How a Neuroscientist Seriously Thought About 'How to Drink Without Being Drunk' - From Absolute Abstinence to Savoring -

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For 30 years, I have been drinking a significant amount of alcohol almost every day. The harmful effects of heavy drinking finally reached a point where they could no longer be ignored, so I switched to five months of complete abstinence. After regaining the sense of being able to control my own life, I thought about it once more. It is safer not to drink. Even so, I wanted to enjoy delicious alcohol during time spent with important people. In this article, I will introduce the path I followed from complete abstinence to moderate drinking. It has only been three months since I resumed drinking. This is not a success story, but a personal experiment in progress. For those who have experienced alcohol use disorder, withdrawal symptoms, or an inability to stop once they start drinking, I do not recommend resuming drinking on your own judgment. Please consult a medical institution or an addiction specialist.

From 30 years of heavy drinking to 5 months of complete abstinence

In the past, I tried many times to reduce my alcohol intake. I failed every single time. As you reach middle age, your body inevitably starts to break down. Work in the morning doesn't progress. Sleep is shallow. Blood pressure rises. You gain weight. You make mistakes while drunk and fall into self-loathing the next morning.

So, I stopped half-hearted moderation and quit drinking completely for a while. I adopted a strategy of understanding the brain's habits and using them against it. As a result, I was able to quit drinking surprisingly easily. This was unexpected even for me.

I wrote in detail about the method I used to succeed in complete abstinence in my previous article, so I would be happy if you took a look.

Why did I consider drinking again after complete abstinence?

From the moment I decided on complete abstinence, I did not swear to abstain for life. I was drawn to the stories of people who chose to put alcohol on hold for only a certain period of their lives.

For example, Anne Hathaway stopped drinking in 2018. She said she hated not being able to fully engage with her young children on mornings when she had a hangover. She replied that she might drink again when her life had enough margin to allow for a hangover.

Denzel Washington's example is also interesting. He reportedly repeats a life cycle of abstaining during filming or character preparation, and enjoying wine for a few months after work is finished. He even has a wine cellar at home that holds about 10,000 bottles; as expected of an Oscar-winning actor, the scale is on a different level.

Although on a tiny scale, I was thinking of something similar.

Even if it is impossible to return my bloated body to its former slender state!!, I will make it a little better. I will regain control over my own life.

Once I reached that point, I would think about whether to drink again. As a result, it might be abstinence for life, or I might drink again. I will decide at that time.

Therefore, I left my two wine cellars at home and the collection packed tightly inside just as they were. And now that complete abstinence has succeeded so easily, I thought: If I hack my brain in the same way, couldn't I drink appropriately?

Complete Abstinence and Moderate Drinking: What is Recommended in Alcohol Use Disorder Treatment?

This should not be thought of in terms of individual willpower. Alcohol use disorder is not a problem of people with weak will. It is a pathological condition caused by the pharmacological effects of alcohol, long-term learning and habits, and overlapping physical, psychological, and social factors. In

Japan's 'New Diagnostic and Treatment Guidelines for Alcohol and Drug Use Disorders,' the most certain and stable treatment goal is abstinence. On the other hand, in mild cases without clear complications, reducing alcohol consumption can sometimes be a treatment goal with the support of medical professionals. The

UK's official clinical guideline development agency, NICE, also considers abstinence to be the appropriate goal for the majority of alcoholics. Let's also look at specific data from the

United States. This is an analysis of 1,226 alcohol-dependent patients in a large-scale trial. The goals chosen by the individuals at the start of treatment were compared among three: 'moderate drinking,' 'conditional abstinence,' and 'complete abstinence'.

As a result, the complete abstinence group had the best outcomes in all areas: the percentage of days abstinent, the time to relapse into heavy drinking, and overall clinical outcomes (↑). Conditional abstinence was in the middle, and moderate drinking had the worst prognosis. However, since the goals were not randomly assigned, there is insufficient evidence to say that 'the results improved because they chose complete abstinence.' Even so, complete abstinence is strong data predicting good outcomes.

There is also data explaining 'why moderate drinking is more difficult.' This is a meta-analysis published in the journal 'Addiction' in 2022, which integrated 38 laboratory studies.

