self medication with alcohol questions

[AbcdeDooDah]

6 minutes ago, MercyA said:

It sounds to me like he's fine without it, just better with it.

She said he's not fine without it.

 

[ktgrok]

So I just did the math, and most of the time yes, he's hovering around  normal/low risk use, based on the numbers posted above. He tried to moderate himself by getting 1 750 ml bottle a week, on payday. Somedays he'd be out the night before, somedays it would last several days longer. If the limit is 14 drinks per week, at 1.5 oz each, a 750ml bottle should last about 8 days. 

[ktgrok]

2 minutes ago, HeighHo said:

What is eaten with the alcohol?

What is the A1C and fasting glucose?

A1C was good, fasting glucose sometimes just a bit high. Normal dinner, then the drinks. He doesn't eat after dinner, pretty much ever. 

[KathyBC]

I can think of two people I know moderately well who fall into this category. The first began using CBD oil instead of daily wine and found improved sleep. I've noticed they seem much easier to get along with. The second got to a different phase of life with a bit more free time in the evenings and began a bit of HIIT exercise in the evenings in the winter and an adrenaline-producing sport they love in the summer. The daily drinking was phased out to reduce calories and became more of a weekend thing.

HTH. This is a difficult life stage.

[gardenmom5]

1 hour ago, Amy in NH said:

I'd say he has a dopamine production deficiency.

Small amounts of alcohol will increase dopamine, but larger amounts will decrease it (hence, the depressive effect).

I've tried GABA w/arginine to improve blood/brain barrier absorption - worked great on my mood problem, but caused severe dyspnea, which I found out later is due to GABA receptors in the epithelial lining of the respiratory system.

I've tried theanine, lysine, tyrosine, tryptophan, l-dopa, & d-l phenylalanine - all did nothing.

I'm now trying ashwaganda, glutamine, and a high quality B-complex with mthf.  I also take a regular multivitamin, and additional potassium citrate.  Results are meh.

I refuse to go on anti-depressants.  I took them about 8 years ago for 2 years, with detrimental life-altering effects lasting an additional 5 years after going off of them.
 

dudeling's ND combines bacopa monnerii with the ashwagandha for anxiety.

I only used the recommended pure encapsulations ashwagndha because it has 7% withaniloids - most have significantly less.  their price skyrocketed last year, and I found Jarrow also has 7% withaniloids (and is cheaper.)  (I had to do a ton of research).

so, he get's 600mg ashwagandha (2 capsules) and 1 capsule of the bacopa 2x per day.  even at half the dose, we saw improvement.  though it's still not enough - but his anxiety is pretty bad.

I've tried tryptophan - but I can't convert it to the 5htp and melatonin.  I had to go to straight 5htp.  (and had to go to nearly double the rec'd dose on the bottle.) 

[Bootsie]

If he sleeps better after consuming some alcohol than when known is consumed, that could impact mood and behavior.  If that may be a link, I would suggest trying to determine if there is a way to get the same level of sleep without alcohol.  Is the timing of caloric intake different when alcohol is or is not consumed?  Is there a difference in activity level in the evening when alcohol is or is not consumed?

[katilac]

What does it indicate? I think it indicates that alcohol is a mood altering drug, and it alters his mood in such a way that he tends to feel happier and more optimistic. 

I'd be fine with one or two drinks a day, it wouldn't bother me at all. fwiw, neither dh nor I drink on a daily basis, so that's not why I don't have a problem with it. It's common and it's within the general recommendations. If I did have a daily drink or two, I'd be pretty annoyed with anyone who referred me to a substance abuse counselor, lol. 

I think the Recovery Village four question alcohol assessment is silly. For those who don't want to click, the questions are: 

Have you ever felt that you should cut down on your drinking? Have people annoyed you by criticizing your drinking? Have you ever felt bad or guilty about your drinking? Have you ever had a drink first thing in the morning to calm your nerves or get rid of a hangover? 

If someone criticizes your drinking habits, I think it's perfectly normal to be annoyed by that. And if someone criticizes your drinking habits, it's a fairly reasonable extension to feeling bad or wondering if you should cut down. That doesn't tell you much, imo. Two people could have the exact same drinking habits, say the one or two drinks a day, and one of them will answer yes to all three questions while the other answers no, strictly depending on the attitudes of the people around them. Just because a person in your family opposes a daily nightcap or opposes drinking altogether doesn't mean you have a substance abuse problem, but it does mean you will probably answer yes to at least two of those questions. I may feel bad about my drinking simply because it makes someone unhappy. I may feel like I should cut down on my drinking simply to get them to shut up, lol.  

