I'll have the Crown & coke without the Crown... I guess.

May 27, 2008 8:45 PM

My doctor told me to quit drinking. I'm a moderate drinker (I think), but I'm having a difficult time with giving it up. Also, what do I tell people?

I'm being treated by a psychiatrist for anxiety disorder; specifically panic attacks. I'm taking 100 mg of Lamictal daily and .5 mg of Klonopin as needed (which is usually once every other day). The doctor's rationale is that people with panic disorder are susceptible to alcoholism via self-medication, and that the alcohol provides a temporary relief but actually makes the anxiety worse in the long run.

I'm 95 lbs and I average 3-5 drinks/week. It has fluctuated up to 7-10 when I was single and probably a bit more when I was in college (~10 years ago). I know there have been times when I had something of a problem. I used alcohol to curb my social anxiety, and while I never had any consequences from it (i.e. DUI, missed days of work, fighting), it became a habit. As soon as I'd get to the bar/party/whatever, I'd slam a drink as fast as possible in order to relax and get through the rest of the night.

Nowadays I'm engaged and we're pretty domestic. We don't go out much; I'll enjoy a beer or glass of wine at home with my fiance. He drinks less than I do, and his presence influences me to drink less than I normally would. When he's away on business, I drink more.

When the doctor told me not to drink, I was immediately angry and resistant although I didn't show it. I really, really didn't want to give it up. He suggested getting rid of all the alcohol in the house, and I haven't told my fiance about that part. My fiance said he'd been concerned about my drinking and that he was glad a doctor had pointed it out, but I think he's oversensitive to it given his family history. I also wonder if the doctor's religion (Islam) plays a part in his no-alcohol policy.

I don't know why I'm so resistant to giving it up. I quit smoking on a dime three years ago, and although I'm sometimes tempted, it's incontrovertible that smoking is harmful so it's fairly easy to resist. Not so with alcohol; I'm not arguing that it's healthy, but since I haven't experienced direct consequences from drinking, it's more difficult to resist.

My family are casual drinkers; there is no history of alcoholism. I don't know what to tell them when I visit. Alcohol is ever-present and I've never been known to refuse at least a glass of wine. I'm also not sure what to tell my friends when we go out; I can get away with ordering soda a few times, but eventually they'll wonder what's up. I am not keen on ordering a drink that looks like alcohol but isn't. Besides, I'm pretty predictable on what I drink and it's not easily camouflaged. I don't want the stigma of "recovering alcoholic" because I don't think that fits.

However... I miss drinking and it's only been a week. I can't really envision a life completely without it. I assume it will get easier, but any tips to smooth the path would be appreciated.

posted by desjardins to health (47 comments total)

I can't speak to what the doctor is telling you, but can you just tell your family that you're taking some kind of meds that alcohol interferes with?
posted by Airhen at 9:05 PM on May 27

I went from being a several times a week drinker, to the occasional bottle of wine, then to the occasional glass of wine, then eventually to a place where alcohol doesn't really make sense to me now except for as a solvent. I never had any medical or personal issues with alcohol consumption, it just seemed natural to let it go. The sense of missing or "needing" a drink seems kind of alien now.

But if you have issues with your doctor's opinion, you can always go consult another doctor.
posted by Burhanistan at 9:09 PM on May 27

I'm 95 lbs and I average 3-5 drinks/week. It has fluctuated up to 7-10 when I was single and probably a bit more when I was in college (~10 years ago).

Something doesn't add up between the quantity you describe and your fiance's concern.

3 to 5 drinks per week is not an excessive amount, even for someone your size. Indeed, a glass of red wine with dinner daily is considered beneficial. Unless your seriously underestimating your intake, or you're giving us a best case example, I don't see any hints of alcoholism in your description.

The behavior your describe from your college days sounds fairly typical of most people. Alcohol is certainly a social lubricator, and while feeling that you have to drink before you can socialize doesn't sound that healthy, it seems like this was something you did in the past.

Questions you should ask yourself include issues around binge drinking, black outs, lost memory, drinking to get drunk and the like. You can google around and find plenty of alcoholism warning signs to compare yourself with.

Your doctor is certainly prejudice against alcohol and his prejudice obviously plays a role in his advice, however I feel like increasingly most doctors and health care professionals are cautioning people to drink less or none at all nowadays. This is in line with the reasoning that anything you put into your body which doesn't have a clear health benefit is bad. You'll have a hard time finding a doctor who says you should a Snickers twice a week too.

The only thing in your post that may give pause is your descriptions of feeling angry about the prospect of not drinking, or feeling like you don't want to ever stop. I believe that you may be over thinking your drinking at this point - it would be a common response to your doctor's advice.

If possible talk with a close friend about your drinking. See if other people have noticed a problem (with you.) Cross reference their advice with their own backgrounds and feeling about alcohol. You may find that your drinking is tame, or that you're going overboard and not realizing it.

