Need to know
Both Alex and his wife enjoy going out to dinner and having some wine, and they occasionally have a drink at home in the evening. But tension started to build in their relationship as a result of Alex’s weekly meetups with friends at the bar. While he usually just had a couple of drinks and left for home, there were times when he would stay out way too long and return very intoxicated. The unpredictability of his behaviour began to cause problems between him and his wife, who have young children at home.
Janelle used to be a light drinker. She eventually got into the habit of drinking wine after work, while preparing dinner for her family. In recent years, she’s found herself drinking several glasses each night – sometimes a bit more. While her drinking never bothered her husband (who also drank), she became concerned after realising just how much she was consuming, while noticing that she also felt more tired in the evening and groggy in the morning.
Among those who drink, the relationship with alcohol runs along a continuum, with potential consequences ranging from mild to moderate to severe. Often, when people think about the challenges posed by drinking, they think of individuals who are on the more severe end, and they might say to themselves: I’m not that bad. But the image of someone with a severe alcohol addiction fits only a small proportion of those who have good reasons to change their alcohol consumption – as do the individuals in the above scenarios (who mirror people I have seen in my clinical work).
While your own drinking may not be severely problematic, perhaps you, too, have found yourself drinking somewhat more than you want to. Maybe you’ve come to suspect that it has been impacting your sleep or energy level, or you’ve found that drinking has taken time away from other, more productive activities that you want to engage in. You may even be a little concerned about how it could affect your health. In this Guide, you will learn what a healthier relationship with alcohol can look like – and ways to go about achieving it.
What is an unhealthy relationship with alcohol?
When trying to determine if someone’s relationship with alcohol has become unhealthy, I typically use two main indicators:
- the person cannot consistently predict how much they will drink, or what will happen once drinking begins; and/or
- the person continues to drink despite experiencing problems related to drinking.
In the opening examples, neither person could consistently predict how much they would drink – and, in Alex’s case, it wasn’t always clear what would happen when he drank. His pattern of alcohol use was also impacting his relationship with his wife, but he continued to overdrink anyway. Both individuals have developed what I would consider an unhealthy relationship with alcohol, whether or not they would be diagnosed as having an alcohol use disorder.
In addition to asking whether either of those indicators fits your own experience, it could be helpful to consider some general guidelines on drinking. In the United States, health authorities describe moderate alcohol consumption as having no more than one drink per day for women, and no more than two a day for men. Heavy drinking is considered, for women, four or more drinks in a day, or eight or more per week; for men, it’s five or more in a day, or 15 or more per week. (A single drink, in these guidelines, is about 5 fluid ounces/148 ml of wine; 12 fl oz/355 ml of beer containing 4-5 per cent alcohol; or 1.5 fl oz/44 ml of hard liquor, or spirits.) Other national governments, including in the United Kingdom and in Australia, provide similar, if somewhat more conservative guidelines.
In one national study conducted in the US, it was found that nearly a third of adults had engaged in excessive drinking during the previous month. The relatively good news was that, among those people, only 10 per cent were found to have alcohol dependence (a more severe form of an alcohol use disorder). Based upon these findings, researchers suggested that the other 90 per cent might be able to modify their pattern of excessive drinking without the need for specialised treatment.
There are many reasons why someone might develop an unhealthy relationship with alcohol. A family history of alcohol problems is associated with increased risk. Emotional health can play a role in drinking, too, as problems such as chronic anxiety and depression can increase the likelihood of using alcohol to cope with uncomfortable feelings. A person’s environment also matters, including whether one has spent time in settings where heavy drinking is typical and encouraged.
It is very common for drinking to get linked in a person’s mind with certain situations, as one learns to associate them with the pleasure of drinking. This, in turn, can lead to more frequent and heavier alcohol use. For example, when feeling stressed after work, you might have learned to use alcohol to relax, so drinking eventually became a go-to source of stress relief in that situation. And since alcohol is so commonly used to loosen up in social situations, many people come to associate these situations with drinking, and consume more than they intend to while out with others.
