The sober path is chosen due to a variety of factors.
Some folks decide to stop because of financial strain, emotional turmoil, or failing physical health.
For others, they just don’t like how alcohol makes them feel, it’s simply run its course.
However, there is a subset of this population that quitting becomes an absolute necessity.
For this type of alcoholic – and yes, there are many variants and types – once they start drinking they cannot stop and every time they try to quit they convince themselves to start back up again.
It not only affects every facet of their own life but the lives of those around them.
Nonetheless, after some time sober and the appearance of the drinking problem as well under control, questions will eventually be posed:
- Do I need to be sober all the time?
- Can I ever drink casually again?
- Don’t I deserve to be a social drinker?
- Is this really a sober life sentence?
In early recovery the idea of being a social drinker seems like the ideal scenario.
It’s likely that if these are the questions you are asking that you still hold.many positive associations with drinking.
It would be wise to employ a cost-benefit analysis.
- Does the risk outweigh the reward?
- Are negative associations with drinking greater than the positive?
The Medical Professionals Take On The Social Drinker
The CDC states that moderate drinking is only ONE drink a day for females and TWO a day for males.
They also provide further clarification.
Recovering alcoholics or people unable to control the amount they drink. SHOULD NOT TRY MODERATE DRINKING.
In other words, the real alcoholic (we will get to that shortly) SHOULD NOT TRY TO BE A SOCIAL DRINKER.
They also note:
Drinking at levels above the moderate drinking guidelines significantly increases the risk of short-term harms, such as injuries, as well as the risk of long-term chronic health problems, such as some types of cancer.
Take these considerations into account when running your cost-benefit analysis.
Leave no wiggle room!
The usual line of reasoning is that those who go back to casual drinking after a period of sobriety and do so successful, were not alcoholics in the first place.
Of course, as stated above, with a wide variety of variants within that term “alcoholic” it’s important we sift through them to assist you in your cost-benefit analysis.
Casual drinking demands control over your drinking, however, for some this is something they will be unable to recover.
If that is the case, and you are this type, then abstinence is the only way.
Let’s peek behind the curtains at the variants.
Alcohol Use Disorder (AUD).
The National Institute of Alcoholism and Alcohol Abuse states,
Problem drinking that becomes severe is given the medical diagnosis of “alcohol use disorder” or AUD. AUD is a chronic relapsing brain disorder characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.
An estimated 15 million people in the United States have AUD. Approximately 5.8 percent or 14.4 million adults in the United States ages 18 and older had AUD in 2018. This includes 9.2 million men and 5.3 million women. Adolescents can be diagnosed with AUD as well, and in 2018, an estimated 401,000 adolescents ages 12–17 had AUD.
To be diagnosed with AUD, individuals must meet certain criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM).
Let’s look at the DSM-5 regarding Alcohol Use Disorder:
The presence of at least 2 of these symptoms indicates Alcohol Use Disorder (AUD).
The severity of the AUD is defined as:
Mild: The presence of 2 to 3 symptoms
Moderate: The presence of 4 to 5 symptoms
Severe: The presence of 6 or more symptoms
- Had times when you ended up drinking more, or longer, than you intended?
- More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
- Spent a lot of time drinking? Or being sick or getting over other aftereffects?
- Wanted a drink so badly you couldn’t think of anything else?
- Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
- Continued to drink even though it was causing trouble with your family or friends?
- Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
- More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
- Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
- Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
- Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure? Or sensed things that were not there?
As stated above, three primary locations can be found on the continuum of AUD (Mild, Moderate, and Severe).
The Real Alcoholic Cannot Casually Drink
Some have tried to simplify this threefold distinction by creating two: alcohol abuse and alcoholism (dependence). Healthline comments on this distinction, “These terms are sometimes used interchangeably, but there are marked differences. People who abuse alcohol drink too much on occasion and their drinking habits often result in risky behavior and poor judgment. But alcohol abusers generally aren’t dependent on alcohol. Alcoholism, on the other hand, means a person needs alcohol to get through their day.”
The Big Book of Alcoholics Anonymous is threefold and basically the same as the DSM-5, arguing for a “the moderate drinker, the hard drinker, and the real alcoholic.”
In any event, the further down the scale you go the more unlikely moderation is possible. Particularly if the brain becomes diseased.
Dr. McCauley, the creator of the documentary Pleasure Unwoven, proposes that the ramifications of addiction on one’s neurobiology is such that the primitive midbrain starts to hijack and inform the prefrontal cortex rather than vice versa. If the choice is centered and executed in the prefrontal cortex then the addict’s decisions are governed by instinctual impulse and survival. Something has gone awry which circumvents reason and rationality.
Brilliantly, Pleasure Unwoven argues that addiction is ultimately an impairment of the pleasure sense. For example, the deaf person has an impairment in their sense of hearing; the blind person in their sense of sight; and the addict an impairment in their sense of pleasure.
We struggle with the latter due to moral implications. However, Dr. McCauley demonstrates just how the impaired pleasure construct reroutes the basic functionality of the brain, triggers the primitive midbrain to confuse the addiction with something necessary for survival, such as food or drink.
A brief cost-benefit analysis would demonstrate the risk of even attempting to be a social drinker for this type of alcoholic far outweighs the reward.
What About The Other Types?
Plenty of folks drink in excess yet barely even meet the criteria for mild AUD. Not everyone who even enters rehabilitation for their drinking is far along the continuum.
Studies have shown that people do moderate and become social drinkers. The studies are limited and only really apply to those highly motivated and committed people on the lower end of the AUD spectrum.