The fourth question conflates two very dissimilar things. Having a Bloody Mary with brunch the day after your cousin's wedding will trigger a yes, but it's hardly the same as pouring vodka on your cornflakes because you anticipate a rough day at work. It's like asking have you ever gotten a speeding ticket OR been arrested for murder? Even as a simple screening tool, these are badly formulated questions that don't provide useful information. The four questions Techwife provided are much better, although I do think that it's overkill to say one yes automatically calls for a professional evaluation. 

Question 1 - During the past year, have you had a feeling of guilt or remorse after drinking?

Question 2 - During the past year, has a friend or family member ever told you about things you said or did while  you were drinking that you don't remember?

Question 3 - During the past year, have you failed to do what was normally expected from you because of drinking?

Question 4 - Do you sometimes take a drink in the morning when you first get up?"

Definitely, it's always great to eat well and supplement your D and other problematic vitamins, to exercise and socialize. But that doesn't mean one or two drinks a day is necessarily a big deal. Even if you know for sure that those things (or others) will work just as well for mood in the long term, that doesn't magically provide the person with the time or energy to pursue them. If someone is working long hours and feels better with that daily drink, I dunno, I'm fine with pouring it for them. 

[Carol in Cal.]

Since he is concerned about this, I encourage you to help him try to come up with alternatives that give him what he gets from this.

For instance, I recently tried a new kind of smoothie—frozen apricots and fresh squeezed orange juice with a tiny bit of honey and a dollop of Greek yogurt.  These are so good that I actually crave them.  They are a TREAT.

Also, I literally crave a runner’s high.  Luckily I can get it really fast or I’d hurt myself, LOL, but it motivates me to go out for a run (actually a walk/jog/walk session).  

Those are genuine treats for me, not just things I enjoy.  I wonder whether he could ‘treat’ himself without the alcohol, maybe once or twice a week, and in so doing cut back on the alcohol without getting irritable?  If it’s more the flavor that he craves, there ARE really good tasting alternative drinks on the market now that are fairly complex and pretty satisfying.  Or he can use mixers to extend a little bit of booze into a lot of drinking.

Also, I wonder whether he has low level back pain that makes it hard for him to rest well?  In that case, a mild muscle relaxant in the evening before bed might solve 3 birds with one stone—no booze that night, no back pain/better rest, no pain the next morning/better mood?  Plus that tends to give your back a kick start toward getting healed because it’s not doing the pain/tense up/more pain/tenser cycle.  My husband is not always aware of when his back flares up, but I can always tell by the way he talks to me.  I finally started to just say, do you need some aspirin now? Whenever he sounded irritated.  Back pain that becomes chronic does cause a lot of irritability.  

Edited April 22, 2019 by Carol in Cal.

[MercyA]

1 hour ago, AbcdeDooDah said:

She said he's not fine without it.

I went back and reread what Katie wrote, except for her first post, which has been deleted. My overall impression reminds the same--he's not as relaxed or happy without alcohol, but still sounds functional and generally "fine." Maybe we're arguing over semantics here, or maybe Katie actually said, "He's not fine without alcohol," in which case I stand corrected.

IDK. He sounds like me when I don't have carbs--grumpy and a little off but still "fine." 

I understand why you are personally more concerned about this, and I respect that. But, truly, I don't see anything here to indicate he's an alcoholic.

Edited April 22, 2019 by MercyA

[ktgrok]

11 minutes ago, MercyA said:

I went back and reread what Katie wrote, except for her first post, which has been deleted. My overall impression reminds the same--he's not as relaxed or happy without alcohol, but still sounds functional and generally "fine." Maybe we're arguing over semantics here, or maybe Katie actually said, "He's not fine without alcohol," in which case I stand corrected.

IDK. He sounds like me when I don't have carbs--grumpy and a little off but still "fine." 

I understand why you are personally more concerned about this, and I respect that. But, truly, I don't see anything here to indicate he's an alcoholic.

LOL, it actually is VERY like when I cut carbs. 

[regentrude]

Coming late to the discussion, but having read the OP:

I don't see a problem. The amount of alcohol he consumes is so low that that would not worry me. 1-2 drinks a night is below the level I find alarming. My DH is a wine lover.

Apparently the reason the person wants to cut back is solely because of the expense of good drink, not because he regrets the way he feels, or things he did or said while drinking. I consider a good bottle the same kind of treat as concert tickets or a pretty dress - not necessary, but perfectly normal if finances allow.

My guess would be that the drink positively affects his sleep - and a person who slept well is happier all day long! I am puzzled why one would find prescription or OTC sleep meds or pain meds preferable.