A healthier relationship with alcohol is achievable
So what is a healthy relationship with alcohol? In a general sense, it means that drinking does not cause you or the people you interact with any difficulties or concerns. It does not cause you emotional, legal, health- or job-related difficulties; it does not impact your relationships or your life in a negative way. When you drink in a healthy way, you rarely (or never) overdrink: instead, you feel in control of your drinking, and drink to experience alcohol’s pleasurable effects, but not with the aim of getting drunk. Very simply, drinking, while enjoyed, is not a big deal and does not cause problems for you or anyone else.
The purpose of this Guide is to help you manage your drinking and improve your relationship with alcohol. It is primarily for people for whom the consequences of drinking are on the relatively mild end, as research indicates they have a greater chance of learning to drink in moderation. People with a more severe drinking problem generally will need to stop drinking completely. They will often benefit from seeking treatment, and in some cases may require medically supervised withdrawal to ensure their safety as they stop drinking. (If you’re not sure whether your drinking falls into a more severe category, a previous Psyche Guide offers advice on recognising signs of addiction.)
If you sense that your drinking, while not severe, is less healthy and predictable than you would like it to be, the next section is designed to give you the tools to achieve positive change. In my work as a therapist, I’ve seen that, when people successfully moderate their drinking, they notice how much better they feel as a result, often reporting better sleep, more energy, and the sense that they have more time to do things such as reading, working out or other rewarding activities. Often, any tension with others around drinking goes away and relationships improve. They feel better about themselves, and more self-confident, knowing that they are in control of their drinking.
What to do
Describe your reasons for wanting to change your drinking
If you are going to be successful in cutting back on drinking, you’ll want to do what you can to maintain your motivation for change. As with any change effort, whether it’s changing unhealthy eating habits or getting involved in a healthy exercise routine, the level of motivation can start to erode if the reasons for seeking to change are forgotten.
To avoid that, write down all your reasons for choosing to drink less. Your reasons may include, for example, wanting to feel better physically, to preserve your health, to improve your relationship with others, or to make more productive use of your time. Take as long as you need to reflect on what comes to mind for you, then add each reason to your list – whether in the form of a word or phrase that represents the reason, or a longer description. Keep it by your bed, in your wallet, and/or as a note on your phone, as you will want to review this list daily so you do not forget about your reasons.
Think of drinking less than before as a choice you are making. There may be a part of you that wants to continue to drink the way you have been drinking. As a result, there might be times when you think to yourself ‘I really want a drink tonight’ or ‘I want to have one more – why shouldn’t I?’ In such moments, you can tell yourself: ‘Of course I want to have that drink, but I can choose not to’ – and you can then reflect on your reasons for drinking less. Doing this will help you to stay focused.
Consider taking a short break from alcohol
As you begin to change your relationship with alcohol, it can be very helpful to take a one-month break from drinking. If that sounds too long, try to stop drinking for two weeks, or at least for one week. I recommend this because when you are aiming for healthier drinking, a good practice is to not drink every day, and it is possible that you have become used to daily drinking. Taking a break from drinking will give you confidence that you do not need to drink every day, and this will help you when you initiate your plan to drink less.
You may find that the first few days are challenging, but that you soon get used to not drinking. You will likely also find that you sleep better, feel more rested, or are more alert, which will strengthen your decision to address your drinking.
Additionally, during this short break, you can try to experiment with doing other things during the times when you would typically be drinking. Fill this time with rewarding and fulfilling activities, whether they are things you currently do or novel ones. You could read a book, exercise, try cooking new recipes, meditate, start a garden or learn a new language, to name just a few ideas. As you continue to change your relationship with alcohol, these can become the activities that help fill your time when you are not drinking (which will make it easier to drink less).
Finally, this experiment with not drinking will give you the opportunity to recognise the times when you have a strong urge to drink. In turn, this offers insight into the role that drinking may be playing in your life – and what you need to do to manage without it. For example, if you feel like drinking after a stressful day at work, you will know that you need to develop other ways to manage those feelings.
Develop your specific plan for healthier drinking
Every person is different, as is their relationship with drinking. In this step, you will develop a plan that is tailored to you and what your goals are. I advise that you write down the details of your plan, considering several different elements of your drinking:
- How much to drink. Decide on the maximum number of drinks you will have on the days when you drink. (If you’ve decided to take a temporary break from drinking, as suggested above, this maximum will kick in after that period.) A good general limit for any given day is one or two, or at most three. And even if your limit is two or three, you can certainly stop at one on days when you drink.
