Worried You’re Drinking Too Much? Follow My Easy Steps To Take Back Control Over Alcohol – Without Going Completely Sober, Says DR MAX PEMBERTON

Last week, I wrote about the signs that you might be drinking too much. It generated a lot of interest and I was contacted by a number of people saying how much they struggled with alcohol and didn’t know what to do about it.

This week, as we reach the middle of Sober October, I want to share the strategies you can use to drink less – even if going totally sober seems too much of a stretch. Let me be clear about why this matters.

We know that alcohol can have a disastrous impact on our health. If you regularly drink more than 14 units a week – that’s roughly six pints of average-strength beer or six medium glasses of wine – your risk of developing liver disease, certain cancers, and cardiovascular problems increases significantly.

Drink 35 units a week, for example, and your risk of liver cirrhosis is around five times higher than someone who stays within the guidelines.

But the good news is that if you reduce your intake – ideally down to 14 units or fewer – those risks start to fall. It’s not all or nothing. Even cutting back by a third can make a real difference to your long-term health.

There’s an important caveat to this, though. If you’re drinking very heavily – we’re talking a bottle of spirits or two bottles of wine a day or equivalent – and especially if you’ve noticed your hands shaking in the morning or you’ve experienced withdrawal symptoms when you’ve tried to stop before, please speak to your GP before making drastic changes.

Alcohol withdrawal can be dangerous and, in severe cases, even life-threatening. You may need medical support to cut down safely.

For everyone else, here’s what I suggest to patients who want to cut back.

Set specific limits before you start

This sounds obvious, but it’s surprisingly effective. Before you go out or pour that first drink at home, decide exactly how many you’re going to have. Not a vague ‘I’ll take it easy‘, but a concrete number. Two pints. Three glasses of wine. The key is deciding that number when you’re sober, not after you’ve had a couple and your judgment is already impaired. Some patients find it helpful to tell someone else what their limit is – it adds a layer of accountability.

Alternate alcoholic drinks with soft

This is one of the most effective techniques I know, and it works on multiple levels. Firstly, it slows your drinking. Secondly, it keeps you hydrated, which means you’ll feel better the next day. Thirdly, it gives you something to hold and sip on, which satisfies that hand-to-mouth habit without the alcohol. Have a posh tonic water with lime, a ginger beer, whatever appeals. Most bars and pubs do non-alcoholic spirits and beers. Make it feel like a proper drink, not a punishment.

Delay your first drink

There’s something about having that first drink that opens the floodgates. If you normally pour a glass of wine the moment you walk through the door after work, try pushing it back by an hour. Have a cup of tea first, go for a walk, cook dinner. You’ll often find that the desperate need for a drink was more about ritual and stress-relief than an actual desire for alcohol.

Lower-strength options

This isn’t about switching to alcohol-free beer. It’s about being cleverer with your choices. If you usually drink wine that’s 14 per cent alcohol, try one that’s 11 per cent instead. You’re still having wine, but you’re consuming significantly less alcohol over an evening. Same goes for beer – many craft IPAs are pushing 6 or 7 per cent, whereas a standard lager is more like 4 per cent.

Avoid your triggers

Everyone has situations where they drink more than intended. Maybe after a stressful day at work, or when with a particular group of friends, or when you’re home alone on a Friday evening.

Work out what your triggers are and plan around them. That might mean suggesting a cinema trip instead of the pub with those heavy-drinking mates, or making sure you’ve got plans on Friday evenings that don’t revolve around the sofa and a bottle of wine.

Keep a booze diary

This might sound a bit tedious, but it’s genuinely eye-opening. For two weeks, write down everything you drink and when.

Most people who do this are shocked by how much they’re actually consuming. That glass of wine while cooking dinner, the pint after work you barely think about, the drinks on Saturday that somehow turn into seven rather than the three you remember – it all adds up. Once you can see the patterns in black and white, it’s much easier to identify where to make changes.

Have drink-free days

If you can’t manage a whole month off booze, try building in regular alcohol-free days each week. Two or three days where you don’t drink at all. This proves to you that you can enjoy an evening or get through a stressful day without alcohol. It gives your liver a bit of time to recover. And it prevents drinking from becoming such an ingrained daily habit that you don’t even think about it any more.

Be honest

This is perhaps the most important strategy of all. Before you pour a drink, ask yourself why you’re doing it. Do you genuinely fancy a nice glass of wine with dinner, or are you trying to avoid feeling anxious? Are you celebrating something, or are you bored? There’s no judgment here, but the answer matters.

If you’re consistently using alcohol to manage difficult emotions, that’s a sign you need to find better coping strategies. You might need guidance from a psychologist to do this, but you won’t realise you need help until you’re honest with yourself.

Victoria’s brave confession

I’ve always liked Victoria Beckham. I loved her as a Spice Girl and have been impressed by her fashion career. And now, having watched her eponymous Netflix series, in which she details her battle with an eating disorder, I have even more respect for her.

It’s still rare to admit to an eating disorder. I’ve worked in this area of medicine for more than ten years and come across a number of well-known people – indeed, household names – who had one, yet none of them have ever spoken publicly about it. Such is the shame attached to it.

And yet we must talk about it – eating disorders have the highest mortality of any psychiatric condition, with about five per cent dying within the first four years of diagnosis. Good for Victoria for speaking so honestly and shining a light on the condition.

The NHS is crying out for more doctors. Just in mental health, the Royal College of Psychiatrists estimated that in 2023, 28.3 per cent of consultant psychiatrist posts were either vacant or filled with locums.

Yet according to the BMA, of the more than 10,000 doctors who applied this year to become psychiatrists, fewer than 500 were able to get a place. This is enraging. Surely it makes sense to increase the number of training posts in line with the number of young doctors who need to progress to further, higher, training? If we don’t, they’ll simply go abroad.

A STUDY has found that prostate cancer awareness campaigns have resulted in harmful ‘over-testing’ as more men ask their doctors for a PSA blood test. It’s a difficult balancing act and clearly we desperately need a more accurate test.

Dr Max prescribes: Family dinners

Last week, in an essay, the Princess of Wales warned that too much screen time is harming family life. We are suffering an ‘epidemic of disconnection’, Kate said, and encouraged us to make a ‘conscious effort’ to be present for the people we care about, perhaps by having regular family dinners. She’s absolutely right. Family dinners promote self-esteem and reduce stress.