Moderation

Moderation seems to be an issue that is constantly coming up, and I get asked regularly what I think about it. I was also asked recently to do a post on why some people end up with drinking problems, where others don’t. In fact the topics are interrelated because a good place to start when talking about moderation is with those individuals who do seem to just naturally have one or two drinks and then stop.

People who naturally have just one or two and then stop are invariable people who have never regularly drunk more than one or two and who consequently don’t even consciously notice that insecure feeling building up when they’ve finished their drinks, let alone would they associate another drink with taking the edge off it. This is the key, and it is also key that we who have travelled beyond that state can never go back to a state that is, ultimately, born of ignorance. That may sound harsh but it is true. Early stage drinkers can only maintain their intake at low levels because they don’t consciously notice the small amount of anxiety that they experience after their one or two drinks, and / or it would never dawn on them to take another drink to get rid of it.

What causes people to drink more or less than others is primarily due to environmental factors. Some people are brought up to just only ever have one or two drinks, others consistently drink to get drunk. This is what you learn from friends, family, colleagues, TV, music, etc and varies between individuals, even varies within the same family. Also some people’s lifestyles allow them to drink more. So for me, I could never do my job under the influence, and I could never do it very well hungover, so for years that tempered my drinking. But if I didn’t have to work, or if I did a job where I could drink doing it, I would have been drinking all the time (as I did when I had extended periods off work, like my two month decompression leave which I had upon my return from serving in Iraq).

Also stress is a big factor. Lots of these long term moderate drinkers tend to have fairly simple, stress free lives. This is why drinking tends to be associated with high pressured and / or dangerous jobs. But stress isn’t an objective test, it’s subjective, so one person may find a certain lifestyle fairly easy to cope with, whereas someone else will find it difficult. So your ability to cope with stress, as well as how stressful your life is, is also a factor.

So can a previously heavy drinker return to this moderate drinking state? I don’t it’s a viable course for the vast majority of people for 2 reasons.

Firstly when you learn that the alcohol withdrawal can be relieved by another drink, you can never unknow that. So for ever after, as soon as a drinks wears off you will want another. The wearing off on one drink becomes the trigger for the next.

Secondly it’s a catch 22 situation. To control alcohol you have to cease seeing it as something enjoyable. If you no longer want it, you have power over it, rather than vice versa. That is the only way it will lose its hold over you. If you see it as enjoyable or necessary, you are going to keep wanting it. The only reason someone would want to moderate is because they still think of alcohol as enjoyable, which means they are vulnerable. If you genuinely don’t see it as enjoyable, why on earth would you want to take it at all, moderately or otherwise?

Take me as an example, a year or two ago I had flu and took some Night Nurse not realising that it is 20% ethanol. It was the equivalent of having a small glass of port. Needless to say I didn’t have any alcohol after that, so I know that theoretically I could have a single drink and stop there, because I did it on that one occasion. But here’s the crux; I don’t do that because I simply have no desire to drink anymore. And if I did have that desire to moderate, if I did have that desire to drink, I wouldn’t be able to moderate, because if I wanted a drink and had one, what would stop me wanting the next and the next and the next?

Let me put it another way, if you think a single drink would be enjoyable, why on earth would the next one not be enjoyable? And the next and the next and the next? Remember alcohol is a drug, drugs create the need for the next dose. Moderation is based on seeing alcohol like a food, in that in taking it you remove the desire for it. So if you fancy a pizza and you have one. You are then full and content (or stuffed to bursting) and don’t want any more. But alcohol doesn’t work this way. When it wears off it leaves an unpleasant insecure feeling that needs another drink to get rid of it. This is the nature of drugs. I genuinely don’t understand how anyone who has previously had problems with drinking could somehow teach themselves to want the first drink but not the next. I have no doubt there are some previously heavy drinkers who moderate but it can never be a stable state, it will always be reliant on them giving into temptation for the first drink or two, then trying to resist that temptation for the next one. And as we all know, the more drinks you have the harder it becomes to resist the next one.

