How casual drinking can become problem drinking

Dear Doctor K: I’m a 36-year-old woman. Lately I’ve been drinking more than I used to. How can I rein in my drinking before it becomes a problem? School colleague, Dr. Debi A. LaPlante, “Responsible Drinking for Women,” can help you make the change. This e-book will help identify issues that could make it difficult to change, and then introduce strategies to overcome them. It is available through online retail booksellers.

You’ll start by setting goals. Do you want to drink less or eliminate alcohol completely? Do you want to start now or in six months? Do you plan to cut back gradually or stop cold turkey?

You’ll also need to acknowledge why you drink. For example, many women drink to help cope with stress or conflict. You may have learned that, in the short run, alcohol alleviates uncomfortable feelings and strong emotions. But you can retrain yourself to cope in healthy ways, making it less likely that you’ll turn to alcohol in times of stress.

Finally, don’t underestimate the importance of overall wellness to help prevent relapse and propel long-term change. Being physically out of shape, for example, is not just a cosmetic issue — you also just don’t feel that well. You don’t have your usual energy; your mind doesn’t seem as sharp. You get sleepy earlier in the day. You’re just not yourself.

When you’re in that kind of state, finding the inner discipline to deal with any problem is a challenge. That’s why improving your diet, maintaining healthy sleep habits and exercising regularly can help you achieve and maintain your drinking goals.

I’ve had several patients who never had a problem with alcohol until a very stressful event, such as the loss of a job or the end of a relationship. Almost always their friends tended to drink pretty heavily — more heavily than they. But because of the stress, they started to follow their friends when that second or third drink was ordered. On occasion, people who had never had a drinking problem started drinking alone, and in excess. But usually they were just doing what their friends were doing — and getting no negative feedback.

I hope this advice, and the more detailed information in Dr. LaPlante’s ebook, will help you decide if you have a problem and, if so, to nip it in the bud. Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK. com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.