Monthly Archives: May 2015

Alcohol: preventing harmful alcohol use in the community

In March the National Institute for Clinical Excellence (NICE) launched a new quality standard looking at alcohol and preventing harmful alcohol use in the community:


Alcohol: preventing harmful alcohol use in the community

This quality standard covers a range of approaches at a population level to prevent harmful alcohol use in the community by children, young people and adults. These statements are particularly relevant to trading standards, other local authority teams, the police, and schools and colleges.

NICE quality standards describe high-priority areas for quality improvement in a defined care or service area. Each standard consists of a prioritised set of specific, concise and measurable statements. They draw on existing guidance, which provides an underpinning, comprehensive set of recommendations, and are designed to support the measurement of improvement.

This quality standard does not cover screening and brief interventions, which are covered by NICE’s quality standard on alcohol dependence and harmful alcohol use. For more information see the topic overview.

Veronica Valli & I (16) discuss Step 12

Today Veronica & I discuss the last of the 12 steps – Step 12 which reads: Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

The final step is discussed particularly how a spiritual awakening as meaning ‘seeing everything differently’.  Something internally shifts Veronica says and you see yourself and the world differently.  What’s not to like about that? 🙂

We are planning on discussing sponsors and sponsorship and the 13th step I’ve heard about once Veronica returns from maternity leave.  Is there anything that you would like us to discuss?  Please feel free to email me at or leave a comment, anonymously or otherwise, of other topics for us to chat through and share.

Veronica Valli is an Addictions Therapist and the author of Why you drink and How to stop:…

2013 How to Stop Cover 960x1280


It’s the real thing …… & Friday sober jukebox

So it was with sadness that I watched the last episode of Mad Men and it was as exceptional as the rest of the series.  If you haven’t watched it yet I suggest you skip this post as I don’t want this to be a spoiler for you!

I’ve love this series from beginning to end.  I came to it late but devoured it – the story lines, the characters, the sets, the cinematography.  Paul over at the Alcoholics Guide to Alcoholism wrote a great post about it here and I’ve written about it in the past too here.

The weird thing is that over it’s 8 year series span I have experience the biggest changes to my drinking from the downward spiral in 2008 to the battling to moderate between 2009 and 2012 and then finally quitting in 2013.

What’s really shocking is that when I watched the original show from which Paul has taken this clip and shared it in his post I was still actively drinking and the fact that Don was totally hammered giving that presentation at the time didn’t even register on my radar or give me a flicker of concern.  I was so in denial about my own drinking that I couldn’t see a problem with his.  Fast forward to now and I’m horrified by that clip and my failure to acknowledge both his and my own issues with alcohol abuse.

But the last episode gave me hope.  Why?  Because up until almost the very end Don is still drowning himself in booze.  Until he goes to a retreat and appears to experience a nervous breakdown spiritual awakening.  He is introduced to meditation and group therapy and in the final scene is seen meditating on a clifftop overlooking the sea and smiling as he ‘oms’.

And the show ends with the iconic 1971 ‘It’s the real thing’ coke ad shown above.  An ad for a soft drink.  Was this Matthew Weiner the shows creator telling us that booze isn’t the answer for Don or the rest of us?  Is the girl at the beginning of the ad the receptionist at the retreat where Don was staying?  Was this Don’s genius ad creation?  Did how the show finished prompt Jon Hamm to get help in real life?  Who knows but this is how I chose to interpret it because this mirrors my experience.  Replacing the numbing of emotions through drowning in booze with the peace and acceptance of where and who we are.  This is how Don looked at the end of the show and how I feel now 🙂

And so for today’s Friday sober jukebox – only one song seems to fit the bill 😉

UK alcohol industry’s “billion units pledge”: interim evaluation flawed

This was a British Medical Journal (BMJ) Analysis looking at the alcohol industries ‘billion units pledge’ and how the interim evaluation was flawed …..

UK alcohol industry’s “billion units pledge”: interim evaluation flawed

billion unit pledge flawed
billion unit pledge flawed

Flaws in the Department of Health’s interim evaluation of an alcohol industry pledge to remove one billion alcohol units from the market raise questions about the claimed success argue John Holmes and colleagues. They say that the report should be withdrawn and revised targets set.

