Are you trying to reduce your alcohol consumption? An expert explains what works

With everything that has happened in the past two years, many people have changed their drinking habits.

We have seen an increase in demand for support, which suggests that more and more people are trying to cut down or quit smoking.

There are so many options for cutting down or quitting alcohol that it’s hard to know which will be most effective.

What works depends on how much you drink

Most people are successful in stopping or reducing their alcohol consumption on their own.

People who drink more frequently are much more likely to show symptoms of addiction and may find it more difficult.

You might be addicted if:

• you can’t easily go a day without drinking alcohol or have trouble cutting down on your alcohol intake

• many of your social activities include or are based on drinking alcohol

• you find yourself thinking or wanting a lot of alcohol

• you have trouble controlling how much you drink once you start

• you have to drink a lot to feel the effects

• you have even mild withdrawal symptoms, such as feeling sick or a slight tremor in your hands when you go a day or two without alcohol.

The more of these signs you have and the more severe they are, the more likely you are to be addicted. You can check your addiction risk here.

If you have a mild alcohol addiction, you may be able to reduce your alcohol intake on your own. But if you are moderately addicted, you may need to get some kind of support.

If you are severely addicted, you should consult a doctor before changing your alcohol intake, as stopping suddenly can lead to serious health problems, including seizures and even death in some people.

For severely addicted people, the usual recommendation is to take a permanent or temporary break from alcohol. It may take six months to a year or more before you can start drinking again.

Some people find it better not to drink at all. With a severe addiction, there is a high risk of quickly reverting to heavy drinking if you simply try to cut back.

If you experience symptoms of dependence, once you stop or reduce your alcohol consumption, you may need specialist treatment or ongoing support to avoid reverting to heavy drinking.

“Cold turkey” or reduction?

If you are not addicted, you should be able to reduce the amount or frequency of your alcohol consumption or quit altogether. You can do it yourself or choose to get help. If one method doesn’t work, try another.

If you are feeling a mild to moderate addiction, every time you have a drink it can become a trigger to drink more. It is therefore sometimes easier to increase the days without drinking, rather than reducing the amount on the days when you drink, or to stop completely for a while.

Severely addicted people usually need some kind of withdrawal help to stop drinking. It’s usually best to quit completely (“cold turkey”) as long as you have medical support.

You can undertake withdrawal treatment in a hospital, at home with the help of a GP or nurse, or via telehealth. Alcohol withdrawal usually lasts about five to seven days.

Non-alcoholic drinks

Soft drinks are alcoholic drinks that do not contain alcohol but retain a similar taste to the alcoholic version. There are now a wide variety of options for spirits, beer and wine.

If you are not addicted but are trying to reduce your alcohol intake for health or other reasons, this may be a good option. By replacing some or all of your regular alcoholic beverages with non-alcoholic beverages, you can still enjoy the social aspects of drinking alcohol without the health risks of alcohol.

If you are addicted to alcohol, the smell and taste of soft drinks can trigger alcohol consumption. They could make it harder to make permanent changes to your drinking.

Treatment applications and online support

A range of computer, web and mobile applications have been developed to help people reduce or quit alcohol. They have shown promising results in early trials. The advantage of these apps is accessibility, but the results are modest and they seem to work best with professional support.

Hello Sunday Morning’s Daybreak program is a large online alcohol support community, accessible via mobile and desktop app. It is designed for moderate drinkers who want to cut down or quit. Early research suggests it is effective in reducing alcohol consumption, as well as improving psychological well-being and quality of life.

Some previously face-to-face support groups like SMART Recovery and Alcoholics Anonymous have moved online, which has increased accessibility. These are generally more suitable for people dependent on alcohol.

Psychological interventions

Brief speeches

As little as 5 minutes of GP advice can reduce alcohol consumption by 30%, especially for people with mild to moderate addiction. So it’s worth talking to your doctor if you need a little help getting started.

Counseling and psychological therapy

The main type of treatment to help with alcohol problems is counselling. Sessions usually take place once a week with a qualified professional, such as a psychologist. Sometimes they are delivered in groups. Counseling is suitable for all levels of drinkers who are trying to make changes.

Some of the main evidence-based counseling treatments in Australia are behavioral and cognitive therapies, such as cognitive behavioral therapy and mindfulness-based relapse prevention. These types of treatments have been shown to be at least as effective as drugs

Intensive group programs

Several more intensive group programs are suitable for people who are dependent on alcohol or have significant problems, including:

• residential rehabilitation, which is generally for people who have tried other treatments without success or who may not be suitable for non-residential treatment because their home life is not conducive to change. It has been shown to be effective in increasing abstinence in addicted drinkers

• day programs, which are similar to residential rehabilitation programs, but participants live at home and go there every day. This is a relatively new type of treatment and there is little good quality research on their results.

Medication

A number of drugs can help people who are moderately to heavily dependent on alcohol. They tend to work best in conjunction with tips.

• disulfiram is an older drug that acts on the alcohol metabolic system and causes nausea and vomiting if alcohol is taken at the same time

• acamprosate may help prevent relapses in people who have already gone through withdrawal

• naltrexone reduces food cravings in heavy drinkers.

Self-help groups

The 12-step movement of Alcoholics Anonymous has a long history dating back to the 1930s, when there were very few opportunities for true treatment for alcoholism.

There is relatively little research on A.A. and much of it has been conducted within the organization. The known results are modest – the success rate is estimated at around 10% and the dropout rate seems high.

AA can be helpful for some people and also provides a very well-established peer support network if you need help. It seems to be more effective in conjunction with professional treatment.

There are many options if you’re trying to reduce your alcohol intake, and no single strategy works for everyone.

The best approach is to start with something that sounds appealing and doable to get the results you’re looking for. If that doesn’t work, try something else or seek professional help.

Nicole Lee, Professor at the National Drug Research Institute (Melbourne), Curtin University.

This article is republished from The Conversation under a Creative Commons license. Read the original article.