Speaking of Psychology - Sober Curious? with Katie Witkiewitz, PhD

Episode Date: February 26, 2020

Drinking is ubiquitous in American culture today. It’s hard to go out and not see people imbibing. In the midst of all this booze, there is a burgeoning movement in the opposite direction: Sobriety is having a moment in the spotlight. For the sober-curious crowd, this can mean taking a break from alcohol for a set period or it can mean quitting altogether. Either way, according to addiction researcher and psychologist Katie Witkiewitz, PhD, stopping drinking even for a short period can be beneficial because it allows us time to explore our relationship with alcohol with a clear head. Join us online August 6-8 for APA 2020 Virtual.   Learn more about your ad choices. Visit megaphone.fm/adchoices

Hello and welcome to Speaking of Psychology, a bi-weekly podcast from the American Psychological Association that explores the connections between psychological science and everyday life. I'm your host, Caitlin Luna. Drinking is ubiquitous in American culture today. It's hard to go out and not see people imbibing. Alcohol flows freely at brunches, baby showers, and birthday parties, not just in bars. In the midst of all this booze, there is a burgeoning movement in the opposite direction. Sobriety is having a moment in the moment. in the spotlight. For the sober curious crowd, this can mean taking a break from alcohol for a set period, such as during specific months, you may have heard of dry January or sober October, or it can mean quitting altogether. Either way, as our guest for this episode says, stopping drinking even for a short period can be beneficial because it allows us time to explore our relationship with alcohol with a clear head. Today we're talking to addiction researcher and psychologist, Dr. Katie Witkowitz, from the University of New Mexico.

She's part of the university's Center on Alcoholism, Substance Abuse, and Addictions. Welcome, Dr. Witkowitz. Thank you, Caitlin. It's great to be here. They were really happy to have you on our show today. So first I want to start off with, why do you think alcohol has such a tight grip on American society? Yeah, I think alcohol, there's a quote of it being a pervasive fact of life. And I think that quote really captures alcohol in our society, even since before prohibition,

but especially during and after prohibition. So alcohol is a legal substance, and it's a legal psychoactive drug that in many cases makes people feel better, either in celebration or when they're not feeling good, it can provide some relief of negative feelings and is commonly used in celebration and generally brings people small amounts of joy in their life. And so I think alcohol is a part of. life in part of society because it is a legal psychoactive drug that many people view as as safe, although we could talk about that assumption and that people just generally use to socialize and

to have fun and also this other side of helping to relieve distress. So relieving negative states, so negative emotions, relieving pain. It's generally a drug that provides a lot of different potential short-term benefits in the moment. And so given it's legal, it's widely available. It's socially accepted. It's not too surprising that we see alcohol everywhere. And we as a culture, most Americans use alcohol, drink alcohol. Let's explore that presumption of safety because you said it's legal, of course, and it's socially acceptable. So how does that affect people's drinking, knowing that it is, quote unquote, a safe thing to be doing? Yeah. And I think, you know it's interesting because there is a mixed research on even the health benefits of

alcohol supposed health benefits of alcohol and so basically there's this assumption that that low levels of drinking are not harmful at all and might even be beneficial for health and so the the research is actually pretty clear on this that the amounts of alcohol that are safe and and potentially even have health benefits is pretty low. And it's pretty low compared to what most people drink. So less than one drink per day is considered a low level of alcohol use and kind of a safe level of alcohol use. And any more than that is potentially associated with health risks.

And there are some research suggesting some health benefits of low levels of alcohol use, but increasing research showing that alcohol use, even in low amounts, increases risks for certain cancers, certainly increases risk for liver disease and other disorders. So even low amounts of alcohol, for some conditions, it is not safe. And for the health benefits of alcohol, it is actually a pretty low amount compared to what many people drink, which is more than less than drink a day when they drink. So it's actually, it's not completely healthy to drink alcohol. And we know more and more about the health risks. That said, I think it's a relatively safer drug compared to other drugs, particularly illicit drugs, that can have more significant consequences.