You can read the full analysis here but these are their key messages:

Key messages

  • The responsibility deal includes a pledge from the alcohol industry to remove one billion units from the market and one of the UK’s central alcohol policies

  • The Department of Health’s interim evaluation of its success makes questionable assumptions and ignores key confounding factors

  • A robust quantitative evaluation of the effect of the pledge may not possible

  • The billion unit target should be dropped in favour of measurable alternatives

This is not a complete surprise I have to say somewhat cynically.  This pledge was set by the industry so they were going to chose a strategy that suited them and not necessarily the general public.  As long as they ‘look’ like they are doing something the govt leaves them alone …….

If  you are interested reading more about addiction and research into the subject then do visit a new organisation that has just launched a website and further resources:

Society for the Study of Addiction

Edited to add: 15/07/2015

Alcohol industry ‘pledges’ ineffective … and perhaps worse

Government-funded evaluators say ‘Responsibility Deal’ commitments made by alcohol companies were usually already done or underway, and even if fully implemented, were unlikely to significantly affect consumption or health. Other sources suggest one effect of the deal has been to forestall a more effective measure – a minimum unit price for alcohol in England | Drug and Alcohol Findings, UK

And more news: 10/11/2015

Dead on Arrival? Evaluating the Public Health Responsibility Deal for Alcohol (PDF)

The Public Health Responsibility Deal (RD) was launched in 2011 as a voluntary partnership between the government, commercial organisations, public bodies, academics and NGOs to promote public health goals. Through a set of non-binding pledges, these actors – and in particular industry – are expected to take steps to reduce health harms | IAS, UK

A Royal Hangover Documentary Film Review

So last Thursday I was lucky enough to be invited to the press/industry screening of A Royal Hangover.  I met Arthur Cauty, Director and Gabrielle Weller, Producer for the second time and their whole crew were there including Silver Levy-So, their Associate Producer.  I also met Lucy Rocca, founder of Soberistas, which was a lovely bonus surprise! 🙂

I’ve said it before but I’ll say it again – this is a spectacularly exceptional film, an unflinching documentary and review of the British love affair with booze .  It is sad, poignant and brave.  In fact even writing that doesn’t do it justice.  As a nurse who has cared for alcoholic liver disease patients and as a public health nurse for me it is perfect and looks at all the key facets of the complex social issue of alcohol abuse and dependence.

A Royal Hangover
A Royal Hangover

Documenting anecdotes from all facets of the British booze bottle, from politicians to police; medical specialists to charities; the church through to history and science; addicts and celebrities; with high profile personalities such as Russell Brand and controversial figures such as sacked Government Drugs Advisor Professor David Nutt, A Royal Hangover underscores the why behind our increasing thirst for the booze.    Why are things so different in Britain?  What sets us apart from our brothers and sisters in Europe, or our cousins across the pond?  Are we aware of the extent of our problems?  Who or what is responsible for this degenerative culture?  Are we too drunk to even care?  A Royal Hangover is an increasingly relevant  portrait of a nation and it’s love of the booze.  Critically acclaimed independent filmaker and accomplished non-drinker, Arthur Cauty, serves up a  documentary mocktail, in equal parts shocking, hilarious, sympathetic and thought provoking, a film we can all relate to.  Bottoms up Brits and cheers to alcohol education.  Hopefully one day Britain will wake up without a hangover.

When asked the question ‘what message do you hope the audience will take away from the film?’ Arthur answered:

I hope A Royal Hangover will help people all  over the World to better understand the harms of alcohol, and for the UK especially to start to develop a healthier and more logical attitude to alcohol as well as other drugs.  I know this is not a problem indigenous to the UK, but I do feel that alcohol is more ingrained in British culture, compared to many other countries.  To not drink in Britain, is to be ridiculed.

Peer pressure is such a huge factor when it comes to alcohol, especially for young people.  If more people like myself – whether that be parent, brothers, sisters, friends, or people in the public eye like Russell Brand – actually felt comfortable about standing up and saying ‘I don’t drink’, this would encourage so many others to feel ok about doing the same.

If this film manages to help any number of people to think about how they, as well as the people around them, use alcohol, I’ll feel like I’ve done my job.

When asked what he would be doing next Arthur answered:

Trying not to get assassinated by the drinks industry.

The thing is in the UK the drinks industry didn’t need to assassinate Arthur – they used a silencer on the film instead.  He and I will be talking about this further and it is a critically important part of the story of this film.  He who pays the barman does indeed call the shots it would seem ……..

