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weeks after the events of Sept. 11, a New Yorker went out to
dinner with his girlfriend and another couple. The idea was to
share some meaningful conversation and good wine.
up the next morning convinced he was a problem drinker. His
rationale was simple.
opened my eyes and saw the wrong girlfriend," recalled the
33-year-old investment manager, who preferred not to be named. "I
run with a fairly liberal group of friends, but I knew what
happened was not OK. I didn't remember much, but it started at the
The New York man vowed never to put
himself in that position again. He first appealed to his
girlfriend for a second chance. Then he went online to research
the various options, including Alcoholics Anonymous.
stopped drinking for 3 1/2 months after the incident," said
the investment manager. "But I didn't want to stop for life.
I still like the thought of traveling to Italy and having a bottle
of wine with a great meal."
The federal government
estimates there are three to four times more problem drinkers than
individuals who are "severely dependent on alcohol."
Nine of 10 problem drinkers avoid traditional intervention; many
experts say it is because these people do not want to be labeled
alcoholics or even risk any association with the
Statistics and labels can explain only so much.
Just what constitutes a drinking problem--or moderation--is a
highly personal question. Its mere asking makes some people
uncomfortable. Yet answering the question can improve your health
and quality of life in tangible ways.
for me is having more time in my day," said Neal Chapin, 37,
a Chicago-based printing executive. "I might have a beer or
two at night, then feel too tired to do any projects around the
For Chapin, there was no single event that
prompted his decision to join a local Tuesday night meeting of an
organization called Moderation Management. Instead, it was a
"buildup of drinking more than I wanted" plus the
opportunity for self-improvement.
"I got in the habit
with friends of keeping up with the rounds of drinks," Chapin
said. "I wanted to find a way to watch myself."
Management is national support organization aimed at Americans who
decide to reduce their drinking. It was created in part to fill
the gap between abstinence programs such as Alcoholics Anonymous
and not seeking help.
"The goal of Moderation
Management and our group is to say drinking is a small but
enjoyable part of life," said Helen Redmond, a University of
Illinois at Chicago social worker who facilitates the weekly group
at the UIC Medical Center. "Initially when people come, it is
about how alcohol is not working in their lives anymore. They
don't want to stop; they simply want more control."
said some Chicagoans following Moderation Management guidelines
will decide to quit alcohol altogether because they cannot control
their urges and behavior. The national organization estimates that
30 percent of its members go on abstinence-based programs. But
most participants find a happy medium.
to intervene at earlier stages in people's lives," said Mark
Kern, a California-based psychologist and co-founder of Moderation
Management. "There are no cultural norms for drinking in this
country except for severe drinkers and teetotalers. Our program
and others like it represent a way to stop or take pause without
becoming hysterical about your drinking."
weekly Chicago Moderation Management meeting, Chapin gathers ideas
about how to control his alcohol intake. He was a founding member
of the Chicago group in March 2001.
"I plan my
drinking more these days," Chapin said. "If I am going
out to dinner, I might say to myself, `OK, I am going to have two
or three drinks tonight.' So I might wait until dinner to have
30 days without alcohol
Moderation Management recommendation is to go 30 days without
alcohol. Another moderation program called DrinkWise--the one
successfully adopted by the New York investment manager--suggests
two to three weeks without imbibing. The result is re-establishing
one's alcohol tolerance, said Teresa Herzog Mourad, a DrinkWise
counselor and public health specialist at the University of
Herzog Mourad said alcohol tolerance is a
physical and psychological issue.
"Once you start
drinking again, you relearn how your body experiences alcohol,"
said Herzog Mourad, who said her clients include attorneys,
doctors and doctoral researchers among others. "Plus,
abstaining for two to three weeks increases your long-term chances
of success. It shows you are open to thinking about how you feel
with or without alcohol as part of your lifestyle. You tap into
your emotional intelligence."
For example, Herzog
Mourad said, many clients discover they feel more "agitated
than satisfied" after consuming alcohol. Deciding to drink
less and skip alcohol on certain days of the week can improve
everything from headache symptoms to marital spats. Moderation
programs typically call for keeping a "drink diary" to
help you become more fully aware of alcohol-consumption patterns
and its temptations.
