Personal change is deeply complex and subject to an array of influences. However, we know that people’s relationships with alcohol are not set in stone. Indeed, people alter their relationship with alcohol throughout their lives.
Young people have to learn to drink. Alcohol is an acquired taste and intoxication an acquired ‘pleasure’. That is partly why alcohol marketing has to continuously target younger drinkers, and reaffirm the notion that not enjoying alcohol is odd.
As we grow older, what, how and where we drink changes. Older people are more likely to drink at home and to drink regularly; younger drinkers to drink less frequently, but get drunk when they do. The routine consumption of alcohol by middle-aged and older drinkers – sometimes referred to through clichés such as ‘wine o’clock’ – can easily slide into a habit that becomes hard to break.
For some people, their relationship with alcohol develops into dependence. It is estimated that there are around 600,000 dependent drinkers in England alone and over a million people are drinking at levels which are likely to cause damage to their health. While some people view alcohol dependence as a disease, we recognise that problem drinking exists on a spectrum – there is no clear line at which dependence begins. Words such as ‘addiction’ cover a variety of experiences and diagnoses and the concept of addiction is not as straightforward as we might think.
But just as people begin to drink more over time, changes in drinking behaviour in the other direction are possible. Decades of research have shown that the majority of dependent drinkers successfully achieve recovery.
The routes to personal change are varied and different approaches work for different people. For some, self-defining as an ‘alcoholic’ and joining a peer-support group such as Alcoholics Anonymous is transformative, but this is not true for everyone. Others may benefit from counselling, motivational therapies, family-based therapies, mentoring or drug-based interventions. For many, simply achieving stability or a sense of purpose in their lives may be enough to effect a change.
It is not only people at the extreme end of consumption who can change their relationship with alcohol. People drinking at low, moderate and high levels can make changes to their drinking and see the benefits. A parent may feel they are stuck in a habit of drinking after work, with negative impacts on the time they spend with their children. Someone may feel pressured to drink after playing or watching sports, despite not enjoying the effects. A couple may find that alcohol, which once formed a bond between them, is starting to cause conflict. A student may dread Freshers’ Week because they just do not want to have to get drunk in order to make friends.
Many of us can positively change our drinking patterns without formal support from alcohol services. But for most people informal support and positive encouragement can make all the difference; online communities, drink tracking apps and behaviour change campaigns have a powerful role to play.
Fundamentally, we know that personal change is possible – wherever people are coming from, and however they wish to take control.
We support approaches that are effective and we promote better research into understanding exactly why certain interventions work or do not, and for whom. We believe there is no single method for changing problematic drinking, so we seek to ensure that access is as wide as possible while also being effectively targeted.
Over three million people reported that they planned to give up alcohol for January 2018. Dry January, a campaign which we run, engages many thousands of people to try a month without alcohol with a view to taking control of their drinking (whatever that means to them) for the longer-term.
Those taking on Dry January are offered the support of online communities and a dedicated app as they give up alcohol for four weeks, giving them an opportunity to break habits and reset their longer-term relationship with alcohol.
Our evaluations so far suggest that, for the majority of participants, Dry January has a long-lasting impact in terms of both reduced drinking and their confidence to refuse drinks when offered.41 We continue to evaluate Dry January in order to deepen our understanding of how, and to what extent, it works in reducing harm, and to continuously improve it.
More generally, by seeking to better understand what motivates and facilitates change, and by using our influence to help raise awareness, we aim to support as many people as possible to have a healthy relationship with alcohol.
