Cutting back on alcohol

[Todd Becker]

As the creator of this blog and forum, I usually find myself in the position of summarizing scientific research, formulating a "position" and giving advice to others. But I think it is good to try heeding one's own advice, so I am going to plunge in here and take a dose of my own medicine.  

I've just posted a piece called "Overcoming Addiction" on the blog today, which discusses the potential of using cue exposure therapy to extinguish addictions.  Over the past few years, I've been successful in losing weight on the Deconditioning Diet, including giving up daily ice cream desserts, and replacing a daily routine of 2-3 cups caffeinated coffee with a few cups per week of decaffeinated coffee.

However, I've found it very hard to give up one particular pleasure: an alcoholic drink or two before dinner.  A year ago, I was successful in cutting back to 1 or 2 drinks a week.  But I do enjoy alcohol, and my habit has crept back to a daily cocktail or beer before dinner.  As I wrote on my blog, my favorite drinks, in order, are:  (#1) B&B cognac liqueur on the rocks; (#2) Manhattan cocktail; (#3) beer; (#4) red wines, especially Pinot Noir.

Over the past 5 days, I've managed to limit myself to a single beer over the entire 5-day period.  It has been harder than I thought. And yet, it is curious that I only find myself craving a drink at a specific time of day -- right after work, when I'm driving home from work, and the first hour that I'm at home. So far I've managed not to "reinforce" this urge except for Saturday night, when I had one beer. Each evening I'm still thinking about the drink. So I am going to try cue exposure to extinguish even this craving.

I'm also trying to formulate a plan for how often I want to drink and under what circumstances. I think drinking one or two evenings a week sounds "moderate" enough to allow some pleasure but have the possibility of improving my general health and energy level. I'm currently training for a big running relay race the first weekend in May, and I'm thinking that cutting back on alcohol may be beneficial.

Wish me luck! ...And I'd like to see if others might be willing to post their own "detox" experiences here....

[Jbird]

Todd, I really enjoyed reading your distillation of the research, and it's particularly interesting and inspiring to see you applying it to yourself. I'm amused by your lack of bad behaviors to give up. Some would even argue that your one drink a day has greater health benefits than no drinks a day. I'm just playing devil's advocate. I have never cared about alcohol one way or another and am dubious about its supposed health benefits. I'd like to apply the technique to my bad habits related to eating. For one, I'd like to stop eating in non-eating environments (office, couch, bed, car, etc.) and eat only at the dining room table. Because I eat alone, I can eat anywhere, but I know it would be better not to. Certainly less messy! I'll start a thread on this and see if I can apply these cue-exposure techniques to help me break my bad habits. Thanks for another great post!   

[Todd Becker]

Jaye, I'll look forward to following your experiment with eating environments.

For me, yesterday was not too bad. I had a busy day at work, and met my wife and another friend after work to head out to a social event that happened to be from about 4-6 p.m.  I was a little hungry (from having not eaten breakfast or lunch) so I did something a bit unusual for me and bought an ice cream sandwich from a sidewalk vendor.  When I got home around 7 p.m. I had only a small meal -- a leftover porkchop and lima beans, then a small piece of chocolate, and that totally satisfied me.  I really did not have any craving for a drink (or appetizers) at all.

I don't really know what caused my lack of desire for a drink: (a) the different evening routine; (b) the unusual ice cream sandwich; (c) eating a satisfying dinner right away without time to ponder a drink.  Could have been any of these or some combination of them.  No "cue exposure" to alcohol was involved, so this doesn't strictly follow the original guidelines of my experiment, except that part of deconditioning is discovering alternative behaviors.  As the Conklin and Tiffany paper observed, extinction is not just passive "unlearning", it is "relearning" new behaviors.  Since the unusual routine and foods may not necessarily be repeated often, I have to be careful not to assume I've really set down any "new routines" or sustainable new ways of responding yet. Also, I did not have much stress yesterday, actually a rather light and fun day, so I have not really "tested" myself in finding alternatives to my use of an evening drink as de-stressing technique.

