Staying Fit
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Many people — including many addiction experts — believe that the only way to handle a drinking problem is to quit altogether. Indeed, abstinence-based programs such as Alcoholics Anonymous (AA) have helped countless people manage their addiction and live healthier lives. And for some drinkers, including those with a more serious dependency, abstinence is still advised.
But for many others whose drinking is less problematic, moderation can be a more appealing, effective option for establishing a healthier relationship with alcohol, says George F. Koob, director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) at the National Institutes of Health (NIH) in Bethesda, Maryland. In fact, he adds, “That's how everyone should approach alcohol if they partake. There is a cohort that doesn't want to drink at all and that's to be respected, but everyone else should limit their drinking.”
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Limiting alcohol consumption is important at every age, but especially for older people. “As we age, the enzymes in our stomach and liver that help metabolize alcohol are less active,” says Austin Lin, M.D., a psychiatrist with McGovern Medical School at UTHealth Houston, who notes that this metabolic slowdown can increase a person's blood alcohol concentration (BAC) by 20 to 50 percent.
If you'd like to cut back on your drinking but aren't sure how, here are some steps to get you started.
1. Be honest
Many doctors don't ask about alcohol use. If they do, patients may be tempted to lie about how much they drink. “Folks are great at hiding their use, and that's detrimental to themselves because they're not able to get the help they need,” says Lin. A first step is admitting how much alcohol you're actually consuming.
2. Track your intake
The NIAAA recommends a maximum of four drinks on any given day for men and three for women, and a total of no more than 14 drinks per week for men and seven for women. Exceeding those limits is considered “heavy” or “at-risk” drinking — but, as noted above, older people may want to limit their drinking further. (See “Are You Drinking Too Much?")
To keep yourself within that range, it's important to know how much you're drinking at any given time. “Counting is really effective,” says John Mendelson, M.D., clinical professor of medicine at the University of California, San Francisco, and founder/chief medical officer at Ria Health. Keep a number in your mind representing how many drinks you will have. ("I'm not going to have more than two glasses of wine tonight.")
A spouse or friend can help you stick to it. If you're alone, Koob recommends making a check mark on a piece of paper each time you have a drink. “We're all forgetful when we get older,” he says.
3. Slow down
If you're accustomed to opening a beer at 5 o'clock every night, try waiting until 7. If you usually order a drink immediately upon arrival at a party, order a seltzer first. When you get a drink, nurse it, then go back to seltzer.
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