Unless there is a danger of interaction with your medication, or you find yourself displaying serious alcoholic tendencies I'd keep doing what you've been doing: enjoying life, enjoying a drink every now and then.
posted by wfrgms at 9:11 PM on May 27 [1 favorite]

The doctor's rationale is that people with panic disorder are susceptible to alcoholism via self-medication, and that the alcohol provides a temporary relief but actually makes the anxiety worse in the long run.

For what it's worth, this was exactly my experience. I developed a whole bunch of weird anxiety problems at one point a few years ago (bunch of overlapping bad events happened, etc) and became aware that there was an uptick in my drinking which helped me with my other problem which was general insomnia and tinnitus. A doctor friend of mine suggested that self-medicating the anxiety issue by drinking (not terribly much but regularly) was actually exacerbating the problem it felt like it was helping solve, that it prolonged my anxiety and didn't help me deal with it. I was like "AAAAHHHHHH, I'll never sleep again" but I decided to really dial it back because I hated being unable to sleep and being sleep deprived and tense and irritable.

It was an annoying stretch of weeks [weeks, not months, in my case] but I really did feel that I came out of it better able to manage my anxiety and not just dull it and ignore it. I drink socially now, not that often, but it's very clearly in a different frame of mind than I did before and I just feel healthier about it. At the time I was CERTAIN there was no problem. Looking back it's OBVIOUS there was one, not a big one, but just a problem. My guess is that you don't have to quit drinking for life [I am not a doctor blah blah] but you need to readjust how you manage and deal with anxiety. I'd go int it that way and see what happens and how you feel after a month or two.

So, just a note about that. As far as what you tell people, you tell them either that your doctor suggested that you cut drinking out to "see what happens" and so you can approach it as a temporary thing if you think they'll be annoying about it, or you tell them that you're on medication and you can't drink with it (some anti-anxiety meds are like this, this is plausible) and thanks but no thanks and change the subject. Do not talk yourself out of doing this because you don't know how to tell people.

I do not mean to be a pill about this, but just note that in your description you seem really defensive about cutting out a habit that is just "a few drinks a week". If it's really the anxiety-relieving effects you may want to try something like exercise, sex or something else that just promotes a general feeling of well-being. If you're getting to the point where your fiance was concerned -- whether or not you think he's objectively oversensitive or not -- it's likely to be an issue on your ongoing relationship so probably a good idea to address, however you decide to do that.
posted by jessamyn at 9:14 PM on May 27 [2 favorites]

I'm not a doctor, but I find it hard to see your level of drinking as problematic. More to the point, I don't think you see it as a big problem - you don't seem all that convinced that you need to give it up. And, to be honest, if you're not convinced then you probably won't.

I don't think that feeling angry and resistant about the suggestion you should stop drinking is indicative of very much at all. Psychiatric problems tend to require enough lifestyle adjustments that taking away a few drinks a week can seem like another encroachment on your life.

Almost everyone who has a psychiatric diagnosis will be told not to drink at some point. Few of us actually stop drinking entirely. For me, being careful and aware of my alcohol intake is as far as I'm willing to go. I don't see anything wrong with compromising and deciding that you're willing to drink less, or only socially, or only with your family, or whatever. Or you could decide on a level of alcohol usage that you think would be a problem, then monitor your alcohol usage. If it looks like you're approaching it, you'll know to cut down.
posted by xchmp at 9:27 PM on May 27

I went through something like this once. I had just started dating someone who was a recovering alcoholic, so me smelling like alcohol was not good for him. I too had that sense of, "really? I'm never going to drink again?" But it did quickly become normal. I found the most difficult thing to be social engagements (I was in grad school at the time). I'd never before noticed how many invitations started with "let's go get a drink!" Worse, I didn't really enjoy going out with people when they were drinking. I would show up, have great conversation, and 45 minutes later be surrounded by people who were totally boring and dopey. People are really stupid when they drink -- it is really amazing. That's some commiseration, or encouragement, if it helps.

My other suggestion is that you consider what your psychology is around quitting other things. For me, having anything "off limits," or quitting anything cold turkey, sets off a "goody two shoes" / "rebel" cycle that would ensure I'd go back full force 10 months later. I have luck quitting things when I taper off and tell myself the occasional exception is okay. (I don't want to contradict a doctor's advice, but perhaps 90% compliance is better than 0%. Or perhaps not, if it really is about how you deal when the going gets tough.) Best of luck.
posted by salvia at 9:28 PM on May 27

I quit drinking last year, for medical reasons as well, and it was a lot easier than I expected. I would just consider it a temporary thing to see if it helps, and then if in a few months you don't think it's had a beneficial effect, you can reassess. That's what I did, and I was both convinced by the results and also not really interested in going back to alcohol. You may have a totally different experience, but why not give it a try?

And don't worry about what to tell people - people are very accommodating.
posted by mdn at 10:02 PM on May 27 [1 favorite]

Alcohol is addictive, even in small quantities, not necessarily physically, but in the sense that it can be a mental crutch. We drink to celebrate. We drink when we're anxious. We drink to drown our sorrows. When you remove the crutch, by abstaining, suddenly our friend, our primary coping mechanism is gone. I would guess that is the resistance you are describing. Suddenly you're left having to fend for yourself without your security blanket.

