New Year’s resolutions give those who make them a chance to focus on a goal, something they’d like to change about themselves, and to work towards it. Many are somewhat minor, but some can be big, important changes that can lead to a healthier life, like someone who might have a problem giving up alcohol.
But where does someone with a drinking problem go if they want cut down or stop drinking altogether?
To learn more about the paths forward for people interested in reducing or stopping drinking, I reached out to Henry R. Kranzler, MD, a professor of psychiatry and the director of the Center for Studies of Addiction at Penn, for his expert input.
Do you have any opinion on making New Year’s resolutions to stop drinking? Is it a good first step?
Resolutions to quit drinking can be useful, though obviously, the seriousness of the resolution is crucial.
If it's been well considered and the individual has begun to come to terms with never drinking again (as compared with a resolution to substantially reduce drinking), then I believe it can be helpful.
By itself, though, a resolution is unlikely to be enough to have a lasting impact; it needs to be accompanied by lifestyle changes that decrease the risk of drinking and particularly of heavy drinking.
What advice would you give someone wanting to quit drinking, but is unsure of where to start?
Abruptly stopping drinking can cause someone to experience alcohol withdrawal, so I'd want to be sure that there's little risk of that before encouraging someone to stop all at once. The best thing to do initially then is to see a health professional who can evaluate the risk of withdrawal.
A recent ability to go for at least a day or two without the common symptoms of withdrawal (those include shaky hands, nausea, vomiting, headache, feeling nervous or difficulty sleeping) would be important. Less common, but more serious effects of alcohol withdrawal are seizures, hallucinations, delirium, and extreme changes in blood pressure, pulse, and body temperature.
Once the risk of withdrawal is evaluated, the individual planning to stop or reduce drinking (many people prefer the latter goal, rather than stopping completely) should identify the high-risk situations that ordinarily lead them to drink, such as stopping at a bar or liquor store on the way home from work, watching sports, etc.
These can inform which high-risk drinking situations to avoid. Working with an alcohol treatment professional can be helpful in developing the specific skills to avoid risky situations. One example is learning to refuse drinks when offered them in social situations. Another important element of treatment is enhancing the individual's motivation to reduce drinking or to quit completely.
If one did see a professional for help drinking, what can be expected?
It depends on the orientation of the professional. Most physicians often refer patients who seek help with drinking problems to self-help groups without much providing much counseling or medication. There are four medications approved by the U.S. Food and Drug Administration to treat alcohol use disorder and there is a key role for them in treatment.
Thus, the best approach is, I believe, to combine counseling and other psychosocial treatments with specific medications to help and individual stop heavy drinking or to quit drinking.
Is there anything you’d like to add?
It’s important to be positive and to recognize that people can and do reduce or quit drinking. I see it regularly in my work with heavy drinkers.
There is a false perception that heavy drinking is not very responsive to treatment. In fact, most people who enter treatment, which is largely provided on an outpatient basis these days in the United States, benefit substantially and maintain those gains over a long period of time.
Alcohol treatment works.