- What type of alcohol to drink. While ‘a drink is a drink is a drink’, some people have found that their ability to control their drinking is better or worse with certain types of alcoholic beverage. If you’re aware that this is the case for you, stick to one of those types of drink that you have better control with. In general, many people do better in this sense with wine or beer than with liquor. However, if wine is what you have been struggling with, you should think about drinking something else, and beer is a good recommendation. Finally, if you do opt to sometimes drink hard alcohol, it probably makes sense to ensure that you use plenty of mixer, as that will make the drink last longer.
- How often you drink. A good general recommendation is to drink at most four days per week. Taking ‘days off’ will prevent daily drinking and it will help keep your alcohol tolerance down. When your tolerance is lower, you will likely feel effects after one or two drinks that it used to take three or four drinks to feel. Spacing out your drinking also forces you to do other things with your time, so that not drinking on some days becomes normal for you if you used to drink daily.
- When to drink, and when not to. Are there certain situations in which your alcohol use is very much in control, while in others it can get excessive? These are your low-risk and high-risk situations, respectively. If this is the case with you, you should decide to drink only in your low-risk situations and to avoid drinking in the types of situations where you have tended to drink too much. High-risk situations might include certain social settings; when you are with certain people; certain times of the day; or when you are experiencing particular emotional states. You might even decide, at least initially, to avoid your high-risk situations altogether, if possible (eg, certain social settings), if it seems too difficult to not drink when in those situations.
Can you ever change your plan? Of course you can, and at times you should. You might find that, despite your best effort, there are times when you end up drinking more often or have more drinks than you wanted. If that happens, it is important to analyse how and why this occurred. You might find that there were high-risk situations that you did not initially identify that need to be avoided. Or maybe you started drinking too early in the day, and one or two became three or four. Perhaps you need to be mindful of the type of alcohol you drink, or should consider decreasing the number of days when you drink, or the number of drinks you have in a day – any of which might give you greater control. The goal is to learn from these incidents and then modify your plan.
What about changing your plan to allow for more drinking? Again, you could, but I recommend doing this only once you have first demonstrated good control over your drinking and it is much healthier. That is, for at least several months, you have been successfully adhering to the frequency and amount of drinking that you decided on, and you are no longer experiencing any of the concerns you identified when you first decided to address your drinking. In that situation, drinking in a healthier way feels more like your norm and you are not finding it difficult to maintain. Do not change your plan simply to accommodate your drinking if you are struggling to adhere to the plan.
There may be ‘special occasions’, such as weddings, celebrations or other events that last a long time, when drinking is a part of the occasion. Vacations, too, can be a time when drinking tends to be heavier. During these times, you might allow yourself to drink a little more than usual; but, again, I would do this only after you have demonstrated good control over your drinking as detailed above. I would also have a clear goal in mind, such as how much you will drink when there.
Practise tactics for better pacing and timing
There are a variety of strategies that you can use in the moment – that is, when you are drinking, or feel like drinking – to help you avoid overdrinking and develop a healthier relationship with alcohol. These strategies can help you to drink less automatically, in a more controlled way. Based on my work with clients who wanted to reduce their drinking, here are some that I recommend:
- Slow down your drinking. Sipping your drinks and making them last will make it much easier for you to drink less. Try to play a game with yourself to see how long you can make your drink last. See if you can make it last for one hour, or if that seems too long, at least 45 minutes. Also, try not to keep your drink in your hand the whole time you’re drinking, as that can lead to more rapid drinking; put it down on the table after taking a sip. Focus on the taste and try to savour it rather than just skipping to the next sip.
- Watch what you drink. Avoid drinking shots of hard liquor as they can go down way too quickly. Multi-shot drinks and punches can also be problematic because you do not know how much alcohol they contain. Often, people do better with wine or beer, but if you want to drink hard liquor, try adding soda, juice or another mixer so that the drink lasts longer.
- Be mindful of drink measurements. Especially when you’re first trying to drink less, it is a good idea to be very aware of the amount you drink as well as the alcohol content of the beverage. If drinking at home, I recommend that you physically measure your drinks to ensure you are having a standard amount of each drink – for example, just 5 ounces of wine, or 1.5 oz of hard alcohol (a standard drink in the US). Beers are easier as they often come in 12-oz containers. However, note that many craft beers can be much stronger than the typical 4-5 per cent. It is not uncommon for bars to make drinks that contain twice the amount of alcohol, if not more, so be mindful of that as well.