You said you hadn't told your fiance everything the doc said, like removing alcohol from the house. Unconsciously, you are probably enabling yourself an out. If you don't tell him, then you feel you can keep an emergency stash around. If you do tell him, then you're afraid of a conflict if you absolutely have to have a drink. Think of how you drink more when he's away.

Telling you friends and family why you aren't drinking is the easy part. It's medical, plain and simple. Whether you tell them you have anxiety, or esophageal reflux, if you honestly tell them your doctor has recommended you abstain from alcohol, they will certainly understand.

desjardins, I am a recovering alcoholic. I can't say whether you are an alcoholic, or not, only you can determine that. For what it's worth, if you have described your complete experience and history, you are most likely just a drinker who has other thinking issues. What I can tell you about staying sober though, is that it does get better. It does get easier.

A week isn't long at all. That's why you're still missing it. Instead of thinking about not wanting to do without alcohol for the rest of your life, break the time down into parcels you can manage. When I went into recovery, I was taught to stay sober a day at a time. Anyone can handle that, right, even the most problem drinkers. Then when you wake up the next day, just tell yourself you made it yesterday, why can't you do it again today. If you really want a drink bad, sit on your hands, and tell yourself you can do it for the next hour, then the next ...

You mentioned not experiencing any direct health consequences with drinking. You are obviously still a young woman, ten years out of college. Should you ever find yourself in the throes of alcoholism, you should know it is a progressive disease. It gets worse and worse and begins eating away your body bit by painful bit. I know you will do the right thing and follow your doctor's orders. How do I know that? Because you came here and asked for help. That is a great sign that you want what is best for desjardins. But just in case, I will leave you with this story from my past in another AskMe thread.

Please feel free to MeMail, or email is in my profile. All my best to you.
posted by netbros at 10:12 PM on May 27 [4 favorites]

Well, even if you're not an alcoholic, getting rid of alcohol won't hurt anything. And the fact that you're taking medication could make alcohol more harmful then it otherwise would be.

You ought to try going without alcohol for a week and see how it goes.
posted by delmoi at 10:34 PM on May 27

I'm concerned, too, that this is such an issue for you. If it weren't an issue, this AskMe wouldn't exist, would it? I was very concerned that you describe your family as "casual drinkers" yet feel wary about saying you can't "refuse" a drink around them. Truly casual drinkers would be completely unfazed by someone saying "No thanks" or especially "No thanks, I'm on meds". It sounds to me like there's more pressure here than you want to admit to, and that isn't casual at all -- that's environmental low-level alcoholism, and a culture of "ever-present" drinking. Maybe it's functioning alcoholism, but it's an environment that encourages drinking so that there are opportunities to drink that are labeled as social obligation. That's not really casual drinking at all.
posted by dhartung at 11:04 PM on May 27

Something's not adding up here. I don't think both your doctor and your fiancé would be concerned about your drinking if it were really 3-5 drinks a week; that's only a beer every couple of nights, after all.

So, the question becomes: is it really 3-5 "drinks" a week like you'd get in a bar, or do you drink three to five times a week? If you make yourself a big, stiff martini, that'd be three or four 'drinks' right there, meaning your real consumption could be 20+ drinks a week. I would be very concerned if you were drinking that much.

The other thought is, and I'm sure you're thinking it too: the fact that it makes you upset and angry, and that you miss it that much, means there's likely at least the beginnings of a problem. I can literally go a month or more at a time without drinking, and don't even notice. I once had a sixpack sitting in my fridge for nearly a year. If the doctor said, "stop drinking", I'd shrug, probably finish off the three or four beers I have in the fridge, and stop.

If I went out socially, I'd stick with seltzer water or something, and if anyone asked, I'd say, truthfully, that it was doctor's orders. Nothing shameful in that.
posted by Malor at 11:28 PM on May 27 [1 favorite]

I quit a year ago having been a boozer my whole adult life, and part of my teenage life too - and definitely the part you have to work at is adjusting to essentially a new lifestyle. If you go into it knowing this, being aware - even though you're not an alcoholic - that booze has played a significant role in the framework of your life, then you're in a much better position. Conversely if you try to maintain the same lifestyle but remove the alcohol you're gonna find it tough. Simply, "you" are different from "you + booze". But "you + booze" also = "you + anxiety" so you're gonna have to suck something up either way. Me, I was in a similar boat, and trading the sauce for the absence of anxiety has been a pretty sweet deal. What do I tell people? "I don't drink." Why? "I got bored of it - I didn't want to do it any more." No-one's ever given me hard time over those answers.
posted by forallmankind at 11:32 PM on May 27 [1 favorite]

Wow, I really admire your honesty and straightforwardness here. It's a touchy subject with a lot of repercussions that must be hard to think about.

