Category Archives: alcohol

Are the recommended guidelines ‘nannying’?

It was recently announced that the recommended guidelines for ‘safe’ drinking are to be reviewed – a move which has been welcomed by both the usually opposing health and industry groups. With it though came a Daily Mail article shrieking about the guidelines being another example of the nanny state, and a barrage of other mis-truths about alcohol and society.

Personally I feel the guidelines are important, but equally so is how the Government and health groups use them. There may be a fine line between providing information and patronising people if they choose not to use it. If people don’t want to reflect on their drinking they won’t, so there’s no point forcing it. But I don’t accept that by simply providing a guideline on ‘safe’ consumption or offering people advice is any way ‘lecturing’ in itself. This is where journalists at times misconstrue things which in turn foster the very problems they hype about.

Take the Mail article. Firstly it refers to the guidelines as “limits” – not an uncommon mistake, but semantics are important here. ‘Limits’ suggests a legal implication (like a speed limit), and that we don’t have a choice. The guidelines are there to help us make an informed decision about our own drinking – should we choose to. I’m not denying there aren’t challenges in conveying units and guidelines, but to turn making information available on an important health matter into an argument for excessive state intervention seems entirely baseless.

The article further misuses information to argue a political case for less nanny-statism; for instance saying that “only 6  per cent of cancer deaths in the UK every year can be attributed to alcohol”, whilst ignoring many other higher levels of alcohol implicated deaths such as liver or hypertensive disease. In typical Daily Mail fashion, the article points the finger of blame at the unemployed; “Most people who have jobs and family duties do not over-indulge”. The stats actually show that it is those in senior professional roles that most often drink above the guidelines, and most people with alcohol dependence are still in fact in work.

Towards the end, the article concludes “Instead of lecturing the great majority with dubious drinking limits, the authorities need to find ways of reforming those binge-drinkers.” It offers no suggestion as to how the Government should actually ‘reform’ these ‘binge drinkers’. Instead it suggests “individuals should take charge of their own destinies”. Funnily enough, that’s exactly what I thought I was doing when I used to pride myself on getting wasted. I wasn’t aware of the guidelines back then, but if I was, perhaps I would have reflected on my drinking a little more before it became quite so problematic.

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Filed under alcohol, Alcohol problems, Government policy (UK), Uncategorized

Re-learning to drink? 3 months in…

Three months ago I tentatively began to drink again after many years of abstinence. I have explored why I felt this might be a possibility for me when for many with past dependency this would be a bad idea. Here’s a brief update on how its going.

Certainly my new experimental relationship with alcohol has been at the forefront of my conscience, carefully weighing up my instincts, the evidence and words of friends and colleagues. When I started, I was sure it would not be until at least several months in before I had an inkling as to whether it was going to work.

At present I feel confident to say that – so far – I am succeeding in non-problem drinking. But it is certainly too early to describe myself as ‘recovered’. Indeed I may never feel this an appropriate term – anyone with past dependency may only ever achieve ‘controlled’ rather than normal drinking. In addition, there are a few issues which might raise some legitimate causes for caution.

Over the last 3 months I have been drinking on average twice per week, usually a couple of lower strength (4%) beers. There have however been exceptions; one in particular where I felt moderately intoxicated, and another where I did not feel imbibed but drank more than on other occasions, but over a longer social event. The vast majority of my drinking occasions have been moderate and harm free. Two have been pushing the boundaries and left me feeling ambiguous about the implications.

Many people would argue that occasional sessions of mild drunkenness or exceeding the (fairly low) guidelines are a part on “normal” drinking.  However “normal” is not something a former problem drinker might consider themselves capable of. I am at present pleased that on the whole I seem capable of a moderated approach, though am cautious that as time passes, I may test and blur these boundaries until the regularity and amount I drink creeps up. And with that could come a range of health and social risks. And my greatest fear – re-occurring psychological dependency.

Overall though, I feel so far so good. But of huge importance is that I never forget my past problems in controlling my alcohol use and the consequences of that. Complacency could easily spell trouble as times passes and self-preserving fears dispel. We should always keep a close eye on our lifestyles and any self-rewarding behaviours. The more in tune we are with these the greater the chance we have of nipping a potential problem in the bud.

