Strategy – When Cutting Back isn’t Working

There are many people who try to cut back but find it is too difficult. There are a variety of reasons for this. One might be that the drinker realizes that their need for or attachment to alcohol is just too strong. This may be an indication that the drinker suffers from an alcohol use disorder (AUD). Not everyone who experiences negative consequences to their alcohol use qualifies for an AUD. Still going through the signs and symptoms may be helpful. Research has shown that the more severe AUD one has, the harder it is to moderate drinking successfully. In this case, abstinence will not only be the healthiest choice, it may be the easier goal to achieve.

To be diagnosed with an alcohol use disorder (AUD), individuals must meet certain criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Under DSM–5, the current version of the DSM, anyone meeting any two of the 11 criteria during the same 12-month period receives a diagnosis of AUD. The severity of AUD—mild, moderate, or severe—is based on the number of criteria met.

To assess whether you or loved one may have AUD, here are some questions to ask.

In the past year, have you:

Had times when you ended up drinking more, or longer than you intended?
More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
Spent a lot of time drinking? Or being sick or getting over the aftereffects?
Experienced craving — a strong need, or urge, to drink?
Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
Continued to drink even though it was causing trouble with your family or friends? Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?

If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more urgent the need for change. A health professional can conduct a formal assessment of your symptoms to see if AUD is present.