My intuitive hit is that quitting drinking - at least for now - could really be a good thing for you. Both your doctor and your fiance (the person you spend the most time with?) have concerns about how much you drink. You are stating that quitting drinking feels very difficult and not what you want to do. These factors make me think that alcohol may be beginning to impede your life in some way.

What if you made an agreement with yourself to quit drinking for six months. Six months isn't long in the grand scheme of things. you can still picture yourself happily having a glass of wine in a year, two years, ten years, etc. Would your quality of life be lowered by that six months of sobriety? It seems worth trying it to see if 1) your health and emotional well being improve when you stop drinking and b) if you are able to quit at all. Feeling unable to stop drinking for a few months is a pretty good sign of an alcohol dependency.

Please don't let the discomfort of dealing with social interactions stop you from making a change in your life. Or rather, don't let that become an excuse to stop doing something if that something is harming you. I know that in some crowds refusing a drink raises eyebrows, but I spent 10 years sober and in my experience, the vast majority of the time, a simple "no thank you" ends the conversation. If a friend or family member pushes I agree with the above commenters who suggest simply saying, "I'm on a medication that doesn't mix with alcohol" and changing the subject.

One other thing: quitting drinking is not easy. You've seen that already. It's fine to get help with it, and that help doesn't have to be AA or therapy if that doesn't feel right to you. But starting a practice that provides some of what alcohol has provided for you may make a difference. Taking up meditation, yoga, a new exercise regimen, or joining a new (less boozy) social group could all help take your mind off drinking. Therapy could also help - especially given the anxiety issues. If you do find that you are unable to quit, please get medical help or seek out a rehab group. Listen, going to one AA meeting doesn't make you "one of them". Even if you're not interested in quitting for life, folks who have quit alcohol might have some useful advice for you.
posted by serazin at 11:35 PM on May 27 [1 favorite]

If your psychiatrist and your fiancé both heartily endorse the idea of your giving up drinking, my guess is that there's something going on with the drinking that may be somewhat maladaptive for you and your happiness.

I think that you are right that it is very hard to directly experience both the negative effects of drinking and the positive effects of giving it up. One of the reasons for this is that alcohol short-circuits your brain wiring by acting directly upon neurotransmitters to produce pleasant feelings that are completely specious and artifactual. Another is just that insight is hard.

In your case, I believe the basic issue is trust. Do you trust your psychiatrist and your fiancé enough to go along with their advice even when you can't fully appreciate the reasons for it? Trust is hard - for some people, it is the hardest thing.

Good luck. I wish you well in your journey.
posted by ikkyu2 at 12:10 AM on May 28 [2 favorites]

Eh, I am somewhat skeptical of the ease with which North Americans cry "alcoholism!" with its implications of addictive doom and shame. I prefer to say "having more than is good for you."

I do notice you carefully write 3-5 drinks per week, with no figure per day. No one could quibble over a drink every day or two, but 5 at once is probably binge drinking for someone who doesn't weigh 100 pounds... that might well cause fiance concern.

For what it's worth, I am a regular drinker, but every now and then I have cut out drinking altogether for weeks and months at a time for weight loss or athletic reasons. The first week IS hard if you are used to a drink most days - I'm prone to having a glass or two while I cook dinner, and another one with. And for a few days, as dinner time rolls around, I get scratchy because all the cues are there, I'm tired and annoyed from work, and I feel like a drink, damnit. And other people drink around me, say after work on a Friday, and I feel left out.

After a week or two, that feeling wears off. Give it another couple of weeks.

Also, you say the doctor's theory is "people with panic disorder are susceptible to alcoholism via self-medication, and that the alcohol provides a temporary relief but actually makes the anxiety worse in the long run." If that theory is true, then that tends to explain your current feelings, doesn't it?

As to what you tell your friends and family, my advice is to say pleasantly but firmly "no thanks, I'm not drinking at the moment", so that nosy people will not inquire further. If they do, you say "it's kind of private" or "I'd rather not talk about it." This is an excellent opportunity to practice your death glare.
posted by i_am_joe's_spleen at 2:31 AM on May 28

The one part here I can speak to directly is the social aspect of not drinking when you are with drinkers, especially family.

My experience has been that explanations are almost never asked for, and are simply accepted as long as the explanation is brief and vaguely believable. Sometimes semi-friends will be pushy about it, but that's a pretty good indication that the connection is the drinking, and they are reacting to losing the only connection they have with you.

So saying things like "could I have water instead?" or "no thanks, not tonight" are usually all it takes. If asked "why?", something like "my doctor insisted no alcohol for right now" or "I'm just taking it easy tonight/this week/for right now" seem to end things for most people. Anyone who gets pushy about it is being an asshole -- it's their behavior that is problematic, not yours. You can give them real answers, but even "I have to not drink or my medication will kill me" will get an answer like "aw, have just one, I won't tell, ha ha." That kind of pushiness usually isn't ended with "because XYZ" answers; it takes diverting the conversation or just removing yourself. But again, that kind of conversation never seems to come from someone who genuinely likes you and respects you.

