5 Tips to Change a Drinking Pattern and Make This New Year’s Resolution Stick
It’s that time of year when many of us make New Year’s Resolutions. For some it’s about adding more exercise. For some, it’s about eating more nutrient rich foods. And for others, it’s about their drinking. Should they stop all together? Can they just cut down? What can they do to successfully change how much they drink? If it’s your New Year’s Resolution to figure this out, consider these…
5 Tips to Change a Drinking Pattern and Make This New Year’s Resolution Stick
There are a number of reasons people start and fail to change a drinking pattern. A few include:
- not being clear about why they drink in the first place;
- not knowing there is actually a scientifically understood guideline for “low-risk” (aka “normal”) drinking;
- not understanding that the differences in drinking patterns is what dictates whether a person can change their drinking pattern to fall within “low-risk” limits or whether they have developed a severe alcohol use disorder (aka known as alcoholism; dependence on alcohol, one of the diseases of addiction, or severe alcohol use disorder) that requires the person to stop drinking all together and get help with treating their disease.
Whatever your reasons, the following tips can help get you started.
1 – Be Clear On Why You Drink
Is it boredom? — You’re home alone (again) with nothing much to do so might as well have “a” drink while you watch TV. Is it to be social? — The people whose company you enjoy, drink, so you drink when in their company.
Is it because you simply enjoy the feeling you get, or the way it helps you unwind after a tough day at work or being the working inside the home parent caring for your children?
Take some time to think about why you drink – jot your reasons down.
It’s important to spend some time thinking about why you drink. Make a list. Next to each reason, make a note of your thoughts leading up to you having that first drink. Jot down how much you typically drink on these occasions (see #2 to accurately assess how much). Make note of what you do after the drinking session — drive home, fall asleep on the couch, stumble into bed, read a book and then fall asleep…?
Having this information can help you identify what activities you can do instead, should you decide you want to change your drinking pattern. Becoming aware of one’s cues/triggers is what allows a person to change a brain map and do things differently. It’s the idea of going back through your list and giving some thought to, “What am I going to do, instead?” and jotting that down, as well. This is how a person can start to rewire their brain for a new /replacement habit, and in the case of this New Year’s Resolution, change a drinking pattern. Check out my post, “Understand Brain Maps | Change a Habit | Change Your Life,” for a better understanding of the brain rewiring process.
2 – Know How Much You Typically Drink
Are you aware of the concept of “standard drinks?” A standard drink means the amount and type of alcoholic beverage contains a single drink amount of ethyl alcohol chemicals (alcohol by volume). It is the ethyl alcohol chemicals in alcoholic beverages that changes how the brain works, and it is these brain changes that change what a person thinks, fells, says and does. In other words, it’s the cause of drinking behaviors. Drinking behaviors include: verbal/physical/emotional abuse; driving while impaired (DUI); unwanted/unplanned sex or sexual assault; alcohol-involved domestic violence/crime/death by suicide, to name a few. And why is this true? See #3.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has a terrific website called “Rethinking Drinking.” To the right is their image of various standard drinks, meaning each “drink” contains the same amount of ethyl alcohol chemicals.
To learn more about standard drinks, click here, and to learn how many standard drinks are in common drink containers, click here, and in common cocktails, click here. You’ll likely be surprised there are more than you’d think 🙂
3 – Know How the Body Processes Alcohol
Alcohol is not processed like other foods and liquids through the digestive system. Instead it passes through the stomach and enters the bloodstream through the walls of the small intestine. Because alcohol dissolves in water, the bloodstream carries it throughout the body, which is 60-70% water, where it is absorbed into body tissue and organs high in water concentration and highly vascularized (meaning lots of blood vessels). One such organ is the brain.
Enzymes produced only in the liver, called ADH and ALDH, break down (metabolize) the ethyl alcohol chemicals so they can leave the body. These liver enzymes can only metabolize a certain amount of ethyl alcohol per hour, which means alcohol leaves the bloodstream more slowly than it enters. This rate of metabolism explains why a person’s Blood Alcohol Content (BAC) can continue to rise long after that individual has stopped drinking or passed out.
Contrary to popular belief, then, we cannot rid our bodies of the ethyl alcohol chemicals in the alcoholic beverages we drink by peeing, sweating, or vomiting. Similarly, drinking coffee or lots of water or eating a big meal or taking a walk around the block will not get rid of these chemicals, either. The only thing that can sober a person up is TIME.
As I stated above, the ethyl alcohol chemicals in alcoholic beverages leave the body by what happens in the liver. While “waiting their turn” out of the liver, these ethyl alcohol chemicals interrupt the brain’s normal cell-to-cell communication process. These changes, in turn, are what cause a person to engage in drinking behaviors, such as: saying mean things, getting into a fist fight, or thinking that having unprotected sex is a good idea. Or a person may “choose” to drink and drive because they “feel fine.” And it’s likely true. At the point they gather their keys and head out, they may be “fine.”
But as the ethyl alcohol chemicals back up (blood alcohol content continues to rise), these chemicals interrupt normal brain functioning. This causes the person to slur their words, not think about the speed limit, not be as quick with their braking reflexes, and find their vision is blurred.
4 – Know What’s Considered “Normal” or “Low-Risk Drinking”
Yes, there is actually a target. Again we turn to NIAAA’s Rethinking Drinking website to learn what’s considered “low-risk” drinking. In other words, the limits that should keep a person in control of their behaviors and health if they choose to drink.
For women: no more than 7 standard drinks in a week AND no more than 3 on any one day
For men: no more than 14 standard drinks in a week AND no more than 4 on any day.