Edited April 22, 2019 by regentrude

[regentrude]

1 hour ago, Carol in Cal. said:

Also, I wonder whether he has low level back pain that makes it hard for him to rest well?  In that case, a mild muscle relaxant in the evening before bed might solve 3 birds with one stone—no booze that night, no back pain/better rest, no pain the next morning/better mood?

Many muscle relaxant have side effects that last all day and impair function more than an alcoholic drink. They can also cause liver damage and lead to addiction. 

Edited April 22, 2019 by regentrude

[AbcdeDooDah]

38 minutes ago, MercyA said:

I went back and reread what Katie wrote, except for her first post, which has been deleted. My overall impression reminds the same--he's not as relaxed or happy without alcohol, but still sounds functional and generally "fine." Maybe we're arguing over semantics here, or maybe Katie actually said, "He's not fine without alcohol," in which case I stand corrected.

IDK. He sounds like me when I don't have carbs--grumpy and a little off but still "fine." 

I understand why you are personally more concerned about this, and I respect that. But, truly, I don't see anything here to indicate he's an alcoholic.

I won't quote it but yes, she said he's not fine. 

That's fine if others don't see it, but combined with the excusing language of the OP and looking for a solution for him, it looks like dependency to me. 

It's not at all like carbs and joking minimizes it. I can pig out on carbs and still drive my kids in an emergency.

 

 

Edited April 22, 2019 by AbcdeDooDah

[regentrude]

6 minutes ago, AbcdeDooDah said:

I can pig out on carbs and still drive my kids in an emergency.

The OP did not mention the person drinking to excess, but remaining under the legal limit.

Several of the proposed alternative solutions involve pharmaceuticals which would render the person unfit to drive.

[AbcdeDooDah]

Just now, regentrude said:

The OP did not mention the person drinking to excess, but remaining under the legal limit.

Several of the proposed alternative solutions involve pharmaceuticals which would render the person unfit to drive.

There's no way of knowing that, especially when he drinks "significantly" more some days. 

I wouldn't recommend pharmaceuticals, either, but whatever it is, he kind of needs to be the one to make the substitute. 

 

 

[ktgrok]

30 minutes ago, regentrude said:

Many muscle relaxant have side effects that last all day and impair function more than an alcoholic drink. They can also cause liver damage and lead to addiction. 

Yes, a muscle relaxant makes me, at least, groggy in the morning if I take it at night. 

17 minutes ago, regentrude said:

The OP did not mention the person drinking to excess, but remaining under the legal limit.

Several of the proposed alternative solutions involve pharmaceuticals which would render the person unfit to drive.

The drinks are over several hours in the evening, not all at once, so yes, still within legal limit to drive. The times it is more than that it is on the weekend usually, so starting a bit earlier (he doesn't get home from work until 7pm) but not heavier at one time.

[MercyA]

46 minutes ago, AbcdeDooDah said:

I won't quote it but yes, she said he's not fine. 

That's fine if others don't see it, but combined with the excusing language of the OP and looking for a solution for him, it looks like dependency to me. 

It's not at all like carbs and joking minimizes it. I can pig out on carbs and still drive my kids in an emergency.

I wasn't joking.😕I was very serious when I said it sounds like how I feel when I don't have carbs. 

Obviously I am touching a nerve here. We all have our own reasons why we react to things the way we do, I'm sure.

For me, probably part of what I'm reacting to is being in too many churches that teach "alcohol is ALWAYS bad," "drinking is NEVER safe," etc. I view alcohol like other gifts of God; it can be helpful or detrimental, depending on how it's used.

All I have to go by is the impression I have from what Katie wrote, and again, I personally wouldn't be concerned about one to two drinks a night to relax and aid in sleep. I understand you are. That's okay. Ultimately Katie and her husband are the best judges of the situation.

Edited April 22, 2019 by MercyA

[moonflower]

35 minutes ago, regentrude said:

The OP did not mention the person drinking to excess, but remaining under the legal limit.

Several of the proposed alternative solutions involve pharmaceuticals which would render the person unfit to drive.

 

Yeah, I don't think pharmaceuticals are the solution, if there is one - it's just substituting one drug dependency for another.

But it might help him and you (you as in the OP) to see it as a dependency - not something that is in itself harmful at this time, particularly (depending on what study you read, I guess), but also not something that is casual or, well, NOT a dependency.  If he's in a bad mood without it, and it's not something the body needs naturally, he's dependent on a drug for mood regulation.  Lots of people are dependent on drugs for mood regulation, it's not the end of the world but it's not nothing either.