- Don’t drink when you’re thirsty. When people are thirsty, they drink faster to quench their thirst. If the drink contains alcohol, you can be sure it will go down quickly, which can lead to more drinking. When you’re thirsty, avoid alcohol and stick to water. After your thirst is quenched, if you want an alcoholic drink, have it then.
- Eat when you drink. Having food in your stomach will slow down the rate at which alcohol gets into your bloodstream. This will help prevent rapid intoxication, which can lead to poorer decision-making about drinking. One note of caution: try to avoid eating salty foods when drinking, such as peanuts, chips and other salty snacks, as that can increase your thirst.
- Delay having your first alcoholic drink. A great way to drink less is to give yourself less time to drink. For example, if you’ve noticed that you typically have a drink when you end the workday, try delaying your first drink or have a nonalcoholic drink instead. Do something else during that time and disrupt your usual pattern.
- Remember that the desire to drink is temporary. Your drinking probably has become associated in your mind with certain times and situations. The anticipation and wish to drink may be very strong then. When that happens, remember that the strong desire to drink does pass, and sometimes it passes quickly. Do something else to distract yourself, and you will experience this firsthand. Over time, you will become better able to manage these moments.
Prime yourself to drink moderately in social situations
Controlling alcohol use in social settings can be tricky. Since drinking is frequently a social activity, over time, social situations themselves can start to prompt a strong desire to drink. Additionally, if most everyone in a situation is freely drinking, that can encourage you to do the same.
When you know you will be in a social setting where there will be drinking, prepare yourself to enter these situations with a focused mindset. On the front burner, remember that you are trying to drink less and not overdrink; you need to keep this idea in mind. If you are tempted to drink more than you should, try to think it through and recall your list of reasons for choosing to drink less. Despite wanting to drink more, make the choice not to – and consider how good you’ll feel the next day when you wake up and know that you did not overdrink.
While you are with other people, try to focus on the pleasure of the situation, whether it’s in a conversation you are enjoying, the music you’re listening to, the food you’re eating, other activities you are engaged in, or the general atmosphere of the setting. Think of drinking as just a small part of your overall experience.
As in other situations, holding off on having your first alcoholic drink when you enter a social scene is a helpful way to slow down your drinking. Give yourself time to adjust to the setting and enjoy it. If you want to have a drink in your hand, you can always have a nonalcoholic one. Once you are having a good time, have an alcoholic drink then, if you want one.
It’s very common in social situations to get another drink or to be offered one as soon as you’re finished. This can obviously lead to heavier drinking. To avoid getting into that pattern, it’s helpful to take a break between drinks, and to have a nonalcoholic drink (even just a glass of water) after having one that contains alcohol.
Assess your progress
You now have a variety of strategies for learning to drink in a healthier way, and you will also have your specific plan (if you haven’t decided on the details already). It’s important, however, to assess your progress along the way. If you are completely honest with yourself, it should not be too hard to judge your level of success. In my experience, if you follow the recommendations I’ve shared, you are likely to see an improvement in your drinking pattern fairly quickly.
Here are some questions to ask yourself periodically, perhaps at the beginning of each month:
- Are you drinking in the way that you specified in your plan?
- Are you no longer experiencing any difficulties due to your drinking?
- Do you feel better about your relationship with alcohol?
- Is drinking in this new way still enjoyable?
If you can answer ‘yes’ to these questions, that’s a good sign that your relationship with drinking is getting healthier. As with any effort to change and learn new skills, this one will take time and practice. While some bumps along the way may occur, the goal is to learn from those and to plan, so that you avoid them going forward.
Key points – How to drink less alcohol
- Many people have good reasons to change their drinking. When drinking tends to be unpredictable or has negative consequences – even if the problems seem mild – it may be time to do something about it.
- A healthier relationship with alcohol is achievable. While someone with an alcohol addiction will typically need to stop drinking altogether, many others who drink more than they would like to can learn to moderate their drinking.
- Describe your reasons for wanting to change your drinking. Getting clear about your personal reasons and creating a handy list can help to bolster your motivation for change.
