When we think about sobriety, twelve-step recovery often comes to mind. Since it was founded in 1935, Alcoholics Anonymous has expanded throughout the world to 180 countries. A.A. remains one of the most popular approaches to substance use recovery, however alternative treatment modalities have gained popularity as our understanding of substance use disorders continues to develop over time. While A.A.’s spiritual principles and abstinence-based recovery lead to high rates of success for some, others seek something different.
What Does Sober Curious Mean?
Sober curious refers to a movement of people who want to explore the option of sobriety without the commitment to abstinence. A person who is sober curious may begin to look deeper into their relationship with alcohol and the ways in which drinking impacts various aspects of their life. Being sober curious does not require one to identify as an “alcoholic” or commit to cutting out alcohol completely. It simply means that the person has chosen to explore potential changes to their drinking habits. This decision may come from concern about physical or mental wellbeing, or out of pure curiosity.
What is Binge Drinking?
According to the National Institute of Health (NIH), binge drinking is defined as consuming five or more drinks on one occasion for men, or four or more drinks on one occasion for women. During a binge drinking session, a person typically consumes alcohol with the intention of getting drunk. One out of six adults in the US report engaging in binge drinking, and a quarter of those adults do so at least once a week. Binge drinking does not mean a person is dependent on alcohol, but this behavior increases the risk of developing an alcohol use disorder. Binge drinking can cause short term problems including accidents and injury, hangovers, embarrassment, unplanned pregnancy, and sexually transmitted diseases, as well as long term problems including depression, anxiety, alcohol dependence, health concerns, and issues in relationships.
What is Moderation and is it Appropriate for Me?
Moderate drinking is a subjective term and definitions range from one to three drinks per occasion for women and two to four drinks for men. Consuming alcohol in excess of these amounts is categorized as heavy drinking. When complete abstinence from alcohol is not realistic or desired, moderating alcohol can reduce, but not entirely eliminate, risks associated with drinking. Chances of successfully practicing moderation depend on many factors such as presence of major life events, prior consequences of drinking, co-occurring mental health diagnoses, family and personal history of substance use, physical health, and amount of alcohol use. There are certain people that should avoid alcohol altogether, including those who are pregnant, under the age of 21, take certain medications, are recovering from an alcohol use disorder, or have health concerns that can be made worse by alcohol.
What are the Treatment Options for Alcoholism?
SAMHSA
estimates that 15 million people in the United States meet the criteria for alcohol-use disorder, however only around 10% seek and receive treatment for their alcohol use. When traditional treatment is not the right fit, there are many other options available. These methods may be more appealing to the 90% of Americans with alcohol-use disorders who have not tried any treatment, those who do not meet criteria for AUD but want to address their drinking habits, or people who do not want to stop drinking, but no longer want to experience negative side-effects of alcohol.
- SMART Recovery offers group support for people with problematic substance use or other unwanted behaviors. It is rooted in evidence-based treatments of Rational Emotive Behavioral Therapy and Cognitive Behavioral Therapy and emphasizes five principles: self-management, choice, mutual support, being evidence led, and person centered. SMART offers over 2,500 online and in-person meetings across 23 countries.
- The Sinclair Method is a medication-assisted treatment used to reduce cravings for alcohol use over time. Naltrexone is used to block endorphins so that alcohol no longer provides a pleasurable or rewarding effect, teaching the brain to no longer associate alcohol with pleasure. It is FDA approved, non-habit-forming, and often covered by insurance.
- Harm Reduction Model focuses on avoiding risky alcohol-related behaviors. Rather than aiming to reduce alcohol use, this model seeks to decrease the instances of dangerous consequences from drinking alcohol. Tips from a harm reduction approach may include ways to avoid blackouts, learning about interactions between alcohol and medication, avoiding physical dependence on alcohol, and reducing damage to the liver.
- LifeRing is a secular network offering support for those seeking sobriety. It separates itself from AA by emphasizing that each person has the power to overcome addiction without a higher power, which is done through creating a personalized recovery program and a philosophy of sobriety, secularity, and self-help. LifeRing provides in-person and online meetings.
- Refuge Recovery is an approach to recovery that is grounded in Buddhism and uses meditation as its cornerstone. The Refuge Recovery book provides guidance on the causes of addiction, daily meditation practices, personal stories of recovery, and advice for finding or creating community.
- Recovery Dharma offers a peer-led, trauma-informed, approach based on empowerment and Buddhist principles. Members hold weekly meetings, worships, and other events both in person and online.
How Can I Start Treatment for Alcoholism?
- Take some time off from drinking. You may have already completed Dry January or given up alcohol for Lent, which is a great start. Experts recommend taking 30-90 days off from alcohol before attempting to drink in moderation. You can use this time to reflect on your relationship with alcohol, including the role it plays in your daily life and activities.
- Practice mindful drinking. Ask yourself questions about your relationship with alcohol and stay present when drinking or thinking about alcohol. Consider the ways in which alcohol might improve or disrupt your experiences before making the decision to drink or abstain. Explore urges and feelings as they relate to your alcohol use.
- Talk to a therapist. Your therapist will use evidenced-based techniques that have been shown to effectively treat alcohol use. These may include Cognitive Behavioral Therapy (CBT) to guide you in examining how your alcohol use relates to your thoughts, feelings, and behaviors. motivational interviewing
- Join a group. Whether it is A.A., an alternative support group, or a therapy group, forming connections with others in a similar situation can be eye-opening. A group can provide a safe and non-judgmental setting to openly express your thoughts and feelings, learn by listening to peers’ experiences, try new skills, feel less alone, and stay motivated. Browse the options that are available or talk to your therapist to find the right fit for you.
If you are ready to take the first step, consider joining “Rethinking Your Drinking.” This group will allow you to explore motivation to change and the role alcohol plays in living by your personal values.
During the 8-week group, you will assess what changes might be appropriate for you, learn about options to make changes to your relationship with alcohol, practice new skills to manage urges, and overcome obstacles to implementing plans for change.