[Mergath]

26 minutes ago, Eliana said:

It is much easier to address dependency and a possible slide into an unhealthy relationship with an addictive substance before someone is an addict.  I think those who have expressed strong concerns based on family experience are seeing troubling signs and hoping that things can be addressed sooner rather than later.

 

I am bothered by the attitude I am seeing here that if someone isn't (yet) a full-fledged alcoholic then there is nothing to worry about.   Alcoholism develops over time and catching warning signs - and not being as happy without daily alcohol consumption is an enormous warning sign - and then addressing then is an important component of prevention.

I am also concerned by the focus some have on the number of drinks because that erases the emotional and mental aspects of addiction in a way I find alarming.  Addiction isn't just about how much someone consumes, the psychological dependency and the using of the substance to fill an empty spot in one's mind or heart (as can happen with self-medicating for depression) is even more relevant than the amount consumed.

 

Because some of us don't see these things as automatically inherently harmful. Someone being annoyed at the cost of alcohol isn't, in my mind, the same as a person being like, "Oh my god, I was blackout drunk for that last meeting and I need to quit drinking." 

And people can become emotionally addicted to almost anything, as has been previously mentioned. Coffee, exercise, reading, volunteering, whatever. I'm definitely emotionally addicted to coffee and reading. Does that mean I need to quit drinking coffee while reading? No, because the act of reading a book isn't hurting me or the people around me. But we attach a value judgment to certain things, like drinking alcohol, and say, "Well, being addicted to books or exercise is good, but being addicted to alcohol is bad." 

As long as the act itself isn't hurting someone or the people around them, and as long as they don't want to stop, I have no problem with people being addicted to things. Its when the former conditions change that it becomes a bad thing. A person being addicted to the high they get from volunteering and helping others is fine; a person in the same situation who spends so much time volunteering that they never see their family and they completely exhaust their financial resources should get help. But really, everyone has emotional crutches of some sort. Society has simply decided that some of them are acceptable and some aren't.

Obviously there are some addictions that are always harmful no matter how infrequently you do it, like meth or heroin. But I don't think a drink or two in the evening falls into that category.

[moonflower]

I think I read somewhere once that people think they sleep better with alcohol consumption but actually do not sleep better.  Maybe see if he could consider taking an extended break - say no alcohol for 3 months, or 6 months, or something.  That might be long enough to get over the addiction (dependency, whatever - I mean it like I would with someone who smoked 2 cigarettes a day, say) and also long enough to see if after a period of withdrawal he can sleep better and feel fine without, so that it's not something he needs or relies on to regulate mood or sleep.

[moonflower]

3 minutes ago, Mergath said:

 

Because some of us don't see these things as automatically inherently harmful. Someone being annoyed at the cost of alcohol isn't, in my mind, the same as a person being like, "Oh my god, I was blackout drunk for that last meeting and I need to quit drinking." 

And people can become emotionally addicted to almost anything, as has been previously mentioned. Coffee, exercise, reading, volunteering, whatever. I'm definitely emotionally addicted to coffee and reading. Does that mean I need to quit drinking coffee while reading? No, because the act of reading a book isn't hurting me or the people around me. But we attach a value judgment to certain things, like drinking alcohol, and say, "Well, being addicted to books or exercise is good, but being addicted to alcohol is bad." 

As long as the act itself isn't hurting someone or the people around them, and as long as they don't want to stop, I have no problem with people being addicted to things. Its when the former conditions change that it becomes a bad thing. A person being addicted to the high they get from volunteering and helping others is fine; a person in the same situation who spends so much time volunteering that they never see their family and they completely exhaust their financial resources should get help. But really, everyone has emotional crutches of some sort. Society has simply decided that some of them are acceptable and some aren't.

Obviously there are some addictions that are always harmful no matter how infrequently you do it, like meth or heroin. But I don't think a drink or two in the evening falls into that category.

 

I don't think you're just emotionally addicted to caffeine, I think you're chemically addicted.  (assuming you consume it every day).  That doesn't make it a bad thing, necessarily.  It does make it a chemical as well as emotional addiction, in the way that regular consumption of any mood-altering drug is a chemical as well as emotional addiction.

[Mergath]

3 minutes ago, moonflower said:

 

I don't think you're just emotionally addicted to caffeine, I think you're chemically addicted.  (assuming you consume it every day).  That doesn't make it a bad thing, necessarily.  It does make it a chemical as well as emotional addiction, in the way that regular consumption of any mood-altering drug is a chemical as well as emotional addiction.

 

Oh, definitely. I get a horrible headache if I somehow get to lunchtime without caffeine. I was specifically referring to the idea of psychological dependency in my post because Eliana brought it up. 

