Preventing Alcoholism

The majority of people in the United States over 18 have used alcohol at some point. 1 It is estimated that 26% of adults over the age of 18 have engaged in binge drinking in the past month.1

The prevalence of alcohol use and misuse contributes to a high occurrence of alcoholism, or alcohol use disorder (AUD). About 8.5% of adults have struggled with AUD.2
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Know the Risk Factors

Several factors contribute to the chances of developing an addiction to alcohol. Fifty percent of the risk is genetic and 50% is environmental.3 Environmental risks are those you are exposed to after birth, such as family life, childhood experiences, your social circle, and when you first were exposed to alcohol.4,5

Common risk factors for developing AUD include:5

  • Having a family history of AUD
  • Having a mental health disorder or a family history of mental health disorders that are associated with co-occurring substance use, such as depression
  • Having adverse childhood experiences4
  • Experiencing significant trauma or abuse
  • Starting drinking at an early age4,6
  • Having a social network that drinks heavily
  • Drinking heavily regularly for an extended period of time4,5
  • Having been an active-duty military member
  • Lacking healthy coping strategies
  • Lacking healthy social support or having significant interpersonal problems
  • Experiencing significant stress

Use Safer Drinking Practices

If you do choose to drink, there are things you can do to drink more safely.

Although no alcohol use is completely safe, some things you can do to lower your risk of alcohol-related problems are:

  • Drink only with those you trust
  • Eat before you drink
  • Consume drinks poured only by you or a bartender
  • Have one standard drink or fewer per hour, as that is what the liver can handle. A standard drink is defined as:6
    • 12 oz of beer or wine cooler
    • 8 oz of malt liquor
    • 5 oz of wine
    • 5 oz of hard liquor
  • Alternate between alcoholic drinks and non-alcoholic drinks
  • Always keep some drink in your glass to keep others from refilling it
  • Avoid shots and drinking games as they can encourage binge drinking. Binge drinking is defined as: 7
    • Four or more drinks per occasion for females
    • Five or more per occasion for males
  • Always have a designated driver
  • Plan your drinking using a blood alcohol content calculator8

Use Active Coping Strategies

Alcohol misuse often begins as a coping strategy when an individual has not developed a tool kit of healthy, sustainable coping skills. Prolonged alcohol misuse can develop into physical dependence or AUD.

This practice of using alcohol to distract yourself, manage feelings of sadness or anxiety, help yourself sleep, or feel more comfortable in social situations is clinically known as “self-medicating.” An individual may be more vulnerable to self-medicating with alcohol if they have experienced neglect or abuse, trauma, stress, or mental health symptoms. 2

While alcohol can provide temporary relief from some negative feelings or symptoms, using alcohol as a coping mechanism is associated with worsening depressive symptoms and an increased risk of developing AUD. 2

Replacing alcohol use with active coping mechanisms can reduce the psychological symptoms you experience and reduce your risk of alcohol misuse and related issues.2

Examples of active coping strategies to help prevent alcohol misuse include:

  • Avoiding places and events where alcohol will be present
  • Investing your attention in an activity that requires all of your concentration for a period of time
  • Performing a self-care task that you need—like taking a shower—or enjoy—like cooking your favorite food—to combat feelings of guilt, shame, or worthlessness
  • Surrounding yourself with people who do not use alcohol or drugs
  • Using your senses to ground yourself in the present moment and calm feelings of numbness and anxiety
  • Challenging negative thoughts, such as by considering how you would respond to a friend who told you that they felt the way you do now about themselves or their situation
  • Using movement, laughter, or other physical sensations to provide a release of feelings of anger and fear
  • Finding purpose through helping someone else, smiling at a stranger, engaging in your religious or spiritual practices, or joining a cause
  • Developing close, healthy relationships with your peers9
  • Attending support groups10
  • Learning about AUDs and the experiences of those with AUDs

In addition to using active coping strategies to reduce your alcohol use, seek help for any underlying issues that have led you to use alcohol as a coping mechanism in the past. You may find healing and learn new coping skills in support groups for people with similar experiences, in therapy, and in treatment for AUD.

Utilize Therapy

Seeking therapy is an important proactive step for prevention. Therapy is not just for someone who has already developed AUD.11

Therapy can help you identify and address your risk factors. Some examples of therapy goals you could have are:12

  • Connecting with your inner child and re-parenting13
  • Increasing self-esteem
  • Improving communication skills
  • Strengthening relationships
  • Increasing a sense of control over your life14
  • Making peace with past adversity
  • Preparing for adjustment back to civilian life after active-duty military service or back to everyday life after an inpatient treatment program
  • Learning how alcohol affects the body and what your limits are
  • Learning healthy coping strategies

Therapy can consist of individual, group, couples, or family therapy. You may decide to utilize several types of therapy or even to see more than one therapist to take advantage of their specific expertise.

A few common therapy modalities used to address the risk factors that lead to alcohol misuse include the following.15

Cognitive Behavioral Therapy (CBT)

CBT involves identifying the thought patterns associated with your distress and maladaptive behaviors and working to help you alter those thought patterns. CBT is effective for different types of mental health conditions, including anxiety, depression, impulse control disorders, and substance use disorders.

Prolonged Exposure (PE) Therapy

PE is a type of CBT treatment that involves revisiting trauma in a safe clinical setting. This can help someone unlearn their reactions to traumatic memories, making triggers related to those memories less distressing, and learn how to navigate future stress-inducing situations.