Herzog Mourad said there is a reason
why it is easy for people to drink too much, whether that is two
glasses of wine or the whole bottle.
"Alcohol has a quick and reliable
positive effect," she said. "You can quickly feel more
relaxed in a predictable manner. On the other hand, the negative
consequences tend to delayed and unreliable. Lots of people can
have three or four drinks and barely feel hung over. They drinks
lots of coffee and take an over-the-counter headache pill to get
Just what defines a problem with drinking is
up to individual interpretation.
Herzog Mourad said many of
her DrinkWise clients use a simple measure for determining a
problem. "For them, it's feeling lousy and not feeling good
about it," she said. "They are ready to change."
Mourad said the reasons people join DrinkWise can be summarized by
"The No. 1 reason men choose our program is
they don't like the way alcohol makes them feel," Herzog
Mourad said. "In some cases, a wife says, `You are out of
here if you don't get help.' But most guys are involved because
they are not working out and they are putting on weight. The first
thing these guys do after the initial phone consultation is they
take a vigorous walk with their dogs or hit the gym. They decide
to become more active. That's hard to do with too much alcohol in
The top reason among women enrolled in
DrinkWise is "quality of life," Herzog Mourad
"For example, women say they aren't getting
through books at a normal pace," she explained. "Some of
them don't remember what they read in bed the night
"Women report low energy, weight gain and not
sleeping well. Lots of my female clients say they wake up in the
middle of the night, then can't get back to sleep. Plus, they are
more likely to describe their problem in emotional terms, such as
Herzog Mourad said medical
research shows a need for programs such as DrinkWise.
indicate the majority of people are not severely dependent on
alcohol," she said. "So treating them as severely
dependent doesn't work."
Better to educate people
about how alcohol affects their bodies and minds. For instance,
research shows alcohol disrupts the brain patterns during the
second half of a night's sleep. As little as one drink per day can
leave you partially dehydrated.
Other scientists, notably
Claude Steele at Stanford University, have discovered the pleasant
distractions associated with alcohol (friends, music) might do
more to reduce "negative mood" or stress than the liquor
itself. Similarly, people who are sad and angry who drink without
pleasant distractions not only won't feel better, but are likely
to feel worse, said Jon Kassel, a psychologist and researcher at
the University of Illinois at Chicago.
Kassel said he does
not favor approaching alcohol problems in a "disease model of
either being alcoholic or not." He said being honest with
yourself about the benefits and costs of both drinking and not
drinking is a more valuable exercise.
"Ask yourself four questions," he said.
"One is what would be the cost of maintaining the status quo
of my drinking. Maybe it means you will still be fighting with
"Two is what would be the benefits of the
status quo of your drinking. These are important to get out on the
"Next ask yourself what would be the cost of
changing your behavior to cut down on your alcohol consumption or
quit. Then consider the benefits of changing."
goal is to tip the answers in favor of making a change, Kasei
said. The costs of maintaining the status quo should outweigh the
benefits of the status quo, while the benefits of making a change
should be greater than the costs.
For Neal Chapin, that
translates to "knowing I am in control rather than the other
For another member of Helen Redmond's
Moderation Management group, it means no longer being so sedated
by martinis that she couldn't routinely awaken to help her
daughter talk about a bad dream or get a glass of water.
for the New York investment manager, his girlfriend has stuck by
him, impressed with his initial research into moderation programs
and happy the two of them can still share a nice glass of wine
during an intimate dinner.
He has sworn off hard liquor to
make things easier and stopped going to bars where the only
activity is drinking. He prefers meeting friends for dinner or a
music show. He admits to still finding it hard to keep to three
glasses of wine or beer on "long nights" out.
of my friends can't believe I lasted a week," said the New
Yorker. "But it works for me. I am much more conscious of my
behavior. I'm happy I did something about it."
or false: One serving of wine is 5 ounces.