As an addiction researcher, are you alarmed by this by the current drinking trends you see in America? Yes, I am, especially given increases in certain segments. I'm actually most concerned about increasing drinking among older adults and among women, where we see actually in recent years greater increases in drinking. And it's alarming to me because, you know, there is this social acceptability and there's also treatments available that work, but a lot of people aren't actually getting treatments that they need, are not seeking treatment, are not getting help. And I think our society as a whole would really benefit from starting to have a conversation about the benefits of reducing drinking.

And what we know is that it's kind of both things are true. So if any drinking increases your risk of certain health conditions, health diseases, health disorders, that reductions in drinking considerably improves health. And so I really want to, I would love for our society to actually flip the conversation to be really more focused on the benefits, the health benefits of reductions in drinking. And I think about it, because it is legal and socially accepted, I really think of drinking alcohol as similar to any other health behavior. And so I think about, I often use the comparison of eating fried food, right?

So we know that eating fried food is not great for us, but it's legal and it's generally socially acceptable. And it's not super healthy to eat fried food. And probably a little bit of fried food is not super harmful to health. But as you increase your amount of fried food intake, you're increasing the health. risk of eating fried food. And I think as a society, at this point, many people are on board with the idea that we should reduce our fried food intake, right, that we shouldn't be having, you know, the supersized French fries at every single meal. And so I would love for us to have a similar kind of thinking about kind of the health risks and benefits of alcohol and thinking similarly

around reducing alcohol use as important as a society. And instead, our society, our society actually kind of glorifies and glamorizes heavy drinking. And that to me is concerning. How have you seen that patterns of drinking change? Because we obviously know the history of drinking of alcohol in America, the prohibition movement, and then also the three martini lunch that was popular a couple decades ago. And, you know, you see a TV show like Mad Men where it seems like people are spending every day at work, you know, under the influence of alcohol or drunk, whatever, however you want to call it. What have you seen in trends in America? Yeah. And I think, you know, it's interesting. The rates of alcohol use have been, you know, they decreased with prohibition.

Prohibition was effective in reducing rates of alcohol use. They increased to really pretty quickly to pre-prohibition levels shortly after prohibition. And so once alcohol became legal again, there was a steady increase in drinking and then drinking. pretty quickly matched the pre-prohibition levels of drinking. There was a decline in drinking prior to prohibition that's important to note because states rolled out different dry laws prior to even prohibition happening. So there was a decrease in drinking than prohibition, the large decrease in drinking, and then after prohibition and increase in drinking. And since that time, alcohol use has remained relatively stable in many segments of society. There's been some increases among

young adult drinking that occurred in the 70s and 80s. And more recently, we're seeing increases in drinking among older adults and women, as I mentioned. And I think the important thing to know, though, even back to the 70s, but certainly today, the characterizations of alcohol use in the media is really wrong. You know, most people who drink alcohol in our society do not drink at very heavy levels. And that's been true for many years. The majority of people do not drink heavily. And it's only about 30% of people who engage in what we would, people in the U.S. currently,

who engage in what we would call heavy drinking, which is defined as more than four drinks in an occasion for women, four or more drinks in an occasion for women and five or more drinks on an occasion for men. So only about 30% of people are drinking at that high level occasionally. Most people, when they drink alcohol, do not drink as much as the media would portray alcohol to be consumed. Why do you think alcohol use has increased in older Americans and women? I think it's a lot of interesting factors that go into the increase in drinking among both older adults and women. You know, there's been a lot of research lately on kind of ideas around disorders of despair that just generally as Americans, a lot of factors play into this, and we could spend several hours talking about them,

you know, increase social media use, increase news, 24-hour news cycle, increase in just daily stressors of society, and people living older and longer, living older and longer alone, divorce is more common. There's just a lot of social stressors right now, and women in particular are, especially the group that's increasing their drinking, which is middle-aged to older women are increasingly being stressed on both sides. So more and more women are, you know, playing multiple roles, both in the workforce, in the home, but also being stretched to be taking care of older parents, as well as taking care of children in many cases. And so there's a lot of stress right now in these populations. And alcohol is a pretty effective stress reliever in the