[Farrar]

My bona fide alcoholic dh and I were just having a chat about this thread. He thinks the idea that this guy is an alcoholic is way off and felt I should post that. But, um, we all bring our own biases to the table, I guess. When dh was drinking, there was no slow slide into dependency.

I often feel like there's a sense in conversations about alcohol that any use is really dangerous or that every use is a step toward addiction. It's not always a morality issue, but it is sometimes. I just don't generally buy that. For some people, sure. But not in all cases.

[Scarlett]

29 minutes ago, moonflower said:

I think I read somewhere once that people think they sleep better with alcohol consumption but actually do not sleep better.  Maybe see if he could consider taking an extended break - say no alcohol for 3 months, or 6 months, or something.  That might be long enough to get over the addiction (dependency, whatever - I mean it like I would with someone who smoked 2 cigarettes a day, say) and also long enough to see if after a period of withdrawal he can sleep better and feel fine without, so that it's not something he needs or relies on to regulate mood or sleep.

There is definitely a threshold where a little helps you sleep but more keeps you from sleeping well.  

[Amy in NH]

2 hours ago, Carol in Cal. said:

Since he is concerned about this, I encourage you to help him try to come up with alternatives that give him what he gets from this.

For instance, I recently tried a new kind of smoothie—frozen apricots and fresh squeezed orange juice with a tiny bit of honey and a dollop of Greek yogurt.  These are so good that I actually crave them.  They are a TREAT.

Also, I literally crave a runner’s high.  Luckily I can get it really fast or I’d hurt myself, LOL, but it motivates me to go out for a run (actually a walk/jog/walk session).  

Those are genuine treats for me, not just things I enjoy.  I wonder whether he could ‘treat’ himself without the alcohol, maybe once or twice a week, and in so doing cut back on the alcohol without getting irritable?  If it’s more the flavor that he craves, there ARE really good tasting alternative drinks on the market now that are fairly complex and pretty satisfying.  Or he can use mixers to extend a little bit of booze into a lot of drinking.

Also, I wonder whether he has low level back pain that makes it hard for him to rest well?  In that case, a mild muscle relaxant in the evening before bed might solve 3 birds with one stone—no booze that night, no back pain/better rest, no pain the next morning/better mood?  Plus that tends to give your back a kick start toward getting healed because it’s not doing the pain/tense up/more pain/tenser cycle.  My husband is not always aware of when his back flares up, but I can always tell by the way he talks to me.  I finally started to just say, do you need some aspirin now? Whenever he sounded irritated.  Back pain that becomes chronic does cause a lot of irritability.  

 

Smoothies are known to be high in sugar.  A sugar high releases dopamine in the brain.  Sugar is more addictive than cocaine.

A runner's high is also a dopamine release.

There are also other endorphins involved. 

FWIW, NSAIDS can help (in a minor way) alleviate the effects of anxiety and other emotional pain.

[Scarlett]

23 minutes ago, Mergath said:

 

Oh, definitely. I get a horrible headache if I somehow get to lunchtime without caffeine. I was specifically referring to the idea of psychological dependency in my post because Eliana brought it up. 

I think my daily coffee is both.  I toss around the idea of giving my up my 2 cups a day, but I know the ritual (psychological dependency) is a strong pull for me....I get up at 6:00, go get coffee for dh and me and sit with and start our day together.  

[Amy in NH]

31 minutes ago, moonflower said:

I think I read somewhere once that people think they sleep better with alcohol consumption but actually do not sleep better.  Maybe see if he could consider taking an extended break - say no alcohol for 3 months, or 6 months, or something.  That might be long enough to get over the addiction (dependency, whatever - I mean it like I would with someone who smoked 2 cigarettes a day, say) and also long enough to see if after a period of withdrawal he can sleep better and feel fine without, so that it's not something he needs or relies on to regulate mood or sleep.

 

Later in the metabolism process it is converted to a histamine, which in higher concentrations it will have a stimulant effect.  If the drinking took place before bed, it can wake you in the middle of the night, or just make you sleep lighter causing you to feel less rested.

[Carol in Cal.]

2 hours ago, regentrude said:

Many muscle relaxant have side effects that last all day and impair function more than an alcoholic drink. They can also cause liver damage and lead to addiction. 

Right but I suggested this specifically with the intent that it would free up his body to heal, if the real problem is the pain and resultant sleeplessness.  My intention was to convey that as a short term fix, not a permanent substitute.  It is really easy for ‘aches and pains’ to become chronic rather imperceptibly, and all the sudden there you are, not functioning quite right. That’s what I think would be good to figure out about this situation.