[Jbird]

I'm glad your experience of socializing without alcohol went so well! When I'm in novel situations that are stimulating in positive ways, I find I'm less interested in food and drink. It can also be so physically awkward if it's a stand-up situation, where you have to balance food and a drink and somehow manage to eat gracefully while socializing. Also, I wonder if your being conscious of not wanting to have a drink plays a role here. I imagine you were conscious of your goals, and you seem to be very disciplined about achieving goals you set for yourself. So there's intentionality. That's how I feel about my own attempt to confine eating to eating environments. I had no problem doing that so far today because it's very top-of-mind that that is what I want to accomplish. I think Sugardude said something on his thread about how any change seems easy at first. I think part of that must be that one is mentally focused on the goal. Also interesting to note that the ice cream sandwich didn't trigger a desire for more sugar in the form of alcohol. Maybe you're not particularly sugar sensitive. Good luck as you continue your experiment!

[SUGARDUDE]

I think you are going to have to put your drinking behavior on extinction, at least with the specific dinner time cue otherwise you may be making the stimulus response even stronger by intermittantly reinforcing it.

[Todd Becker]

Interesting point, Sugardude, I hadn't thought of that. You are right that intermittent reinforcement is well known to make extinction more difficult. Casinos and internet gambling sites exploit this by putting payouts and jackpots on a somewhat random basis, so gamblers keep betting even when they are not getting regular payouts.  That's also why parents who give in occasionally to whining kids encourage the kids to whine to get what they want, even if they usually don't give in.  I'll have to think about your point. If I settle on more or less of a regular "drinking schedule", one that is predictable and not too random, I think I would avoid this problem. For example, if I have a beer after work every Friday with co-workers, and then one other time each week, perhaps on the weekend, but not during the week, I think this would be non-random and I would avoid getting cravings during the week. I think I just need to make some "rules" about it.  This is like the "putting on cue" concept of Karen Pryor I discussed on the Psychology page.

I skipped breakfast and lunch and took a run at lunchtime, which normally suppresses my appetite somewhat. Today was Friday, so I had a beer after work as I had planned, and a B&B cocktail at home tonight.  It was pretty uneventful. If anything, I would say both the beer and cocktail were somewhat bland or unsatisfying, and I almost didn't finish the cocktail.  So perhaps my desire for alcohol is waning somewhat. However, today was a nice day at work, not very stressful, and my appetite was diminished due to the run.  So maybe this wasn't a very hard test of what it would be like on a more stressful day.  Will see.

[Todd Becker]

Yesterday (Saturday) went very smooth. I had no cravings for a drink, and didn't even think about it until I realized dinner had come and gone. This may have had to do with a somewhat different routine (helping my daughter get ready for her prom and driving her around), but I'm not sure. My original plan had been to designate 2 days of the week for drinking: Friday and one weekend day. I'm thinking instead to space these out a bit more, like Friday and then either Monday or Tuesday night.

On the one hand I'm thinking - why drink if I have no desire to drink? Why not just go to one day a week, Friday, which fits in with my company's tradition of a beer or two late Friday afternoon.  But on the other hand, I think I want to go more gradually, from 5-7 nights a week down to 2 nights a week, instead of going to 1 in a single bound.  Plus, I'm persuaded to some extent by Sugardude's point that a regular pattern may make extinction easier than a randomized pattern.  (The flip side of this is that randomized eating helped me decondition my appetite, so why wouldn't the same apply to drinking?)

Today I plan to do a little "swilling" of some B&B and spit it out, just to proactively dampen my taste for alcohol.  This is inspired in part by a method called "enlightened tasting" suggested by Tim Beneke, a contributor on the Shangri-La Diet (sethroberts.net) forum, and it is also consistent with the findings of Conklin and Tiffany that adding a "behavioral" element to sensory deconditioning is beneficial in achieving extinction.

...update Sunday evening. I did some cue-exposure with the B&B drink, right around dinner time.  This involved swirling and sniffing it in the glass, sipping it, and spitting it out.  The sensation on the tongue was warm and pleasant. The aroma was interesting, I don't think I'd paid attention to aroma by itself as much before, but it was sort of an odd sweet smell that wasn't especially great.  After this cue exposure, I had no real desire for the drink, and it made me wonder why I like it so much.  I also had no appetiizers, but just made a seafood stirfry and that was dinner.  No problem.

 

[Todd Becker]

Today I decided that I would have my second drink of the week.  I had plans to take my daughter on a driving lesson around 5-6 p.m, which would be the time I would normally be arriving home.  And sure enough, on the way home I experienced a slight craving to drink. It was slighter than normal, but still there.  I picked up my daughter and we went for an hour's driving, including shopping.  By the time we got home, around 6:16 or so, I no longer had any desire for the drink.  But I decided that I should go ahead and keep my schedule, and in fact it was a good thing to have the drink precisely at a time that I had no desire for it, to help with the deconditioning.

