So… how about a drink? More specifically, how about a drink with alcohol in it?

Chances are, you’ve heard that question. Or you’ve asked it. Or, maybe you’ve asked yourself that question.

We live in a culture in which alcohol is widely promoted. We see it in advertising. At events with family and friends. At restaurants, as well as the numerous bars that are prevalent in big and small towns.

A lot of my clients talk to me about their drinking. Some of them have been treated for problems with alcohol use in the past, and are working on maintaining their sobriety. Or currently struggling with it. Others don’t drink at all and are comfortable with that decision. I also have clients who drink socially and feel okay with the role of alcohol in their life.

But I also have clients who are not sure if their current use of alcohol is healthy for them. They may have doubts that they aren’t quite ready to acknowledge. Many of these clients are also living with chronic conditions.

Here are a couple of examples:

A young man I’ll call Mark is living with an autoimmune condition that causes pain and fatigue. Accepting his diagnosis and adjusting his lifestyle to accommodate the symptoms and treatment of his condition has been a challenge, and he has been feeling sad about the changes in his life, and fearful about the future. He’s been coming home from his job and sitting in front of the TV with a glass of wine which, on many evenings, has progressed to a bottle of wine. His weekend drinking can exceed that if he is home alone in his apartment.

A woman in her 50s I’ll call Mary is living with two chronic conditions, including Type II diabetes. She recently talked about attending a family event and accepting the offer of a drink. While she was aware that this could have consequences, she wanted to feel part of the celebration and not an “outsider.” This led to a second drink, followed by symptoms that required some assistance from her husband. Mary felt the effects of those drinks for a few days after this event.

If you’re living with a chronic condition, you have most likely had the alcohol lecture from your physician. Alcohol can reduce the effectiveness of medications. It can bring on uncomfortable or even dangerous symptoms. Alcohol can interfere with your ability to cope emotionally. And it can have a long-term negative impact on your health.

So why do my clients with chronic conditions drink? Well, for a lot of reasons. Some of them include:

  • To feel like part of the group. Sure, everybody else seems to be having a drink. And you might be talking yourself into joining in to feel like one of the group. Normal. But lifting that glass doesn’t determine whether you are an insider or an outsider.
  • To numb emotional pain. Feelings like anger, sadness, disappointment. It may work for a little while. But keep in mind that alcohol is also a depressant, and it can leave you feeling even more down.
  • To cope with physical symptoms. If this is a fix at all, it is temporary. And it can have a further impact on your health as well as keep your medications from working as well as they can.
  • To cover up feelings of loneliness. Alcohol can feel like a good buddy who is there every step of the way. But at the bottom of that empty bottle is just more emptiness.

It’s not my intention to lecture you about alcohol use. But I do want to share some of the advice that I give my clients when they talk about the role of alcohol in their lives and how it interferes with their physical and emotional wellness. Here goes:

Take responsibility for your alcohol use. Sure, people around you may be pushing for you to drink. Or, having that glass of wine or two at home may be a long-term habit. Or maybe you just “need a drink” when the stress builds up. Whatever the reason you have for drinking, you are still making a choice. You can choose to take a drink. You can also choose to change your drinking behavior. It starts with a decision that’s yours and yours alone.

Ask yourself why you are reaching for that drink. Think about the reasons listed above. You may have a reason of your own to add to the list. The point is to be aware. To walk into each and every situation where there is the possibility of having a drink – whether with other people or alone – with both eyes open. Why am I doing this? What am I hoping to get from taking this drink?

Remind yourself of the consequences. Every action – positive or negative – has a consequence. Drinking alcohol certainly does, starting with the first sip. What are the consequences for you, physical, mental, emotional? To answer that question, think about the impact of the last time you drank. You might want to record the consequences in a place you can reference the next time you are considering having a drink, or in a situation where you might drink irresponsibly.

Also ask: Am I willing to accept those consequences? That’s really what it comes down to, right?

Define what responsible alcohol use means for you. Now that you’ve given your alcohol use some hard thought, it’s time to define the place you want alcohol use to have in your life, if any. What does it mean for YOU to drink responsibly? Responsible alcohol use is up to the individual. You might want to have a conversation with your doctor as you define what responsible means for you. (By the way, you may not like what you hear.) Whether it’s abstinence, rarely, or with moderation, isn’t your wellbeing worth taking charge of your alcohol use?

Focus on the benefits of responsible alcohol use. The use of mind-altering substances like alcohol is often associated with the word “no.” As in, just say no. But also consider what you are saying yes to when you make healthy decisions about drinking. Better emotional health? Feeling better physically? Avoiding the damage that alcohol can cause? Say YES to the benefits of responsible alcohol use!

Do some homework on alternatives to drinking. As the saying goes, nature abhors a vacuum. So if you’re going to drink less, or not at all, what are you going to replace that glass of spirits with? Think little picture and big picture. In a social setting, is there something else you can sip on when everybody else is drinking alcohol? At home, is there something healthier you could sip on when watching TV? And from the big-picture perspective: Are there healthier ways to cope with your feelings? Is it time to spend more time with supportive people? To find some new ways to spend your time?

Ask for support. Talk to a friend or your partner to help you modify your alcohol use at social events. Have a list of people you can reach out to when you get that urge to hang out at home with a bottle. Let the people you live with know what you need. And if you can’t do it on your own, the bravest thing you can do is to reach out for help. Call a mental health professional, talk to your doctor, or check out alcohol treatment programs or 12-step groups in your community. There’s a lot of help out there!

So, how about a drink? Better yet, how about taking a look at what alcohol means to your health and deciding the place you want – or don’t want – alcohol to have in your life? Just say… Yes! To taking charge of your alcohol use. And to taking the best possible care of yourself!

More from Dr. Gary:
Someone With My Condition Just Died. What Does That Mean for Me?
Holiday Time! What Are You Saying "Yes" To?
Advice. Good, Bad? How to Decide, How to Say No