[Carol in Cal.]

52 minutes ago, Amy in NH said:

 

Smoothies are known to be high in sugar.  A sugar high releases dopamine in the brain.  Sugar is more addictive than cocaine.

A runner's high is also a dopamine release.

There are also other endorphins involved. 

FWIW, NSAIDS can help (in a minor way) alleviate the effects of anxiety and other emotional pain.

Oh sure, although in the case of this smoothie I think I am craving something else that my body actually badly needs.  (Because I get plenty of sugar in my regular diet, and this is very specific.). I’m guessing I was needing C or A or something.  

[hornblower]

4 hours ago, Ktgrok said:

So I just did the math, 

I did it for 43 ml/drink which is what my guides say one shot (1.5 fl oz) is, and that works out to 17.44 servings which is considered high risk for men. 

I'd also like to add this psa that the safe drinking levels for women are significantly lower: 3 drinks at a time or 7 total per week. I think women's alcohol abuse is huge.

Definitely we all bring biases to these discussions. People who drink vs. people who are alcoholics & children/spouses/parents of alcoholics will obviously bring a different view to it. 

 

Edited April 22, 2019 by hornblower

[PeterPan]

4 hours ago, katilac said:

I think the Recovery Village four question alcohol assessment is silly.

 

6 hours ago, TechWife said:

RAPS4 Questionnaire - A brief screening device.  "A 'yes' answer to at least one of the four questions suggests that a person's drinking is harmful to their health and well-being and may adversely affect their work and those around them. In this case, the person should get a full evaluation from a qualified professional

Question 1 - During the past year, have you had a feeling of guilt or remorse after drinking?

Question 2 - During the past year, has a friend or family member ever told you about things you said or did while  you were drinking that you don't remember?

Question 3 - During the past year, have you failed to do what was normally expected from you because of drinking?

Question 4 - Do you sometimes take a drink in the morning when you first get up?"

My source for this information is: 

Mental Health First Aid USA, First Edition (Revised) Adult (2015, 2017); publisher: National Council for Behavioral Health; ISBN: 978-692-60748-0

I'd just like to point out that the questions on the CAGE are almost identical to the RAPS4 questionnaire Tech posted and that there's statistical evidence behind their validity as a screening tool.

[PeterPan]

32 minutes ago, hornblower said:

I think women's alcohol abuse is huge.

Total aside, but when my ds was first diagnosed on the spectrum (or maybe it was a different disability, but I'm thinking spectrum), I read the advice NOT to take up drinking to deal with the stress. Now it's true I don't drink, but I'm human and could do anything and would get into pickles. I just took it as cautionary. I haven't seen stats on the alcoholism rates in the SN parent/caregiver community, but they could easily be unfortunately high. I think it was a blogger I was reading, and she seemed to have a lot of anecdotes driving her warning. 

[PeterPan]

1 hour ago, Farrar said:

He thinks the idea that this guy is an alcoholic is way off

I'm a teatotaler but like you I'm like ok, your life, your business. The thing I thought was noteworthy was the person saying they want to drink less. Once they're at that point and having trouble doing it, that to me was the issue. 

[ktgrok]

46 minutes ago, hornblower said:

I did it for 43 ml/drink which is what my guides say one shot (1.5 fl oz) is, and that works out to 17.44 servings which is considered high risk for men. 

I'd also like to add this psa that the safe drinking levels for women are significantly lower: 3 drinks at a time or 7 total per week. I think women's alcohol abuse is huge.

Definitely we all bring biases to these discussions. People who drink vs. people who are alcoholics & children/spouses/parents of alcoholics will obviously bring a different view to it. 

 

I got 44.3 ml per drink, which times 2 drinks a day ended up being about 8 days or so worth. sometimes he finished that amount in 7 days, sometimes in 10 days, probably averages to 8 days. 

Edited April 22, 2019 by Ktgrok

[ktgrok]

And, he seems to be doing better today. He had a lot of "peopling" to do this weekend, and lots of sunshine outdoors in the heat, which he doesn't like, so maybe that was part of it. Or it was withdrawal and he's past it. Mood definitely better. 

[PeterPan]

1 hour ago, Amy in NH said:

Sugar is more addictive than cocaine.

On the plus side, I haven't had any relatives go to jail committing felonies to feed their sugar addiction. 

[katilac]

1 hour ago, StellaM said:

For someone who is thinking about how to space out a bottle of booze over 7 days so they can sit just on guidelines or a little over, and that means working out how many standard drinks he can get away with per night ?  