Lastly, my personal feeling is that it isn't always necessary to clearly delineate the boundary between alcoholic and non-alcoholic. Sometimes it is enough to say to yourself "I kind of have an issue with alcohol sometimes, and so the right thing is for me to not be drinking for right now." It doesn't mean you can't have a drink ever again in your life, but rather than you need to rethink your relationship with alcohol and the place it has in your life, and sometimes the easiest way to see that is to just take a break for a while. The language of alcoholism and addiction has a lot of baggage that can be both helpful and unhelpful; you can sidestep that by ignoring that question and just focusing on some of the details of your life over the next few weeks.
posted by Forktine at 3:21 AM on May 28 [1 favorite]

Why don't you discuss your feelings with your psychiatrist? That's what they are there for. You need to figure out whether you feel this way because you are getting defensive at being told what to do, or you are getting defensive at being told the truth.

hungrysquirrels, 3-5 drinks a day is too much. At least in this context, where the "x drinks a day" thing means every day. Three beers a night, every night, is not a good thing.
posted by gjc at 5:07 AM on May 28

You're having anxiety over drinking because your 'friend' alcohol, which you've used as a crutch (by the way, crutches help people with a bad leg actually walk - I don't mean it here as a bad thing...), is suddenly being denied to you.

Which of course, fuels your anxiety; because what happens when this new drug that you don't trust, doesn't help enough? How can you dial in the amount of reduction of anxiety based on the situation?

Two thoughts: one, seek some level of therapy beyond your physician. The med only approach isn't addressing the underlying causes of your anxiety. Second, ask your doctor, how exactly are you supposed to cope, when/if your anxiety increases in a given situation. The two of you ought to form some 'plan' or method that you can increase the levels of meds.
posted by filmgeek at 5:23 AM on May 28

Lots of great advice upthread, and I also agree that 3-5 drinks, if truthful, is not really worrisome (that's not even a drink every day - my experience with not-real-alcoholics-but-kinda-relying-too-much-on-alcohol-to-unwind people is that they'll need a drink every day after work).

The advice I wanted to add was re: what to tell other people - I regularly have "I'll stop drinking" phases and I always tell people I'm "on a healthy streak" (usually when I stop drinking I do also go on a health spree with more exercise, lots of fruit & veg, so that helps - and hey, that wouldn't do you any harm either since exercise is supposed to be great against anxiety).

If you do decide to stick with the "no alcohol" policy long term, you can tell people that you feel so much better / have better skin / [insert other beneficial effect] now that you're not drinking anymore, so you've just decided to live your life that way. Being slightly militant about it ("you should try it too...") helps as people will either be bored and change the subject - or maybe actually follow your advice!
posted by ClarissaWAM at 5:28 AM on May 28

Just trying to make a point about the 3-5 drinks a week not being much of a problem, but yes, definitely beware drinking daily. One doesn't expect to get dependent or addicted to it, but once it's being used to self-medicate for anxiety, it's far to easy to slip down the slope. Getting back up isn't easy, it's a slippery slope. I know from experience.
posted by hungrysquirrels at 5:31 AM on May 28

Also I agree with just telling people that you don't want to drink. While it's normal for people who usually see you drink to wonder why you stopped, and it's normal for them to ask, it's also completely normal to say "I'm trying to cut down" or "I don't want to right now." On one hand, it's none of their business. On another hand, what do you care what they think? On a third hand, sometimes it creeps people out about their own issues with alcohol when they see someone else not commiserating with them. (Note the root word of commiserate - misery)
posted by gjc at 5:48 AM on May 28

The solutions to your social problems seem pretty straightforward ("My doctor said it'd mess up my medications"), unless nobody knows that you're seeing a psychiatrist. Even if that is the case, you can still say something like "I've found that drinking makes me anxious and I'm stopping to see if it helps me feel better."

I know the fear of the pushy people who say "come on, just one." You just have to be prepared to say no. Often. Stick up for yourself. Offer a reason once, maybe twice, and then just say no. No no no no no.
posted by that girl at 5:51 AM on May 28

If you decide you want to quit, and need a simple excuse for social situations: blame medicine.

There are lots (lots!) of drugs that should not be taken with alcohol. Even common ones, like Tylenol.

Most people avoid delving into the medical histories of acquaintances, so saying that you're not drinking because of something you're taking is a pretty effective way to shut down their questions. Well, in my experience, anyway. YMMV.

It works better if you say it in a way that conveys an unwillingness to discuss matters further (eg: say it quietly, and insert a pause, like you're searching for the right word -- "Well, due to some.....things I've been taking, I'm not supposed to consume alcohol"). Using words like "consume alcohol" rather than "drink" helps too.