short term. And many people come to use alcohol to relieve stress because it is effective in the short term. It's not a long-term solution. And that's where kind of getting into help comes in. At the same time, it is effective in the short term. So more people are turning to alcohol, which again is legal, it's socially acceptable. It's everywhere, as you noted in the beginning of this. And so I think more people are turning to alcohol to relieve what is an increasingly stress. world. Turning this up to the completely opposite direction, why do you think the sobriety movement, the sober curious movement, whatever you want to call it, why do you think it's catching on? Yeah. Well, I'm just thrilled about it. And I have to say, I think it's wonderful for us to be

kind of starting to recognize that not everyone has to drink heavily. Not everyone has to drink. and really shifting the conversation to be focusing on, wait, we as a society could make an effort to reduce our drinking and even, you know, not drink at all. And so I think, frankly, a lot of people are also a little bit fed up with drinking. I mean, when you really look at alcohol use, particularly when you're talking about heavy alcohol consumption, there's hangovers, there's worries about violating laws and consequences of heavy drinking. There's There's just the health effects of continual heavy drinking. So, you know, a lot of time in the holidays, people will just say like, oh, I just, like,

every day has been a party and I've been drinking so much and I just feel like I need a break. And so I think it's wonderful that we would normalize and create a society, a culture that actually supports sober, sober choices, supports non-drinking choices, non-drinking activities. and what's been happening lately is people kind of joining together to choose to not drink. And there's a social component to that that I think is really important. And so I really think that people are starting to just kind of question, hey, is this drink, drink, drink, culture really what we want? Are we getting what we want out of it?

And a lot of people are answering that questions with maybe not. Like I'm having consequences. I'm hungover. I don't feel well. I'm saying things I don't want to say. I'm, you know, maybe having relationships with people I don't want to have relationships with. My life is revolving around alcohol and I want other options. And I think it's great.

I think that's why this is catching on because there are other options. We don't have to only drink. And a lot of people know that. A lot of people have already discovered that. But I think the people who are kind of drawn to this sober curious crowd or this sobriety movement are people who've kind of filled their life with a lot of drinking activities and are now evaluating whether that's what they really want. Yeah, and to that end, there are some sober bars, if you will, however it's which way you want to call it. But these bars that only serve non-alcoholic drinks, and we're seeing a lot of really creative mocktails showing up on bar menus and restaurants. Do you think this, seeing all these options out there, does this make the sober curious crowd or someone who's just taking a break feel more comfortable because it's not like they just have to sit there and sip water?

They can have a nice, tasty drink. They don't feel left out of just having a good beverage. Definitely. Yeah, I think that that's one of the really hard things for individuals who want to not drink is they want to be in a social environment with other people, friends, colleagues, after work, family members. And oftentimes in those settings for years, the only choice has been like water soda, which a lot of people don't want to drink for the sugar or alcohol. And it really sets up an environment where people then become uncomfortable. They don't want to be. drinking water or soda all night. And so these mocktails or these these really creative avenues for having a setting, a social setting where people can engage in non-drinking of alcohol, but still be in that environment and feel like they're having something good and rewarding, especially they do. They're kind of these fun mocktails with like fun names and they're expensive. And they actually like kind of mimic that experience of a reward of having some sort of kind of treat that that you're

going to have and that you're going to savor and really enjoy instead of just, you know, downing some ice water in the company of people who are drinking these fun flavored drinks. Yeah, and there's also people who I call sober evangelists out there who've written books. I'm thinking, Holly Whitaker who wrote, quit like a woman and Ruby Warrington who wrote Sober Curious, The Blissful Sleep, Greater Focus, Limitless Presence and Deep Connection, awaiting us all on the other side of alcohol, quite a mouthful. So there are people out there in this space who are promoting the message of sobriety. And, you know, interestingly, as we touched on earlier, a lot of this caters to women. So what are your thoughts