Gabrielle did let us know that the film should be available on iTunes, Amazon on Demand and Google Play in the very near future and the minute it’s out I’ll let you know 🙂

Edited to add:  Just had word from Arthur that it is available on iTunes from TODAY!!

Here’s the link:

Go watch it people – it’s FAB!! 😀

Consuming three alcoholic drinks a day may cause liver cancer – study

This was in The Guardian at the end of March and looked at a study that had found that consuming three alcoholic drinks a day may cause liver cancer.

liver cancer

Consuming three alcoholic drinks a day can be enough to cause liver cancer, experts have said.

The World Cancer Research Fund (WCRF) has pinpointed the level of drinking implicated in liver cancer after undertaking what it says was the biggest review so far of the evidence on the relationship between diet, weight, physical activity and the disease.

Its assessment of 34 previous studies covering 8.2 million people, more than 24,500 of whom had liver cancer, revealed “strong evidence” linking intake of three drinks a day to the disease.

“Around three or more drinks per day can be enough to cause liver cancer,” said Amanda Mclean, director of the charity’s UK branch. “Until now we were uncertain about the amount of alcohol likely to lead to liver cancer. But the research reviewed in this report is strong enough, for the first time, to be more specific about this.”

The WCRF’s findings prompted the Alcohol Health Alliance, a coalition of health organisations, to claim that alcohol is so toxic that cans and bottles should carry health warnings.

“Alcohol, like tobacco and asbestos, is a class 1 carcinogen and it is totally unacceptable that the public is not provided with such basic information”, said Prof Sir Ian Gilmore, the alliance’s chair.

“This report shows that there is no safe level of drinking when it comes to cancer prevention. It’s time for the government to take action to minimise the risk of harm, including ensuring that labels carry mandatory health warnings and lists of ingredients to standards that are developed independently from groups with vested interests.”

About one in 100 men and one in 200 women in Britain develop liver cancer at some point in their lifetime, and 4,703 people were diagnosed with it in 2012. It has one of the lowest survival rates among the 200 different types of cancer.

Women should try to limit themselves to no more than one drink a day and men to two in order to minimise their risk of the disease, the WCRF said.

Dr Sarah Jarvis, a medical adviser to the drinks industry-funded education group Drinkaware, said: “To help reduce the risk of getting alcohol-related liver cancer, it’s best to drink within the lower-risk guidelines of 2-3 units a day for women – that’s a 175ml glass of 13% wine – or 3-4 units a day for men – a pint and a half of 4% beer.”

The report also pinpoints obesity as a risk factor for liver cancer. Almost one in four (24%) cases of the disease in the UK could be prevented if people kept to a normal weight and did not drink, it estimates. Liver cancer is now the tenth type of cancer that evidence has linked to excess weight.

The WCRF’s analysis also found strong evidence that coffee could help protect against liver cancer, though it did not specify the amounts someone needs to drink. It has previously linked coffee to a reduced risk of womb cancer.

Paul Pharoah, professor of cancer epidemiology at Cambridge University, cast doubt on the WCRF’s findings. “I do not think that the published data are sufficiently robust to conclude that three drinks a day specifically is associated with an increased risk of primary liver cancer,” he said.

Two European studies among the 34 the WCRF examined showed that people consuming between one and three drinks a day were running no increased risk of liver cancer, but both found evidence that four or more drinks a day does worsen the chances of getting it, Pharoah added.

Makes sense to me ….

Alcohol or Marijuana? A Pediatrician Faces the Question

This was taken from The New York Times in March and I’m featuring it because it is something I too have thought about as a parent.

As my children, and my friends’ children, are getting older, a question that comes up again and again from friends is this: Which would I rather my children use — alcohol or marijuana?

The immediate answer, of course, is “neither.” But no parent accepts that. It’s assumed, and not incorrectly, that the vast majority of adolescents will try one or the other, especially when they go to college. So they press me further.

The easy answer is to demonize marijuana. It’s illegal, after all. Moreover, its potential downsides are well known. Scans show that marijuana use is associated with potential changes in the brain. It’s associated with increases in the risk of psychosis. It may be associated with changes in lung function or long-term cancer risk, even though a growing body of evidence says that seems unlikely. It can harm memory, it’s associated with lower academic achievement, and its use is linked to less success later in life.

