In the city that never sleeps, it’s possible to drink from happy hour to last call, to keeping the party going at an after-hours or making a beer run to your 24-hour bodega, to a bottomless brunch (and so on). But let’s say you’re more of a “moderate” social drinker. What does that mean exactly? And how do you moderate in a city that seems to be all about excess (and all about drinking)?
No one wants to get granular here, but just for posterity, we will. According to the Centers for Disease Control and Prevention (CDC; 2022a), the current U.S. dietary guidelines for women are one alcoholic drink or less per day, and two drinks or less per day for men (due to differences in body chemistry and metabolism; CDC, 2022b). Even moderate drinking can have negative effects on the brain, liver, heart, pancreas, and immune system, and increase the risk for various cancers including breast, colorectal, liver, and esophageal (CDC, 2022b). This is in addition to potential external consequences resulting from impaired decision making when under the influence – everything from missed workdays to accidents/injuries to increased risk of STI’s and sexual violence (CDC 2022a).
Like any coping mechanism, there are many reasons we drink alcohol. PET scans show that that glass of wine or shot of tequila releases endorphins, which subsequently bind to opiate receptors in our brains (Merz, 2017). As a result, we feel more relaxed, more social, and get a quick mood boost (Merz, 2017). Pair the molecular-level changes with social and cultural norms, and you get a powerfully seductive combo. Alcohol tends to play an integral role in everything from parties to dates to weddings to concerts to sports events to dinners out to unwinding after work. So, what exists in the liminal space between instant gratification and long-term negative health effects? Fun? Spontaneity? Bonding? Bad ideas? Tears? Anger? Hangovers? Breakups? Sunday morning subway ride of shame with disapproving church ladies? DUIs? All of the above can be true. How do we gauge when things are getting out of control – especially in a context (and city) where excessive drinking is often normalized?
Alcoholics Anonymous (AA) provides a brief self-assessment that can help you get a sense of whether your drinking has become problematic: https://www.aa.org/faq/am-i-alcoholic. The organization stresses that “only you can decide” (AA World Services, Inc., 2024). While moderating your drinking (a “harm reduction” approach) may work for some, others may find that one drink is a slippery slope–and the last thing on your mind is moderation. Sobriety may end up being the right approach – and the good news is, there are plenty of resources and support available here if that is the route you want or need to take.
If you or a loved one need help urgently with an alcohol/drug-related or other mental health crisis (the two often co-occur), the Substance Abuse and Mental Health Services Administration provides a 24/7 helpline: https://www.samhsa.gov/find-help/national-helpline. Through SAMHSA, you can get referrals to local treatment facilities, support groups, and community-based programs. On the NY Intergroup website: https://www.nyintergroup.org/ you can find a list of hundreds of AA meetings, both in person and on Zoom, every day of the week. These meetings are free and if you are not sure if you are an alcoholic but want to get a feel for what a meeting is like, you can attend an “open” meeting. The only requirement to attend a “closed” meeting is a desire to stop drinking.
While you may have a misconception that AA is some sort of unbearable, sad sack, time out for crusty old drunks, the reality is, there are people of all ages, from all walks of life, telling their stories, laughing, crying, cringing, and everything in between. There are all different kinds of meetings, so it’s possible to try out as many as you like and find one that feels right. It’s whatever works for you and while the 12 steps reference a higher power (of your choosing), there are agnostic/atheist groups too.
If you are questioning whether your drinking (or other substance use) is a problem and just want to talk to someone about it, therapy is a great place to do so! We can look at your drinking habits and the thoughts, feelings, and behaviors/consequences that surround them from a place of compassionate curiosity. We will also explore your context – family history, social, environmental, etc, and give you tools and skills to manage difficult emotions (you know, the kind that make you want to drink). As therapists, we are not here to judge you or tell you what to do – we’re here to assess and discover with you, so that you can make the best decisions for yourself. This is not always fun or easy, but it is ultimately rewarding when it brings you closer to what is most meaningful to you and to living your life from a place of authenticity, self-acceptance, and self-love. Bottom line is, if you become aware that the drawbacks of drinking are beginning to outweigh the benefits and you are willing to face that, you might find that alcohol loses its power, kind of like the man behind the curtain in the Wizard of Oz.
Alcoholism is a progressive disease. It might start out that only like 1 in 10 times you are suffering the consequences of drunk/high decision-making, but over the years those scenarios can progress to depression, isolation and anxiety so debilitating it almost kills you. Often when you are drinking, you are not accepting your experience as it is. You are either amplifying it, or numbing it, or completely obliterating it, which is a temporary fix. It’s not always easy to accept your experience as it is and be fully present for it as you are, but when you realize that alcohol is always going to be everywhere you go in this city and you don’t need it anymore, it is truly the best party trick there is.
References
Alcoholics Anonymous World Services, Inc. (2024). Am I an alcoholic?. https://www.aa.org/faq/am-i-alcoholic
CDC. (2022a, April 19). Dietary guidelines for alcohol. https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm
CDC. (2022b, October 17). Excessive alcohol use is a risk to women’s health. https://www.cdc.gov/alcohol/fact-sheets/womens-health.htm#:~:text=After%20drinking%20the%20same%20amount,of%20alcohol%20compared%20with%20men.
Merz, B. (2017, July 14). This is your brain on alcohol. Harvard Health Publishing. https://www.health.harvard.edu/blog/this-is-your-brain-on-alcohol-2017071412000