I used to drink a lot of alcohol, and when I say a lot, I mean a bottle or two of wine a day, not just a glass or two. I could not get through a day without drinking, but now I no longer drink alcohol at all. This transformation is miraculous in itself, but what is even more noteworthy is the how and why of it. I have not done this by white-knuckling, teeth-gritting, going to AA meetings every day, or by sheer willpower (although there was a bit of that in the beginning), but by being honest enough to admit that I had a problem, and that I did not just like to drink, I needed to drink. By dealing with the how and why of my drinking, with the underlying stress and tension that I could only find relief from by drinking, and by finding other ways of dealing with tension and learning to love and care for myself, the need for a drink just fell away…
Alcohol is a beloved drink of many doctors. Many of us love wine, are real aficionados of it, and some even have wineries as a hobby on the side or to enjoy in our retirement. We have been told for many years now that a glass or two of red wine is good for our heart, and there have been studies to back this up.
But recent meta-analyses(1,2,3) have shown that these studies were flawed and biased and that alcohol is not good for any part of us. In fact, studies in recent years have shown what our bodies have always known… that there is no safe level of alcohol consumption. The American Society of Clinical Oncologists(4) came out and stated this fact in 2017, a fact that the Cancer Council Australia(5) stated some years ago in 2011.
The physical harms of alcohol are well known, although often conveniently ignored. And we underestimate the social and interpersonal damage alcohol does in homes, through domestic violence, child neglect and abuse and in our communities through assaults, mental health issues and motor-vehicle accidents. Being raised in a household where there is alcohol abuse can profoundly impact children, with long-lasting effects on their emotional and physical health.
Alcohol and doctors
The culture of medicine has supported our own use of alcohol to relieve our tension and stress, to reward ourselves at the end of a hard day’s work and help us to wind down and take the edge off the day. Even though the studies that show the incontrovertible harm of alcohol have been out for a few years, supporting the truth of what our bodies have always known, they have largely been ignored, and we continue to drink and advise our patients to do the same, or at the very least, we don’t counsel them not to drink.
Alcohol is a touchy subject to talk about, a no-go zone for many. We are willing to do whatever it takes during the day, as long as we can have a drink at night.
We are willing to follow the latest guidelines on food, exercise, to base our practice on the best available evidence when it comes to anything else, but not when it comes to alcohol.
Why are we so attached to drinking alcohol?
What does alcohol do for us, that we are willing to override the truth that we know and feel in our bodies, as well as the available scientific evidence?
The social sanctioning of alcohol use, reinforced by doctors telling people that they can drink in moderation and using science to back this up, has done us untold harm, as individuals and as a society, and it is now up to us to redress this imbalance by being honest about the harmful effects of alcohol, in any amount and any form.
But the first step in that process is the willingness to be completely honest with ourselves.
Being willing to observe ourselves just as we are and deepen our understanding of why we do what we do, can help us to make true and lasting changes in the way we live our lives.
Alcohol is an acquired taste
We are fond of saying that we like a drink, or even that we love a drink, but what do we mean by that? If you give a child a glass of red wine or whisky, they will not like it; it is definitely an acquired taste! What do we even mean by that phrase? “Acquiring a taste” for alcohol means teaching ourselves to get used to something that is by nature distasteful, as it is made of fermented fruit or grains, so it is naturally ‘off’ and the body reacts to it. Why do we even try it more than once? And why, when we go there and feel the after-effects the next day, do we choose to go there again?
Alcohol is such an integral part of our culture. I know that when I was growing up, I was given a glass of wine with dinner from a very early age by my parents, who were both doctors, to teach me how to drink. It is a social lubricant and a socially acceptable way of dealing with stress, a legal drug that does not hurt us or other people… or so we have been led to believe… but can we still say that is true?
Drinking ‘just’ a glass or two of good red at night may take the edge off our stress and tension, but it also takes the edge off us. It numbs us, slows us down, helps us to check out, to switch off, makes us less available to our loved ones at home, and prevents us from dealing with the unresolved problems that are causing our tension in the first place.
For some, these factors build up in the body, leading to more and more tension, and then we need to drink more to deal with that. This can set us up in a vicious cycle of discomfort and relief, of hard work and reward, that we can find harder and harder to break free of, and before we know it, our drinking may be not just a simple pleasure, but a compelling need.
I am not saying that everyone who enjoys a glass or two of wine at night is going to end up with a serious drinking problem, but that certainly happened to me and I know that I am not alone in this.
Let’s say we are finding ourselves on that slippery slope of not just wanting but needing to drink… what can we do instead?
What can we do instead of drinking?
There is no one-size-fits-all solution to this problem, and we each have to find our own way to live, but there are some simple steps we can take that can help us get back on track.
The first is to be absolutely honest with ourselves and each other, about how we are feeling and why we are drinking. Are we doing it to be social and fit in, are we doing it for relief, is it a pleasure we can take or leave, or is it getting to the point where we cannot get through the day without it and we look forward to it all day?
It is not just about finding other ways to relieve ourselves at the end of the day, but also learning to deal with stress and tension as it arises, so that it doesn’t have to build to the point where we feel we have no other way to deal with it but to have a drink.
Learning to re-connect with ourselves, with the lovely warm feeling we had inside us when we were young, with the simple pleasures of life, can be a great start to learning to deal with the tension of being in life. Doing this can be as simple as taking a few moments to breathe in a way that develops that re-connection, and the gentle breath meditation, has certainly been life-changing for me. Once we reconnect to the delicious truth of who we are, and the sweetness that lives inside us, we are far more likely to care for ourselves, and will feel far less need to look for that sweetness outside of us, especially in its fermented forms. Drinking alcohol is a poor substitute for enjoying the sweetness of life, people, nature, and the beauty that lives inside us.
Once we reconnect to the loveliness inside us, the world reflects that loveliness too, and stopping to smell the roses, enjoying nature in its many glorious forms, walking and other gentle rhythmic exercises that bring you back into your body and allow you to enjoy it, connecting with and spending time with people you love, are all simple things we can do to relieve stress and tension and increase our enjoyment of life.
And last but by no means least, learning to appreciate ourselves, just as we are, for who we are, irrespective of what we do, is a vital step for us as doctors. We are so used to being appreciated for our great work, and have learned to look for this appreciation outside of ourselves from an early age, but we are also worth appreciating as the great people we truly are.
- Alcohol Consumption and Mortality From Coronary Heart Disease: An Updated Meta-Analysis of Cohort Studies. https://www.ncbi.nlm.nih.gov/pubmed/28499102
- Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data http://www.bmj.com/content/349/bmj.g4164
- Chronic heavy drinking and ischaemic heart disease: a systematic review and meta-analysis http://openheart.bmj.com/content/1/1/e000135
- There’s no safe level of drinking when it comes to cancer risk, oncologists warn https://www.advisory.com/daily-briefing/2017/11/09/alcohol-cancer
- Alcohol and cancer: a position statement from Cancer Council Australia https://www.mja.com.au/journal/2011/194/9/alcohol-and-cancer-position-statement-cancer-council-australia