I had the impression the spacing out was more about not spending too much money, and that he is not the one who worked out how many standard drinks that meant, but I could be wrong and I'm too lazy to check at the moment. 

1 hour ago, PeterPan said:

 

I'd just like to point out that the questions on the CAGE are almost identical to the RAPS4 questionnaire Tech posted and that there's statistical evidence behind their validity as a screening tool.

I absolutely do not see how those sets of questions are anywhere near identical! 

Two huge differences: RAPS4 asks about blackouts, CAGE does not. RAPS4 asks about failing at a responsibility due to drinking, CAGE does not. 

Two of the four questions in CAGE have a huge amount of crossover (feeling you should cut down, feeling bad or guilty) and use such mild wording that many, many people are going to answer yes. RAPS4 uses one question out of four for this, with somewhat stronger language - guilt or remorse vs bad or guilty. People feel 'bad' about many things, and there is no way to distinguish from the 'yes' that can be brought about by a a minor sense of feeling bad, maybe because you shouldn't be spending the money, and feeling guilty, which is a much stronger word. CAGE also uses two words, which should be avoided when possible, but guilt and remorse have much closer meanings than guilt and feeling bad. Feeling bad is usually used for much milder feelings, and doesn't imply that you think you yourself are doing something wrong the way guilt does. Another question is not directly related to the person's drinking, but to how the person reacts when criticized for it. Most people are going to be annoyed when criticized (annoyed and criticized are their wording, not mine). That has little meaning. 

 Both have a question related to drinking in the morning; the CAGE one is a compound question that conflates two very different events. I would answer yes, I have had a drink in the morning to ease a hangover, because it is specifically mentioned. I would answer no, I do not sometimes take a drink in the morning when I first get up on the RAPS4 test. Lots of people would answer yes to the compound question because lots of people have had a mimosa or Bloody Mary at brunch the day after a wedding, but that's a fairly meaningless indicator. 

I used to work on databases for work. The first thing you learn is that if you don't ask the right question in the right way, you get meaningless answers and meaningless data. 50% of the questions are completely different, and 50% are asked in markedly different ways (one of which ways is obviously crappy imo). I'd be dubious about the statistical evidence for a few reasons, but mostly because the research and statistics regarding addiction and addiction treatment is almost uniformly poor. 

 

Edited April 22, 2019 by katilac

[Corraleno]

I'm kind of gobsmacked by the idea that more than 7 drinks per week means a woman is verging on alcoholism. In Europe, having a glass of wine with lunch and another at dinner, or maybe two glasses with dinner, would be considered perfectly normal. When I worked in Los Angeles, it was very common for staff to go out to lunch and have a glass of wine with lunch, and many of those people also ate out most nights, which would usually include another glass or two of wine. Who in the world is making these rules about how much women should be allowed to drink? They're not French or Italian, that's for sure!

[katilac]

28 minutes ago, Corraleno said:

I'm kind of gobsmacked by the idea that more than 7 drinks per week means a woman is verging on alcoholism. In Europe, having a glass of wine with lunch and another at dinner, or maybe two glasses with dinner, would be considered perfectly normal. When I worked in Los Angeles, it was very common for staff to go out to lunch and have a glass of wine with lunch, and many of those people also ate out most nights, which would usually include another glass or two of wine. Who in the world is making these rules about how much women should be allowed to drink? They're not French or Italian, that's for sure!

 

I know! Americans are prone to hysteria, we have to take everything to extremes. 

[wathe]

47 minutes ago, Corraleno said:

I'm kind of gobsmacked by the idea that more than 7 drinks per week means a woman is verging on alcoholism. In Europe, having a glass of wine with lunch and another at dinner, or maybe two glasses with dinner, would be considered perfectly normal. When I worked in Los Angeles, it was very common for staff to go out to lunch and have a glass of wine with lunch, and many of those people also ate out most nights, which would usually include another glass or two of wine. Who in the world is making these rules about how much women should be allowed to drink? They're not French or Italian, that's for sure!

 

 

These people (in Canada).  A nice summary of the evidence.  The goal is to identify the consumption level at which the risk of premature death in drinkers exceeds that of non-drinkers.

 

Canadian guidelines (short summary)

ETA - the Canadian low-risk guideline recommends no more that 10 drinks per week for women, with no more than 2 per day, and to plan non-drinking days every week.  Numbers for men are 15/week 3/day.

 

 

 

 

 

Edited April 23, 2019 by wathe

[Corraleno]

13 minutes ago, katilac said:

I know! Americans are prone to hysteria, we have to take everything to extremes. 