about this movement out there where people are having these sober role models? Yeah, I think, I think it's wonderful. I think, again, as you noted, alcohol use is increasing among women, or as we've been talking about, alcohol use is increasing among women. It's really part of another culture that at least I hear about in the work that I do of, you know, these, like, for example, there's these wine and art classes where you, you know, you go and paint paintings and I think it has a funny name. Maybe you know it. I don't know it. But you go and like, you do paintings with, you know, with your friends and then you're drinking alcohol or book club. Oh my gosh. I know. I was in a book club in graduate school and it was really about drinking a bunch of wine with my

female friends. Occasionally I would read the book. But so book club or these like art classes or just getting together for brunch and, you know, mimosa brunch and having having several mimosas. So I think women have been really pulled into this with these other activities that really don't necessarily need alcohol. Like you're doing this other thing that's that's also really enjoyable. And so I think another piece of this is that women have generally been left out. of treatment and research and kind of thinking about alcohol use disorder. It's up until recently, it's primarily been a male disorder. I mean, the majority of people in earlier clinical trials for alcohol use disorder, for example, were men, Alcoholics Anonymous, is, as another example,

is very male-dominated. It's very, it was created by men. It used to be kind of a men's group, and the wives were supporting the men in their path to sobriety. So it's really only recently that that alcohol use disorder is increased among women, that alcohol use has become socially acceptable among women, that alcohol use is encouraged among women, and even drinks, types that are coming out to really cater to women. So these kind of so-called low-calorie, like the hard selters, the drinks that specifically advertise and market to women. And so you've seen this increase of women being targeted by the alcohol industry, of women increasingly engaging in alcohol use. I think it's absolutely wonderful that women are also leading the charge and kind of providing some other ways

to think about how to reduce drinking and kind of reevaluate alcohol's use in your life. I often think about someone with an alcohol use disorder as someone who drinks excessively all the time. And I don't think I'm alone in that. But I was reading an article from the Cleveland Clinic that said the definition of an alcohol use disorder is being unable to stop despite negative consequences. And that threshold could be one drink a night or one drink a week. So that was really interesting to me that it wasn't necessarily a physical dependence. It wasn't your drinking 10 drinks a day. It was like it could just mean you need to have, you feel like you need to have that nightly glass of wine. Yeah, exactly. And I think another problem with our society that I love,

what I love about the sober curious movement is people who are not at that severe end of what we think of as someone who has a problem, you know. And so we we kind of have this vision in our culture, our society, that if you're drinking 10 drinks a day and having terrible problems, then you have an alcohol use disorder and you can never drink again. And everyone else can drink as much as they want. And really, that's that, that idea that there's this us or them that, that people either are addicted to alcohol and physically dependent on alcohol or they can drink as much as they want because they're not physically addicted. That whole notion is completely wrong based on the science. So what the science tells us and years of science has shown is that there is really a continuum. And so people

who can drink a lot of alcohol don't necessarily have symptoms of alcohol use disorder. And some people who drink very little do have symptoms of alcohol use disorder. And so, you know, the thing that I use as my kind of rubric, so there's obviously a longer assessment. the diagnostic system to diagnose someone with an alcohol use disorder, which I'm sure the Cleveland Clinic outlined, which largely does revolve around kind of consequences of drinking, as well as having a tolerance and needing alcohol in your life. I would really kind of simplify it to, you know, I see if alcohol is starting to cause problems in your life, then alcohol is causing problems in your life. And you should take a look at it. You know, it doesn't mean that you are,

have a severe alcohol use disorder, it means that, yeah, alcohol is maybe not fit into your life the way you want it to. And it might be worth taking a look or reducing your drinking. And then if reducing your drinking is hard, if you're unable to reduce your drinking, if you're finding yourself really wanting a drink and really struggling to not drink, then that might be a sign that it's time to get some help or reach out to get some help. Yeah. And the terminology, I think, is important. And then you and I touch on this when we had our initial call about the episode, is that, and you were, you know, you corrected me when I said alcoholic and you said it's someone with an alcohol use disorder. Can you talk about the importance of how we, you know, label someone and how we describe someone who has an alcohol use disorder and getting away from that term alcoholic? Yeah, definitely.