But these are all associations, not known causal pathways. It may be, for instance, that people predisposed to psychosis are more likely to use pot. We don’t know. Moreover, all of these potential dangers seem scary only when viewed in isolation. Put them next to alcohol, and everything looks different.

Because marijuana is illegal, the first thing I think about before answering is crime. In many states, being caught with marijuana is much worse than being caught with alcohol while underage. But ignoring the relationship between alcohol and crime is a big mistake. The National Council on Alcoholism and Drug Dependence reports that alcohol use is a factor in 40 percent of all violent crimes in the United States, including 37 percent of rapes and 27 percent of aggravated assaults.

No such association has been found among marijuana users. Although there are studies that can link marijuana to crime, it’s almost all centered on its illegal distribution. People who are high are not committing violence.

People will argue that casual use isn’t the issue; it’s abuse that’s worrisome for crime. They’re right — but for alcohol. A recent study in Pediatrics investigated the factors associated with death in delinquent youth. Researchers found that about 19 percent of delinquent males and 11 percent of delinquent females had an alcohol use disorder. Further, they found that even five years after detention, those with an alcohol use disorder had a 4.7 times greater risk of death from external causes, like homicide, than those without an alcohol disorder.

When I’m debating my answer, I think about health as well. Once again, there’s no comparison. Binge drinking accounted for about half of the more than 80,000 alcohol-related deaths in the United States in 2010, according to a 2012 report by the Centers for Disease Control and Prevention. The economic costs associated with excessive alcohol consumption in the United States were estimated to be about $225 billion. Binge drinking, defined as four or more drinks for women and five or more drinks for men on a single occasion, isn’t rare either. More than 17 percent of all people in the United States are binge drinkers, and more than 28 percent of people age 18 to 24.

Binge drinking is more common among people with a household income of at least $75,000. This is a solid middle-class problem.

Marijuana, on the other hand, kills almost no one. The number of deaths attributed to marijuana use is pretty much zero. A study that tracked more than 45,000 Swedes for 15 years found no increase in mortality in those who used marijuana, after controlling for other factors. Another study published in the American Journal of Public Health followed more than 65,000 people in the United States and found that marijuana use had no effect at all on mortality in healthy men and women.

I think about which is more dangerous when driving. A 2013 case-control study found that marijuana use increased the odds of being in a fatal crash by 83 percent. But adding alcohol to drug use increased the odds of a fatal crash by more than 2,200 percent. A more recent study found that, after controlling for various factors, a detectable amount of THC, the active ingredient in pot, in the blood did not increase the risk of accidents at all. Having a blood alcohol level of at least 0.05 percent, though, increased the odds of being in a crash by 575 percent.

I think about which substance might put young people at risk for being hurt by others. That’s where things become even more stark. In 1995 alone, college students reported more than 460,000 alcohol-related incidents of violence in the United States. A 2011 prospective study found that mental and physical dating abuse were more common on drinking days among college students. On the other hand, a 2014 study looking at marijuana use and intimate partner violence in the first nine years of marriage found that those who used marijuana had lower rates of such violence. Indeed, the men who used marijuana the most were the least likely to commit violence against a partner.

Most people come out of college not dependent on the substances they experimented with there. But some do. So I also consider which of the two might lead to abuse. Even there, alcohol fares poorly compared with marijuana. While 9 percent of pot users eventually become dependent, more than 20 percent of alcohol users do.

An often-quoted, although hotly debated, study in the Lancet ranked many drugs according to their harm score, both to users and to others. Alcohol was clearly in the lead. One could make a case, though, that heroin, crack cocaine and methamphetamine would be worse if they were legal and more commonly used. But it’s hard to see how pot could overtake alcohol even if it were universally legal. Use of marijuana is not rare, even now when it’s widely illegal to buy and use. It’s estimated that almost half of Americans age 18 to 20 have tried it at some point in their lives; more than a third of them have used it in the last year.

I also can’t ignore what I’ve seen as a pediatrician. I’ve seen young people brought to the emergency room because they’ve consumed too much alcohol and become poisoned. That happens thousands of times a year. Some even die.

And when my oldest child heads off to college in the not-too-distant future, this is what I will think of: Every year more than 1,800 college students die from alcohol-related accidents. About 600,000 are injured while under alcohol’s influence, almost 700,000 are assaulted, and almost 100,000 are sexually assaulted. About 400,000 have unprotected sex, and 100,000 are too drunk to know if they consented. The numbers for pot aren’t even in the same league.

