moderate drinking

Book review: The Alcohol Experiment

We’re huge fans of Annie Grace at Drinker’s Helper, so it’s no surprised we loved her latest book, The Alcohol Experiment, which condenses much of the content of her flagship book This Naked Mind into a short read intended to be used as a guide to taking a 30-day reprieve from drinking.

That’s right: we think of it as a reprieve, not a break, or a fast, or anything like that, because after all, you’re doing something good for yourself that ultimately ends up being fun and fulfilling!

Here’s what we really like about the book:

  1. She has a broad understanding of the most common beliefs (we refer to them as triggers) that make people want to drink - things like stress relief, dealing with kids, having better sex, etc. Reading either of her books often feels like you’re reading your own innermost thoughts from your time as a heavy drinker. This empathy makes it that much easier to listen to what she says about why these beliefs are based on faulty premises.

  2. We also strongly believe in the importance of self care. That’s why an entire section of exercises in Drinker’s Helper is designed to help people who are experiencing sadness to ward it off with something beside alcohol. This isn’t just about getting massages or taking hot baths; it’s also about watching the way you speak to yourself (she has ample evidence about the importance of this!), not beating yourself up when you make a mistake, and not labeling yourself as weak-willed, such that you handicap your own efforts to cut back or quit.

  3. We share a similar view on moderation, which is that it’s absolutely possible, although we personally found it exhausting and chose sobriety for that reason.

The areas we disagree are few and far between, but I’ll highlight a couple that stood out to me:

  1. It seems we place a bit more emphasis on discovering and enhancing your personal motivation to change your drinking. Her book focuses more on addressing the beliefs and thoughts that lead to drinking, which is closer to cognitive behavioral therapy (which we also use) than motivational enhancement therapy. We use exercises drawn from a combination of both, primarily because we think different people may have very different reasons for changing their drinking, and that it’s important that they find the reasons that work for them. This may be in part related to the other area where our thinking differs…

  2. …which is that we do admit that alcohol has some real benefits (I know, I know, cue screeching record sound!). To be clear, we think the downsides of drinking VASTLY outweigh the benefits. But we think it’s important to acknowledge that drinking in small amounts does lower your inhibitions, making first dates and new social gatherings easier; it does make you feel a happy buzz (again, at low levels of drinking, like below a 0.055 BAC. It can be frustrating to try to deny that those feelings happen as a result of drinking. The problem is that it’s really, really hard, especially over time, to stick to those very low levels of drinking. And if you can’t, well, the risks are enormous. That’s why we also think you need to spend time figuring out your most important reasons for changing your drinking - so you can have the strongest cons to bring to bear against those pros in your decision-making.

All in all, we love the book and think the experiment is well worth doing. If you have decided to quit drinking or pursue moderate drinking, we’d love to be part of your journey! Drinker’s Helper is a moderate drinking app (or quit drinking app) that has exercises, tracking, insights, and a virtual support group to help you along the way. Try it free for seven days!

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TL;DR: Drinking and smoking: the health risks

We’ve posted before about the health issues associated with moderate drinking.

We think it’s an important topic to cover because while we think moderate drinking is a perfectly reasonable goal, it’s still not as good health-wise as no drinking at all. It’s like chocolate cake in that way. A lot is really bad; none at all is best; just a bit is in the middle, but can be easier to achieve.

But this study of historical data highlighted the cancer risks associated with moderate drinking. See the full article for more details, but here’s what we learned:

  1. According to the research, drinking at the moderate drinking limits for women (7 a week) translated to about 10 cigarettes a week in terms of cancer risk.

  2. That sounds alarming, but the actual percentage point increase in lifetime cancer risk is only 1%-1.4%.

  3. The study didn’t take into account some other risk factors for cancer among the population.

Read the article and decide for yourself if moderate drinking or sobriety is for you - it’s important to make an informed decision either way!

If you’ve decided to cut back or quit drinking, we’d love to help. Download the Drinker’s Helper app today!

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TL;DR: Binge drinking triggers greater cravings

Part of what gets lost when we focus on genetic causes of alcohol use disorder is the powerful effect behavior can have on the expression of genes.

This study at Rutgers University showed that alcohol changes the expression of certain genes in ways that make people want to drink more and find it more difficult to stop.