And thank you for raising the question of terminology. It's really so important. And one of the biggest reasons that alcohol and other drug use disorders are so difficult in our society is the stigma associated with them. And one thing that perpetuates stigma that we know perpetuates stigma is labels. And the term alcoholic, and I wish you could see me using air quotes because I'm using air quotes around that term. The term alcoholic is very pathologizing and stigmatizing. And in fact, there's been research on this idea that even seeing that term, term makes people, general population, feel more negatively towards a person if they are labeled

with that term. And even bigger concern. So there's a stigma concern and it really is associated with negative pathologizing views of a person that the person is inherently flawed if that term is applied to them versus what we really should be thinking about is this is someone who has had problems with alcohol. This is an individual who maybe has had difficulty in controlling their alcohol use or has had problems associated with alcohol might be criteria for alcohol use disorder. So there's those problems with the term. Another problem with the term and generally is that it really creates an either or that you either, again, using air quotes, are an alcoholic or you're not. And that is where I think

another big problem-wise, because actually alcohol use disorder occurs on a continuum, as I was saying. So people have a range of severity of symptoms, and there really isn't a line at which you are a, quote-unquote, alcoholic versus when you're not. People meet criteria for just one or two symptoms of alcohol use disorder might still be experiencing problems related to their alcohol, might still benefit from reducing their alcohol use, might still benefit from seeking treatment. But because, Because of this false notion that there is a line at which you become a quote unquote alcoholic versus not, by perpetuating that false notion, we actually, people don't get the help that they need early on. And alcohol is a progressive neuroadaptive disorder. Alcohol use disorder is a progressive neuroadaptive disorder. So the more you drink, the more you drink over time, the more your brain adapts to having alcohol on board. So the longer you go without recognizing that there's a problem with your alcohol use, the more your brain is going to become disrupted by the use of alcohol.

So if we could kind of get away from this rock bottom, there's a line at which you have an alcohol use disorder to a perspective of, no, this is a health behavior that occurs on a continuum. It's not something you want to wait until you're so badly beaten by the disorder before you seek help. and so I would love for a society to just move away from this binary us or them. There is a problem where there's not a problem in more towards, again, seeing alcohol as a behavior where we can engage in it at low levels and still experience problems. And then when we're experiencing problems from alcohol, that's a signal that it might be time to reduce your drinking, to reevaluate your relationship with drinking and possibly seek help. If you are questioning your relationship with alcohol, what should you do? What are the first steps you should take?

Excellent question. So the first step, I think that's really important is to just know what you're drinking. So to pay attention to what you're drinking and actually log what you're drinking, just like we would keep track of a food log. If we were on a diet, we would keep track of what we're eating. If we're thinking about changing our drinking, I think the first step is to keep track of what we're drinking. And that also includes knowing what's in a drink. So a lot of people don't even recognize what to log because so many of our drinks now are actually more than a single state. standard drink. So a standard drink is 14 grams of pure alcohol and how that translates is roughly a 5 ounce glass of 12% wine, 12 ounce glass or can or bottle of regular beer at about 5% alcohol and about 1.5 ounces of 80 proof liquor. So what that means, though, is that a lot of us, when we're drinking, especially in bars or other places where we're not controlling what we're pouring, we're often getting actually larger than that in standard drink units. So for example, if you go to a restaurant and a lot of higher-end restaurants do these just absolutely massive pores of wine that are like nine-ounce pores. And so that's almost two standard drinks,

