Sober curious movement

Maybe you’ve heard of dry January, but have you heard of the sober curious movement?  Jody Glance, MD, medical director of Addiction Medicine Services at UPMC Western Psychiatric Hospital, explains what it is and how to get started and discusses its many health benefits.

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– This podcast is for informational and educational purposes only. It is not medical care or advice. Clinicians should rely on their own medical judgments when advising their patients. Patients in need of medical care should consult their personal care provider.

– Is drinking less among your resolutions in the new year? Well, have you heard about the sober curious movement? Hi, I’m Tonia Caruso. Welcome to this UPMC HealthBeat Podcast. And joining us right now is Dr. Jody Glance. She’s the medical director of Addiction Medicine Services at UPMC Western Psychiatric Hospital. Thank you so much for joining us.

– Oh, thank you for having me. I’m really excited to be here and talk about this topic.

– Right, so, let’s start with really the basics. What is sober curious? How long has this idea been around?

– Sure. Well, the idea of sober curious actually evolved from a concept called “Dry January” that you might have heard of. The Dry January movement came around maybe a decade ago, but sober curious was coined by an author named Ruby Warrington. She wrote a book in 2016, I believe it was, called “Sober Curious.” Sober curious is about considering our relationship to alcohol. Are there any changes we would want to make around that? It’s not prescriptive. It’s not like, “OK, we’re going to take 30 days, and we’re going to stop drinking and see how it goes.” It’s more about, “What do I want to do? What choice do I want to make with this? Do I want to cut back on my drinking a little bit? Do I want to limit how much I drink for this many times per week, this many times per month? Do I want to just stop drinking completely?” And it’s just a chance to kind of recalibrate our relationship with alcohol.

– Right, and when we talk about Dry January, let’s tell folks what that is. It’s sort of the idea coming, that we’re coming off of the holidays, lots of parties, lots of socializing, and alcohol tends to be at parties.

– Right. January is when people tend to make resolutions. We’re done with the holidays. We’ve, like you said, come away from the parties. And a lot of times, that’s when people are making health-related resolutions, so it fits really nicely with that. And so the idea of Dry January is, “OK, these 31 days, I will abstain from alcohol and give myself a reset, a break, and see how it goes, see how it feels, see if I notice any benefits, any changes from not drinking.” And, just like I said, a reset, a recalibration, to see where you might want to go from there.

– So, sober curious: How does that differ from sobriety? They’re not the same things, correct?

– No, they’re not exactly the same thing. So, the term sobriety is typically used more for people who maybe have noticed they had a problem with alcohol. Maybe they started drinking and found they had difficulty stopping drinking, or they couldn’t control their alcohol use. And so, you hear that term more when people are completely abstaining, they’re not drinking at all. Sober curious is more about, “I’m not sure if I am ready to really commit to not drinking at all, but I am kind of curious about what it might be like.” Would there be any benefit to it?” And so, it’s a really more flexible kind of term.

– So you’re evaluating, and, “I’m going to try this, and I want to see, you know, are there benefits from here?” Is there another side of that that encourages you to do something else instead of drinking? Or, what sort of mindset when you walk into a party, what does this movement encourage you to think about?

– If you’ve spent a lot of time drinking, if it’s something you do regularly, it can be a challenge to think about, “OK, what will I do instead of drinking?” And so, it might be a really good idea to think about, what do you enjoy doing that doesn’t involve alcohol? Are there outdoor activities? Anything that gets you moving could be really good: a bike ride, a walk in the park, a walk in the woods, something like that. It could be about coming up with a different social scene that doesn’t involve alcohol, where there isn’t even alcohol around. So maybe you choose to do a coffee date instead of a meeting at the bar for a drink kind of a date. If you know you might be around alcohol but you’ve decided not to drink, it’s good to have an idea of what you want to say in situations like that. So, sometimes you can just be straightforward, like, “Hey, I’m cutting back.” But, sometimes you might not feel as comfortable with that, so you might want to come up with something else in advance about the reason that you’re not drinking, like, “Oh, I have an early morning tomorrow.” It helps to just have a drink in your hand if you’re at some kind of a party where people might continually be noticing, “Oh, you’re not drinking. Here, do you want something?” and offering you something. So, maybe you just have a glass of sparkling water, or something in your hand that people aren’t going to be asking you constantly.