I wish to highlight that I feel controlled drinking is in most cases not the best option those with past dependency. I have explained here why I felt I was able to attempt controlled drinking.

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Filed under About the author, alcohol, Alcohol problems, Personal experiences, Uncategorized

Re-learning to drink? One month in…

One month ago I ended eight and a half years of abstinence with a single drink. That one weak  beer though was a long contemplated, carefully planned and controlled occasion. Since then I have drank 6 times, each time not more than 2 drinks or 3 units. In consumption terms, I have been a perfect moderate drinker, but the key question is can it last? Am I in the process of re-learning how to drink, or back onto a slippery slope with only one inevitable outcome?

Perhaps the answer is neither – alcohol dependence is not determined purely by consumption or genetics, so my wider life events and choices will inevitably influence what happens. If an unexpected traumatic event comes out the blue, as in life sometimes happens, my emotional state and ability to rationally control my behaviour would be likely to suffer. But assuming my circumstances remain stable, what is the effect of again inducing alcohol’s reward effects onto my brain? The changes and recovery potential for a once alcohol dependent brain is a little known science.

On the surface, my recent drinking occasions have been uneventfully normal. Reassuringly I have not felt particularly compelled to ‘keep going’, despite certainly enjoying the mild but pleasurable effects. A good start so far. On the other hand, I have been regularly thinking ahead to the next drinking occasion in a way few ‘normal’ drinkers probably would. Though I am anxious this could be some indication of a craving, I believe these thoughts are more induced by the personal significance of these occasions and the careful planning to ensure my drinking remains controlled and dispersed by alcohol free days.

My strategy for controlled drinking so far has been simply to stick to the recommended guidelines, not to drink to get ‘drunk’, and have only a few drinking occasions per week. Its working so far, though I have already contemplated whether I can revise these boundaries in the future. If things go steady, and loss of control doesn’t appear imminent, then wouldn’t the odd binge drinking session be ok? Possibly, but probably not to be tried any time soon. What about drinking more regularly, allowing myself to drink most nights of the week rather than only a few? That for me may be the true slippery slope. Instinctively, the more regular the drinking occasion, the more the door is opened to dependence.

It is then perhaps where and why I drink that has preoccupied me most over the last month. A month ago I felt the safest way to drink was at home, as part of a Friday or Saturday evening unwinding. Now though I’m not so sure. Drinking should largely be a social activity, something we do with friends, not to help us deal with stress or negative emotions. My past heavy binge drinking was problematic, but it was the regularity of it that probably led to emergent dependence.

Perhaps the best way to ensure we avoid developing a problem (asides from keeping an eye on how much) is by honestly asking ourselves what our motivations are to drink. At present, I wish to enjoy the social benefits of drinking, the taste of a nice drop and the subtle relaxing effect it brings. But if the reasons begin to shift back to the past, I must immediately re-evaluate. Drinking motivated by wanting to ‘let go’ or escape, quench a psychological thirst or craving, or deal with underlying problems are surely signs that alcohol use is becoming problematic.

Want to assess your own drinking? You can do an online self-assessment here which is based on the validated AUDIT alcohol screening tool. For further UK help and advice see here or call Drinkline anytime on 0800 917 8282.

Image credit: Evgeni Dinev / FreeDigitalPhotos.net

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Filed under About the author, alcohol, Personal experiences

Will I drink again… recovery or re-lapse?

“Will I drink again?” was the perhaps ambiguous conclusion to my last post.

Over the last year or so I have been considering attempting ‘controlled drinking’. By this I mean harm-free drinking, most importantly for me without any re-emerging dependence. If I succeed by learning to drink ‘responsibly’ and without problems, some may believe I was never an ‘alcoholic’. Others will say this is consistent with evidence that it is possible to return to ‘normal’ drinking following former problem drinking (including in some cases dependency). I accept I may later regard any failed attempt at controlled drinking as a re-lapse.