if it's a 12% glass of wine. And so what that means is you think you're just having two drinks at the restaurant, but you're actually having four, almost four drinks. And as I noted earlier, are four drinks for a woman is considered heavy drinking. So your two glasses of wine actually corresponds to a heavy drinking event. Similarly, for the microbrewery movement, there's microbreweries everywhere, and these microbreweries and brew pubs, they have pretty high alcohol content beer. And so, for example, if you have a 16 ounce pint of an India Pale Ale, then it might actually be closer to one and a half to two standard drinks, not the one drink that you think you're having. So what we encourage people to do is just become more aware of what they're drinking,

what they're putting in in their glasses and how much alcohol they're consuming and then keeping track of that, logging that over time. And so just paying attention to what they're drinking over time. And then maybe evaluating where could you make some changes? Where could you maybe decide to insert, you know, I don't have to have drinks every night of the week. I'm going to have, you know, one sober day where I'm not going to drink any alcohol and try implementing that or maybe deciding that, you know, I typically have two to three drinks on Monday nights and I really would get by well with just one drink on a Monday night. And so looking at places in your schedule of drinking of where you could maybe cut back or reduce your drinking or have a abstinence day

where you're not drinking at all. And then from there, if you're noticing that you're having trouble with living by your own guidelines and setting your own rules, if you're having trouble sticking to that, let's say you're, you know, two drinks a night that you were going to have, you wanted to make it a one drink a night and you can't do it, you know, that you keep failing or that you're not successful in cutting down or having that one abstinence day a week, for example, that might be an indication that there's something going on here. And in fact, that's a symptom of alcohol use disorder is repeated attempts. at cutting down that are unsuccessful. And so if you're having trouble cutting down, this might be a time

when you start looking for more support. And that might involve looking online for an online support group among people who are reducing their drinking, maybe reaching out to a friend and seeing if a friend would be interested in making the same change that you're making, kind of like an exercise buddy, a drinking reduction buddy, where both of you are going to decide that when you meet for your book club, instead of having three glasses of wine at book club, you're going to have one glass of wine at book club. So enrolling some social support in making these changes can be really helpful. If that's not working, then potentially seeking out some sort of mutual support group, such as Alcoholics Anonymous or Smart Recovery or Women for Sobriety, there's a lot of different

online groups that are geared towards helping people reduce their drinking, providing kind of social and peer support for that. And if that's not working or that doesn't feel comfortable for you, then another option can be talking to your primary care provider. So we actually have effective medications for alcohol use disorder that primary care providers can prescribe that are very effective. One of my favorites, particularly for people who don't want to stop drinking altogether, but who are interested in reducing their drinking, is naltrexone. Nelotrexone can be prescribed by a primary care provider.

It has pretty minimal side effects and has helped people kind of take the edge off drinking where they don't want to drink as much and they might have less craving for alcohol. So instead of having five drinks, they'll be okay with having two and they won't want to keep drinking. So it kind of helps people put the brakes on their drinking when they're drinking. And so that's a great medication for individuals who just really want a little bit of extra support in reducing their drinking. We also have medications for people who are more geared towards abstinence and supporting abstinence. So one of those medications is called a campersate. And a campersate can help people who are wanting to maintain not drinking at all, particularly for people who are maybe

struggling with not drinking as far as having a lot of withdrawal symptoms or negative moods coming in. We also have really great behavioral therapies that work for alcohol use disorder. So I would also encourage people to potentially seek out a treatment provider who's a therapist or counselor or social worker who's trained in delivering brief behavioral treatment. for alcohol use disorder. And these can be as short as two sessions of just looking at your alcohol use with a provider to talk about your alcohol use, to talk about kind of where you want to make changes, how you might make some of those changes, kind of problem solving about what's

getting in the way, or a longer treatment. So anywhere from four sessions to maybe eight sessions of treatment with a provider where you look a little bit more closely on some of the reasons why you're drinking, maybe kind of treating some of the underlying problems. So a lot of people, like I said before, are drinking for reasons to feel better, to relieve pain, to relieve negative moods, to reduce social anxiety. And so getting some treatment to support those underlying causes can really help in supporting people and reducing their drinking because they're not turning to alcohol to deal with those problems. And you use mindful, based treatment for addiction relapse prevention in your work. Can you explain what that is and how