Compared to a control beverage, drinking a small amount of alcohol equivalent to the first drink increased subsequent alcohol consumption and the craving to 'drink more.' Both are small to moderate effects, but they are statistically significant. In short, with moderate drinking, once you have one drink, you want the next one more strongly. And the consideration is that with complete abstinence, there is no such added craving, so it is advantageous.

However, the focus of this meta-analysis is laboratory research. It is not a study that directly proves the relapse rate in real life. Therefore, it cannot be said that 'if you have one drink, you will definitely relapse.' Even so, the tendency that the first drink increases the motivation for the next drink on average has been reproduced in multiple studies.

Seeing data like this makes me think again.
Hmm. What should I do?
If I start drinking, will I go back to heavy drinking again?

Even so, alcohol has its charms.

I know the disadvantages of drinking well. Gaining weight. Skin becoming dull and puffy. Blood pressure rising. Sleep becoming shallow. Performance the next day dropping. Sometimes making mistakes at drinking parties. And falling into grand self-loathing.

So, let's reconsider the charm of alcohol. First of all, it is excellent as a beverage. Good alcohol satisfies all five senses. Enjoying the bottle and label visually. Opening the cap. Feeling the rising aroma. Hearing the sound of it being poured into a glass. Gazing at the color through the light. And, savoring it slowly with a meal.

Let's stop. I'm drooling.
If I am attacked with a combination like this, I have no choice but to lose. It's a complete defeat.

A dining table is complete even without alcohol. However, the exquisite marriage of food and drink is in a league of its own.One cannot simply say 'a samurai doesn't eat but uses a toothpick' and leave it at that.

Close friendsand drinking with them is also truly enjoyable. You feel a little light, your tension eases, you talk about things you wouldn't normally, and you laugh at silly things.

Alcohol while travelingis the same. Not just sake, but wine has also been getting better and better lately. It condenses the water, climate, and food culture of that land. To come all that way and not be able to taste a single drop feels like a lost opportunity for experience.

If so, instead of completely banishing alcohol from my life, could I welcome it back while keeping the initiative?If it doesn't work, I'll just go back to total abstinence. I thought it was a battle worth challenging, even while acknowledging the possibility of losing.

Neuroscience to avoid being drunk by alcohol

I established two basic strategies.
Strategy 1: Decide never to return to heavy drinking.
Strategy 2: Don't fight with the willpower of the prefrontal cortex alone, but use the dorsal striatum to create habits.
The principles are the same as the previous prohibition.

Strategy 1: Never return to heavy drinking: First, confront how terrible you were before. Your brain doesn't work, and you waste the morning. Your appetite runs wild. The devil's infinite triangular loop of alcohol, salty food, and sweet food. Blood pressure rises. You gain weight. You become unsightly. You say unnecessary things in a drunken stupor and keep blaming yourself the next morning. I will not return to that state.

Strategy 2: Don't fight with the prefrontal cortex alone: Humans get tired if they make decisions from scratch every time. Should I drink today? Can I have one more? No, should I stop? This is what's called 'decision fatigue'.

If you leave these judgments to the rationality of the prefrontal cortexevery time, you will lose. Days when you are tired from work. Days when something unpleasant happened. During travel. Celebrations. The brain can make any number of excuses to drink.

Therefore, make absolute rules and repeat the same choices. The circuit of the basal ganglia, including the dorsal striatum, is important for habit formation. It is about reducing the number of decisions and making it easier to choose pre-determined actions. You need rules so that the autopilot doesn't go off the rails.

Rule 1: Do not drink on days before work: The reason is simple. I don't want to lower my work performance. If I'm sluggish, I can't do difficult work like writing papers in the morning. However, I made an exception for situations where work and dining are integrated, such as academic conference receptions. Drinking with close friends and comrades is also a valuable opportunity for exchanging information. So, I decide on a limit before drinking. It is up to 3 glasses in wine equivalent. Increasing exceptions on the spot is prohibited. That is just a slippery slope.

