How mindfulness practices can support moderate drinking goals and help you develop awareness around alcohol use.
While it might be a little jarring to hear this coming from two addiction specialists on the front lines of clinical practice, alcohol can be a positive force in many people’s lives. Practitioners like us see a very skewed sample of drinkers — mostly those with severe problems that cause severe consequences. Not surprisingly, we concentrate more heavily on the real and present dangers of drinking than on its many positive reinforcing effects.
But we cannot and should not overlook the fact that drinking alcohol for its mood-altering effects is a normative behavior that has been part of the human experience for literally thousands of years. When used appropriately, alcohol can enhance landmark experiences, facilitate connection between strangers, help people relax and enjoy the moment, and create an atmosphere where new ideas spontaneously occur. Even the teetotaling Shambhala Buddhists teach a class on mindful drinking because they consider it a tool to loosen the subtle cling of the ego — but only for the most highly evolved practitioners who have sufficient mastery over alcohol to turn a would-be poison into a positive force.
The fact is, only a small fraction of the vast alcohol-consuming population ever develops significant problems related to drinking. And studies show that the overwhelming majority of people who do develop some type of problem do not suffer from a moderate or severe alcohol use disorder — or what was previously referred to as “alcoholism” or “alcohol dependence.”
So what is the right role for alcohol in a person’s life? And how can those concerned about their drinking continue to enjoy its benefits without putting themselves at risk? Understanding what moderate drinking really means is a good place to start. Here is the bottom line: the key to maintaining a healthy relationship with alcohol is to be mindful of when, where, why, how much, and how quickly you drink; to know when it’s time to say “when” or take a vacation from drinking; and to have a set of personal guidelines for managing your consumption within reasonable limits. Since this is easier said than done, I want to offer some practical insights.
How Much is “Too Much”?
There is no universally accepted medical definition of “moderate” drinking. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), “low-risk” alcohol use is defined as up to two drinks daily for healthy adult men and one drink daily for healthy adult women. One drink equals one 12-ounce beer, one 5-ounce glass of wine, or 1.5 ounces of 80-proof spirits. The NIAAA considers significantly exceeding these limits to be “heavy” or “at-risk” drinking.
Keep in mind that these are upper limits — not recommended levels — based on the statistical relationship between alcohol consumption and certain health outcomes. People can still have alcohol-related problems within these limits, particularly if they drink too quickly, have medical or mental health conditions, take medications that interact with alcohol, or are elderly. Risk factors vary from person to person based on genetic, personal, and environmental variables. Someone with depression, anxiety, trauma, or a family history of alcohol problems may develop difficulties at lower levels of consumption than someone without those risk factors.
What Mindful Moderate Drinking Actually Looks Like
Drinking mindfully is the key to drinking moderately. This approach is closely related to the concept of smarter drinking. Mindful moderate drinking, as contrasted with thoughtless habitual drinking — what I often describe as “autopilot” drinking — means being fully conscious of your drinking in real time. It means paying attention to how each drink is affecting your mood, your behavior, your thinking, and your body.
A few important cautions before I get to the practical strategies. Small changes can make a big difference. Progress is often incremental, and it’s important not to get discouraged by temporary setbacks — bumps in the road — if you find that you continue to drink more than you intend on certain occasions.
However, if you have any reason to think you might be physically dependent on alcohol and at risk of withdrawal symptoms — shakes, agitation, extreme anxiety, insomnia, seizures — it is essential that you consult a medical doctor before you significantly reduce your intake or stop drinking abruptly. And if you’ve tried repeatedly to moderate without success and simply find it too difficult to implement the strategies I describe below, then you might consider taking a break from drinking for a few weeks or months — what I call “sobriety sampling” — and seeking consultation from a healthcare professional.
An addiction specialist who practices within a harm reduction framework can help you decide whether a professionally-guided attempt at moderation or abstinence makes the most sense for your situation. The SAMHSA National Helpline can also help you find qualified treatment providers in your area. Additionally, FDA-approved medications such as oral naltrexone, long-acting injectable naltrexone (Vivitrol), and acamprosate can help reduce alcohol cravings and the urge to overdrink for a subset of individuals.
Ten Tips for Mindful Moderate Drinking
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Keep track. There are many apps available to track your drinks, blood alcohol concentration (BAC), and alcohol-related caloric intake. Having objective data during and after an episode of drinking gives you a more realistic view of your consumption. Invest in a personal mobile breathalyzer like the BACtrack S80 and set a goal of not exceeding a certain BAC when you’re drinking.
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Pace and space. Drink slowly and have no more than one drink per hour, especially during the first hour. Keep in mind that martinis and many other mixed drinks contain at least two to three drink units per serving.
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Avoid drinking with heavy drinkers. If you do find yourself out with heavy drinkers, try having a club soda with lime in your hand so you can skip the next round and deflect unwanted attention.
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Don’t drink past your “off switch.” In other words, stop drinking before you stop thinking. In general, men lose their off switch after three to five drinks and women after two to four drinks, when consumed in less than three to four hours.
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Include food and water. High-protein foods and non-alcoholic beverages decrease the absorption of alcohol into your bloodstream. Eat something before your first drink, then intersperse food and non-alcoholic beverages between drinks.
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Pinpoint your heavy drinking triggers and plan ahead. Make a list of the people, places, and circumstances that encourage heavy drinking and try to avoid them — or at minimum, have a plan for managing them.
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Don’t drink when you’re emotionally upset. Using alcohol to medicate negative emotions is a setup for overdrinking. This is the self-medication trap I see repeatedly in my practice.
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Be careful about interactions with prescription medications. Discuss with your doctor the risks of drinking while taking any prescription drugs, over-the-counter medications, dietary supplements, or herbal remedies.
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Safety first. Plan your transportation and make sure a reliable ride is always within reach. Uber and Lyft are essential.
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Think about tomorrow. If you have to be at work or have something important first thing in the morning, plan to stop drinking early enough to be on your game the next day.
The overarching principle here is awareness. Autopilot drinking — pouring a drink out of habit, accepting every round, losing track of how much you’ve consumed — is where people get into trouble. Mindful drinking is the opposite: intentional, conscious, and self-aware. For many of my patients, simply paying closer attention to their drinking patterns is the first step toward meaningful change. If you’d like guidance in developing a personalized approach, a confidential conversation can help you figure out what strategies make the most sense for your situation.