However, it bears repeating: it’s the height of irrationality for someone with severe AUD to attempt moderation.
Abstinence vs. Moderation
Abstinence refers to complete restraint from any alcohol.
Moderation refers to controlled drinking.
It’s important to differentiate between the individual the abuses alcohol and is dependent upon it.
Those further down the scale of AUD usually are dependent upon the drink.
Therefore, as stated numerous times, if you’re further down the scale on the AUD continuum then abstinence is the only option.
The Alcoholic Brain & The Social Drinker Brain
It is tempting, especially after a period of sobriety, to think that you are suddenly cured. The mind likes to play games on itself, with illusions of power and selective memory.
It’s not unusual for those recently sober to think after a short period of time are suddenly cured of their malady.
Undoubtedly, for some on the lower end of the AUD continuum, this may in fact be a reality.
However, for those on the higher end of the spectrum, their brain will play games with them, being very selective of the memories it chooses, as well as providing a false sense of power and ability.
The brain concocts an image of the past that “wasn’t that bad.” It associates drinking with the good and conveniently ignores the bad.
In my clinical experience, I found those with mild AUD often don’t even bring up moderate drinking, they usually just give it up.
More often it’s the severe type that dreams of drinking again and attempts to rationalize e.g. I’ll only drink beer, I’ll stay away from the hard stuff, I’ll only get drunk on weekends…
These thoughts are common but are telltale signs of a dependent brain. As Dr. Keith Humphreys in the Journal of Psychiatric Services states, “The vast majority of Moderation Management members have low-severity alcohol problems, high social stability, and little interest in abstinence-oriented interventions.”
If you are more on the severe end of AUD, these thoughts demand intervention and if left unattended will likely result in a severe relapse, not moderation.
The dependent mind likes to create false confidence, recall Dr. McCauley’s explanation that the lower regions of the brain confuse the drink as a necessity for survival.
It will do whatever it can to get the dependent alcoholic to drink because it wants to survive!
It uses the language of the rational brain to achieve this end. So if you scored high on the AUD criteria, beware of what your mind is telling you!!
One Drink Is All It Takes
The problem with the individual who is alcohol dependent is it’s likely stress that is causing these thoughts.
John Dupuy of Integral Recovery affirms the basic premise of Pleasure Unwoven when he writes,
Once the brain has been calibrated in his manner, even if the brain is healed and in a homeostatic state, if triggered it quickly kicks into gear the same stress system it already previously developed. Once this system is engaged it will be practically impossible to stop apart from medical, clinical, or judicial intervention.
Naturally, for this type of alcoholic, stress produces these thoughts of moderation. This is the stress system trying to get tapped into the rig, it wants to be re-engaged to deal with the issues at hand.
However, once a drink is taken it quickly requires more to maintain the system runs optionally. Consequently, moderation becomes rare.
At the risk of sounding like a broken record, I’ll repeat myself again: moderation is not an option for someone on the higher end of the AUD continuum.
Is There An Alternative To Social Drinking?
Some individuals opt for non-alcoholic beverages. The only problem with this is that not all non-alcoholic drinks are made equal.
Many of the people who make the laws about what is and isn’t alcohol-free understand that 0.5% is an insignificant amount of alcohol meaning 0.5% is considered alcohol-free or non-alcoholic in many countries.
Additionally, medical professionals still insist that even a small amount of alcohol is enough to trigger the cravings and relapse cycle.
The same principle holds true: for those with severe AUD, it’s not even worth the risk.
“A mocktail is a cocktail without the liquor. Instead, juices, sodas, infused waters and many other non-alcoholic ingredients, mixed in just the right ratios, provide flavor.”
Though some professionals caution that they too can easily become triggers. Particularly if the beverage smells like booze, however, for those who really want to remain alcohol-free or for those further along the AUD continuum that still want the fun nightlife and “drinks with friends,” but minus the intoxication then mocktails provide a solid alternative.
Below are a few fan-favorite mocktail recipes. This scene has exploded the last decade, the list is virtually endless, but these are ones you’re likely familiar with.
Just to reiterate, for those with severe AUD I would still err on the side of caution and avoid that bar scene altogether, at least for a few years, it’s still all risk and very little reward.
“Some of the most well-known and longest-lasting mocktails, all named for celebrities from the early and middle 20th century, are:
Shirley Temple: A ginger ale, lemon-lime soda, lemonade or other non-alcoholic base mixed with grenadine syrup and frequently garnished with a maraschino cherry. Named after the famous child actress.
Roy Rogers: A cola base, similarly mixed with grenadine syrup and garnished with a maraschino cherry. Named after the famous Western film actor and entertainer.
Arnold Palmer: A mix of iced tea and lemonade. The exact ratio and type of tea, whether sweet, unsweetened or something else entirely, is open to interpretation and local tastes. Unlike the other two drinks, which simply bear the name of a popular celebrity, champion golfer Arnold Palmer was known to make this drink at home and order it at country clubs after finishing a round.
Keep It Simple
In my personal opinion, if alcohol has caused any problems in your life then avoid it.
You can socialize without being a social drinker.
If you use it as a social crutch maybe it’s time to learn different coping skills. That’s the gist of a sober lifestyle after all.
However, if you are on the lower end of the AUD continuum your risk is minimized but you still need to be highly motivated. I would remain cautious and do a thorough cost-benefit analysis.
For those with severe AUD, counter these thoughts by talking to a clinician, coach, or sponsor. Get it there, get vulnerable, and heal.