I’m a pediatrician, as well as a parent. I can, I suppose, demand that my children, and those I care for in a clinic, never engage in risky behavior. But that doesn’t work. Many will still engage in sexual activity, for instance, no matter how much I preach about the risk of a sexually transmitted infection or pregnancy. Because of that, I have conversations about how to minimize risk by making informed choices. While no sex is preferable to unprotected sex, so is sex with a condom. Talking about the harm reduction from condom use doesn’t mean I’m telling them to have sex.

Similarly, none of these arguments I’ve presented are “pro pot” in the sense that I’m saying that adolescents should go use marijuana without worrying about consequences. There’s little question that marijuana carries with it risks to people who use it, as well as to the nation. The number of people who will be hurt from it, will hurt others because of it, begin to abuse it, and suffer negative consequences from it are certainly greater than zero. But looking only at those dangers, and refusing to grapple with them in the context of our society’s implicit consent for alcohol use in young adults, is irrational.

When someone asks me whether I’d rather my children use pot or alcohol, after sifting through all the studies and all the data, I still say “neither.” Usually, I say it more than once. But if I’m forced to make a choice, the answer is “marijuana.”

Aaron E. Carroll is a professor of pediatrics at Indiana University School of Medicine and you know what – I completely agree.  What are your thoughts?

Edited to add: supporting evidence

Weed is 114 times less deadly than alcohol, study finds

Sober Sex

sober sex

So thanks to Laura over at Club Soda for sending this to me 🙂  The language is ripe so be warned!

I was really laughing up until the last 5 seconds where it let itself down …. but it’s still worth sharing.

Sex is a subject that we don’t talk about much out here in the sober blogosphere (and here’s my one and only post about it here) but as you can see this short video has had over 28 million views since it was posted in the summer of 2012.  That’s a lot of views!!

That said I would have rather talked about my sex life to you than the truth about my drinking before I stopped so there is some shared awkwardness and shame around these two subjects in an ‘elephant in the room’ kind of way.

Laura tells me they have an intimacy therapist doing some sessions for Club Soda in the not too distant future which sounds interesting if anyone is worried about this element of sober living 😉

How to drink mindfully

Following on from the past two days posts about Moderation Management and moderate drinking I finish up talking about mindful drinking.


Choosing to alter your relationship with alcohol and drink moderately can be achieved through mindfulness and deliberate behavior modifications.  Mindfulness allows you to become aware of your ongoing moment-to-moment experience.  It is the opposite of “checking out.”  When you choose to tune in to the present moment and tap into your ability to increase self-awareness, changes in problematic drinking habits can occur.

Mindfulness acts as a well-lit mirror turned upon the self.  It allows you to see yourself and reality exactly as they are.  If the idea of casting the bright light of mindfulness onto your drinking habits makes you uncomfortable, it is worth asking yourself exactly what it is that you are afraid to see.  Mindfulness does not create anything that isn’t already present.  It is a tool that enables you to see things exactly as they are. When being mindful, you make no attempts to judge or change reality – you simply accept it.  Once you see things clearly and accept them for what they are, you are in the position to assess what you would like to see change.

So for me the mindfulness only came out when I stopped drinking as I liked to get ‘mindlessly drunk’.  As lovely as the idea of mindful drinking sounds it is also an oxymoron as alcohol reduces inhibitions so works to pull you in completely the opposite direction.  Nice idea – never gonna work for me and quite frankly I’m mad enough as it is! 😉

voluntary madness



How to drink moderately

Following on from yesterday’s post about the organisation Moderation Management here are a few more to ponder the issue and whether this is the starting point for you in your journey of re-evaluating your relationship with booze and whether you are able to drink moderately: offers an evidence-based treatment (listed on the National Register of Evidence-Based Programs and Practices – NREPP) for people who wish to cut back on drinking through making deliberate behavioral choices and increasing awareness of drinking habits.  Moderate drinking is not recommended for individuals who are physically dependent on alcohol, have physical conditions aggravated by alcohol, or who identify as alcoholics.

