I have a former boyfriend called S, he has had drink problems, I would not mention this if work and a whole host of other people did not know this already. or at least I would not refer to him so directly if this was not the case. He has brought this largely under control over the last six months and needs a lot of praise for doing that.
Most of this has been done by a principles of alcohol reduction. So he learnt how to tell if something was a weak or strong wine and choose a weak one, he learnt to alternate glasses of wine and water, he taught himself it was possible to go into a pub and order pineapple juice and that actually he quite liked sparkling mineral water. He learnt to have days off completely from drinking. This cut his consumption substantially, each skill was introduce separately so as not to over burden his as he was under pressure at work as he need to complete a course.
On Thursday evening I rang Stuart, as I had cancelled quite a bit of weekend activity due to the cold and say that whereas before I had not been able now if he wanted too he was welcome to come around. He comes around to chat and talk how things are going we normally share a bottle of wine and some garlic bread. He told me his news, basically that he has gone teetotal. That was a surprise as actually no-one has put any pressure on him to go teetotal.
I think the doctor thought that having completed the course and done this reduction policy so successfully the next stage was to get him to adopt a moderate drinking policy. This was for him a complete turn off, trying to manage his drinking in such a way was to re apply the pressure he drinks to escape. Therefore he decided this was too much hassle. You can guess how he spent the evening and anyway he gave me no details.
However when he went into work the next day he met one of the Broomhall Breakfast guys already plastered (the miracle is not I think that the guy was drunk but that he was up at that time), then being called on his drinking by another former drinker who works at the Museum and the also realising he was jeopardising the progress he has made. In the last six months he has come to a better level of financial security, he generally feels better in work and is able to cope better. Faced with that he felt he really had only two choices to loose what he had gained in the last six months and go back on a downward spiral or to give up drinking completely. He chose to give up completely.
I think moderate drinking is a good message for your average drinker. You want such people to understand what their bodies can take and to drink sensibly. Most people who drink recreationally are able to understand about safe limits and are not stressed by the accountancy work of the sensible drinking message.
However I suspect for a number of people with problems with alcohol like S, such a message can be counter productive. The fact is they drink to escape pressure. If the safe drinking message produces pressure, then the either will ignore it and go back to drinking heavily or a few like S may give up completely. I don’t think without the six month building of alcohol reduction Stuart would have done it, he need the tangible benefits of those six months to build the knowledge of what alcohol was costing him.
I also suspect that concentrating solely on the drinking is not a good idea. When you have someone whose drinking problems have got out of hand you need to look at causes. I suspect it is causes rather than cause, and I suspect to be successful you need to act holistically. That meant for S that he needs help in methods to handle pressure, he needs an accountability network (and seems to have at least a rudimentary one) and he needs to develop a life style that favours sobriety. The last includes developing hobbies and interests where not drinking is easy. So as to discourage going to the pub in an evening for some company.
If these two factors are correct, I suspect I know why Alcoholics Anonymous and schemes such as one I heard of in Russia are successful. The Russian scheme involves the detoxing alcoholic actually lives in community I think for upto a year and even then they tend to move into places where there are churches which have other people who have been through the same programme. In other words they have a simple message of absolute abstention and a support network in doing that. They work because they reject the modern individualism and replace it with personal accountability to others.
Now by all means keep educating people into sensible drinking habits when they are social drinkers. It may prevent some people from sliding into problem drinkers, but with problem drinkers themselves, then some care needs to be taken in using this tool, as it has the potential to push a person further into problem behaviour. We need a different approach then.