Either way, I am in no way suggesting that anyone in recovery attempt controlled drinking on the basis of my experience; if at all. Abstinence is the only 100% safe option and the evidence for successful controlled drinking in former problem drinkers is to some degree under-developed. What seems clear is that the more serious one’s level of past problem drinking, the more appropriate an abstinence goal appears for successful recovery. In addition, prolonged periods of abstinence are also important for ‘former alcoholics’ that have reportedly succeeded in normal drinking. So ultimately, why should a formerly alcohol dependent person ever put themselves at risk by drinking again if they have succeeded in abstinence? I’d expect for most it is not a risk worth ever taking.

In fact I failed in a sustained attempt to moderate my drinking after first recognising my difficulties nearly 10 years ago. But that circumstances were so very different then, environmentally and personally, it is not surprising I did not succeed. My attempts to cut down were without professional guidance, in a drinking centred environment where I had not learned other coping skills. It now seems quite apparent why I came to realise that not drinking was the only way I could avoid my drinking problems at that time. Abstaining provided a clearly defined line – no drinks was no drinks whichever way you looked at it, whereas ‘just a couple’ all too easily became many more.

Nearly a decade later, most of it sober, I have increasingly felt that I could now drink in a controlled way. There is no single reason I can point to, though my circumstances are entirely different. I have a fulfilling and active life in which social pressures to drink are limited. Years ago I felt angry and troubled which was I believe was linked to a strong desire to get drunk. Today I feel happier, more emotionally secure, and somehow like I could enjoy one drink without craving for another. This isn’t a professional judgement, just an instinctive and I believe honest assessment. Most importantly, I feel ready to accept that if I attempt controlled drinking but feel dependence creeping back, I would accept that drinking is not an option for me.

Below are the two key reasons as to why I think controlled drinking may be achievable for me.

  1. Whether we call it alcoholism or dependency, there is evidence to show that a minority of those who recover from serious alcohol problems later achieve controlled drinking. The research is perhaps limited, but it is there, as far as I am aware most comprehensively collated in the book ‘Controlled Drinking’  (Heather; Robinson, 1980). The book finds that the greater the level of dependency, the less likely controlled drinking may be achievable. The length of abstinence and significanct shifts in social circumstances also seem important factors in determining the likelihood of recovered control. Essentially it argues that the notion of alcoholism as an irreversible condition has been proven false.
  2. Whilst there is undoubtedly a genetic component to the risk of developing alcohol problems, alcohol dependency cannot be accepted as only biologically determined. Arguments against the disease model present significant aspects of ‘alcoholism’ as socially learned behaviours. This has been most persuasively set out in the influential book ‘Problem Drinking’ (also by Heather & Robinson, 1997). A key premise of the book is to redefine alcohol misuse and addiction as a wider scope of ‘problem drinking’ behaviours. It aims to reconstruct some of the simplistic misconceptions that appear to surround the subject of problem drinking such as the often narrow and flawed perceptions of alcoholism and its causes. From this perspective and my own thoughts, I am as yet unconvinced that I am, and therefore always will be, an ‘alcoholic’. If I fail in any attempt at controlled drinking, I may still be inclined to reassess.

In considering the theory of alcohol problems as socially learned and the evidence of normal drinking in former alcoholics, I stand in relatively good stead to succeed. Perhaps most significantly, that I never reached a stage of severe (or physical) dependence. I have clear recollections of thinking ‘if I don’t stop now, it will be increasingly hard to do so if I continue drinking’. I had instinctively recognised mild dependence and stopped before it developed. Therefore in scientific terms, that I never developed severe dependence is a key factor in the likelihood of success. That I have been sober for many years, reconstructed my social life and improved my overall mental well-being are also undoubtedly significant. On the downside, some family history and early onset of harmful drinking do not favour so well as indicators of likely success.

Nonetheless, the last time I drank I had no intention of it being for good. That I haven’t had a drink for over 8 years was down to my own recognition that I felt it was best for me not to do so, as the risk of dependency felt present. Many things have now changed and I feel confident that I have a good chance to re-learn alcohol use without developing problems. I may be wrong, but I unless I try I will always wonder. Will I drink again? Yes… but carefully.

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Filed under About the author, alcohol, Alcohol problems, Personal experiences