By Ted Alcorn, New Mexico In Depth
How much is it safe to drink?
People generally overestimate the proportion of their peers who drink. In New Mexico, a majority of the adult population abstains: only 49% report having consumed a drink in the previous month.
Drinkers’ beliefs about what constitutes safe and appropriate drinking levels are powerfully shaped by the drinkers around them. Hence the old joke, “The definition of an alcoholic is someone who drinks more than their doctor.” Allowing norms to guide your behavior is problematic because people tend to associate with people who have similar drinking habits, and heavy drinkers gravitate to heavy drinkers as companions.
The science is increasingly clear that alcohol consumption confers no health benefits and that any level of consumption poses risks. But there are objective measures of how much alcohol you can consume before those risks increase significantly.
Beer, wine, and liquor all contain the same intoxicating ingredient, ethanol, which affects every organ in the body in proportion to the volume one drinks. Due to their different concentrations, a 12 oz beer (at 5% ABV), a 150 ml glass of wine or a 1.5 oz shot of 80 degree alcohol each contain approximately the same amount of alcohol and are therefore equivalent to a “standard drink”.
Experts currently recommend that men should limit their consumption to two glasses a day and women to one. Indeed, alcohol has a more profound impact on women than on men: for a given amount consumed, women reach higher blood alcohol levels than men and experience more profound effects. The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as 14 drinks per week for men and seven drinks per week for women.
What are the signs of an alcohol use disorder?
Scientists have dismissed the idea that drinkers can be easily divided into those who drink responsibly and “alcoholics” who cannot. In 2013, the American Psychiatric Association revised its diagnostic criteria to describe alcohol use disorder as a continuum ranging from mild to severe, all “characterized by an impaired ability to stop or control alcohol use. alcohol despite adverse social, occupational or health consequences”.
There are a number of tools for diagnosing alcohol use disorders, but one of the simplest follows the acronym CAGE:
- Have you ever thought that you should REDUCE your alcohol consumption?
- Have people ANnoyed you by criticizing your drinking?
- Have you ever felt bad or GUILTY for your drinking?
- Have you ever had an EYE OPENER in the morning to calm your nerves or get rid of a hangover?
Answering “yes” to two of these questions is highly predictive of having an alcohol use disorder.
There are also online tools to quickly screen your own alcohol consumption and explore the risks your current level of drinking poses to your health.
How can you help a loved one find the motivation to change?
Like someone with another chronic condition such as diabetes or asthma, someone with an alcohol use disorder may not feel motivated at first to change long-standing behavior patterns.
According to Dr. Larissa Lindsey, director of clinical services for UNM’s alcohol and drug addiction program, allowing the patient to wait for motivation “can lead to a deepening of unhealthy patterns that can send someone on a much tougher road and possibly a much worse result.”
Instead, friends and family may encourage the person to find this motivation, but it is usually unnecessary to criticize, reprimand, or avoid. According to William Miller, professor emeritus at UNM, “When you tell an ambivalent person what to do, their natural and normal response is to say why they don’t want to do it and why it isn’t important. And if you stick with it, you’re basically helping the person talk themselves out of making a change.
It’s more persuasive to do “the exact opposite,” Miller said, asking the person to talk about their drinking and its consequences, and helping them convince themselves to change. He advises friends and family to speak without judgment about the effects of drinking, to offer options and support, and to let the affected person know that they can and deserve to make the change.
Where can I find help?
- The Santa Fe Recovery Center is just one of many treatment providers in the area, offering clinically managed residential care, among other services: 505-471-4985
- Moderation Management is an online community of people who want to reduce their alcohol consumption but not necessarily abstain. They hold online and in-person meetings where members share their experiences and coping strategies.
- Ria Health is a telehealth program that offers medical consultations, online coaching, medications and other tools to help people reduce their alcohol consumption or quit altogether. The annual program costs $350 per month, cheaper than most rehab programs, and accepts some forms of health insurance.
Doctors recommend this pamphlet on the impact of addiction on the brain, which can help affected families understand the science of what they are going through.
Ted Alcorn is a New Mexico-raised writer whose work has appeared in The New York Times, The Atlantic, and The Washington Post Magazine, among other publications. For New Mexico in depth, he investigated how state prisons ignored a hepatitis C outbreak, how Albuquerque built its non-police emergency response branch, and how hospitals at nonprofits skimp on community health. Follow him on @tedalcorn.