We used to laugh at those zany friends and relatives who would make one too many trips to the holiday punch bowl and end up wearing a lamp shade by the end of the party. • Today, we know the destruction alcohol can wreak on families, marriages, health, the workplace and on the road. Today that fun party animal is encouraged to get help, stop drinking and join a group like Alcoholics Anonymous to help remain sober. • Many experts say that's still the best solution: Give up the booze and never, ever touch it again. But some are touting another option, one that's controversial because it suggests some problem drinkers maybe be able to continue drinking, in moderation. • "The majority of clinical programs teach or preach abstinence. If you have a problem with alcohol, you should stop drinking now and not drink alcohol in any quantity," says Dr. Patrick Marsh, an assistant professor of psychiatry in USF's Department of Psychiatry and Behavior Medicine. "But maybe there is middle ground." • The approach goes by many names. Moderation management is one of the most common. The goal is to set and stick to limits for alcohol use. Some people follow guidelines from Web sites and join online and local support groups. Others seek help from therapists willing to assist with this alternative form of therapy.
WHO'S A CANDIDATE?
The people who might benefit from moderation management are those who have not yet developed the physical, family, social, workplace or legal problems that often accompany alcoholism. Though not physically dependent on alcohol, they are concerned that they may have a problem because their drinking feels out of control at times.
Doctors call them at-risk drinkers.
"Moderation is a useful goal for a lot of people. But it is also a test at the same time," says Dr. Jon Grant, professor of psychiatry at the University of Minnesota.
"Part of the process is to let at-risk drinkers figure out how much control they have and how much they want or don't want to drink."
HOW IT'S DONE
Grant tells patients who want to try moderation to limit their drinking for a month or, better yet, try to go for a month without any alcohol.
"People with a drinking problem don't have the control that they think they have," says Grant.
If you can't stick to the limit you've established, then moderation probably isn't going to work for you. It's not going to help you to bring your drinking under control and prevent more serious consequences.
WHAT IS MODERATE DRINKING?
According to the National Institute on Alcohol Abuse and Alcoholism, moderate drinking is one drink a day for women and two drinks a day for men. One drink is one 12-ounce bottle of beer, one 5-ounce glass of wine, or 1 ½ ounces of 80-proof distilled spirits.
But moderation can mean different things to different people and groups. Moderation Management (www.moderation.org), an online self-help group for at-risk drinkers, suggests that drinkers practice three or four days of alcohol abstinence each week. On the days they do imbibe, the group suggests limits of no more than three drinks a day for women and no more than four for men.
RECOGNIZING THE PROBLEM
USF's Marsh says anyone who suspects they have a problem with alcohol should consider taking the CAGE questionnaire, which is widely used by physicians to help identify at-risk drinkers:
C: Have you attempted to Cut down on your drinking unsuccessfully?
A: Do you get Annoyed when someone talks to you about your drinking?
G: Do you feel Guilty for the consequences of drinking, such as missing work or family events?
E: Have you ever needed an Eye-opener, a drink to help you in the morning or to steady your nerves?
One yes answer to any of those questions and there's a 50 percent chance that you have an alcohol problem.
"Answer yes to two or more questions and your risk is in the 90 percent range," says Marsh.
WRITE IT DOWN
Keeping a written record of your drinking can help determine your risk for developing problems with alcohol. The more drinks you have on a single day and the more heavy drinking days you have in a week or month, the greater your risk for alcohol abuse and dependence.
Heavy drinking is defined by the NIAAA for women as more than three drinks in a single day, seven in a week, and for men as more than four drinks in a single day or 14 in a week.
A small amount of alcohol can actually be good for your heart, but routinely exceeding healthy limits is a powerful warning sign of potential trouble ahead.