So I had my B&B cocktail, cheese and salted almonds as hors d'oeuvres, followed about 20 minutes later by a small dinner.  The cocktail & snacks were no different than normal.  Perhaps the drink might have seemed a little bit "fainter" than normal, but it's hard to say.  It was not unpleasant, but nor was it "delicious" or unusually pleasant.  I limited myself to a single drink (1/3 of a glass).

I plan to go forward with a schedule of two drinking days per week, which means the next drink will be on Friday.

[Todd Becker]

This experiment continues to go surprisingly well. I had a concern that my drink two days ago might have re-ignited the daily pattern, but it did not. Yesterday and today I didn't even think about a drink during the dinner hour, or any other time for that matter.  Today was a fasting day, with no breakfast, lunch or any other snacks.  Just one cup of decaf and one tea all day long. No food or alcohol cravings all day long! I took a very enjoyable 30 minute walk during the middle of my workday, as the weather is turning nice.

Tonight I broke my fast with some nuts, two slices of Havarti cheese and a glass of soy milk.  Dinner was a large artichoke, which I could not even finish, with a glass of soy milk.  FYI, I am not committed to soy milk over regular whole dairy milk, so I go back and forth between the two.  I just like unsweetened soy milk because it is so low in sugar content and it tastes good to me and is refreshing.   The soy milk kind of substitutes for a non-alcoholic drink that at least has an interesting flavor, something besides plain water or herb tea.

Tomorrow is our regular weekly Friday after-work company social event, with free beer and snacks, so I plan to take advantage of that for my now-weekly beer or two.  There is really something to having a regular drinking schedule.  I still will have that source of pleasure to look forward to each week, so I don't feel I'm depriving myself of anything at all.  I think it is also important to strive for moderation, not a prudish abstinence, because with moderation I am controlling the pleasure, but with abstinence, the forbidden fruit could control me.   I think the Stoics and the other Hellenistic philosophers like Aristototle were really onto something with their doctrine of moderation.  It can sound very boring and pedestrian as a philosophy, but in reality it is a way of allowing pleasure and self-control to co-exist in a very satisfying way.

[SUGARDUDE]

I plan to go forward with a schedule of two drinking days per week, which means the next drink will be on Friday.

As a recovering alcoholic I have to laugh at this. Fortunately for you (assuming you do not have an addictive personality) many people could do what you are doing with no adverse effects. But a drinking schedule is one of things that is discussed in the Big Book of A/A as the type of thing that an alcoholic does in an attempt to drink like a normal person but to no avail.

[Todd Becker]

Today was amazing.  I fasted until 4 p.m., including a group run at lunch with colleagues who are training with me for the big relay next Saturday (Its a 200 mile relay with 12 runners doing 3 legs each. I have 3 five mile legs to run).  It was a fairly relaxed run today.  At 4 p.m. I had a sandwich and one beer.  Very refreshing.  I was thinking I'd have a second beer when I got home, but I had no desire at all for a beer or any other alcohol.  I had given my self permission to have 2 drinks today, but I could only manage one!  That just seems strange to me.  I wasn't that I was repulsed or couldn't possible drink one if you forced me; it was that I had absolutely no desire, and I preferred to drink a soy milk with my chicken dinner.  Also my appetite was very small today.  I just had the chicken tonight, no extras.

I plan to go forward with a schedule of two drinking days per week, which means the next drink will be on Friday.

As a recovering alcoholic I have to laugh at this. Fortunately for you (assuming you do not have an addictive personality) many people could do what you are doing with no adverse effects. But a drinking schedule is one of things that is discussed in the Big Book of A/A as the type of thing that an alcoholic does in an attempt to drink like a normal person but to no avail.

Sugardude, I'd like to learn more about your experience with this and why AA and others feel this is impossible. From my research, I realize that AA is very, very adamant about this point that there is no option of recovering alcoholics ever returning to moderate drinking.  But there are others who dispute this.  I'd like to understand exactly why AA and others believe that a return to moderation is impossible.  I can understand that it is difficult, but impossible?  Why?  I also have read differing viewpoints on whether the concept of an "addictive personality" is a scientifically valid concept, or just a label that gets thrown around. Certainly, I know some people who would fit the stereotype, but I also worry about using deterministic labels that imply no possibility of change.  I've seen change, in myself and others, so I guess I'm a believer in the possibility of change.

HOWEVER, I want this blog and forum to have a spirit of openness and the give-and-take of ideas. So I'm very interested in hearing about how I might be wrong on this point.