Moderate Drinking

The general consensus in the scientific community about what constitutes “moderate drinking” is:

  • No more than 3-4 standard drinks per drinking episode
  • No more than 9 drinks per week for women
  • No more than 12-14 drinks per week for men
  • Limiting how fast you drink (generally no more than one drink per hour), keeping your blood alcohol concentration (BAC) below .055 (.08 is the DWI limit in most states)

The idea behind drinking mindfully and in moderation is to enjoy alcohol responsibly without getting “drunk.” People have vastly differing relationships with alcohol.  Some people are naturally predisposed to being mindfully tuned in to their alcohol consumption and have little trouble enjoying alcohol mindfully and responsibly.  Other people struggle to maintain mindful self-awareness, allowing alcohol to act as a behavioral disinhibition system that results in engaging in actions counter to their values.

If you struggle with this form of alcohol abuse, it is important to honestly assess your own behavioral patterns and ask yourself what you are willing to change.  If you find that your use of alcohol leads to feelings of guilt, shame, or remorse, choose to be honest with yourself about the problem.  You can make the choice in this moment to rethink your relationship with alcohol and begin to drink more responsibly and mindfully moving forward.  Use the present moment as an opportunity to begin to act differently.

Drinking in moderation means that you can still enjoy a few drinks with friends and family without being worried that you will lose self-control.  It means that you are in control of your behavior… the alcohol is not in the driver’s seat anymore.

“Costs” of Drinking in Moderation

Consider all of the things you will lose by choosing to drink in moderation:

  • Problems in your relationships with others because of your drinking
  • Problems at work or school because of your drinking
  • Financial or legal problems due to your drinking
  • Health problems due to your drinking
  • Blackouts” – not remembering portions of the night before
  • Hangovers” – feeling sick, tired, and sluggish for the majority of the day after drinking
  • Damage to your reputation due to your drinking

Will you miss any of those consequences of heavy/irresponsible drinking?  Doubtful.  When you choose to alter your drinking habits and enjoy alcohol in moderation you are finally free of the fears and pain associated with alcohol abuse.

“Benefits” of Drinking in Moderation

Reflect upon all that you have to gain by choosing to drink in moderation:

  • Feeling alert, rested, and refreshed in the morning
  • Harmony and trust in your relationships with others
  • A clear conscience – knowing you have not behaved in ways that you regret and that are not aligned with your values
  • More money – less spending on excessive alcohol consumption
  • Feeling physically healthy
  • Feeling confident that you remember things that you say and do
  • Being in control of your actions

Moderation Management offers a behavioral change program designed to help people concerned about their drinking habits take responsibility for their drinking behaviors and begin to make healthy lifestyle changes.  This type of moderation program may be particularly helpful for those concerned about alcohol abuse (i.e., not alcohol dependence).

Choosing to commit to a drinking moderation program means that you will begin to become more mindfully aware of your drinking patterns and take full responsibility for your actions. In order for behavioral change to occur, you must commit to doing the work. When the pain and suffering that irresponsible drinking becomes great enough, you will become willing to do what it takes to make an honest self-appraisal and make behavioral changes.

Moderation Management

Moderation Management encourages individuals interested in drinking moderately to:

  • Begin by abstaining from alcoholic beverages for 30 days
  • Examine how drinking has affected your life
  • Write down your life priorities
  • Take a look at how much, how often, and under what circumstances you drink
  • Learn about guidelines for drinking in moderation
  • Set moderate drinking limits (track your drinking through a journal or spreadsheet)
  • Begin to take small steps toward balance and moderation in other areas of life

How do you envision that your life will be different if you begin to drink moderately and mindfully?  How committed are you to making real behavioral changes?  Begin to think of drinking in moderation not as a temporary project, but as an actual lifestyle change.  Take the time to weigh the pros and cons of drinking mindfully, moderately, and responsibly.  How much longer are you willing to endure the negative consequences associated with irresponsible drinking?  Choose to get committed to a lifestyle that promotes mindful awareness, health, and balance.

– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – –

If you are interested in assessing your “chances of success,” according to, for drinking moderately, you can take a free online assessment.

If you are interested in getting general feedback about your drinking habits, you can take a free “Drinker’s Check-up.”

eCHECKUP to-go” offers online evidence-based prevention and assessment tools for both alcohol use and marijuana use.

As you can probably tell this is from an American website.  For UK guidelines you can visit the NHS website Change for Life or the alcohol industry funded

Another post tomorrow will rap up this short review and reflection on moderation as an approach and consideration.