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Section 2
Alcohol Consumption

Question 2 | Test | Table of Contents | Addictions CEU Courses
Psychologist CEs, Counselor CEUs, Social Worker CEUs, MFT CEUs

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On the last track we discussed self monitoring.  The three steps to self monitoring were to focus on ounces and percentage of alcohol, when and where alcohol is consumed, and self monitoring around others.

At some point in your clients self monitoring progress, a goal can be set for the appropriate level of alcohol consumption.  To reach that goal, it may be necessary for your client to begin slowing down.  When my controlled-drinking clients are prepared to implement the moderation tool of slowing down, I encourage them to focus on three aspects of drinking that can effect rate of consumption.  These three aspects are types of drinks, making it last, and spacing drinks.  I also review with my ‘controlled drinking clients the five steps to slowing down. 

Georgia, age 42, was a successful realtor and a mother of two.  Georgia used as alcohol as a way to relax from her hectic days.  A recent divorce and increasing stress regarding her two teenagers led Georgia to accelerated drinking.  Georgia began missing appointments with potential buyers.  Thus Georgia sought help with moderation as a controlled-drinking  client, because she felt drinking was becoming a problem for her she wanted to try controlled drinking.

Three Aspects of Drinking that can Effect Consumption

#1  Types of Drinks
First I spoke with Georgia regarding the types of drinks she usually enjoyed.  Georgia’s preferred drink was a vodka martini which, as you know, has a relatively high percentage of alcohol.  I stated to Georgia, "Consider changing what you drink.  For example, since you like vodka, try mixing it with juice to dilute the alcohol content."  Other examples of relatively strong drinks you may encounter include malt liquor or straight bourbon.  An alternative to malt liquor might be light beer, and straight bourbon could be replaced with a mixed cocktail. 

What is your client’s drink of choice?  Can you think of alternative, low-alcohol types of drinks your client may be willing to substitute for what they call ‘the hard stuff"?

#2  Making It Last
Next, let’s discuss making it last.  Georgia wasn’t willing to give up her vodka martinis.  Therefore, we discussed things she could do to make her drinks last longer.  Georgia was a rapid drinker.  On the average, she spent 10 minutes on each drink and typically poured another as soon as she was finished.  Georgia agreed to increase the time she spent drinking each drink from 10 minutes to thirty.  To increase the time she spent drinking each martini, Georgia decided to try to increase her average number of sips from 4 to 10. 

To help her meet this goal, I stated, "Remember, taking smaller sips won’t help if you compensate by sipping faster.  Try to allow a couple minutes between sips.  One simple trick that might help is to put the drink down and take your hand away from it between sips.  This will help you break the habit of holding and sipping.  Beware of drinking absentmindedly as when watching television.  The discipline of slowing down your drinking involves mindful awareness, at least at first." 

#3  Spacing Drinks
In addition to types of drinks and slowing down, a third aspect of slowing down was for Georgia to start spacing her drinks.  I explained to Georgia that spacing drinks meant to decide that she would allow herself only one drink within a certain amount of time.  I asked Georgia how much time she spent drinking each day. 

Georgia replied, "I spend about two hours drinking each day."  Clearly, if we analyze Georgia’s time spent on each drink in relation to the time she spent drinking each day, it becomes clear that Georgia had between 10 to 12 vodka martinis during her usual drinking times.  However, the goal that Georgia had set for herself was 2 martinis.  Now that Georgia had increased her drinking time from 10 minutes per drink to thirty minutes per drink, she needed to work on spacing her drinks in order to meet her goal. 

Georgia began to spend the remaining time drinking a cola.  At a later session, and after implementing other tools for moderation discussed later on this course, Georgia stated, "I’m still drinking for two hours when I drink.  But now I drink a martini, which takes about half an hour, then I have a coke.  That takes about thirty or forty minutes.  After my coke, I have another martini, another coke, and I’m done!" 

Think of your Georgia.  Could he or she add slowing down to other tools for moderation to control his or her drinking?  Could your client benefit from focusing on the following five steps to slowing down?

Five Steps to Slowing Down
In addition to the three aspects of drinking that can affect rates of alcohol consumption, I provided Georgia with five steps to slowing down.  The five steps to slowing down are concise to provide controlled-drinking  clients with definitive guidelines for beginning moderation.  As you listen to these five steps, consider how to implement them with your client. 

This is how I gave the five steps to slowing down to Georgia.

  1. Make your drinks last longer by sipping more slowly and by taking smaller sips.
  2. Allow time to pass between finishing one drink and starting the next.
  3. Put your drink down between sips.  Georgia benefited from this step in that she was used to holding a drink.
  4. Have a nonalcoholic beverage between drinks. 
  5. If you like your drink chilled, keep it fresh by adding ice or cooling it instead of gulping it before it gets too warm.
  6. Do something between drinks.  Georgia filled time between drinks with phone conversations with friends.  Your client may wish to dance, have a snack, or chew gum.

Consider your client. Could hearing Georgia’s example of implementing the three aspects of slowing down benefit your client?  Would playing this track be beneficial in your next session?

On this track we discussed the moderation tool of slowing down.  Three aspects of slowing down are types of drinks, making it last, and spacing drinks.  We also summarized slowing down in five concise steps. 

On the next track we will discuss affirming progress through rewards, self agreements, and his progress partner.

Peer-Reviewed Journal Article References:
Cho, S. B., Su, J., Kuo, S. I-C., Bucholz, K. K., Chan, G., Edenberg, H. J., McCutcheon, V. V., Schuckit, M. A., Kramer, J. R., & Dick, D. M. (2019). Positive and negative reinforcement are differentially associated with alcohol consumption as a function of alcohol dependence. Psychology of Addictive Behaviors, 33(1), 58–68.

Lewis, M. A., Neighbors, C., Geisner, I. M., Lee, C. M., Kilmer, J. R., & Atkins, D. C. (2010). Examining the associations among severity of injunctive drinking norms, alcohol consumption, and alcohol-related negative consequences: The moderating roles of alcohol consumption and identity. Psychology of Addictive Behaviors, 24(2), 177–189.

Marczinski, C. A., Stamates, A. L., & Maloney, S. F. (2018). Differential development of acute tolerance may explain heightened rates of impaired driving after consumption of alcohol mixed with energy drinks versus alcohol alone. Experimental and Clinical Psychopharmacology, 26(2), 147–155.

What are three aspects of slowing down drinking? To select and enter your answer go to Test.

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