Introducing Live Sensibly

Welcome!

A friend of mine once quipped to a buddy who teaches English as a Second Language:

I do English intuitively. Why don’t you just teach your students to follow their intuition?

Silly, eh? Skills aren’t honed solely by following our intuition. And yet, a lot of us have heard a parallel recommendation for living sensibly with alcohol:

Use your intuition to drink moderately! If you can’t do that (or abstain) on autopilot or by self-directed willpower, you have a problem.

With any other self-care habits — diet, exercise, grooming — we assume that good health comes from gathering information, setting limits, developing discipline, getting support, and testing a range of options. Sorting all of this out leads us to simple options that work best.

Drinking stands alone, though, as an area in which asserting ourselves is branded as proof of a problem. A black-and-white dichotomy is used by experts who say that only two options are available for being healthy with alcohol:

• Having a natural ability to moderate or abstain without coaching or self-imposed rules
• Abstaining with the support of a 12-step-based support group.

Beyond the 12-step-or-willpower dichotomy

Regardless of misinformation to the contrary, we can assert ourselves with alcohol:

• The first option is as simple as what we do with diet and exercise: Educate ourselves on healthy limits. Make personal rules for our drinking. Prevent problems when possible, and resolve problems proactively as needed. Do it independently as a preventative measure, or use the tools and support from a therapist, a coach, or a group like Moderation Management to prevent or scale back problems.
• Another option, of course, is to abstain. (To me, that’s still a matter of living with alcohol since it’s virtually impossible to wall myself off from the influence of alcohol.) Abstinence can be framed sensibly:
  • As a self-guided process;
  • With a 12-step program like AA;
  • Using pragmatic approaches like SMART Recovery® or SOS: Secular Organizations for Sobriety; or,
  • With support geared to our needs as women (like WFS: Women for Sobriety) or based on our faith (like Alcoholics Victorious, for Christians, or JACS, Jewish Alcoholics, Chemically Dependent Persons, and Significant Others.
• Reducing harm offers a third option which is helpful as a first step or as a fallback plan when our primary, but as yet unattained, target is abstinence or moderation.

Whether our primary goal is healthy drinking, abstinence, or harm reduction, use of these additional tools and concepts has been developing since the early 1990s:

• Prescription drugs, like Naltrexone, which may decrease the urge to drink, and even temper the intoxicating effects of alcohol.
• Therapy focused more on increasing self-direction and personal motivation than traditional interventions to break down denial.
• Solutions based on evidence of how people create long-term change, highlighting the fact that change generally occurs as part of an extended process more often than as a result of a single decision.

The options matter

It’s crucial that we talk about these options as laypeople, ordinary folks who are responsible for our own well-being and consumers of health care services.

I’d like to think that public awareness would have grown in sync with the evidence since former first lady Betty Ford got treatment in 1978. Anecdotal evidence from the April 19, 2004 episode of the Oprah Winfrey show tells me otherwise. Much of our public awareness remains stuck in concepts that were innovative in the 1930s, oblivious to a lot of evidence gathered since.

Too often, this lack of progress has blocked the flow of information, preventing us from learning about the options when we have needed the information most.

We’ll be talking with experts, as well — I welcome their input. There are a number of people in the substance abuse field who have been doing great work for years, and yet have been undervalued.

Asserting ourselves as laypeople

The key to Live Sensibly is that it will be driven by and for laypeople who are interested in options. A critical mass of evidence and personal experiences has been assembled by smarter folks than me, and their findings merit much more attention and discussion than they’re getting.

As health care consumers, we must hold our health care providers accountable for delivering evidence-based care and information. As with the history of other health care issues, much-needed change may not happen until enough voices insist on it.

It’s not only about advocacy. A two-pronged approach is needed:

• Put life back in balance. If we’ve gotten stuck in not-so-smart drinking patterns, we need to push our lives back on track: Fill our personal knowledge gaps, get appropriate professional care, support each other, and take whatever steps are necessary to achieve health and balance.
• Develop sensible public voices. Too many folks are struggling in the quest for health and balance because support for viable options is not readily available. As consumers, we need to spread the word that the options exist, they are viable, and supporting them is a matter of good health care.

Ambitious stuff, eh? But, essential stuff. Life-saving stuff. Life-giving stuff.

Let’s talk about it!