Drinking less, treated as real medicine

Cutting back is a legitimate medical goal

Treatment here does not require a vow of lifetime abstinence before the first prescription. For many people, the honest goal is drinking less: fewer drinks per week, fewer heavy drinking days, evenings that end where they were supposed to end. That goal is treated with the same seriousness as stopping, because it is measured the same way and it changes the same risks.

What gets counted

A reduction goal lives or dies on its count. Three numbers carry it:

• Drinks per week. The plain total, recorded between visits in a simple log of what you drank, where, and what was happening.
• Heavy drinking days. Days that pass the heavy line for your body, counted separately, because one heavy day a week is a different pattern than a steady moderate one.
• The AUDIT-C score. Taken at your first appointment and re-scored as treatment runs, so progress is a number, not an impression.

How the medicine classes fit a reduction goal

Two classes do most of the work for this goal. The medicines that lower craving turn down the pressure that builds toward the first drink. The medicines that take the reward out of a drink weaken the payout, so one drink carries less momentum into the next. Which one fits you is decided at your evaluation, against your pattern, your liver, and everything else you take. None of them is a controlled substance.

The first 12 weeks for this goal

Weeks 1 to 2: the evaluation, the safety screen, and the baseline count. Weeks 3 to 5: the medicine starts and craving is tracked. Weeks 6 to 8: the count is reviewed against the goal you set, and the plan is adjusted where the count breaks through. Weeks 9 to 12: the AUDIT-C is re-scored and the goal is confirmed or changed, out loud, with the data on the table.

When the data argues for stopping instead

Sometimes a reduction plan keeps failing in the same place: the same evening, the same trigger, the same broken limit. That is not a character verdict. It is information that this goal, at this time, is not holding, and the honest next conversation is about stopping, with your own numbers making the argument. Plenty of stopping plans start exactly here. The related page on stopping lays out how that goal is run, and the treatment page covers the full method.

Questions about this goal