcohol and the Effectiveness and Cost-Effectiveness of Alcohol Control Policies: An Evidence Review.

2) Scottish Government (2019). Scottish Health Survey 2018: volume one-main report. Chapter 3 – Alcohol

3) https://www.oxfordlearnersdictionaries.com/definition/english/moderation

4) https://www.health.harvard.edu/mind-and-mood/alcohol-abstinence-vs-moderation






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