And, best of all, you're not really lying. I have not used this tactic in relation to alcohol, but I have used it quite successfully in other areas.
posted by aramaic at 6:28 AM on May 28

I agree that 3-5 drinks does not necessarily make you a problem drinker, so if you look at this like it's not a permenant thing, maybe that will help.
What I can tell you from experience is if I drink more than one drink per week OR TWO, it interferes with my meds. I take meds for depression, not anxiety, but pouring pretty much any amount of alcohol on top of them seems to undo any benefit whatsoever. It took a long time for me to figure that out, too, so in your shoes I would be grateful that the doctor is telling you up front. Granted, most meds say don't mix with alcohol, but none of them say 'don't mix with alcohol or they just won't freaking work'. Which for some reason, is much more effective. :)
posted by 8dot3 at 6:33 AM on May 28

1. If you are reluctant to give it up, that's a problem. This means you are past "take it or leave it".

2. I'm not a drinker. Once you leave college, few people care if you drink. Of those that do care, many of them are alchoholics who are offended that I don't drink.

3. There is no question that alchohol is a) bad for you physically; b) bad for you mentally. All the physical benefits of red wine can be found in the grapes themselves, and all the mental benefits of "relaxing with a drink" should be found elsewhere, from yoga to exercise to meditation to vegging out on the sofa in front of the TV.

4. Trust your doctor, and trust yourself. "I don't know why I'm resistent..." is your self awareness trying to tell you something.
posted by ewkpates at 6:34 AM on May 28 [1 favorite]

Putting aside your fiance's concerns for the moment, I think it's important to note that from your description, your doctor's not advising you to give up drinking because he thinks you're an alcoholic, he's advising you to give up preemptively give up drinking because it's his opinion that alcohol negatively affects long-term treatment of anxiety.

If I were advised to give up drinking in your circumstances, I'd be frustrated and angry too. I'd feel like I was being unfairly punished, and that possibly the doc didn't believe that I wasn't drinking more than I reported. If this is how you feel, you should discuss it with your doctor.

As for what to tell your family, I agree that you don't need to make any grand statements about Giving Up The Sauce. Just say that you're going on the wagon for a little while as an experiment to see if it helps you with some anxiety. (A word of caution -- if you're too vague about why you're refusing that glass of wine, they're going to assume that you're pregnant.)
posted by desuetude at 6:54 AM on May 28

A few points from the inside:

Most physicians, if they suspect an alcohol problem, take any admission by a patient of alcohol use to represent a fraction of the actual amount used.

The fact that you responded with anger and resistance to his suggestion, combined with your inability to envision life without alcohol, would be a strong signal to a physician of dependency.

Physicians also get nervous about medications that decrease breathing effort; Klonopin and alcohol both do that at sufficient doses. Usually either one in a typical dose is very safe. However, no one wants to be sued by a husband because he gave a potential alcoholic a benzodiazepine sedative and now she's a vegetable. NB: from the physician's perspective it only matters that she is potentially an alcoholic, that there's a potential for mixing, and that there's a potential for a lawsuit.

As for politely declining offered drinks, it should suffice to note that you're on a medication that could interact badly with alcohol. A vanishingly small number would challenge you on this.
posted by adoarns at 7:37 AM on May 28

One of the things about alcohol is that humans do not have insight into their own dependency. We are amazing at our ability to rationalize and avoid thoughts. Two of the four typical alcohol dependence screening questions are about the reactions that you are talking about. First, that you get annoyed or angry when other people comment on drinking. Second, that cutting back is very hard, or that you've failed when attempting to do so.

It sounds like you required alcohol to deal with social stress. You say that you'd immediately have a drink, but not how much. Even if you're not drinking too much right now, your doctor might be worried that when a very stressful situation comes up you will turn to significant alcohol. Mentally being a non-drinker ahead of time might help you avoid that.

Most people are horrible at estimating how much they drink. An experiment that your fiance would probably be happy to conduct is that you not pour/get yourself any alcohol for a month. You just ask him, and he's your waiter. Saves you from getting up/waiting in line, and puts the responsibility (and ability) on someone else to keep track for the month. I remember when I really tried to figure out how much I was drinking; I was astonished by how much higher it was than I thought.
posted by a robot made out of meat at 8:38 AM on May 28

Thank you for all your answers. I've just gotten back to this thread now and am reading through the responses.

Just to clarify - I am being completely honest when I say I have 3-5 drinks a week, spread out over a week. For example, last week I had one beer on Sunday while having lunch with a friend, and two beers with pizza at home on Thursday. The week prior, I had two martinis while out with friends, and a glass of wine while having dinner with my parents.

The last time my fiance was out of town, I drank 1/3 to 1/2 of a bottle of Crown Royal (with Coke) over the course of 7 days (alone, at home). He was concerned that the bottle was empty when he returned. I'm not excusing it, but one contributor was that the birthday of my cousin (who committed suicide a year ago) fell within that week. Certainly there would have been better ways to handle my grief, but there you are.
posted by desjardins at 8:40 AM on May 28

If you are reluctant to give it up, that's a problem. This means you are past "take it or leave it".

I'm not so sure about this one. If someone told me I had to give up cake, I'd be pretty damn reluctant. That doesn't mean I'm addicted to cake. That doesn't even mean I have a "problem" with cake. It just means that I really like cake.
posted by Evangeline at 9:16 AM on May 28

I am the same size as you and drank about that much until I got too broke to drink. Anyway, it was very much not a problem for me. In fact, I drank less than most of my peers.

