Controlled Drinking: Is it possible?

I have said before that I have never met anyone in many years that has ever managed to control their drinking after it already becoming a big problem, but it is something I get asked about all the time. Understandably, when you discover that drinking is a problem the first thing you want to do isn’t to give it up, but to try and control it.

Here’s the thing. The inability to moderate is by definition what makes a person alcohol-dependent. So, if somebody could just ‘control it’ would they not be doing that? There are many ways in which people try to do this. The most common ones include:
Switching drinks for example, wine instead of spirits or beer instead of strong cider.
Setting goals and limits on their drinking
Having no alcohol in the house
Drinking more slowly
Drinking on a full stomach
Drinking glasses of water in between each alcoholic drink
Also trying to have alcohol-free days.
This all sounds like just as much demanding work as it takes to get sober. Only when you are sober you don’t have to do all this because you have made your choice to stop, and all your energy then goes on living a full life.

The fact remains that most people who drink excessively do not want one drink, they want ten!! Alcohol is extremely hard to moderate for the simple reason it is not meant to be moderated. It is a highly addictive drug which makes it completely incompatible with moderation.

I think the key thing here has to be the severity of the drinking problem in the first place. Someone who occasionally drinks too much or abuses alcohol at times, is different to someone who has become dependent. It also depends on the consequences of the alcohol use, to the persons physical and mental health and the effects or potential damage to their life.

Someone who is dependent will continue to drink despite negative consequences because they cannot control it. Clearly, even for those who have not developed an addiction, they still find it a very tough drug to control. This is no surprise. Let’s look at what happens to the brain when alcohol is consumed.

We all know that alcohol can make you chattier and more confident, also less coherent. But what else is happening behind the scenes? It slows down your mental and physical reactions and reduces your ability to think, reason and remember. It directly affects the brains chemistry, changing thought processes, behaviour and emotions.

To really make sense of why someone would not be able to control or moderate their drinking, we need to look at a chemical called dopamine. This is what is released when we have an alcoholic drink, and it is known as the pleasure or reward hormone. By jacking up the levels of dopamine in the brain alcohol tricks you into thinking that it is making you feel great, but the effect is that this subsides, and you then need to keep drinking to get more dopamine release.

Unfortunately, at the same time you are altering the brain’s chemicals that enhance feelings of depression. Over time the dopamine effect diminishes until it is almost non-existent. This means to get the feel-good effect again you will need to drink increasingly more. Even then the tolerance that has built up and the changes to the brain will mean this feel-good effect will not return to the same degree.

The brain records and remembers the association between the alcohol and pleasure, which causes the mental obsession and physical compulsion to drink. Science has proved that the brain is literally rewired from excessive alcohol use. Alcohol addiction is certainly not a lifestyle choice. It has been recognised for many years by the medical profession as a chronic, progressive illness.

The bottom line is that the feel-good effect from alcohol disappears, but not drinking causes the low mood to sink lower and lower, which then produces the cycle of needing to drink again, and so it goes on. Although the brain is altered due to the alcohol use, abstinence can also rewire the brain once more. This is how millions of people living alcohol-free lives are happy and healthy today.

Apparent evidence produced that a dependent drinker can go back to moderate drinking has caused fierce controversy, even reaching the courts in the US. It was seen as dangerous data and likened to playing Russian roulette with the lives of human beings. One article on drinking after dependence read: Your cholesterol is dangerously high and your doctor says ‘No butter, no cheese, no cholesterol raising foods – full stop’

You plead ‘can’t I just cut down or take some tablets?’ The doctor is unmoved and says ‘If you want me to help you, you will have to take my advice, otherwise you are clearly not serious about protecting your health. No point coming back after you have had a heart attack’…. This certainly gets you thinking. If you were told anything else was causing serious harm to you, would you avoid it?

Looking at a path other than sobriety can include taking medication that removes the pleasurable effect when drinking. I have no idea why anyone would want to keep drinking but feel no pleasure and take medication to ensure this? Seems crazy to me. There are also moderate drinking programmes out there too. Moderation Management was designed for harm reduction purposes to help people try and control their drinking instead of giving up.

It was founded by a lady who sadly went on to drive in an alcoholic blackout and cause a fatal accident where 2 people were killed. This created some huge question marks about whether it is a good idea to try to moderate when you have a severe problem with alcohol.

Obviously just because this person could not drink moderately in the end, does not mean everyone who perhaps tries to control their drink will have the same terrible fate. The sad thing is, I wonder, if this person had worked towards and achieved sobriety instead of battling to control her alcohol use, could this tragedy have been prevented? We will never know. I think it comes back to the individual’s situation again.

For some people harm reduction is definitely better than continuing to drink at dangerous levels. Any harm reduction programme is trying to achieve just that, a reduction in any harm coming to a person or people around them. There are not many people out there who would not have tried to reduce their intake when it became a serious problem, most just don’t succeed.

At the end of the day, it is absolutely a personal choice and one that should be considered carefully. If you can say that you would be happier and healthier continuing to drink, but trying to moderate those drinks instead of giving up, then only you know what is the best decision for you.

For many, however, it is just not worth it. When alcohol has such a negative effect on someone’s health, life and relationships, it is worth leaving behind and instead concentrating on creating a life that is healthy, happy and alcohol free!