Rethinking alcohol: Can heavy drinkers learn to cut back?

By Allison Aubrey, NPR

The thinking about alcohol dependence used to be black and white.

There was a belief that there were two kinds of drinkers: alcoholics and everyone else.

“But that dichotomy — yes or no, you have it or you don’t — is inadequate,” says Dr. John Mariani, who researches substance abuse at Columbia University. He says the thinking has evolved, and the field recognizes there’s a spectrum.

Problems with alcohol run the gamut from mild to severe. And there are as many kinds of drinkers along the continuum as there are personality types.

People with severe problems, such as those who keep on drinking even after they lose jobs or get DUIs, need treatment to stop drinking completely.

But there are other drinkers, including some who are in the habit of drinking more than one or two drinks a day, who may be able to cut back or moderate their consumption and reduce their risk.

Women who consume eight or more drinks per week are considered excessive drinkers, according to the CDC. Breast cancer, liver disease and heart disease have all been linked to excessive drinking over time.

In fact, a recent study by the Centers for Disease Control and Prevention found that the majority of Americans who drink more than one or two drinks a day are not alcoholics. They don’t report symptoms of dependence.

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