The main concern is the mixing of the meds and the drinking. I used to be on a very small dose of anti-anxiety meds for a short time and even drinking a tiny amount could get me wasted. It did save me a lot of money (just kidding, I rarely drank during that time).

Get a second opinion if you're concerned. I would if I were in that situation because it seems like a pretty extreme thing. Like saying to get all the alcohol out of the house as if you have a serious drinking problem.
posted by fructose at 9:46 AM on May 28

I don't think any determination of alcoholism is possible just by looking at the number of drinks someone has. It's not the quantity that one consumes but the drinker's relationship to that quantity. Plenty of people can drink every night and not be considered an alcoholic (though I'm guessing it's not super common)- it's about the ability to *stop* drinking when there are consequences to the behavior. On the other hand, someone who drinks 3-5 times a week and is *dependent* upon those 3-5 drinks and is freaked out by the thought of stopping, and continues to drink in the face of consequences (anxiety, deterioration of personal relationships, bad physical health) might want to re-consider the role that alcohol plays in their life.
posted by otherwordlyglow at 9:49 AM on May 28

You're female, young, in a long term relationship and may quit drinking alcohol? It doesn't matter what you say, people will assume you're pregnant anyway.
posted by Lebannen at 10:01 AM on May 28

I didn't read the above responses thoroughly. I am on Lamictal and have been on Klonopin regularly in the past, for similar reasons that you were (panic attacks and general anxiety).

1. No one here is qualified to tell you that you shouldn't listen to your doctor.

2. Alcohol and Klonopin don't mix. Klonopin has sedative effects. So does alcohol. I woke up to find my partner watching me to make sure I was breathing. Not fun. Terrifying, in fact.

3. I thought I might be an alcoholic because it was so, so hard for me to give up alcohol. I'm like you--smoked for a few months and then quit smoking in a second, no real problem doing so. Alcohol was different. I had become a sort of situational alcoholic because the anxiety and panic attacks and the alcohol were a way of life for a long time. Not just a habit, like smoking, but a real lifestyle that involved my friends and my partner. So I'm not surprised it's a struggle for you, and I respect you for getting help. I think I would have had a much easier time if I'd gone to AA, but I didn't, and I was still able to quit.

4. When I quit drinking, no one cared as much as I thought they would. I live in NYC, there is a bar on every corner, and the majority of my social life revolved around drinking, happy hours, bar nights. Everyone I told that I quit drinking respected my choice. I told them the truth--I was having a lot of trouble with panic attacks and anxiety, I was on meds, and I needed to quit drinking. At my birthday party, which was soon after I decided to quit, everyone competed to buy me the wackiest non-alcoholic drink.

5. I haven't lost friends, I've gained them, because I can be a better friend now that I'm healthier. I did have to jettison one friend who was always pressuring me to drink. That was really scary, but she was a negative force in my life anyway (super insecure, always talking shit and being rude, etc), so it ended up for the better.

Whatever you decide, good luck. Anxiety sucks! It sucks a lot. I'm glad you've taken steps to get healthy.

Good luck!
posted by sondrialiac at 10:53 AM on May 28

Oh, and if you don't want people to assume you're pregnant, tell them "I'm not pregnant." I did this after announcing a rather unexpected elopement. It worked for me!
posted by sondrialiac at 10:57 AM on May 28

Drinking at that low level is pleasurable, and it sucks to give up a pleasurable activity. Focus on the benefits of taking an alcohol vacation. That glass of wine/beer/margarita will still be there in 3 months.
posted by theora55 at 11:18 AM on May 28

desjardins, not to pile on, but your meds don't go with alcohol. You need to stop drinking.

When I read this:

"I drank 1/3 to 1/2 of a bottle of Crown Royal (with Coke) over the course of 7 days .... I'm not excusing it, but one contributor was that the birthday of my cousin (who committed suicide a year ago) fell within that week."

I see what you doctor is concerned about. You are self-medicating with alcohol.

Recommendation: trust your doc - don't mix meds, drop the alcohol.
posted by zippy at 11:20 AM on May 28

I don't see how there could be anything wrong with taking the advice here and going back to your doctor with your conclusions or decisions. For what it's worth, martinis are heavy drinks. I weigh well upwards of 200 lbs and two martinis is quite a buzz, three is probably wasted. I dunno where you got served but most martinis I see are at least doubles, just look at a martini glass full of straight gin.
posted by Wood at 11:31 AM on May 28

I'd like to suggest that although the amount (3-5 drinks per week) you are drinking does not necessarily suggest a drinking problem in itself, what your doctor and your fiance may be reacting to is your attitude toward those drinks. My husband is not a heavy drinker, but he makes me very uncomfortable when he drinks. Drinking works for some people but not for others, and you may simply be one of the ones for whom it doesn't work.

