Oh, I absolutely agree that patients under-report, or minimize their bad habits. I’m not a family practitioner (retired foot & ankle surgeon), but just a little digging in patient’s pre-op H&Ps and further questioning routinely reveals minimized reporting of alcohol, tobacco and drug use. Whether they are lying to the doc, or lying to themselves, it’s always counter-productive to minimize your social history to your physician.
Often it’s the patient’s spouse who squeals on them.
Bob, you drink a hell of a lot more than a six-pack a week!!!
I normally have a bottle of single malt whisky open and many nights I’ll have a nip, using a wee Glencairn glass. We fill it to about the widest point, which is about about 30 ml, just over an ounce.
So my normal drink is not even a full drink.
I go to dinner with a friend about every 6-8 weeks. Last time we went for cocktails first, but had just one cocktail each, and then a glass of champagne, and a glass of wine, so three servings, over 3 hours.
About every 4 months, my work has an alcohol-fueled evening. That might be around 4 servings in 2 hours, and those occasions are becoming fewer and fewer. For many work-related drinking, I tend to choose beer, and stick with one beer. With wine it is too easy to lose track of consumption.
Ehh, part of the problem is defining a drink. Credit to @DSeid who very clearly defined it for this thread, but I have a friend who IMHO drinks to excess but doesn’t report it accurately for this reason.
In his opinion, he has one drink a day after work and 2-3 on each day of the weekend. Which is, well, more than I would, but not super excessive.
Except the drink is normally a heavy bourbon old fashioned (about 3 oz), which would count as two drinks for purposes of this thread, doubling his actual drinking. And they don’t count an extra drink that is ‘used to take the edge off’ after a bad day because that’s practically medicinal, not really ‘drinking’. Which would probably add at least 2-4 more per week.
But, it is important to get an accurate history. I’m not going to give a PO script for a narcotic analgesic to an abuser. My job is to help patients, not kill them.
I voted none. When I was well into perimenopause, even one glass of wine started to affect me badly. It made my heart pound and I felt sick. So I just stopped having even a little wine with dinner.
That was about fifteen years ago. I don’t miss it a bit.
Rant: or exaggerating. I’m still mad at the pediatrician who didn’t want to see my son when he had a cut on his scalp. I carefully described the exact dimensions of the cut. Later, i brought the kids in for something unrelated, and there was still a scab from the healing cut. “Usually, we’d put a couple of stitches in a cut this large…” Well fuck you for assuming i wasn’t telling the truth when i called.
At least i learned my lesson. When my daughter had a similar sized cut on her face, and i tried to get pre-authorization for a visit to the emergency room, i didn’t accept “just ignore it” as an answer. She came home with 26 tiny stitches.
Sorry, rant off. I’m sure lots of patients lie to their doctors. I’m not one of them.
Aside from the fact that different people perceive the effects of alcohol in different ways, that last sentence raises the question of what one means by “buzzed”. Technically, the perceived pleasurable feelings from occasional or moderate use of alcohol are related to those produced by opioids, specifically the release of opioid peptides in brain regions that are associated with positive reinforcement. This is a remarkable and potentially beneficial fact and also a red flag for addiction potential. Some people’s psychology may make them more prone to motivated drinking; for example, those with an excessive tendency toward stress and worry.
Without being judgmental one way or the other, I can appreciate that fact and is one reason that I indulge in it myself (and perhaps, by many definitions, over-indulge) another reason being the wonderful synergy of wine with good food that I mentioned before. Where it becomes objectively very problematic in several different ways is if one regularly drinks to the point of impairment. This is of course physically very harmful, but inasmuch as an impaired individual isn’t really capable of doing or enjoying much of anything, ISTM that regular impairment is indicative of a deep underlying problem. Worse than that, sustained very heavy drinking has the opposite effect on the brain’s reward center and creates opioid deficiency, leading to a potential downward spiral of withdrawal and depression.
All of which is to day that IMHO regular and even daily drinking can be pleasurable and rewarding, while at the same time one must be very cautious that regular heavy drinking to the point of impairment – flat-out drunkenness – is exceedingly dangerous in multiple different ways. Both those things can be true simultaneously.
Regardless of the amount, a little or a lot can make people feel differently. I’ve been buzzed before and drunk before and neither feels very good to me. When I was 18 to 23 years old or so, I partied and drank. It was fun and kind of novel but wasn’t particularly great. A few friends in recovery told me that those first few drinks are the most amazing feeling in the world. It’s not necessarily stress relief as much as it’s indulgence. (Nothing wrong with indulgence. I have my own ways of doing so.)
None for the past 15-20 years. Before then, my baseline was a case of beer a week - mostly Friday thru Sunday. Plus whatever I’d drink if we went out. I tried moderation management which IIRC was 14 drinks/week, no more than 3 on any day, no more than 2 days in a row. Decided it was easier to just stop cold turkey.
Wish I had learned moderate drinking habits instead of nearly daily binging in college.
I drink maybe twice a year. I can only do it when I’m not the one driving because I have interactions with various medications. I won’t even do one drink because I don’t want to strand myself. So it really only happens when my husband is with me, and it’s rare I’d have occasion to drink in that circumstance.
I love alcohol very much which is why I try to stay away from it as much as possible.
More than none and way less than a couple per week.
I’ve never been much for alcohol, even less now due to living with a recovering alcoholic. Sometimes she’ll fall off the wagon and get us some beer; last time was a couple of years ago.
In early 2018/19 I dated a woman who decided that she needed to quit alcohol. I didn’t personally think that she had a problem but I never articulated that and told her that I would support her. In solidarity, I gave up soda. I had already backed down from a couple of sodas a day to a couple of sodas a week over the previous several years. She started drinking a few months later and dumped me soon after (probably not completely related). I still haven’t fallen off of the soda wagon.
Thanks to a couple of stomach ulcers, I can’t drink anymore. I have been known to sneak a beer (or two, but that’s pushing it) at special events, but the last time was about eight months ago. Red wine and liquor are totally off limits, and I miss them!
You seem like a compliant sort.