I have seen four new patients already this week. One was referred to me by her employers. They really want to keep her. She's a nice person and does an excellent job for the company - when sober.
She's the lucky one. When most people lose control of their drinking, I never hear from their employer, because they no longer have one. Usually they have just been kicked out.
I've heard some harrowing stories about people losing control of their lives after losing control of their drinking. When people first come to me, I tell them they need to think about the consequences of their drinking, especially the binge drinking. I ask them: what has happened to you that made you feel embarrassed or ashamed - and that word is important, ashamed - afterwards? What's been the effect on your livelihood, your employer's opinion of you, your family's?
Often their heavy drinking is evident to colleagues at work parties, clients' functions, summer barbecues, where they would become inebriated and embarrass co-workers, and more importantly embarrass the company's clients (which bosses absolutely won't tolerate). Some people keep their heavy drinking covered up in their private lives but it manifests itself at these work functions and the genie - as well as all the alcohol - is out of the bottle.
If you think you have a drink problem - and are drinking red-eyed in the last chance saloon - often it's just best to avoid office functions like the Christmas party. Make an excuse. In truth, no one really cares if you go or not. Don't put yourself in a high-risk situation. It is incredibly difficult to be a dysfunctional drinker and a controlled drinker.
Alcohol disinhibits you, and some drinkers think 'oh s***, I'll just have another one.' As they say in Alcoholics Anonymous, alcoholics just press that 'don't care anymore' - or stronger words to that effect - button, and top up.
If you are going to go to the office party and drink, but worry about your alcohol intake, you need to alternate wine and water, avoid spirits, eat beforehand, arrive late and leave early.
If you have a drink problem, you need to sit down with a professional and consider the consequences - to your family, your physical health and then things like your appearance. Are you starting to look like a boozer? I ask patients whether their drinking is affecting their mental health - making them feel guilty, and that word again, ashamed. Is it affecting their relationship with their family? A patient said to me the other day: "My daughter said 'you'd rather have a drink than talk to me'."
I am a bit ambivalent about Dry January. If you have to be dry for a month, does that mean you have a significant drink problem in the first place? As Alcoholics Anonymous would say, giving up alcohol is a 'one day at a time' process. Often, after Dry January, people resume drinking alcohol to excess as if January never happened.
On the positive side, sometimes people do need to give up alcohol to realise just how bad they felt when they were drinking. Patients are often motivated to give up alcohol by their appearance, because they are under so much pressure in today's society to look a certain way. That pressure is huge.
I have a patient whose skin was breaking up as a result of alcohol, they had psoriasis. Now their skin is fine. This is an important confidence booster in our image obsessed world.
But there are loads of benefits to giving up alcohol; your blood sugar will normalise, you will feel much more clear-headed, less depressed and you will have more money in your wallet. If you spend, say, around £20 a week on 2 bottles of wine, you will save £1,040 by the year's end.
Your sleep patterns are likely to improve within a week. Heavy drinking causes blood cells to become larger and that makes you more tired because they are unable to transport oxygen efficiently around the body. You will look visibly better. Alcohol is toxic to your largest organ - your skin. The toxins make your skin less elastic and it is very ageing. Your liver will improve. It can handle small quantities, but excessive drinking causes it to get inflamed - which is what we call 'alcoholic hepatitis', a silent disease. In the early stages, you can't feel that, but it can lead to cirrhosis, which is permanent.