Ask an Expert: Can I Ever Drink Again?

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Ask an Expert: Can I Ever Drink Again?

By Arnold M. Washton Ph.D. 10/11/16

Our expert discusses the variables involved in making the decision to drink again after a lengthy period of abstinence.

Image: 
Black and white photo of a man drinking a foamy drink out of a glass.
Don't get too excited.

In my twenties I drank so heavily that I had alcohol poisoning a few times. Now I'm 50 and I want a beer! Is it true I'll definitely relapse or can I do some careful testing?

"Can I ever drink safely again?" is one of the most common questions that clinicians, especially those of us specializing in the treatment of substance use disorders, hear from clients with a history of significant drinking problems who have managed to abstain from alcohol use for weeks, months, or even years. There is no simple answer to this question. None of us can say for sure whether moderate or less risky/harmful drinking is a realistic or attainable goal for anyone with a history of problematic drinking. Research does seem to indicate that, in general, chances of succeeding with moderation might be better for those with less severe and less protracted drinking problems and those with higher levels of psychosocial functioning. But these findings, like all generalities, do not predict the outcome for any one individual. 

A professionally guided attempt at moderation is perhaps the best way to discover for oneself whether moderate drinking is a realistic and attainable goal. Before planning out a careful experiment with drinking for this 50-year-old who reports a few episodes of alcohol poisoning as a young adult followed by over 20 years of not drinking, it would be important to explore the reasons for not drinking for so many years and what motivates the current desire to drink again. This would include an in-depth evaluation of his/her prior substance use and related issues and particularly why now, after all these years of not drinking, does he/she want "a beer"? Since it is quite likely that the desire to drink again has been percolating (perhaps subliminally) in this person's mind for a very long time, it would be productive to engage him/her in an open non-judgmental discussion about the reasons for abstaining for so long, how this was accomplished, what have been the pros and cons of doing so, what might be the pros and cons of attempting to drink again, and how significant others view the prospect of him/her drinking again. 

The discussion should also include, of course, exploration of ambivalence about the prospect of drinking again, along with hopes, fears, and expectations about the likelihood of succeeding with moderation versus drifting (or plummeting) into full-blown relapse. As implied by the wording of the question, the stated longevity of sustained abstinence, and fears about relapse, it seems likely that this person has been conceptualizing his/her drinking problem as "alcoholism" within the traditional disease model framework. This might underscore the importance of discussing how expectations can influence outcomes and perhaps even more importantly that there are alternative models  (i.e., harm reduction) for understanding substance use problems that offer strategies for reducing the potential risks and consequences of drinking without abstaining completely. All in all, it would be very interesting to help this individual explore these various issues and empower him/her to make a well-informed decision about how to proceed.

Arnold M. Washton, Ph.D., is an addiction psychologist in private practice in New York City and Princeton, New Jersey. His practice specializes in treating executives, professionals, and other high-functioning adults for substance use and other behavioral health problems. He has also previously written in The Fix's Professional Voices column. Full bio.

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