Addiction experts have a new view of alcohol abuse these days, and it's no longer black-and-white (either you have things under control or you need to go to AA). Throw out the image of a disheveled, puffy-faced wreck who's lost her job and family. "These 'typical' symptoms aren't common at all," says Mark Willenbring, MD, director of the treatment and recovery research division of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). It's also time to forget the idea that problem drinking is a lifelong curse cured only by abstinence. A recent multiyear study of 43,000 Americans conducted by the NIAAA found that the vast majority of people who abuse alcohol do so only for a few years—a single period of addiction often triggered by prolonged stress. "[Drinking] should be addressed as any other poor health habit that needs to change," says Willenbring.
So what is "risky" drinking? Probably less than you think—for women, the NIAAA says, it's having more than three drinks on any one day or more than seven drinks per week, with the danger rising the more frequently you drink in excess. (Women metabolize alcohol differently from men, adds Robert Swift, MD, PhD, professor of psychiatry and human behavior at Brown University. As a result, they may get drunk faster and addicted faster, and are quicker to suffer the medical consequences if the problem gets out of hand: liver and heart disease; increased risk of high blood pressure, stroke, and breast cancer. The longer any dependence goes on, the more intractable the problem.)
The Web site RethinkingDrinking.niaaa.nih.gov has a good list of tips for cutting back. And there are now more treatment options for problem drinkers who aren't visibly out of control, "who in the past had nowhere to go," says Andrew Tatarsky, PhD, a New York City clinical psychologist. Among them: therapies that allow moderation as an alternative to abstinence and a variety of prescription drugs (naltrexone, acamprosate, et al.) that reduce cravings. Here's how to tell if you have a potential problem and what to do about it.
You break your word.
If you tell yourself you'll have just one glass of wine but often find yourself on your third, you may have a problem. Try keeping track of what you drink. Write down how many you've had; if possible, even measure each pour. Seeing how much alcohol you're consuming may slow down your consumption.
Another bad sign: The only way you can calm down after a tough day is with a cocktail at happy hour. Think about what puts you over the edge and triggers the urge to drink—and then try to avoid those things. If you regularly drink alone at home, stop keeping booze in the house.
You imbibe daily.
If a lot of your time is spent drinking, thinking about drinking, or recovering from the effects of drinking, it's time to find new ways to fill your time. Make a plan for how you'll handle the impulse to drink, keep reminding yourself why you want to change, and schedule days when you won 't drink at all.