Re-Learning to Drink
In February of 2013, Caleb1 had hit a breaking point. Crystal meth wasn’t exactly creating dramatic negative consequences in his life—he was still successfully employed—but he wanted to quit and was struggling not to use. He turned to Stonewall, San Francisco AIDS Foundation’s substance use treatment program, in addition to joining Crystal Meth Anonymous (CMA), for help with his meth problem.
CMA, a 12-step program, prescribes complete abstinence from all substances, not just meth. Members are asked to stop drinking alcohol and using other substances since they could trigger meth use, leading to relapse. For about a year, Caleb stopped using alcohol—in addition to meth—completely, even though his alcohol use was not his primary concern.
Caleb, during his period of sobriety, quickly realized the extent to which—as a gay man living in San Francisco—alcohol permeated his social world. “Gays definitely drink a lot. I don’t know if it’s just gay men—or anyone living in San Francisco—but if I wanted to drink socially every day, I could. Without any problem. And I live in the Castro so the bars are nearby.”
Because alcohol played such a large role in his friendships and social life, when Caleb quit drinking, his social world shifted. “I didn’t want to be in bars if I wasn’t drinking. It wasn’t like I couldn’t be in a bar and not drink, it just wasn’t fun. Badlands with a drink is bad anyway—but Badlands without a drink? I realized how much of my socializing was alcohol-focused. And when I wasn’t able to participate in the same way—I felt weird—and often other people around me felt weird too. A lot of those friends just fell away.”
This past May, Caleb decided to reintroduce alcohol back into his life. In addition to sessions at the Harm Reduction Therapy Center, Caleb joined an alcohol drop-in group at Stonewall. There, he learned harm reduction techniques to moderate his drinking.
Pietro “Peter” Carnini, LMFT and facilitator of Stonewall’s alcohol group, explains that harm reduction strategies are tailored to each individual and their specific needs—helping people to set limits, manage their use, and/or reduce physical, financial, psychological, emotional, or other negative effects that can come from using substances.
“Harm reduction strategies can be an effective way to reduce negative consequences that can come from drinking alcohol or using drugs. This perspective doesn’t necessarily view alcohol or drug use as a moral or legal issue—but instead, as a public health issue. So it reduces shame and guilt associated with use. It can be a sensitive and compassionate way for someone to address and minimize harm caused by alcohol or other substances,” notes Carnini.
At the drop-in group, Caleb learned tactics to moderate alcohol consumption in way that doesn’t lead to negative consequences.
“We teach people mindfulness techniques—so people can be more aware of thoughts and feelings that lead to use. We also teach people how to avoid specific situations that can lead to use, how to distract yourself if you’re feeling a craving or experiencing a trigger, how to set limits, or about how you can substitute beverages with lower alcohol content for ones with higher alcohol content,” explains Carnini.
Now, the goal Caleb sets for himself is to be more mindful of how he drinks. For him, this means that he sets rules about quantity and frequency of drinking—he currently aims to drink no more than four times a week, with no more than two to four drinks per sitting. Caleb explains that by limiting the number of times that he drinks per week, it means that when he does drink, it’s with deliberate intention. He’ll purposefully go into a night out, for instance, knowing what he’s going to drink, that he’ll drink water in between drinks, and that he’ll communicate ahead of time to friends what his plan is.
Caleb now says that his moderation “has gotten pretty easy. Now, it just feels normal.”
If anything, Caleb finds that he’ll end up thinking too much about moderating his drinking. He points to an experience from this past weekend, when he was invited to a dinner party with his boyfriend.
“It was going to be my fourth day drinking that week. And I didn’t plan to have a fourth day. But we were bringing a bottle of wine, and I knew everyone else was going to be having wine. I kept thinking: ‘Will I be drinking because I want to be drinking? Or because I want to be part of the group? Or because we’re having a meal and we brought meal-appropriate wine?’ At the end of the day, it didn’t really matter that much. I just needed to make a decision, and set the plan ahead of time.”
Caleb was also forced to contend with alcohol’s role in dating and relationships. He started seeing the guy he’s dating now when he was sober, quickly coming to the realization how often dating involves drinking. But Caleb got to know his boyfriend sober, and his boyfriend did the same.
“He never drank in front of me, which was never a requirement—he just decided not to. And I really appreciated it. I think it added something. It was a nice demonstration that he was willing to forgo something that was part of his life while he was around me.”
As Caleb navigated his way to partial abstinence, he involved his boyfriend in every step of the way. “He’s always been available to talk to about my drinking,” he adds. Now, they enjoy wine with dinner or a cocktail during an evening out together.
The Stonewall Project’s walk-in Alcohol Harm Reduction Group is held on Tuesdays from 6-7:30 p.m. in the Castro, at 4200 18th Street, Suite 203. Facilitated by licensed marriage and family therapist Pietro “Peter” Carnini, the group welcomes anyone interested in safer, controlling, reducing, or quitting drinking.
1Names have been changed.
Interested in hearing more about drinking alcohol in the best way possible? Join San Francisco AIDS Foundation on Tuesday, November 4 for a discussion about drinking booze, having the party we want, and keeping ourselves, our partners, and others safe. Read more about Can You Party Smart? Let’s Talk Booze, here.