– And I’ve read some things about younger people are really taking this on.

– Yeah.

– So, initially I was thinking, oh, these are just old people who are like, “Now I can’t drink like I used to, and so I’ve cut back.” So I’m sober curious, just out of facts of life.” But this is a young person’s movement as well.

– It is. And so, Gen Z tends to drink less than the older generations, just as a whole. And younger people are really embracing this and deciding, you know, that they don’t want to drink as much or that they don’t want to drink at all. And, of course, it’s not limited by age. Anybody can decide that they want to give this a try.

– What do we know, though, that some of the benefits are of being sober curious?

– Well, they’ve done some studies on this and looked at what do people say, what do they report as being some benefits? So, people, by and large, do say it gives them a sense of accomplishment that, “Wow, I didn’t know if I could do it, but I went a whole month, I didn’t drink anything.” Or, they stuck to their goals. So, there’s that. But there are also some really more tangible benefits. So, better sleep, better energy, feeling like you can think more clearly, better cognitive functioning during the day. And then, there are also a lot of other health benefits. Alcohol in excess can really cause all kinds of damage to our bodies and to our brains. It can be a strong factor for some kinds of cancer, in fact; liver disease, of course; heart disease, high blood pressure. A lot of the drinks are really sweet and sugary and can lead to things like metabolic problems, diabetes, even. So, if you’re not drinking as much, then you’re going to notice benefits in all of those areas.

– How does alcohol impact the brain?

– There are some short-term effects and some long-term effects. So, in the short term, it can cause a lot of disinhibition, so people will notice sometimes that their personality might change if they’ve had too much to drink. It decreases reaction time, response time. So, of course, drinking and driving is a huge problem because we don’t always know that we’re impaired until it’s too late. And then, longer-term, alcohol can give us problems with our thinking, with our memory. Memory can be really sensitive to the effects of alcohol. And, just that day-to-day cognitive functioning, you can feel kind of cloudy. If you think about after a day, if you’ve had maybe a little too much to drink the night before, then that day you might really be struggling to get through the workday or get through the day.

– If someone is watching this, listening to this, and they’re thinking, “I might like to try this,” what is the best way to get started? And, I’m wondering, are there online communities? I’m sure this has taken off across the internet.

– It really has. There are online communities. Reddit has some really nice communities. If you just looked up Reddit, and then “Dry January,” or Reddit and “Sober Curious,” you would find lots of people who have tried it, who have done it, and they can give you some great tips. And you can post on there, too, and just say, “Here’s what happened with with me. I’m wondering if anybody has ideas for what do you do at a party or at a wedding?” Those kinds of things. So, yeah, you can get a lot of good support online.

– And is it safe to say that we can make up our own rules? So, if we’re being sober curious and not Dry January, so Dry January, you know, that’s an entire month where I’m not going to have one thing to drink, sober curious, when you start, are there some hard and fast rules you should follow? Or can we make up our own rules?

– We can make up our own rules. It’s not a hard-and-fast thing; it’s not black and white. It’s just, what do you want to do? What fits in with where you are right now? You might decide right now, you just want to think about cutting back to a certain number of drinks per week or per month. And down the road you might say, “You know what? That went pretty well. Maybe now I want to give it a few weeks without drinking anything.” I do want to say, though, that stopping alcohol, to use the term “cold turkey,” just to abruptly stop drinking, can be dangerous depending how much you have been drinking. So, if you’ve been drinking more than one or two drinks every day, it would be a good idea to talk to a health care professional about is it safe to just stop drinking? Or do you need to have a little help to taper down and to stop?

– What are some of the dangers that run into that?

– Stopping abruptly can put you at risk of things like having seizures from withdrawal, from alcohol withdrawal. They’re not really common. They’re not super common, but they’re very dangerous. So, because of that, it’s a good idea to talk with someone. There are other more mild forms of withdrawal that can be uncomfortable, not necessarily dangerous, like feeling sweaty, tremulous, shaky. So, if you’re starting to think about stopping, and you go for a day or two where you’re not drinking, and you notice any of those things – shaking, tremors, sweat – it’s a really good idea to talk to somebody about it and to not try to do it by yourself.

