House Call: Alcohol use and new thinking about drinking

Many of us enjoy a glass of wine or a cocktail without giving it much thought, but checking in on your alcohol consumption can and should be a routine part of your wellness care. While a drink can be relaxing or celebratory at first, drinking more can result in adverse health effects such as stress, poor sleep and over the long term, drinking that is not in control.

It’s easy to let your drinking frequency or amount creep up without noting it, making unhealthy levels the new habit. It also turns out that drinking moderate amounts of alcohol daily does not (as once thought) provide health benefits like protection from heart disease or lead to a longer life, according to new research analysis.

It’s important to review your alcohol consumption habits at your annual wellness exam with your primary care provider. Ask yourself some honest questions like “Has my alcohol consumption become a health problem? Have I been asked to cut down by others? Do I wake up irritable and looking forward to that next drink? Do I ever feel guilty about my alcohol consumption or behaviors when I drink?” These questions, when answered honestly and openly, can be a clue that something needs to change. Your provider can help you to distinguish between light social alcohol consumption, excessive use or possible alcohol use disorder.

There is new research on approaches to moderating consumption that offer research-based advice to cut down or stop drinking alcohol. Alcohol and substance use researchers at Kaiser Permanente recently focused on what strategies work and outlined five options that can help people make changes. They are counseling, medications, peer support, group-based alcohol treatment programs, and making changes on your own (which many people do successfully).

It can be helpful to talk with your health care provider about the options and use planning resources for examining your alcohol use, like the free, research-driven workbook Options for people who are thinking about their drinking.

Let’s talk about an unhealthy level of drinking. The Centers for Disease Control recommend people drink no more than one or two drinks a day. A standard drink is 12 ounces of regular beer, which is usually about 5% alcohol; 5 ounces of wine, typically about 12% alcohol; or 1.5 ounces of distilled spirits, which is about 40% alcohol. You can find these alcohol-by-volume (ABV) numbers on the label.

If you are thinking about cutting down on your drinking, these research-based approaches can help:

Set small goals you know you can achieve. A clear goal for how many drinks you would have in a single day or the amount of money you want to spend on alcohol in a week can help you stay accountable and on track.

Try starting with a set break from alcohol. Making a plan to abstain from alcohol for a set number of weeks or months, and following through with that plan, could provide some eye-opening insights and reveal health benefits you didn’t even realize you were missing out on.

Keep track in a diary, calendar or an app that allows you to record how much you are drinking and when. This will give you a more realistic overview of how much alcohol you are consuming and can help you identify patterns and triggers that may lead to more drinking.

Limit the days of the week you drink or the number of drinks you have in a single sitting. If you are drinking several days out of the week or have several drinks when you do, setting limits can start you on the path of reducing your overall alcohol consumption.

Space out your drinks and slow your pace. Leave more time between your drinks, alternate with nonalcoholic drinks, eat a well-balanced meal before drinking or decrease the amount of alcohol in each drink.

Know what a standard serving is. Drinks come in different sizes and different amounts of alcohol. A bottle of beer with a higher alcohol-by-volume (ABV) is more than a standard serving, as is a full pint; some cocktails or wine are more potent than others. Just being aware of your serving size (noted above) can be helpful and so can measuring each drink out as you pour. It’s easy to underestimate how much you’re consuming if you don’t know.

Monitor the side benefits of cutting back on alcohol. Keep track of benefits such as money saved, weight lost, better mornings and mental health to motivate you to keep going.

Celebrate milestone achievements with a nondrinking reward. Having something to look forward to like a new pair of shoes or a day at the beach can make cutting back on alcohol feel more manageable and will help you stay motivated long term.

Reach out for support, whatever that means for you. Sharing your intention to cut back on alcohol with a trusted friend or family member can be an incredibly helpful way to stay on track. Talking with others can also help you learn something about your motivation to drink. Choose people you trust who will be supportive of your efforts to make positive changes to your drinking habits. You can also talk with your health care provider or find peer groups in person and online for support.

If you have identified your alcohol consumption as being problematic it’s important to remember that while no one choice or approach works best for every person, most people have a better chance of changing their drinking with help, whether that’s your peers or provider, a written plan, counseling or medication. As with all major lifestyle changes, reducing alcohol consumption requires dedication, commitment and work, but the benefits are well worth it. Just remember to be kind to yourself along the way.