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We’re back with Dr. Jody Ryan, chief medical officer at WellPower, to discuss tips for managing alcohol and substance use during the holidays. Dr. Ryan is a board-certified and American Board of Addiction Medicine (ABAM)-certified psychiatrist with a specialty in addition medicine. If you missed last month’s interview on addiction trends in Denver, you can catch up here.

Q: I tend to drink more alcohol during the holidays, and I know people who use substances more often to deal with the increased stress. What are some ways to manage this?

A: That’s quite common, especially in times of increased stress. There are so many benefits to being mindful of our substance intake. I’ll offer five tips to start:

• Reflect on your routine. What could I do instead of doing the same thing every day? Often, alcohol and other substances fill a role in our routine, and we use them on “autopilot.” Are there small things you could do that are different from your routine that aren’t already linked with alcohol or other substances?
• Think about realistic goals. Realistic is key here, because it’s so common to think that we have to make major changes all at once. So, maybe your goal isn’t to cut out all alcohol, for example, but to start walking three times a week instead of having a drink during that time. The more you make walking a habit, you might discover that you’re not doing what you used to do with the same frequency.
• Add good things. Using alcohol as an example again, try building enjoyable activities that compete with drinking. Create more of a life where the time you spend drinking is in competition with the other things that you find enjoyable. The idea is that if you don’t have time to drink because you’re doing something you really enjoy, you’re benefitting in two ways: 1) you’re making more time for good things, which we should all be doing more of anyway, and 2) you just happen to be drinking less as a result. So, the focus is not so much on taking away something undesirable, it’s on adding something good to your life.
• Find other ways to indulge yourself. Adding good things doesn’t always have to involve other people or be a big-time commitment. I know someone who discovered a kind of sparkling water he really enjoys. He’s made the conscious decision to indulge in this delicious beverage on weeknights, which naturally conflicts with alcohol. As a result, he just happens to be consuming less alcohol. Chocolate is another common option – what if you had a little of your favorite chocolate instead of one glass of wine?
• Win the party with a mocktail. Rather than showing up with yet another generic bottle of red to add to the counter, why not try bringing a non-alcoholic cocktail (often called “mocktails”)? You can either make your own or just pick something up from the store. The pre-made varieties have come a long way in recent years and there are some genuinely delicious options out there, with new ones coming out all the time. This isn’t just as a substitute for people who don’t drink alcohol – other people are going to want to join in, too, and now you’ve introduced a good thing that happens to result in people moderating their alcohol intake a little. It also makes a great topic of conversation, and there’s a good chance that people will be talking about it afterwards because they’ve never had it before.

Q: What about for people who are working on managing an addiction – either ourselves or other people in our lives?

A: Addiction is a learned coping mechanism: “When I’m stressed, this drug helps” – for a while, that is, and then it gradually stops working as well, so now I need to add or change drugs to compensate. From there, it isn’t too long before substance use is no longer about feeling the effects of the drug and much more about just avoiding the deeply negative experience of withdrawal. This pattern can quickly cycle until we realize in hindsight that we’re now dealing with addiction.

If you have someone in your life who you want to drink less, you might try using yourself as the focus of the conversation, at least at first. Ask the person things like, “Do you think I drink too much?” as a way of bringing up the topic and helping them to look at it objectively.

At some point in the conversation, you might suggest that the two of you do something new together that doesn’t involve drinking or substance use. This goes back to the “adding something good” approach – what’s something enjoyable you can both add to your time together that doesn’t involve substance use? If you hang around with people with the same goal, you’ll have a much better chance of achieving it.

It’s also helpful to have a healthcare provider you can have an honest conversation with. Ask them what they think about how much you drink or use other substances. It can be helpful to start with an open conversation and decide together what you want to do.

Q: What are some resources if I need more help for myself or a loved one?

A: Here are a few resources to start with depending on your situation:

• 911: If you or someone else is having a medical emergency, call 911.
• Colorado Crisis Services: In Colorado, you can access 24/7 support through Colorado Crisis Services:
  • Call 1-844-493-8255,
  • Text TALK to 38255, or
  • Visit a walk-in center
• SAMHSA Helpline: The Substance Abuse and Mental Health Services Administration (SAMHSA) has a helpline you can call for resources around addiction: 1-800-662-HELP (4357).
• STAR Program: If you’re in Denver (or a few other counties in Colorado) and see someone who looks like they could use some help and it is not a medical emergency, remember that you can call the STAR program. STAR sends a paramedic and mental health worker to certain 911 calls. You can either call 911 and ask the dispatcher to send STAR or call STAR directly: 720-913-7827.