To drink less, first tally how much you drink each week, then chat briefly with a doctor.

21. To drink less, first tally how much you drink each week, then chat briefly with a doctor.

Cost: No cost at all. Just count the number of drinks each day and jot it down. Asking your doctor about this during a routine visit costs nothing extra.

In plain terms: A doctor can spend a few minutes reviewing your weekly alcohol intake, explaining the associated risks, and helping you set a realistic goal. After a year, people following this approach typically cut their weekly consumption by about 20 grams of pure alcohol — roughly equivalent to half a liter of beer. Longer consultations do not bring any additional benefits. For those already struggling with heavy drinking, two medications have been proven effective abroad: roughly one in twelve treated individuals stops drinking excessively after treatment.

Benefit: Data from 34 randomized trials involving 15,197 participants show that individuals receiving brief interventions ended up drinking 20 grams less pure alcohol per week than those receiving minimal or no intervention (95% confidence interval: 12–28 grams; evidence of moderate quality). The average baseline consumption among these participants was 244 grams per week. “Brief interventions” here refer to no more than five counseling sessions totaling under 60 minutes; longer sessions provide no extra advantage. Regarding medications: 122 trials with 22,803 participants indicate that acamprosate helps one additional person per 12 treated to abstain from any drinking (95% CI: 8–26). Oral naltrexone at 50 mg daily also yields similar results — one extra abstainer per 12 patients (95% CI: 8–26).

Evidence grade: A

Sources: Kaner EF, Beyer FR, Muirhead C, et al. (2018). Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database of Systematic Reviews, 2, CD004148. <https://doi.org/10.1002/14651858.CD004148.pub4>; Jonas DE, Amick HR, Feltner C, et al. (2014). Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis. JAMA, 311(18), 1889–1900. <https://doi.org/10.1001/jama.2014.3628>

Notes: The benefit is classified as “small” because these figures reflect reductions in alcohol intake rather than lower mortality rates; per our guidelines, outcomes based on surrogate endpoints receive this rating. Most drug trials were conducted abroad, with participants already meeting criteria for alcohol dependence and receiving psychosocial support alongside medication; the reported benefits represent additional gains on top of those standard treatments. Availability and prescribing rules for these drugs in China depend on local medical practice and drug regulations; do not purchase them online without professional guidance. Those experiencing withdrawal symptoms should refer to section 20 of this chapter — do not attempt to quit abruptly on your own.