Rule 2: Do not drink two days in a row: This is an absolute rule. If I drink today, I will not drink tomorrow no matter what. If drinking alcohol continues for days, it changes from a 'special pleasure' to a 'usual habit'. I would be in trouble if the habit circuit I built to reduce decision-making turned into a drinking habit. Even though the dorsal striatum became my ally, it would be like it becoming an enemy. Note that there is no medical evidence for the number 'two consecutive days' itself. It is my subjective view.

This is surprisingly difficult during travel and academic conferences. Conferences last for 3 or 4 days. Travel can be even longer. If you drink every night saying 'because I'm traveling' or 'because it's a special occasion', you will easily return to consecutive drinking. Therefore,

decide the days to drink in advance. If traveling, the day you go to the restaurant you are looking forward to the most. If at a conference, the day of a truly important dinner. Otherwise, don't drink. Decide in advance and don't think about it on the spot.

Rule 3: Redefine drinking opportunities: I changed the positioning of alcohol. It used to be a daily necessity, but now it's a reward. Pair it with good food and savor it happily with important people. I redefined it as an exquisite opportunity.

I used to love izakayas and fully enjoyed shareholder benefits.

I used to go to these restaurants alone once a week, binge-eating while watching Netflix, living a life of 'how much are you enjoying being alone?!'.

It's over.
I quit this life completely.

Shareholder benefits are still alive and well. However, the way I use them has changed.

Rule 4: Do not drink at home alone: This means not drinking at home on days when my husband is not there. Since he is working away from home, I am often alone, which is dangerous. Being at home is far more dangerous than drinking out. In the living room, the wine cellar is sparkling and shining.

I open one bottle alone, and then open a second one. There are no eyes on me, and no one to stop me. Once I'm a little tipsy, my judgment drops. 'Since I already opened it,' 'I'm not that busy tomorrow.' The brain easily creates reasons to drink. However, this does not mean making my husband a monitor or a therapist. It is an environmental setting to turn alcohol from 'an act of chasing quantity alone' into 'a place to share a high-quality meal with someone'.

Rule 5: Even if you break a rule, restart from the next day: This is the most important rule. If by any chance you break a rule, do not get depressed; just return to the same rule the next day.

Human cognition has a tendency to think in all-or-nothing terms. 'I broke the rule. I am a failure after all. Since it's impossible anyway, I might as well drink.' One deviation is inflated into self-denial or total failure. However, there is no need to abandon your efforts so far or your future because of one failure.

I do not pretend the failure didn't happen. I look back on what triggered it and whether the rule was unreasonable without getting emotional. But I do not punish myself with self-loathing. Because there is no good in blaming yourself. Reset and restart from the next day. What is important in maintaining a habit is not to never go off the tracks, but to return to the original tracks quickly when you do.

However, if deviations are repeated, the amount of alcohol continues to increase, you hide your drinking, or you cannot return on your own, I do not dismiss it as just 'one failure'. That is a sign that rule redesign or professional support is needed

3 months since starting reduced drinking

While repeating the rules, I have gradually gotten onto autopilot.

Honestly, it was harder than complete abstinence. There were days when I thought, 'I want to drink...' Still, I have been able to follow all the rules for at least 3 months. My weight has not increased at all. There is no hangover. My blood pressure is also normal.

However, I will not write that I have 'overcome it'. This is an ongoing experiment.

Conclusion: Becoming Free from Alcohol

Honestly, I was worried about whether I could do it. However, for now, it is continuing calmly. The fact that a foundation for a life without alcohol had been built through 5 months of complete abstinence is having an effect. Another thing is that I feel the

mindful eating I learned during abstinence is working. Feeling the taste and aroma deeply. Placing consciousness there, one bite at a time. Then, the feeling of 'I want more quantity' weakened, and the feeling of seeking quality, 'this bite is delicious,' became stronger. I can be more satisfied by carefully savoring one glass than by drinking a lot. This is a feeling I didn't have before. Being able to drink alcohol is not freedom. I think that being able to

choose for yourself whether to drink or not to drink is freedom. How do you keep your distance from alcohol? A comfortable and safe distance varies from person to person. If you don't mind, I would be happy if you could share your own ingenuity and thoughts in the comments.