Problem Drinkers Finding More Help Online

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Did you resolve to stop drinking in 2010 — or even to just cut back a bit? One place to spend some of the time you don't plan to be spending in bars may be the Internet. A new study adds to a growing body of literature suggesting that free online drinker-checkup programs can have powerful effects on reducing alcohol-related problems.

The new research, published in the journal Addiction, found that heavy drinkers cut their alcohol consumption 30% after using the website Check Your Drinking. The reduction was maintained for at least six months. A 2005 study of a slightly more intensive program, Drinkers Check-up, found a 45% to 55% drop maintained for a year, depending on how drinking was measured. Both sites are free, do not collect identifiable personal information and are open for public use. And the outcomes are comparable to those achieved with brief face-to-face counseling.

"These were people in the problem-drinker category," says lead researcher John Cunningham, senior scientist with the Canadian Center on Addiction & Mental Health. He explained that before they used the website, subjects were typically consuming 22 alcoholic drinks per week. "They drink enough to risk health consequences but are not severely dependent."

A 30% reduction in drinking for this group could easily move them out of the risky-drinking range and into the range that is believed to have neutral or even potentially positive health consequences. For example, cutting back from 21 drinks a week to 14 puts a man in the range that is considered moderate by U.S.-government guidelines. For women, the recommendation is no more than seven drinks per week. "It's a way to get people to think about drinking and motivate them to change if they think they are drinking too much," says Cunningham.

Although it is not known which components of the sites are most important in helping reduce drinking, getting people to just sit down and actually count their drinks per week is a big first step. But the program goes further than that. For example, Check Your Drinking provides information about what people of the same age and gender typically drink. "I'm not sure if the same parts are helpful to different people," says Cunningham. "For some, it's population norms: 'Wow, I drink more than 95% [of people] my age or sex.' The amount of money they are spending could be important to someone else." In addition, the program provides colorful charts and graphs as well as information about the effects of various amounts of alcohol on different parts of the body.

Drinkers Check-up, the subject of the 2005 study, helps people consider the pros and cons of continuing to drink in their current pattern. Reid Hester, director of research at Behavior Therapy Associates in Albuquerque, N.M., and one of the authors of the study, says he suspects that these additional elements may have accounted for the better results his site got. His study also included people with more severe problems, some of whom may have been more motivated to change.

Both studies add to a larger body of research that suggests that meeting people where they are — both physically and emotionally — can be less intimidating than requiring them to seek formal treatment that involves a diagnosis and a possibly stigmatizing label. "When you label people, when you tell them what to do and are confrontational, it basically raises a brick wall," says Hester. In fact, some studies have shown that the more counselors confront clients, the more the clients drink or take other drugs.

A website is not for everyone, of course. For those whose problem is so serious that quitting entirely is the only safe route, more intensive treatment — often maintained indefinitely — may be needed. Still, for people on the borderline who don't want to find themselves in that danger zone in a few years, a little Web-based self-awareness may make a very big difference.