– Right. And so that sort of then just plays into the larger picture of the sober curious, in that you can do this in small steps over time.

– Yes. Yes.

– And sort of the idea that the more you go without drinking, the better you start to feel, sort of then influences your decision then. And is the goal, like no matter what, if you’re down the road, you don’t feel compelled because there are so many social settings where alcohol is the primary.

– Yeah.

– And is it really the goal, then, to get to where that’s not the main attraction, that’s just there and if you want it, you have it, but, you know, you don’t feel odd saying, “No, I’m not going to have any tonight.”

– Right. Because the more you practice that, the easier it gets. I think people can’t even imagine it at first. You know, “Well, how am I going to say no when everybody else is drinking?” And, “I’ll be so uncomfortable if everyone else is drinking, I’m the only one not drinking.” What will people think?” But, really, probably people aren’t thinking about you at all, and they’re not even noticing that you’re not drinking. Or if they do and you just say, “Oh, no thanks,” I mean, most of the time people are not going to even think twice about it.

– Right. So tell me a little bit more about your work in Addiction Medicine Services.

– Yeah, so here at Western Psych, where I work, we have a pretty broad array of services that we offer to help people with both substance use disorders, and mental health disorders, and psychiatric disorders. So, a lot of times, they can go hand in hand. We have services that can help people stop drinking safely or stop using any kind of substance safely, including opioids, benzodiazepines, cocaine, anything. And then we also offer outpatient services for people who have co-occurring psychiatric and substance use disorders. And we have special programming for women with substance use disorders, for pregnant women with substance use disorders. We have opioid treatment programs, and we have one of the only opioid treatment programs in the country that offers full psychiatric services, in addition to all of the services for the opioid use disorder.

– And that’s so significant. And really, across the board, there’s stigma about drug and alcohol use, and it’s a medical problem.

– Yes.

– So, what do you want to say to people about not being afraid to seek out treatment?

– Yes, there is still a lot of stigma. I think that stigma is less than it used to be, but it’s still definitely there. Substance use disorders are so common, and they creep up on us. We don’t see them coming. Everybody that I see says, by and large, you know, they had no idea that they would end up where they are. Nobody sets out to try to get addicted to a substance or to have a substance use disorder. So, just know that there are millions of people out there with these problems, and you are not alone at all. And, we can talk in confidence. We can talk about whatever you think might be a problem. If you’re not sure if it’s a problem, we can talk about that and just kind of evaluate. Do we need to get into some kind of more formal treatment, or just kind of watch and wait and see how it’s going? So, you know, everybody is here to help you. If you want to talk to us, we’re here.

– And so, getting back to sober curious as we close, do you find if someone does this in a buddy system, does that work better?

– It really does work better to do it with another person or a group of people. You can do it alone, but it’s hard. It’s really hard because there will be times where it’s really challenging. Even people who don’t have a problem with alcohol or an alcohol use disorder, you know, if you’re just kind of in that habit and you’re used to drinking at certain events or having a glass of wine every night and you decide you don’t want to do that, these will pop up as cravings, and you’ll feel very strongly this urge like, “Oh my goodness, I really need a drink.” It can be helpful, though, to know that these really do just last no more than a couple of minutes, these kinds of cravings, and usually more on the magnitude of seconds. So, if you can just think of it like a wave, you know, “Yes, I’m feeling this real strong urge right now to drink, but I know that that’s going to go away.” The more often you let that kind of ebb and flow, the easier it gets. And the first couple weeks, I think, are the hardest. If you are trying to stop altogether, the first couple weeks can be really, really tough. And, so, having someone else who’s doing the same thing with you, an accountability partner, can be really helpful. And then, after the first two, three weeks, it gets a lot easier.

– Yeah. Well, some fantastic information. We thank you so much for coming in and spending time with us today. We certainly do appreciate it.

– Thank you, Tonia.

– You’re welcome. I’m Tonia Caruso. Thank you for joining us. This is UPMC HealthBeat.

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