We're like, sure, go ahead and pop those anti-depressants and stimulants and sleeping pills and blood pressure meds, eat tons of junk food and processed crap, but stay away from the wine! Average life expectancy in France is 4 years longer than in the US. Maybe eating less crap and drinking more wine is not such a bad idea.

[J-rap]

Interesting thread.  I'm in the camp that thinks 2 drinks/day is okay.  Sometimes I do that.  Often I don't.  I don't NEED it. 

But, I also get when people think they need it.  (Meaning just a drink or two.)  Life is hard.  So what if people have a drink or two to take the edge off of life.   As long as it doesn't affect his everyday living, and he seems to have the self-discipline to control it, then it's fine with me.

On the other hand, if he has a very constant depression, then I'd be looking for alternatives.  What's causing his depression?  Maybe there's a simple or better alternative.  

[Farrar]

For what it's worth, if he wants to drink less but find other ways to relax or deal with stress, then I think that's totally fine too. I was out with a friend yesterday who was saying she's giving up alcohol for the next month for a variety of reasons. But none of that means she's an alcoholic.

I don't personally drink much, in part because dh is an alcoholic, so we don't keep alcohol in the house for the most part. But it just feels like it's pathologizing normal behavior.

[hornblower]

WRT Europe, I think there's this myth that European drinking patterns are somehow 'healthier' and that it's all pretty normal & rosy there.

In fact, health authorities have huge public health initiatives aimed at reducing the huge toll of alcohol. "Europe continues to have the highest levels of alcohol consumption in the world, resulting in the highest share of all deaths attributable to alcohol consumption. ... Every day, about 800 people in Europe die from alcohol-attributable causes." All of the countries are introducing taxes, limits on advertising, age restrictions, education programs etc. 

(source: fact sheet linked near the bottom of this page http://www.euro.who.int/en/health-topics/disease-prevention/alcohol-use/data-and-statistics )

[mathnerd]

Is it at all possible for him to be away from home (or from his drink) during the time that he has his daily drink? For e.g. read a bedtime story to the kids, fold his laundry, run on the treadmill, go for a walk, take a shower or something else?? That would break the routine and habit that he has gotten into and perhaps divert him from his stressful day as well.

Each of us has different levels of tolerance and body types and well as levels of physical fitness. It does not matter what standards others have about how many drinks a week constitute an unhealthy habit. What matters is that people around him are pondering this question (perhaps he is contemplating this as well). Would he be open to having a drink on alternate days to begin with? Also, when I go for an annual physical exam, the questionnaire asks specifically how much alcohol I consume on a day to day basis. Could he bring it up with his physician during the next visit? That would probably give him some ideas on how trivial or nontrivial this habit is.

[sassenach]

12 hours ago, Liz CA said:

 

There is still a difference between "dependency" and "abuse." You can google Substance Use Disorder (SUD) definition.

Abuse is generally defined as having difficulty carrying on with maintaining a job, relationships and most time is devoted to procuring the substance.

You totally quoted her. First sentence- “please don’t quote”

[Liz CA]

2 hours ago, sassenach said:

You totally quoted her. First sentence- “please don’t quote”

 

Fixed it. Thanks.

[ktgrok]

6 hours ago, mathnerd said:

Each of us has different levels of tolerance and body types and well as levels of physical fitness. It does not matter what standards others have about how many drinks a week constitute an unhealthy habit. What matters is that people around him are pondering this question (perhaps he is contemplating this as well). 

He is the one pondering this, I'm just trying to help. 

[PeterPan]

nt

Edited April 23, 2019 by PeterPan

[ktgrok]

8 minutes ago, PeterPan said:

When my loved one came off substances, they did what people are describing to you here, including changing their location, keeping BUSY, going to GROUPS, and developing a relationship with a mentor.

Not having btdt, I think the being out, not only physically but relationally, where you're saying you have an issue and need help, is part of getting there. I think if he says he's not like "those people" who need help or groups or whatever, well that's walking away from help. Maybe he can go to some of those groups and see. They're pretty good at helping people sort out what their underlying issues were, which seems to be his question. There's sort of a self-discovery journey there.

And as far as finding those groups, there are national groups and also groups through churches. My loved one did both and both at the same time. 

Well, considering he doesn't have time for exercise or family time etc, I don't think he's going to feel he has time for a support group for people quitting a substance, especially since he's already quit and is not struggling to stay quit. And I don't think he has quite 100 percent long term, he probably will continue to drink socially sometimes, etc. Showing up at a meeting for people who are struggling to stay sober and saying, "I plan to drink sometimes, I just didn't like how much I was spending on single malt" isn't likely to work out well, I'd think 🙂