(a) Sober you up
(b) Make you more
(c) Both of the above
(d) Neither of the
3. True or false: Two ounces of hard liquor
represents a serving.
4. Fact: Alcohol helps you fall
asleep, but it disrupts the second half of your night's rest.
Ask yourself: Among 10 friends and family members, where do you
rank as "most frequent drinker"?
6. Ask yourself:
Do people make remarks about your drinking?
7. Fact: Three
drinks in 90 minutes will put you over the legal limit for
8. Fact: Eighty-six percent of Americans say they
do not experience a hangover in a typical month.
yourself: Do you drink alcoholic beverages without a meal?
are answers to the drinking quiz:
1. True. For your
information, the typical bottle of wine has 750 milliliters or
2. D. Better to drink lots of water during
and after drinking to prevent dehydration. Researchers have found
a caffeinated beverage might help with a hangover because it
constricts cerebral blood vessels.
3. False. A 1 1/2-ounce
serving of 80-proof liquor is considered a serving.
Alcohol disturbs and likely shortens your deep-sleep cycles.
Frequency is an issue that bears self-monitoring. The DrinkWise
moderation program suggests that answering "true" to the
statement "I drink every day" is reason enough to
consider cutting down or quitting.
6. Others making remarks
about a person's drinking is a primary warning sign of a drinking
problem, especially if a loved one has suggested cutting down in
the last year.
7. You might hear that it requires three
drinks in an hour for a 137-pound woman to be over the legal limit
and four drinks in an hour for a 170-pound man. But factors such
as empty stomach and level of fatigue can reduce the number of
drinks required. Experts always recommend drinking no more than
one beverage per hour. It requires several hours or more for the
body to fully metabolize alcohol.
8. It is estimated 75
percent of Americans will experience at least one hangover during
a year's time, but most people don't suffer them monthly.
Hangovers are one indicator of consuming too much alcohol for best
health, but some people simply don't feel greatly affected the
next day. For instance, some research indicates the
alcohol-destroying enzymes in the human stomach lining work better
in men than women.
9. Moderation counselors uniformly
recommend eating something (preferably a healthy snack and some
nutritionists say it should include protein) before consuming an
Tactics that lead
Many strategies developed by DrinkWise and
Moderation Management participants encourage moderate drinking
without squelching fun.
Here are some of the ideas the
- Delay drinking. Don't have anything
with alcohol until you sit down with dinner.
drinking mixed drinks. Stick to wine or beer.
alcoholic drinks with water or other non-alcoholic beverages. Try
sparkling water or club soda with a lime slice or splash of fruit
- Substitute non-alcoholic beers or "mocktails."
Never drink alcohol when you are thirsty.
- Don't drink
alcohol after fasting. DrinkWise counselor Teresa Herzog Mourad
encourages clients to make a trail mix for commuting home,
including nuts, dried fruit and even chocolate chips. The snack
takes the edge off your hunger and thirst.
Another idea is
starting your evening with a tray of fresh veggies and low-fat
dip, accompanied by mocktails. The purpose is attending to your
hunger and thirst before consuming an alcoholic drink. Remember to
do the same after physical activity. Some moderate drinkers vow to
drink a tall glass of water before every alcoholic drink.
More wineries are producing half-bottles. Stock some to resist the
temptation of always finishing the bottle. Invest in a quality
recorking device to retain flavor over days.
- Develop a
plan for your drinking. Examples: No more than two drinks, or stay
only two hours at a party or bar.
- Make it a point to talk
to a loved one about your drinking habits. Promise yourself not to
be defensive or self-conscious. You are likely to learn a lot and
make a positive difference in the relationship.
For more information about the
DrinkWise program at the University of Michigan, which welcomes
participants by phone consultation, call 800-222-5145 or check out www.med.umich.edu/DrinkWise/. For information about
Moderation Management, contact the national headquarters at 212-871-0974, or
visit www.moderation.org or attend the local weekly meeting 6 p.m.
Tuesdays at the University of Illinois at Chicago Medical Center,
first-floor cafeteria, Private Dining Room A.
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