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.