Alcohol abuse can have serious consequences for your health, relationships, career, and life. If you drink heavily or binge drink, you may be wondering if you need to quit drinking altogether or if you can get your drinking under control by cutting back.
How much is too much?
Moderate alcohol use is defined as up to 1 drink per day for women and up to 2 drinks per day for men. Heavy drinking is defined as 8 or more drinks per week for women and 15 or more drinks per week for men. Binge drinking is consuming 4 or more drinks within 2 hours for women and 5 or more drinks within 2 hours for men.
Drinking more than the moderate amounts or binge drinking on a regular basis can lead to alcohol use disorder (AUD). About 16 million adults in the United States have AUD. AUD is a chronic relapsing brain disease characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational or health consequences.
What are the risks of heavy drinking?
Heavy and binge drinking comes with short-term and long-term health risks:
- Injuries, such as motor vehicle crashes, falls, drownings
- Violence, including homicide, suicide, sexual assault
- Alcohol poisoning
- Risky sexual behaviors
- Miscarriage, stillbirth, or fetal alcohol spectrum disorders
- High blood pressure, heart disease, stroke
- Liver disease
- Digestive problems
- Cancer of breast, mouth, throat, esophagus, liver, colon
- Weakened immune system
- Learning and memory problems, including dementia
- Mental health problems, including depression and anxiety
- Social problems and job problems
- Alcohol dependence
The more you drink, the greater your risks of developing these problems. Even cutting back on heavy drinking can help reduce your risks.
Should you quit or cut back?
Deciding whether to quit drinking vs. cutting back depends on several factors:
| Consider | Favors Quitting | Favors Cutting Back |
|---|---|---|
| Alcohol dependence | Physically addicted | Not physically addicted |
| Ability to control drinking | Hard time stopping after 1-2 drinks | Can stop after 1-2 drinks |
| Withdrawal symptoms when stopping | Yes | No |
| How much you drink | Heavy drinking or binge drinking | Only mildly/moderately high amounts |
| Why you drink | To cope with stress, trauma, mental health issues | To be social or enhance enjoyment |
| Impact on work, relationships, health | Significant problems | Minimal or no problems |
| Failed attempts to cut back | Have tried unsuccessfully to reduce drinking | Have not seriously tried to cut back |
| Family history | Close relatives with alcoholism | No family history of alcoholism |
As this table illustrates, if you have alcohol dependence, severe drinking patterns, inability to control intake, withdrawal symptoms, or other indicators in the “favors quitting” column, you may need to stop drinking completely. On the other hand, if you only have mild to moderate drinking with minimal impact on your life, cutting back may be a reasonable goal.
How to quit drinking
Quitting alcohol altogether is safest if you are physically dependent with severe AUD. Here are some tips:
- Get medical help – See your doctor or enter a detox program to manage withdrawal safely.
- Consider medication – Prescriptions like naltrexone and acamprosate can help manage cravings.
- Go to counseling – Individual and/or group therapy helps develop coping skills.
- Attend support groups – 12-step programs like AA provide social support.
- Avoid temptations – Stay away from people/places/activities triggering drinking.
- Address mental health – Treat any co-occurring conditions like depression or anxiety.
- Make lifestyle changes – Find rewarding hobbies, connect socially, eat healthy foods.
- Communicate needs – Tell loved ones how they can help support your sobriety.
Quitting is very difficult without a strong support system. Building a sober network is crucial. With professional treatment and social support, long-term sobriety is possible.
How to cut back on drinking
If your drinking is moderately high but not physically addictive, you may aim to cut back rather than quit. Strategies include:
- Record intake – Keep a journal of when and how much you drink.
- Set limits – Stick to 1-2 standard drinks maximum per day (women) or 2-3 drinks (men).
- Space drinks – Have at least 1 non-alcoholic “spacer” between each alcoholic drink.
- Avoid triggers – Stay away from people/places/activities where you drink too much.
- Plan ahead – Eat before drinking and have non-alcoholic drinks available.
- Pace yourself – Sip drinks slowly. Don’t gulp them down.
- Measure pours – Count standard drink sizes of beer (12oz), wine (5oz), spirits (1.5oz).
- Include alcohol-free days – Take at least 1-2 days off from drinking per week.
- Reward success – Celebrate achievements and milestones in reducing drinking.
Cutting back requires paying close attention to when, why, and how you drink. It also requires learning new coping strategies to manage stress and social situations without relying on alcohol.
When to get professional help
It’s a good idea to see your doctor, a mental health provider, or an addiction specialist for help if you:
- Have tried unsuccessfully to cut back or quit drinking
- Drink more than 15 drinks/week (men) or 8 drinks/week (women)
- Binge drink on a regular basis
- Experience withdrawal symptoms like nausea, sweating, shaking, or anxiety when you don’t drink
- Drink as a way to cope with physical or emotional pain
- Continue drinking despite negative consequences
- Have an alcohol-related health condition
Detoxification in a specialized rehab facility may be recommended in cases of severe alcohol dependence and withdrawal risk. Therapy, medications, support groups, and lifestyle changes can help achieve and maintain recovery goals.
What’s the take-home message?
If you are concerned about your drinking, first honestly evaluate your patterns of use and the impact alcohol is having on your health and life. Consider both the risks of continuing to drink and the benefits of reducing or stopping alcohol use. Severe alcohol use disorder usually requires quitting entirely. More moderate problematic drinking may respond to cutting back with limits and behavior changes. Don’t be afraid to ask your healthcare provider for help and access recovery support services in your community. With commitment and support, achieving your drinking goals is within reach.
