Changing how you use

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Post by Kurt Andersson-Noorgard 07 Dec 2012

People use alcohol and other drugs (AOD) for all sorts of reasons: to improve their mood, to drown their sorrows, because they’re anxious, because they’re bored. 

Whatever the reason, by the time someone’s AOD use has become a problem, the reason has usually been lost along the way. Sometimes, too, so have jobs, houses, partners, health.

Many people who come to see me want to continue to drink or drug but at a ‘controlled’ level. This approach is useful for those who recognise they have a problem and want to reduce the amount and frequency of the substance they use.

Others are fed up with their ‘habit’ and want to stop their AOD use completely.

Whichever end result you’re after, the first steps towards getting there are the same.

To start with, you need to know as much as you can about the thing you want to change.

Step 1

Get yourself a blank piece of paper. Divide the page into columns as shown below. Date it and make a record of every drink (or cone or blast) you have.

Try to be specific about the amount. Standard drinks can vary from state to state so take that into account. In NSW, for example, one standard drink equals a middy of beer, 100mls of wine or 30mls of spirits. If you have a measuring cup at home, use it so you know exactly how much you are drinking.

Be sure to fill in each column and if anything particularly unusual, stressful or good happens during the day, note that down as well. But make sure you record every drink (or whatever it is you are using). This will let you see how much you are really having, the pattern it takes, when are your riskiest periods, how much it is costing and even the reasons why you imbibe.

You might hate doing this but stick with it for at least a week.

At the end of the week have a look at what you have recorded. Pay attention to anything out of the ordinary or spikes in your drinking. Maybe you drink more on a Saturday watching TV or before going out? The pattern can tell you something about the way you use.

Knowing why you are using can help you replace it with something else. In the table, for example, the person seems to drink to relax. So, an alternative for them could be to learn different ways of relaxing: like meditation, exercise or taking up a hobby.

Step 2

Now you have a record it is time to set some goals and limits for yourself. Be realistic. There is nothing worse than deciding to never drink again only to start drinking within a few days. This can be demoralising and make you think you cannot change.

What you are trying to do is set boundaries for yourself. You want to include:

  • Amount: How much will you drink? e.g., three standard drinks per day
  • Where: The only place you will consume alcohol e.g., at home
  • When: What times will you drink? e.g., only between 4pm and 7pm and nil on Tuesday and Wednesday (having two alcohol-free days gives your body a rest)
  • Who with: Some people are triggers for drinking more e.g., only with Claire or alone and not with John
  • Triggers: Some moods trigger us to drink more so, e.g., when I’m sad, I won’t have drink; I will go for a walk instead.

It’s very important that you write down these goals/boundaries so you don’t forget them. And a good place to put this constant reminder is at eye level on the fridge door.

Step 3

The best laid plans can sometimes fall apart because of some unforseen event. An old friend arrives unannounced or you feel particularly anxious about an upcoming medical review.

This step involves looking at some high-risk situations and planning ways you might cope with them should they arise.

Include things like being pressured by friends, feeling particularly good or bad, dealing with a conflict, having access to more money than you usually do or feeling physical pain.

Write them down and add new ones to the list when you think of them. Here are some examples:

  • If someone brings a bottle over, I will pour myself a ginger beer.
  • If I get bad news instead of drinking I will meditate . . . play my favourite songs . . . walk the dog . . .

Next steps

For those of you who can’t or don’t want to access AOD services, here are some reputable websites that you may find really useful:

Kurt Andersson-Noorgard is the HIV/HCV and Drug and Alcohol Clinical Nurse Consultant at the H2M Service at St Vincent’s Hospital in Sydney.