[SUGARDUDE]

A basic belief of A/A is that alcoholic drinkers are different than other people. In my experience and from what I have read as a whole I tend to believe this as well.

From my A/A experience, I have heard countless stories of people who have stopped drinking for 1-10 years only to feel comfortable that they could drink normally again which ultimately takes them right back to where they were and worse.

From what I've read, and please excuse for for not providing citations, there have been multiple documentations of recovering alcoholics who also have a strong sweet tooth. now not everybody has a strong sweet tooth. This tends to indicate to me that there are fundamental physiological response differences to alcohol/drugs/sugar in the "alcoholic" brain as opposed to the non alcoholic brain.

For me, it's never been about alcohol. My drug of choice was always cocaine. As you know it affects the pleasure centers in the brain much like sugar does. There was a recent study that confirms this that was mentioned in "The Week" magazine a couple of weeks ago. But again, not everyone is affected by sugar to the same level. ( To be continued because of that same problem again))

[SUGARDUDE]

As to your inquiry about whether a return to moderation is impossible I would say no depending on what type you are. Some people just have no business drinking alcohol at all. Many in A/A got sober because they were on a collision course with early death. From a behavioral perspective, the need to continue drinking after that first step was so strong they simply were unable to stop. The feeling is that once you've gone that far down the road (and if one has felt compelled to attend such a meeting then that road has been travelled), you cannot simply rewire your brain to drink differently. Maybe that is untrue, but the cost benefit analysis weighs in favor of abstinence for those.

One thing that has been fairly well established among alcoholics in A/A is that trying to moderate by way of a drinking schedule results in disaster.........always for the alcoholic.

[Moonbeam]

My Dad is an alcoholic, and I've had issues with drugs and alcohol so I'll give you my 2 cents, for what it's worth.  He and I have talked and wondered about this topic quit a bit; mostly about the differences between people and what their real diagnoses are. 

He goes to AA an so is of course for total abstinence.  I used to party a lot when I was younger, more than average, and I eventually realized that I needed to clean up my act if I was going to live a normal life.  So I did--I quit drinking (and drugging, but that was mostly just pot) and finished school, etc.   At some point I decided that I really didn't have to or want to continue to abstain completely, and so now I don't.  I have to watch how much I drink, because I still like it a lot, but as long as I'm careful and keep track, I'm fine.  This is has been many years ago now, quitting in my early twenties and then in my late twenties deciding I didn't have to forego completely.  Now, I have periods of time of drinking more or less; I'd like to keep it to less for health reasons.

OK, as far as what is going on with alcoholics--I think that in a lot of cases the alcoholism is just one symptom of a larger mental illness.  Anybody who has been around people from AA know that often they have a lot of issues other than just alcohol.  (I think my Dad's problems were a combination of a terrible childhood, extreme anxiety, and an OCD-like condition), and just as people with any mental or physical illness can do things that make the disease better or worse, they make their disease worse by drinking.  On the other hand, Dad says that there are people in AA who once they quit drinking are pretty much "cured", meaning that they have no residual mental health issues--their problem was purely due to their drinking.  Did I have some other mental issues that caused me to drink?  I don't know for sure, but I don't really think so; it was just the time and place and crowd I chose to hang out with; wanting to have fun.  I don't have much going on now mental-health wise except for the nagging things I put in my intro post; things I'd like to take control of better in my life. 

So--I think there are people who have a "disease" (some sort of mental condition) which includes problem drinking, which exacerbates the original problem.   Other people, for whatever personality reason, just like to drink and sometimes drink to excess, and this can become a habit, but if they break the addiction, they will be OK as long as they are careful and remember their propensity.  Then it becomes like any other sort of tendency that you know about yourself and have to watch out for (bad temper, over-eating, whatever indiscretions a person may be prone to.)

This is all purely subjective and personal, but there is no reason to think that I am the only person who ever drank too much and then was able to quit and then go back to drinking fairly responsibly.  I really d0 think it depends on what else is going on with the person's mental state.

[SUGARDUDE]

This is all purely subjective and personal, but there is no reason to think that I am the only person who ever drank too much and then was able to quit and then go back to drinking fairly responsibly.  I really d0 think it depends on what else is going on with the person's mental state.

If it was just the person's mental state how does that explain the corelation between alcoholism and sugar addiction? There has to be some sort of physiological process involved which makes it impossible for certain people to stop once they start.