effective it is? Yes. And so I failed to mention our own treatment program and talking about treatment options. Yeah. So mindfulness based treatments we've been working with for almost 20 years now. And it's an incredibly effective treatment for alcohol use disorder and other drug use disorders for getting at some of the kind of root causes of addiction and really looking at and being aware of how our mind works and really being able to come to terms with ourselves and with our minds and with our bodies and to just increase our awareness of kind of the stressors of daily life, of other comorbid problems that we have. So pain, anxiety, depression, to really be able to sit with those experiences and be with them without turning to alcohol. And so really being able

to experience distress in the moment and sit with that. distress and to do so with acceptance and without judgment. And so it's a really helpful training program for, we even say retraining the brain to basically retrain the brain to be able to be with the present moment. And our society is very much not in the present moment. And oftentimes we're reaching for things or we're living in the past. And we very rarely really relish and appreciate and savior the present moment experience. And alcohol actually takes us way out of the present moment, right? It changes our experience. And so we, in mindfulness-based treatment, train people to reconnect with, be open to accept and non-judgmentally be aware of the present moment experience.

And in doing so, can help change their relationship to themselves, the world, but also their relationships with alcohol and drug. Because alcohol and drugs can really, again, in the short-term get us out of the moment when the moment is hard. And so mindfulness-based treatments really retrain us to be okay with the moment even when it's hard and not reach for alcohol and drugs. And of all the treatment options you mentioned, from tracking to the self-help books, to the medication, to the mindfulness treatment, is there research showing what might work best, or is it particular to the individual? It's really particular to the individual. What we know is that for some individuals just tracking their alcohol use will result in pretty drastic reductions

in their drinking. Just seeing how much you're drinking can be really helpful to reduce your drinking. For other individuals, particularly people who've been drinking for a very long time, who might be more physiologically dependent and have neuroadaptations from drinking, they probably will benefit more from probably a combination of medication and a mindfulness-based treatment, potentially even having a detoxification in there to kind of clear alcohol from their system. So it really depends on the individual and individual range of severity. I think for most people who are questioning and kind of in this less severe range, I think even just tracking their drinking, having some social support around reducing their drinking,

even just talking to their primary care provider could be really helpful in reducing their drinking, and that's going to be most people. How does taking a break from alcohol benefit you mentally and physically? I mean, does it need to be a set period of time, or what are your thoughts on that? Excellent question. So what we know is that alcohol is toxic. It actually requires work from the liver to clear it out, and it impacts actually all systems of the body.

It impacts the brain as well. So any reduction in drinking, our latest work is showing that any reduction, in drinking is associated with mental and physical benefits. And so even reducing by one drink a day or reducing from four drinks to two drinks, you're going to see benefits. For people who take a longer break from alcohol, let's say a week or two weeks or up to four weeks, so people who kind of complete one of these dry January months or sober October months or kind of take a longer break from alcohol, they might see even larger improvements. So people report when you take a longer break from alcohol, that you'll have better sleeping patterns is one of the first ones that

people notice that they sleep better. Alcohol does interfere with sleep in a number of different ways. People report their skin looks better and that they just feel better. They have more energy. Of course, it's not just the alcohol, right? If you're reducing your alcohol and then you're sleeping better, you're going to have more energy, right? So it's kind of a cascade of effects from even stopping for a short time. But I also really like to reiterate, that you don't necessarily have to stop for an entire month or even stop for several weeks. Even reducing your drinking is likely to result in some benefit, albeit a little bit more subtle than what people report when they stop drinking altogether.

