Is Dry January a good idea?

Dry January is a somewhat recent trend in which some people stop drinking alcohol for the month of January. In general, cutting back on alcohol consumption is a good idea for our health, especially after the holidays from Thanksgiving to New Year’s, during which many of us may eat and drink more than we normally would.

But as a professor of public health, when I think about the concept of Dry January, I have a few hesitations. One is that we need to think about the prevention of alcohol use and overuse as a continuum—there isn’t a one-size-fits-all approach.

In the field of substance use research and prevention, we often talk about harm reduction in terms of opioids and stimulants, trying to decrease the risk of infectious diseases and overdoses, acknowledging that people are going to use substances, but that we can reduce the potential negative risks related to that use. I look at cutting back on alcohol consumption from a harm-reduction perspective as well.

Dry January is well-intentioned, and it may work really well for people who can stick to it, maybe even beyond January. Other people may be more inclined to cut down on alcohol consumption rather than quit drinking completely for the month. So, rather than having five to 10 drinks per week, they might aim to consume three to five instead. There may be different levels of reduction that people are ready for—a middle-of-the-road approach.

If we reduce the amount we drink, we can also reduce risks related to alcohol. Consuming alcohol can raise blood pressure, damage the liver, and increase risks of chronic obstructive pulmonary disease (COPD) and cardiovascular disease. Cutting back may help negate those harmful effects, as well as improve sleep quality and the appearance of skin, and contribute to weight loss.

Reduced alcohol use could also reduce feelings of guilt over drinking too much or spending too much money on alcohol and reduce the intake of empty calories. And it can help reduce impaired decision making and lowered inhibitions, that can lead to driving under the influence, having unprotected sex, or poly-substance use.

Research indicates that, on average, it takes several attempts to be successful in dropping a substance use addiction, whether it’s related to alcohol, opioid, or stimulant use, but there is substantial variability in addiction’s course.

People often return to reuse. Increasingly, we’re moving away from using terms like relapse or falling off the wagon because it implies failure, and harm-reduction approaches aim to be judgment-free, meeting people where they are, figuratively, geographically, and physically.

Substance use disorder is a disease. It takes time to treat the disease and to stay connected to the continuum of care—from prevention to treatment initiation to sustained therapy, whether through medication, self-help, or individual therapy or group support.

Finally, some people should not quit drinking cold turkey. People who have alcohol use disorder and stop drinking suddenly can experience a condition called delirium tremens (DTs), or alcohol withdrawal, where they can shake uncontrollably, experience hallucinations, vomiting, and hypertension, and become irritable.

In these situations, abrupt discontinuation may be contraindicated, as patients may need medications to treat their withdrawal symptoms until their tolerance for alcohol diminishes over time.

In consideration of all these issues, perhaps a drier January should be the goal, viewing alcohol use through a harm-reduction lens, reducing risks along the way.

Dry January is a somewhat recent trend in which some people stop drinking alcohol for the month of January. In general, cutting back on alcohol consumption is a good idea for our health, especially after the holidays from Thanksgiving to New Year’s, during which many of us may eat and drink more than we normally would.

But as a professor of public health, when I think about the concept of Dry January, I have a few hesitations. One is that we need to think about the prevention of alcohol use and overuse as a continuum—there isn’t a one-size-fits-all approach.

In the field of substance use research and prevention, we often talk about harm reduction in terms of opioids and stimulants, trying to decrease the risk of infectious diseases and overdoses, acknowledging that people are going to use substances, but that we can reduce the potential negative risks related to that use. I look at cutting back on alcohol consumption from a harm-reduction perspective as well.

Dry January is well-intentioned, and it may work really well for people who can stick to it, maybe even beyond January. Other people may be more inclined to cut down on alcohol consumption rather than quit drinking completely for the month. So, rather than having five to 10 drinks per week, they might aim to consume three to five instead. There may be different levels of reduction that people are ready for—a middle-of-the-road approach.

If we reduce the amount we drink, we can also reduce risks related to alcohol. Consuming alcohol can raise blood pressure, damage the liver, and increase risks of chronic obstructive pulmonary disease (COPD) and cardiovascular disease. Cutting back may help negate those harmful effects, as well as improve sleep quality and the appearance of skin, and contribute to weight loss.

Reduced alcohol use could also reduce feelings of guilt over drinking too much or spending too much money on alcohol and reduce the intake of empty calories. And it can help reduce impaired decision making and lowered inhibitions, that can lead to driving under the influence, having unprotected sex, or poly-substance use.

Research indicates that, on average, it takes several attempts to be successful in dropping a substance use addiction, whether it’s related to alcohol, opioid, or stimulant use, but there is substantial variability in addiction’s course.

People often return to reuse. Increasingly, we’re moving away from using terms like relapse or falling off the wagon because it implies failure, and harm-reduction approaches aim to be judgment-free, meeting people where they are, figuratively, geographically, and physically.

Substance use disorder is a disease. It takes time to treat the disease and to stay connected to the continuum of care—from prevention to treatment initiation to sustained therapy, whether through medication, self-help, or individual therapy or group support.

Finally, some people should not quit drinking cold turkey. People who have alcohol use disorder and stop drinking suddenly can experience a condition called delirium tremens (DTs), or alcohol withdrawal, where they can shake uncontrollably, experience hallucinations, vomiting, and hypertension, and become irritable.

In these situations, abrupt discontinuation may be contraindicated, as patients may need medications to treat their withdrawal symptoms until their tolerance for alcohol diminishes over time.

In consideration of all these issues, perhaps a drier January should be the goal, viewing alcohol use through a harm-reduction lens, reducing risks along the way.