5 – If You Exceed “Low-Risk” Limits, Understand What It Takes to Change Your Drinking Pattern
If you’ve spent some time on the NIAAA Rethinking Drinking website by now, you likely understand there is a range of drinking patterns. In other words, it’s not must “normal” or “alcoholic,” it’s binge drinking, heavy social drinking, excessive drinking and the drinking pattern we commonly know as alcoholism. This range of drinking patterns are known as alcohol use disorders (AUDs), and within this framework, there are mild, moderate and severe alcohol use disorders. The difficulty with the new term, however, is most people are not aware of it nor the idea of mild, moderate or severe AUDs. So I tend to use both the new and old language, which I explain in my post, “About the Terms: Alcohol Abuse | Alcoholism | Alcohol Use Disorder.”
For the purposes of this post,
- Mild AUDs include: occasional binge drinking, which is defined as 4 or more standard drinks during a single occasion for women and 5 or more for men, and occasional heavy drinking, which is defined as consuming 8 or more standard drinks a week for women and 15 or more for men. When you look back at the low-risk drinking limits you see that binge drinking exceeds the daily limit and heavy drinking exceeds the weekly limit.
- Moderate AUDs — what we commonly call alcohol abuse — includes regularly exceeding the daily or weekly limits, that is, regularly binge drinking or heavy drinking, for example. The American Psychological Association (APA) defines Alcohol Abuse as:
a drinking pattern that results in significant and recurrent adverse consequences. Alcohol abusers may fail to fulfill major school, work, or family obligations. They may have drinking-related legal problems, such as repeated arrests for driving while intoxicated. They may have relationship problems related to their drinking.
- Severe AUDs — what we commonly call alcoholism or alcohol dependence is a brain disease, also called a brain disorder, and therefore cannot be narrowly explained or defined by a drinking pattern like binge drinking or heavy drinking. The APA explains that…
People with alcoholism — technically known as alcohol dependence — have lost reliable control of their alcohol use. It doesn’t matter what kind of alcohol someone drinks or even how much. Alcohol-dependent people are often unable to stop drinking once they start. Alcohol dependence is characterized by tolerance (the need to drink more to achieve the same “high”) and withdrawal symptoms if drinking is suddenly stopped. Withdrawal symptoms may include nausea, sweating, restlessness, irritability, tremors, hallucinations and convulsions.
Here are three alcohol use assessments you may want to use if you’re concerned about your drinking pattern or the drinking pattern of a loved one, for that matter:
- NIAAA’s Rethinking Drinking > “What’s Your Pattern?“
- World Health Organization’s > Alcohol Use Disorder Identification Test (AUDIT) – the questionnaire assessment is on page 17 and the scoring and interpretation guidelines are on pages 19-20. Note: the AUDIT is intended for use and interpretation by a clinician but can be used by you, as a layperson, wanting a general understanding.
- And here is a reprint of the American Psychiatric Association’s DSM-5 assessment that differentiates between a mild, moderate, or severe alcohol use disorder. As with the AUDIT, it is intended for use and interpretation by a clinician but can be used by you, as a layperson, wanting a general understanding. Circle the number(s) that apply to the symptoms of your or your loved one’s drinking pattern.
In the past year, have you [your loved one]:
- Had times when you ended up drinking more, or longer, than you intended?
- More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
- Spent a lot of time drinking? Or being sick or getting over other after effects?
- Wanted a drink so badly you couldn’t think of anything else?
- Found that drinking – or being sick from drinking – often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
- Continued to drink even though it was causing trouble with your family or friends?
- Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
- More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
- Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
- Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
- Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure? Or sensed things that were not there?
The presence of at least two of these symptoms indicates an alcohol use disorder. The severity of the alcohol use disorder is defined as:
- Mild: The presence of two to three symptoms
- Moderate: The presence of four to five symptoms
- Severe: The presence of six or more symptoms.
Feel Free to Contact Me
As always, if you have further questions, feel free to send me an email at lisaf@breakingthecycles.com to arrange a phone, Skype, Zoom or What’sApp call. There is no charge for these kinds of outreach calls/email exchanges.
Lisa Frederiksen
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Wonderful article Lisa. I appreciate your choice to use old language and the new accepted language for substance use disorders. You’ve made it a clear bridge to understanding. I would like to add a note that there are biological response differences between genders when processing the alcohol and why it’s important for WOMEN to understand that they are at GREATER RISK TO ALCOHOL DEPENDENCE than men. In a shorter period of time women go from occasional use to definite abuse and begin to suffer social and physical consequences. Why? Women’s bodies contain more fatty tissue proportionately than do men’s means that the same QUANTITY of alcohol consumed by both a man and a woman of equal size will result in a higher blood alcohol level for the woman. The alcohol will also be stored in that fatty tissue for a longer period of time. In addition, women have been shown to produce LESS alcohol dehydrogenase, that stomach and liver enzyme that breaks down the alcohol you wrote about. The consequence of this enzymatic differential is that women break down less alcohol in the digestive process and, thus, again will show a higher BAC than men. (Deal & Galaver, 1994). In fact, according to Deal and Galaver, “the hypothesis of increased absolute bioavailability of alcohol in women is supported by scientists who BELIEVE WOMEN ARE MORE SUSCEPTIBLE TO LIVER DISEASE.” As a woman, I wish I had learned this early on. As a matter-of-fact, I wished I had learned it in health class in middle / high school.
Wow! Thank you so much, Shelley, for sharing this important information. And I agree – if only this kind of information were taught in middle/high school – especially given the brain developmental processes occurring then.