Two Chiantis equals One Martini

That a martini counts as two drinks, not one, was just one of the startling facts I learned from addiction doctor Arnold Washton at the Princeton Chamber breakfast on January 14. Washton counsels CEOs, doctors, and lawyers who realize they have a problem but who don’t want to declare themselves alcoholics. As financial problems rise, so will addiction rates, he predicts. Neither animals (lab rats) nor humans handle uncertainty well.

Washton is a substance abuse consultant for Princeton House Behavioral Health who has his own consulting practice, and he spent 10 years working with heroin addicts in Harlem. He says it is hard to pick out a substance or alcohol abuser in the workplace. “I can’t remember the last time somebody walked in my door looking high or drunk,” he says. Abusers build up tolerance.

It doesn’t matter what you choose – beer, wine, or distilled spirits – to relieve your anxiety, says Washton. The brain responds to the concentration of alcohol in your blood. “Every time you take a drink, you are playing with your brain chemistry.” Some alcoholics don’t drink every day – they go on binges, or maybe they drink on the weekends.

“People gravitate to substances that work, but the substance betrays them,” he says. Caffeine and nicotine are addictive, but they do not induced aberrant or psychotic behaviors that lead people to do crazy, self destructive things. For information, go to SAMHSA’s National Clearinghouse for Alcohol and Drug Information.

For those whose problem falls short of addiction, Washton offers the hope of continuing to drink in moderation. The upper limits for what can be considered a moderate drinker: For a man, three to four units of alcohol per day, but no more than 14 per week. A unit is 5 ounces of wine, 12 ounces of beer, or 1 shot of distilled spirits (martinis count for two). It’s that “14 a week” that’s key. You can’t drink three beers a day every day and still be counted as a moderate drinker.

For women, the moderate level is 2 to 3 drinks per day, and only 7 per week. (I’m such a cheap date that I’m pretty much done in by 4 ounces of wine.) Those with a family history of addiction should observe a lower limit. Medication affects the limits, and alcohol makes sleep problems worse.

To cut down to “moderate” levels, his patients must abstain for one or two weeks. He presents it as “an interim period of abstinence” versus requiring them to attend an AA meeting. “It doesn’t work to tell them to stop drinking for the rest of their lives. For my patients, that’s unthinkable. The more severe the problem, the more reluctant they are to give it up.” After the abstinence period, the patients help set their drinking rules. “When they fail miserably, they see it is what they did.”

Some eventually realize they need to abstain. “I pair them up with another high profile business executive who is already going to AA.”

The best advice: Don’t drink when you are upset. Break the cycle of self medication.

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