When it comes to fixing problem drinking, abstinence isn't necessarily the only way. Sometimes there's a middle path: learning healthier drinking habits through a controlled-drinking program.
''While Alcoholics Anonymous has been around since the 1930s, the controlled-drinking approach is relatively new, so there's still a perception that it's abstinence or nothing,'' says Bronwyn Hegarty, who organises a controlled-drinking program at the University of Wollongong's Northfields Clinic. ''But studies have found that with the help of controlled drinking, two-thirds of problem drinkers can reduce their alcohol intake to a safe level.
''It works on the premise that if you've learnt to drink a certain way then you can also unlearn it. Controlled drinking helps people realise that the habits we set up aren't as rigid as we think.''
Techniques include learning to be an assertive drinker, which means you can say ''no'' to another drink without feeling like a party-pooper. It also involves keeping a diary to track when and why you drink, and finding ways to change the pattern.
''You might have a drink as soon as you get home from work, but maybe you could have a different kind of drink and delay the first alcoholic drink until dinner,'' Hegarty says. ''For many people, drinking too much is simply a habit that's built up slowly over time, partly because alcohol is a big part of our culture. We drink when we're happy, we drink when we're sad, we drink when we catch up with friends, we drink when the team wins and when it loses.''
Controlled drinking deserves a higher profile, Mark Donovan, clinical supervision co-ordinator at Northfields Clinic, says. ''We have drinking guidelines recommending no more than two standard drinks in a day, but there are no messages telling you where to go for help if you're having eight drinks,'' he says.
So where do you go? Controlled-drinking programs are offered at Sydney's St Vincent's Hospital as well as at Northfields, but the most accessible is the free ''control your drinking'' online program run by the Australian Centre for Addiction Research.
Since it began in 2005, about 5000 people, 60 per cent of them women, have completed the program, which typically attracts people in their 40s.
''We've followed people up after two months and find most make big reductions in the amount they drink - less than 5 per cent don't reduce their drinking,'' Thiagarajan Sitharthan, the centre's director, says. ''They've admitted they have an issue with alcohol; they've continued the program for eight weeks and no one forced them to do it - they're motivated to begin with.''
''Most people live in a state of ambivalence about their drinking,'' Donovan says. ''It's fun, but they know it makes them feel terrible the next day; it's fun, but they know it makes them do stupid things. But often something happens that tips the balance so they realise drinking is becoming a problem.
''You might be getting snappy with the kids because you've had a few drinks or you feel a bit dusty in the morning at work and then you realise you're hanging out for a drink at the end of the day. Or perhaps your blood pressure's too high - or you've been charged with drink-driving.''
Still, controlled drinking isn't for everyone. ''Someone whose life has become dominated by alcohol is likely to need help to stay abstinent, especially if there's little structure in their life or no family support,'' Donovan says. ''But if you're still functioning well, holding down a job and have a family, the chances are you have a mild dependence on alcohol, and controlled drinking is more likely to work.''
Paula Goodyer |August 10, 2013