But even if you could moderate for a period of time, wouldn’t you just end up spending your entire life obsessing about alcohol and thinking about when to drink and when not to drink? I don’t drink. Simple. Whether I go out for an evening and get offered a drink, or have a bad day, or go on holiday, or have a birthday, or meet old friends, or celebrate Christmas. Whatever happens I don’t drink. I think about drinking a lot, but I spend zero time considering whether to take a drink or not. But if I were to say to myself that I would drink in certain circumstances or within certain parameters, I would be spending all my time thinking about whether I could or couldn’t drink. I may or may not end up drinking all the time, but my life would certainly be dominated by alcohol. I would end up spending great swathes of time agonising over whether I could or should have a drink or not. Why on earth would I want to do that?

The other problem of course is that moderation, in whatever form, perpetuates the myth that alcohol is desirable and necessary in certain situations in order to fully enjoy and / or cope with them. If you say you want to moderate, you are buying into that myth. You are saying that you cannot bear to think of living the rest of your life without this particular drug. If that’s the position you’re in, have you beaten your addiction, or does alcohol still have a hold over you? If it still has a hold over you, isn’t it even more dangerous to dabble in it? Do you think heroin or meth addicts should moderate? Imagine if your son or daughter or father or mother or partner was hopelessly addicted to herion, and was close to dying form it, but then managed to quit for an extended period. Imagine they then have a bad day at work, or an argument with their partner, or are going out with old friends. Would you say to them “Why don’t you inject a little bit of herion? It’ll be fine, just have a little bit, a little bit won’t hurt you. A little of what you fancy does you good.”

Why is alcohol different? And why would you give your loved one different advice to that which you would do yourself?

The very concept of moderation denies that alcohol is an addictive drug.

Let me highlight another aspect that I think is important, that of responsibility for our actions. Let me give you an example which I’ve used before. Imagine there is a drug that makes you go mad and kill people. Someone spikes your drink with this drug and unknowingly you drink it and kill someone. Are you morally responsible for that death? I would say no, because you had no intention to kill them and didn’t chose to do so, it was the drug that made you do it.

But what if you deliberately took the drug knowing that you would kill someone, and indeed did so? Would you be morally responsible for that person’s death then? I would say of course you would be, you deliberately took the drug knowingly it would result in a person’s death. The key difference is choosing to take it or not. In one situation you didn’t choose to take it, in the other you did.

But what if we now blur that line. Imagine if you deliberately took the drug, but in the mistaken belief that it would just make you feel relaxed and happy for a few hours, and didn’t realise it would make you go mad and kill someone? You’ve actually chosen to take the drug, but not realising its actual effect. My view is that in this situation you wouldn’t be morally responsible for any deaths you caused while under the influence of it because you didn’t intend anyone’s death and it was in ignorance of this effect that you took the drug.

Drinking makes us tired, bad tempered, and likely to do stupid unpleasant things, but it’s sold to us as something benign and fun. If you drink and do something terrible, then my view is you shouldn’t beat yourself up for that because society tells us that drinking is fun, sociable and (for most people) harmless.

But when you know through your own experience that you are capable of some quite unpleasant and irresponsible acts when you are drunk, and you choose to drink anyway, you’ve got to start taking responsibility for what you do when you are drunk. You may blur the moral lines of responsibility even further by convincing yourself that you can moderate and that this time will be different, but the more times you prove yourself wrong on this, the less you can absolve yourself of responsibility when you do horrible and embarrassing things when you’ve been drinking.

In the Alcohol Explained Facebook group this topic recently came up. One of the members posted the horrendous story of Audrey Kishline. She was the founder of Moderation Management which was set up to help problem drinkers achieve and sustain moderate, controlled alcohol use. She died aged 59, it is thought by suicide, after killing a 12 year old girl and the girl’s father whilst she was driving in an alcoholic blackout.

Alcohol is an addictive drug. Taking it creates the need for the next dose. For this reason moderation can never be a long term, stable condition. And even if it were you could never be better of moderating than quitting completely because quitting provides freedom. Moderation on the other hand simply ensures that alcohol continues to dominate your life.