- Consider taking a short break from alcohol. A hiatus can provide insight into your drinking and reinforce that you don’t need to drink every day, which is helpful for cutting back long-term.
- Develop your specific plan for healthier drinking. Decide on limits for how much you will drink in a day, how many days a week you will drink, and what kinds of drinks you will have. Consider whether there are certain situations in which you should avoid drinking.
- Practise tactics for better pacing and timing. Delaying your first alcoholic beverage, challenging yourself to stretch out and savour each drink, and other in-the-moment tricks can help you consume less.
- Prime yourself to drink moderately in social situations. Remind yourself of your goals and your reasons for limiting your drinking, and try to focus on the pleasure of the whole situation, treating drinking as one small part of it.
- Assess your progress. Check in periodically about how well you have been adhering to your plan and whether your relationship with drinking has improved.
Managing social situations where there is pressure to drink a lot
There will likely be times when you are faced with attending a social event that involves heavy drinking, such as a wedding, a sporting event, a barbeque, a holiday or a birthday party. In such situations, despite the tools you have adopted, drinking in a healthy way can be more challenging. This is especially true if these events happen before drinking less has become your new normal. You might also have groups of friends for whom heavy drinking is the norm and, when seeing them, it can be harder to keep to your limits. These are some of your high-risk situations, mentioned in the What to Do section above, and perhaps they cannot be avoided.
Be prepared when entering these situations. If people ask why you are not drinking or notice that you are drinking much less, feel free to say anything that feels comfortable for you. For example, you can tell them that you are feeling tired and don’t want to drink any more; that you need to drive later and do not want to be intoxicated; that your stomach has been a bit off; that you are taking medication and were told to avoid alcohol. You can also be direct and simply state that you decided to drink a little less as you felt that you were drinking too much.
If appropriate, you can consider bringing something to drink in place of, or in between, alcoholic beverages, whether it’s a nonalcoholic drink in cans, a mocktail, or even alcohol-free beer, wine or spirits. Also remember that you can limit the time you spend at the event and leave early if the temptation to drink more is there.
Another situation that can potentially be challenging is when a romantic partner or a roommate drinks regularly. For some people I have worked with, this does not bother them at all: they are committed to drinking less, and being around others who drink does not impact them. This is usually the case when the other person is a light drinker. However, for others, especially if the other person is a heavy drinker, this can be more difficult.
In such circumstances, you can certainly talk to the other person about your decision to drink less than you have been, and ask if they might be willing to support you and perhaps limit their drinking when around you. If you state this in a respectful way, they will likely be considerate of your request. And who knows? The discussion may even encourage them to examine their own drinking.
What about abstinence?
Sometimes people decide that abstinence from alcohol might be a better way to proceed. Despite their best efforts to drink less and in healthy ways, they continue to overdrink and alcohol continues to negatively affect their lives. In fact, for many people, abstinence is the best way to avoid alcohol-related problems.
If you find that you continue to drink in unhealthy ways even though you have been trying hard to moderate your intake of alcohol, it makes sense to give abstinence a go. Try not to feel bad about yourself if you cannot consistently control your alcohol consumption. Rather, you can recognise that you have learned something important about yourself – and you can begin a different journey. There are many resources that can help you stop drinking; you can find some of these in the Links and Books section below.
Links & books
The website of the US National Institute on Alcohol Abuse and Alcoholism offers a wealth of information on alcohol use and how it impacts health and wellbeing.
The Alcoholics Anonymous (AA) website provides information for people who are interested in achieving abstinence from alcohol, including how to find AA meetings in your area.
SMART Recovery is another self-help programme that assists people in achieving abstinence from alcohol. Its main website includes information on the programme and local mutual-support meetings in the US and Canada, while the international website provides access to online meetings in other countries.
My book Take Control of Your Drinking (2nd ed, 2021) helps the reader decide whether to try to moderate drinking or instead strive for abstinence. The book lays out specific strategies for success, whichever path is decided on.
The book Controlling Your Drinking (2nd ed, 2013) by William R Miller and Ricardo F Muñoz has a focus on moderating drinking, offering a number of other useful techniques to keep drinking in control (such as estimating your blood alcohol level based upon your sex, weight and number of drinks consumed).