Here’s the TL;DR on what we learned (read the full article for more details!):

  1. Binge drinkers don’t get as much help as they need from genes intended to control their stress response system and biological clock.

  2. This alternation affects the children of heavy drinkers, too, such that they are more likely to abuse alcohol if they consume it.

This made a lot of sense to us. Binge drinking is problematic for a number of health reasons; it builds up a desire to get drunk, not just tipsy; and it over time increases your tolerance for alcohol, which of course encourages even heavier drinking.

If you’ve decided to cut back or quit drinking, we’d love to help. Download the Drinker’s Helper app today!

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Health risks of even moderate drinking

While most studies agree heavy drinkers are in for it, health-wise, we’re sure you’ve also seen headlines purporting to prove that drinking actually protects the heart (typically, those claims revolve specifically around red wine). Sometimes, these studies showing health benefits from moderate drinking don’t correct for other variables that could explain health differences between non-drinkers and moderate drinkers.

A new study has attempted to correct for some of these variables (age, sex, body mass index, etc.), and found drinking just 7 to 13 drinks a week (within moderation limits recommended by the NIAAA) can increase risk of stage 1 hypertension by 1.5 times. See the full article here.

In Drinker’s Helper, we do support moderation as a goal for those who are concerned about their level of drinking and possible addiction to alcohol. But that endorsement of moderation comes with acknowledging that any drinking at all does have health risks.

Think of it like a sugar addiction. Moderating your sugar intake is good, and probably means you’re beating the addiction, but quitting entirely would be better for your long term health.

Just sharing what we’ve learned! If you’re looking to cut back on drinking, or ultimately looking to quit, try out Drinker’s Helper today!

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How you can track your progress in Drinker's Helper

When quitting or cutting back on drinking, it’s important to set goals and track your progress.

Many apps offer helpful trackers for the purpose of counting days of sobriety. Drinker’s Helper is a little different, primarily because we also support people who are trying to cut back on drinking, in addition to those who quit entirely.

Here’s how we help people quit or cut back with Tracking & Insights.

We help people set and track drinking against their limits:

  1. We guide people to set daily and weekly drinking limits that are in line with what the NIAAA recommends as a healthy drinking limit. Only 2 in 100 people who observe these limits have an alcohol use disorder, according to their research. People can also set a limit of zero, of course, if their goal is total sobriety!

  2. When people track their drinks, they can see whether they are on track or not for the week vs. their goals. If someone has a heavy drinking day, for example, they might be off track for the week, but can catch up if they stay sober the rest of the week.

We help people motivate themselves with signs of progress:

  1. We help people see their streaks over time (how long they’ve stayed within their limits). This is one of the most important ways people can motivate themselves in the app. We let them know when their streak has gotten longer.

  2. People can also set a pledge in the app to stay sober for a certain number of days. This is one way to motivate themselves to complete a short-term stint of sobriety. They can be anywhere from a single day to a full year. We believe this can be one of the best ways to start out using the app!

  3. We also help people compare their progress to others using the app. That way they have a better sense of whether they’re checking in often enough, or doing enough exercises, compared to the community.

We help people understand why they’re drinking:

  1. Our insights give people a better sense of why they’re drinking. When people track a drink, they also track where they were, who they were with, and more. Then they can see over time what their top drinking situations are. It helps people to discover their triggers, so they can plan to deal with them. This helped us out a ton when we were first using the app ourselves.

  2. Finally, we also help people track urges to drink. It’s important to be able to track what gives you urges to drink, even if you don’t give in. This helps you get an even better sense of what triggers make you want a drink.

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Moderation programs

It’s not as common to hear about people working to moderate their drinking (vs. quit drinking entirely), as many of the more prominent programs that help problem drinkers focus on total abstinence from alcohol.

However, cutting back on drinking is a much more palatable goal to many people, and some may avoid seeking help until it’s to late because they don’t want to go fully sober.

Moderation programs can be especially good for people who have not yet developed a dependence on alcohol, but instead merely drink in a risky manner.

While we at Drinker’s Helper always advocate for sobriety (it’s just easier in the long run, in so many ways), we believe moderation can work for a lot of people and setting a moderate drinking goal in our app. We also believe there are a few additional programs out there that do a great job helping people stick to moderation goals:

  1. Moderation Management: We especially love this program because its founder focused heavily on cognitive behavioral therapy in developing their strategies to help people stick to moderation goals. There are online forums as well as in person meetings, online drink tracking, and resources in the form of handbooks to help you quit or cut back.