Eye-movement Desensitization and Reprocessing (EMDR)

EMDR is recommended for treating trauma. In EMDR, the therapist uses bilateral stimulation—visual and/or audio cues that move back and forth, such as eye movements, taps, or tones—during recall of traumatic events. The theory behind EMDR is that focusing on other stimuli while recalling trauma helps the brain to reprocess the experience so that it is no longer as disruptive to a person’s life.

Interpersonal Psychotherapy (IPT)

IPT has been shown to be effective with depression and trauma-related issues. IPT involves exploring feelings and behaviors to learn how to communicate them to others. It can help strengthen relationships and help to build social supports.16

It is common for therapists to integrate a few different modalities in their work based on their specialties and each client’s unique needs.

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Understand Prevention as a Parent

Most people with alcohol-related concerns begin drinking in their teenage years and young people are much more likely to binge drink when they do drink.17

However, just because someone drinks as an adolescent does not necessarily mean they will drink heavily as an adult or develop AUD. Drinking in adulthood is associated more closely with having anxiety and depressive symptoms than with alcohol use at a young age. Treating these symptoms decreases the risk of alcohol misuse. Individuals who use mental health services in adolescence are less likely to use substances in older adolescence and adulthood.18

Substance use in teens and young adults has also been shown to be related to students who:19

  • Put a lot of pressure on themselves to succeed
  • Use ineffective coping strategies
  • Have less closeness with parents

It is not uncommon to worry that kids might be more influenced by their peers when it comes to drugs and alcohol. However, parents can have a greater influence on their kids if they have close and trusting relationships with them.20

Some things you can do for the prevention of alcohol misuse in your child are:20

  • Do not allow your child to drink, even at home and in your presence
  • Establish rules, communicate them clearly, enforce them consistently, and have appropriate consequences for breaking the rules
  • Model using healthy coping strategies
  • Model safe drinking practices
  • Have frequent, open, honest, and age-appropriate conversations about alcohol use
  • Always know where your kids are and make sure they have adult supervision in situations where there is a high risk of alcohol misuse
  • Seek therapy for your child if they struggle with extreme perfectionism or mental health symptoms, impulse control, or other behavioral issues
  • Seek counseling or therapy if you feel you need help with parenting

If you are concerned about your alcohol use or that of a loved one, call 800-839-1686Who Answers? for 24/7 help.

Resources

  1. National Institute on Alcohol Abuse and Alcoholism. (2021). Alcohol Facts and Statistics.
  2. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed).
  3. Szalavitz, M. (2015). No more addictive personality. Nature, 522, 48-49.
  4. Anda, R.F., Whitfield, C.L., Felitti, V.J., Chapman, D., Edwards, V.J., Dube, S.R., & Williamson, D.F. (2002). Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression. Psychiatric Services, 53(8), 1001-1009.
  5. Sinha, R. (2008). Chronic stress, drug use, and vulnerability to addiction. Ann NY Acad Sci, 1141, 105-130.
  6. UC Santa Cruz. Alcohol and your body.
  7. National Institute on Alcohol Abuse and Alcoholism. Drinking levels defined.
  8. American Addiction Centers. Blood Alcohol Content (BAC) Calculator.
  9. Klostermann, K., Chen, R., Kelley, M.L., Schroeder, V.M., Braitman, A.L., & Mignone, T. (2011). Coping behavior and depressive symptoms in adult children of alcoholics. Substance Use and Misuse, 46(9).
  10. Kelley, M. L., Braitman, A., Henson, J. M., Schroeder, V., Ladage, J., & Gumienny, L. (2010). Relationships among depressive mood symptoms and parent and peer relations in collegiate children of alcoholics. American Journal of Orthopsychiatry, 80(2), 204–212.
  11. Kingree, J.B. & Thompson, M. (2000). Mutual help groups, perceived status benefits, and well-being: A test with adult children of alcoholics with personal substance abuse problems. American Journal of Community Psychology, 28, 325-342.
  12. Park, S. & Schepp, K.G. (2015). A systematic review of research on children of alcoholics: Their inherent resilience and vulnerability. Journal of Child and Family Studies, 24, 1222-1231.
  13. Haverfield, M.C. & Theiss, J.A. (2014). A theme analysis of experiences reported by adult children of alcoholics in online support forums. Journal of Family Studies, 20(2).
  14. McCoy, T.P. & Dunlop, W.L. (2015). Down on the upside: redemption, contamination and agency in the lives of adult children of alcoholics. Memory, 25(5).
  15. Reisman, M. (2016). PTSD treatment for veterans: What’s working, what’s new and what’s next. Pharmacy and Therapeutics, 41(10), 623-627, 632-634.
  16. Markowitz, J.C. (2010). The cutting edge: IPT and PTSD. Depress Anxiety, 27(10), 879-881.
  17. Harding, F.M., Hingson, R.W., Klitzner, M., Mosher, J.F., Brown, J., Vincent, R.M., Dahl, E., & Cannon, C.L. (2016). Underage drinking-A review of trends and prevention strategies. Am J Prev Med 51(4S2), 148–157.
  18. Nkansah-Amankra, S. & Minelli, M. (2016). “Gateway hypothesis” and early drug use: Additional findings from tracking a population-based sample of adolescents to adulthood. Preventative Medicine Reports, 4, 134-141.
  19. Pascoe, M.C., Hetrick, S.E., & Parker, A.G. (2020). The impact of stress on students in secondary school and higher education. International Journal of Adolescence and Youth, 25(1), 104-112.
  20. National Institute on Alcohol Abuse and Alcoholism. (2021). Parenting to prevent childhood alcohol use.

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