Some celebrated their successes with Dry January. A 30-year-old woman from Utah, who chose not to be named, tried it for the first time to prove to herself that she could go a month without drinking. “I am so glad I did,” she wrote. “I’ve lost about 10 pounds, I’m sleeping better, I have more strength and stamina during physical activity and I have noticed that my anxiety levels are greatly reduced.” She now has the occasional glass of wine but plans to significantly cut her consumption to continue the positive impacts on her well-being.
Ken from Massachusetts was able to cut his drinking after realizing that the wine glasses he was using were much larger than the standard drink, “meaning I was drinking more than I thought.” Being aware of glass size and the alcohol content in his drinks has helped Ken cut his intake by 70 percent.
Another helpful tip came from Anna in Illinois, who reminded me about one of the “easiest and most enjoyable” methods to moderate drinking: “swap out alcoholic drinks for tasty (and often healthy, depending on how you make them) mocktails!” Anna is glad the mocktail movement has led to more offerings in shops, restaurants and bars. “No longer are people relegated to non-alcoholic beer, bland seltzers or sugary sodas.”
Teddy from D.C. tried “Damp January,” the more lenient version that doesn’t require abstinence but instead sets the goal of reduced consumption. He liked it, and now he and his wife have committed to each having no more than five drinks a week. “We need your help to settle an argument,” he wrote. “I think it’s better to have all five drinks on Saturday night. She thinks we should spread them out and have one drink a night on five nights. Who’s right?”
His wife is right. Drinking a large amount on one occasion is much more harmful than spreading out drinks. Binge drinking — which the Centers for Disease Control and Prevention define as having more than five drinks for men and four for women — is associated with many adverse health outcomes, including higher incidences of car accidents, falls and drownings.
Drinking large amounts of alcohol also stresses the body’s organs. There is a condition called holiday heart syndrome, named for when individuals on holiday drink a lot and develop atrial fibrillation, an irregular heart rhythm that increases the risk of blood clots and strokes.
There is a reason the national dietary guidelines have a daily rather than weekly alcohol recommendation. It’s great that Teddy and his wife have decided to drink in moderation, consistent with these recommendations. Please, though, do not “save up” your consumption for one big night out.
It is also not a good idea to replace your alcohol consumption with other substances. Destiny from New York and Callum from Colorado both wrote that their families were concerned about their alcohol intake, so Destiny has replaced alcohol with daily cannabis and Callum with psychedelic mushrooms.
I do not advise these practices. Contrary to public opinion, marijuana is not a harmless drug. While it has some medicinal properties, it impairs judgment and cognitive function. Frequent use is linked with increased risk of heart attacks. And about 30 percent of regular users have cannabis use disorder, which is challenging to treat.
Similarly, psychedelic drugs, including psilocybin, found in “magic mushrooms,” appear to have great promise in treating serious mental illnesses. But psilocybin can also cause hallucinations, psychosis and suicidality when used outside carefully monitored therapeutic settings. People should not self-medicate with these drugs.
There are other proven methods for those who need help cutting back on alcohol. Becky from Maine shared a plea to “please, please talk about medication-assisted therapy.” As she said, we don’t expect people addicted to heroin to recover without medications, and we also shouldn’t expect this for people with alcohol addiction. “Medication is evidence-based. It’s a crime that more people don’t know about it.”
Thank you, Becky, for raising this important issue. Alcohol use disorder is an underdiagnosed and undertreated medical condition. Effective treatment exists, including three medications approved by the Food and Drug Administration: Naltrexone, disulfiram and acamprosate. These can be highly effective tools for treating alcohol use disorder alongside psychotherapy, community support groups such as Alcoholics Anonymous and other treatment modalities.
Despite their proven efficacy, usage of these medications is shockingly low. The National Institute on Alcohol Abuse and Alcoholism reports that only 2.2 percent of adults with alcohol use disorder received medication-assisted treatment for alcohol use in the preceding year. This could be because of a lack of clinician and patient awareness as well as pervasive stigma around addiction. People with alcohol use disorder and those concerned about alcohol use should speak with their primary-care physician about treatment options.
Thank you to those who wrote with their comments and questions. Many people also responded to last week’s request to share experiences accessing Paxlovid through Pfizer’s new Patient Support Program. I have new reporting on this topic and will be writing about it in next week’s column. Stay tuned!
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