  2. ModerateDrinking.com: This online, self-directed web app program helps people stick to moderate drinking goals, and has been proven effective in a randomized clinical trial funded by NIH/NIAAA.

Both Moderation Management and Moderate Drinking are included on the SAMHSA National Registry of Evidence-Based Programs and Practices (NREPP), which means they have been shown to be effective for some people to quit or cut back on drinking.

You can use either of these programs in conjunction with Drinker’s Helper, and many of our members try multiple approaches at once to have the best chance of success.

Can moderation work?

There is a widely held belief, in the US especially, that if you have a drinking problem (a ‘real ‘drinking problem, or alcohol abuse disorder) that your only option to get better is to stop drinking alcohol entirely. This is partly because of the prevalence of Alcoholics Anonymous as the only brand name treatment for alcohol abuse disorder - they advocate for abstinence and maintain it is the only possible course of action to resolve a drinking problem.

This belief in the US was strengthened by the death of the founder of Moderation Management, a popular online moderation program, in a drunk driving accident (however, it should be noted that said founder had actually returned to Alcoholics Anonymous and was trying to quit entirely at that point).

While there are benefits to quitting drinking (see our previous post on this topic), there is strong evidence that moderation can work well as a goal, and actually has some additional side benefits.

As for the proof that moderation can work, here are just a few examples of studies showing that programs designed to reduce drinking rather than eliminate drinking can work:

  1. One University of New Mexico study followed people 3 to 8 years after completing moderation-focused goal-setting and self-monitoring therapy for problem drinking, and found 65% were doing better than they were originally. It suggested moderation could work for all but the most heavily addicted to alcohol.

  2. A University of Texas study followed up with people a year after an 8-week drinking reduction program, and found they had reduced their drinking by 64%, and that those who still used the strategies from the program were most likely to be controlling their drinking.

  3. Two surveys published in the American Journal of Public Health showed that of people who resolved their drinking problems on their own, without treatment, 40-60% were successfully moderating their drinking.

Now, for the side benefits:

  1. Better awareness of your problem: If you start moderating your drinking (and tracking it, using an app like Drinker’s Helper), you become more aware of how much you’ve been drinking and how strong your desire to keep going after 1 or 2 drinks is. If you simply quit, you miss the booze, but it’s easier to convince yourself that you might not have had a problem in the first place.

  2. More people getting help. More people are comfortable with the idea of moderating their drinking than quitting entirely (in fact, one study found that when people are given the option, 80% choose moderation over abstinence). If you try to ask for a change as significant as quitting entirely, you may just get a no. But once someone is moderating, it is much easier to then contemplate taking that further step.

The most interesting part is that aside from having a LOWER level of dependence on alcohol, one of the biggest contributing factors to success with moderation is BELIEF that you can do it.

So go forth and do it! We believe you can, and we can help, with Drinker’s Helper.

What is moderate drinking?

We often toss around the phrase ‘moderate your drinking,’ but what do we actually mean? After all, your Irish uncle might have his own definition…

By ‘moderate drinking,’ we mean the “low risk drinking” recommendation of the National Institute for Alcohol Abuse and Alcoholism, which is:

  • For men: 4 per day, 14 per week

  • For women: 3 per day, 7 per week (yes, fellow ladies, more proof that life simply isn’t fair)

This is considered low risk because very few (less than 2%) of those who drink at this level develop an AUD (alcohol use disorder).

Note: Different governments and research institutions have slightly different recommendations. The NIH in the UK, for example, says no more than 14 units of alcohol a week for both genders (that translates to about 6 drinks).

You’ll probably find studies suggesting (or being framed up to suggest) that moderate drinkers are healthier (in terms of heart health, or weight, or hospitalizations) than their sober counterparts. However, it’s important to know that many of those studies don’t correct for overall differences in income (and therefore lifestyle - exercise, healthy eating, etc.). Often, people who don’t drink are slightly less well off than those that do (perhaps some don’t drink at all because they can’t afford to?). The only conclusive evidence is that drinking heavily does serious damage to your health in the short and long term.

So quit or cut back today with us!

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