If you are dependent on alcohol, or have other medical or mental health problems you should stop drinking completely. Reduction of heavy drinking may be a more acceptable goal for some patients who lack readiness to quit drinking.

The frequency of heavy drinking (more than five drinks per day for men and four for women) has the highest correlation with negative life consequences such as impaired driving, interpersonal problems, and injuries.

You need to cut down if in the past one year you have taken one or more times more than 5 drinks in a day (4 drinks for women). This positive response to a single question “How many times in the past year have you had X or more drinks in a day?”, where X is 5 for men and 4 for women, is recommended for use by the National Institute on Alcohol Abuse and Alcoholism. The sensitivity and specificity of this question is 81.8 and 79.3 percent, respectively.

One can also know the dependence of alcohol by using the CAGE questionnaire.
1. Have you ever felt the need to Cut down on drinking?
2. Have you ever felt Annoyed by criticism of your drinking?
3. Have you ever had Guilty feelings about your drinking?
4. Do you ever take a morning Eye opener (a drink first thing in the morning to steady your nerves or get rid of a hangover)?
One positive response to any question suggests need for closer assessment; two positive responses are seen in the majority of patients with alcoholism. Two positive response has a sensitivity of 77 percent and specificity of 80 percent in patients with alcohol dependence. Over 80 percent of nonalcoholic patients have a negative response to all four questions and virtually none has a positive response to more than two questions.

National Institute on Alcohol Abuse and Alcoholism suggests the following for stopping or reducing alcohol:
1. Put it in writing why you want to reduce or stop: Write what you want to achieve for example will feel healthier; will sleep better, will improve my relationships.
2. Write confessions: learn and practice various confession exercises. This will help you take care of inner guilt which may be the precipitating factors.
3. Set a drinking limit: Those who are cutting back should set a limit as per your health. Most healthy people should limit to less than 40 ml in one hour, 80 ml in one day and less than 240 ml in a week. Women should take less than half of this amount.
4. Keep a diary of your drinking. For initial 3-4 weeks, keep track of every drink. Note the situations you are most likely to drink. Give each situation rating out of ten. Try avoiding those situations for the next few weeks.
5. Don’t keep alcohol within your reach. Remove alcohol from your living place. This can help limit drinking.
6. Eat your drink. Drinking slowly can help. Sip and do not gulp. Sip soda, water, or juice after each drink. This is called Mindfulness drinking. Be aware of your drinking will cut it down. If your mind is not in drinking you will drink more.
7. Never drink on an empty stomach.
8. Keep a weekly one or two spiritual fast. This will allow alcohol-free days. Decide not to drink a day or two each week.
9. Observe spiritual retreats: Observing spiritual retreats (Navratri by Hindus, Ramazan by Muslims, and Easter by Christians) with no drinking can help. Or try abstaining for a week or a month to see your commitment to not drinking.
10. Become a tortoise: Learn to withdraw yourself from all stimuli which can force you to drink.
11. Watch for peer pressure. Learn to say no. Do not drink just because others are, and you shouldn’t feel obligated to accept every drink you’re offered. Stay away from people who encourage you to drink.
12. Keep busy. Take a walk, play sports, go out to eat, or catch a movie. When you’re at home, pick up a new hobby or revisit an old one. Painting, board games, playing a musical instrument, woodworking — these and other activities are great alternatives to drinking.
13. Ask for support. Let friends and family members know that you need their support.
14. Guard against triggers. Stay away from people and places that make you want to drink. In Yoga it is called Pratahyara and means staying away from the external stimuli. Lust cannot be removed by staying in a lustful atmosphere.
15. Be persistent. Most people who successfully cut down or stop drinking altogether do so only after several attempts.

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