And overall, what we know is going back to what we started saying at the beginning of the podcast around any reduction, you know, any increase in drinking is associated with worse health outcomes, including mental health and physical health. and any reduction in drinking is associated with better health outcomes. And so in the long run, any reductions you can do is going to be good for your health and well-being. And it seems like a lot of people understand this. You know, as you mentioned, the end of the year holiday time, people feel like they are

overdoing it in a lot of different ways. So that's why you see a lot of people participate in dry January, which we've recently ended. Do you think that's a good way to have that crowdsourcing effect of a lot of different people you know are all trying to get through the month without any alcohol. Definitely. And the other thing it does is it creates a because there is a movement behind it, it creates a very natural and socially acceptable kind of statement around not drinking that a lot of people can be like, oh, okay, that's kind of cool. What is that? I recently actually was at a work event with several

people and it was in January and, you know, we offered a drink to one of the people in attendance. And the person said, actually, I'm doing dry January. And it was so liberating to hear someone say that. And, and, you know, then that person just felt really comfortable not drinking the rest of the night because he made a social proclamation that he was doing dry January. And it didn't have to be like this weird, you know, really big deal that he was stopping drinking forever, that he was, you know, kind of just out of treatment or some sort of other stigmatizing kind of scary notion. It's just like, yeah, I'm doing dry January. I'm not drinking this month. And it's fine. And so I love that about it. create this crowdsource of support. I know personally I did dry January years ago and four of my

friends and I, we all did it together. And we would even actually go to the same bars that we would go to. We would go to each other's houses. We would still hang out socially, but we would do so without alcohol. And because we were doing it together, it really, it did that crowdsourcing effect of just not feeling left out and not feeling like you were missing out. That said, I think one thing to be aware of is that abruptly stopping alcohol when you're severely dependent on alcohol is actually deadly. So withdrawing from alcohol is lethal for people who are consuming a lot of alcohol. So what I would say for someone who is very severely dependent on alcohol, who's physiologically very dependent on alcohol, who is drinking many, many drinks a day every single day to stop abruptly

could have health risks. And so I would encourage anyone who's drinking at that level and wants to try dry January to do so under the care of a medical physician and with awareness of some of the health risks of stopping drinking abruptly. Yeah, that's very important to share because I think, like you said, people need to make sure that they are taking care of their health, but also doing it safely. Exactly. And actually, speaking of that, another piece is if you do do dry January or

or if you do sober October coming up, or you decide to take a break from drinking, then it's also important to know that your tolerance for alcohol is going to go away pretty quickly. And so it's not a great idea to, like, February 1st, go out and have a bender of an evening where you're drinking a ton of alcohol because you're at risk of overdosing.

So kind of both things are true, like the extreme, you know, going from a lot of alcohol use to nothing, that's going to put you at risk of withdrawal, going from no alcohol use to a lot of, drinking is going to put you at risk of overdose. And so just being aware of kind of those risks around a sober period of kind of tapering to sobriety if you're going to go to sobriety and then definitely not returning to drinking what you used to drink after a period of sobriety because your body will not be able to process it as much as it used to. Thank you so much for that very

insightful information, Dr. Wickwith. I think our listeners will really appreciate the tips you've given them and also the importance of staying safe, whether you decide to give up alcohol completely or if you do give alcohol completely and maybe want to start trying again, I think it's important for people to understand the health risks and what they need to do to keep themselves healthy. And you've offered a lot of really wonderful information about how people can take a better look at their drinking if they feel that that's needed in their lives. Thank you. Thank you for having me.

It's been great. And for links to resources, you can visit our website, speakingof psychology.org, or Check the link in the episode notes. Before we go, just a reminder that we want to hear from you. You can email your comments and ideas to speaking of psychology at APA.org. That's speaking of psychology, all one word, dot org. And please consider giving us a rating in iTunes. We'd really appreciate it.

You can find previous episodes of Speaking of Psychology on Apple, Stitcher, Spotify, or wherever you get your podcasts. You can also go to our website, speakingof psychology.org. I'm Caitlin Luna with the American Psychological Association. Thanks for listening. Thank you.