As for what to tell people, I think the best long-term excuse is that it interferes with your sleep.
posted by HotToddy at 2:11 PM on May 28

I'm currently undergoing treatment for anxiety (PTSD, as it happens). I'm also 'dry', as it were. This is annoying, since I really really like red wine and a fine single malt. When I'm stressed, a glass or two is a wonderful relaxant also.

The shrink has told me to cut out alcohol, pretty much. For the same reasons as you outlined above. Personally, i feel a bit cranky about this, because when I want a scotch, I want a scotch, dammit. It doesn't happen more than about once a month, but still.

Sigh. The shrink assures me it's temporary. No more than a year or so. But damn, it's annoying.
posted by ysabet at 3:41 PM on May 28

If you are reluctant to give it up, that's a problem. This means you are past "take it or leave it".

This is silly. Why even indulge in something at all if you are completely indifferent to it? The fact that she enjoys something and is disappointed that she can't have it anymore doesn't mean she has an unhealthy relationship to it. Especially given that some people seem to be overly suspicious of alcohol, it isn't completely crazy to question whether their advice is well-grounded.

As I said above, I think taking temporary time off and judging for yourself is the best bet. I always thought drinking was important to my social life, but now that I don't do it, it seems pretty obviously secondary. People are important to my social life, but it turns out not be a big deal holding a tonic water.
posted by mdn at 4:48 PM on May 28

I think you think it's silly because you don't get it.

Do you have to have birthday cake at least once a month to be happy? Once a week? Once a day? Do you count the days since you last had birthday cake? If you went to a birthday party and they served "ice cream cake", would you be really disappointed? Do you buy birthday cake and take it home and eat it by yourself?

birthday cake. I can take it or leave it.
posted by ewkpates at 6:26 AM on May 29

ewkpates, you've already said that you're not a drinker, so perhaps you don't get why people enjoy alcoholic beverages aside from the inebriation, but really, most people who enjoy wine or beer or cocktails or all three aren't fooling themselves into choking down a vile liquid in anticipation of the joy of slurred speech -- there really is pleasure the tasting.

Anyway, if you replace the words "birthday cake" in your above comment with "chocolate" and replace "ice cream cake" with any non-chocolate dessert-like thing, you'd have a common scenario sans hyperbole.
posted by desuetude at 7:15 AM on May 29

birthday cake isn't woven into life, though. What about coffee? Would you be disappointed if you were told you could never have coffee again? Or what about tea or kittens or Metafilter? :) Would you be sad if you were told you could never have these things again? Does that mean you have an unhealthy addiction to these things? Maybe you just enjoy your daily coffee and consider it a good start to the day. I don't think that has to be indicative of something bad. It could just be that you've found something you really like.

Addiction is a complicated concept, and it's possible that the OP would want to categorize her relationship as addictive, but I'm just saying, being disappointed that you have to give something up is not automatically indicative of something being wrong.
posted by mdn at 7:16 AM on May 29

[please take addiction discussion to email or metatalk, it's not answering the OPs question and getting a little off-topic, thank you!]
posted by jessamyn at 7:24 AM on May 29

Stop trying to envision a life completely without it. I think that kind of thinking is usually a tactic of the habituated aspect of your mind that pushes you away from abstinence. Unless you've left out some pretty serious history, there's no reason to believe you're going to end up abstaining from alcohol forever, but it seems like trying going without for a while is a reasonable suggestion.

You suggest a raft of personal issues with alcohol - none acute, but still it's a handful. If I read you right you're fighting a panic attack every other day, on a new medication regimen, giant life change coming up. Keep at it longer, determine if you feel better. Tell your fiance about your Doctor's suggestion: he ought to stop with you for the time being, it will be easier. When you reintroduce alcohol do so deliberately (as opposed to impulsively), start slow and be honest with your doctor about it. If you have trouble doing any of these things it's worth taking a second look at why (and talking to your fiance and doctor about these feelings, if it's the sort of doctor relationship where you talk about your feelings, and if not, maybe you should be talking to some doctor about your feelings).

As far as what to tell people, you don't have to tell them anything. You can just say you don't feel like it or you're taking a break, or be however honest and specific as you are comfortable with. I started out as basically a teetotaler for many years: people don't really notice or care that much. If you are non-dramatic about it people will forget about it and stop paying attention.
posted by nanojath at 1:44 PM on May 29

To put that half bottle of Crown Royal into perspective, a half bottle of strong liquor works out to about 14 UK alcohol units. 14 units per weeks happens to be the upper limit of the accepted guidelines for weekly alcohol consumption for women. It's slightly over the US guidelines, but not by much. A third of bottle would be well within the US guidelines. Both assume that it's not being drunk all at once.

I'm not saying that it's a good idea to do this on a regular basis, or that it's a good idea for the original poster to do this. But a third to half a bottle of alcohol spread out over the course of a week isn't a particularly large amount. Drinking a glass of wine per day can amount to more alcohol (depending on the wine and the size of your glass).

Regarding the alcohol + klonopin thing, people are variable and the OP is probably in the best position to know whether a moderate amount of alcohol in combination with her medications causes problems for her.
posted by xchmp at 10:34 PM on June 2