Is it time for “Dry January”?

The science behind the campaign, and other top tips for sustaining your New Year’s health resolutions!

I saw a patient recently who had increased his alcohol consumption gradually over the years and increased binge drinking during the working from home phase of the pandemic. Unfortunately, he was starting to see the effects of alcohol consumption. He was starting to drink earlier in the day and his wife was getting concerned. He was getting more angry, irritable and had problems sleeping. He was developing tremors, numbness in the hands and feet along with problems with his balance. He was also having heart palpitations and felt a general malaise. His liver was getting fatty with some early signs of fibrosis and he failed some simple bedside neurological testing and was developing some signs of early liver disease. It was time to quit and he needed help.

In recent years, “Dry January” has become popular globally. The concept is to avoid having alcohol for a month to give your body a break. As I say to patients – your body needs to be reminded about what it feels like to not have alcohol running through your veins. Excess is often jet fuel for most preventable illnesses. Examples of past global campaigns (3) include “Dry January Canada” (MADD, 2021), “Dry Feb” (Canadian Cancer Society, 2021), “Dry January” (Alcohol Concern, UK, 2013), “On the Dry” (Irish Heart Foundation, Ireland, 2015), “Dry July” (Australia, 2008) and Buddhist Lent Abstinence Campaign (StopDrink Network, Thailand, 2003).

A patient of mine taught me about another approach called “One, one and one” which I often share with patients. Take one month off a year, one week every month and one day a week to abstain from alcohol. This approach gives you some autonomy to choose the times of the year and it also allows your body to have a break from alcohol on a regular basis.

But does “Dry January” improve one’s health or is it simply a short term “circuit breaker”?

Fortunately, studies have shown that one month of abstinence amongst heavy drinkers has a positive effect on improving insulin resistance, blood pressure, body mass and cancer related growth factors (4). Follow up studies at six months after temporary abstinence also led to less frequent drinking, lower volume and an increased confidence to resist alcohol (4). Temporary alcohol abstinence also improves self-reported sleep quality, energy levels, concentration and well-being. However, a 2021 UK study evaluated the “Dry January” campaign between 2015 and 2018 (37,142 respondents to the Alcohol Toolkit Study) and did not find a statistically significant large decline in alcohol consumption detectable at the population level (5).

Reset your relationship with alcohol

The UK “Dry January” campaign has been promoted as “the perfect way to reset your relationship with alcohol”. A classic book by Caroline Knapp named “Drinking: A Love Story” (1997) describes her challenges as a “functioning” alcoholic from a successful upper class family who used alcohol as “liquid armor” to escape personal relationships and the realities of life. Problem drinking is a slippery slope from social drinking to habit forming behaviours. Studies have shown that social rituals and pressure to drink alcohol make it difficult to abstain. Learning about one’s own personal drinking habits (patterns, amount, calories) can be achieved through digital tools like Drinkaware (Drinkaware Home | DrinkawareOpens new window) that also does population based research. The Centre for Addiction and Mental Health (CAMH) also has a free app, Say When: How to quit drinking or cut down available via Apple iPhoneOpens new window and AndroidOpens new window devices.”

Success in abstinence is linked to social support, continuous self-monitoring, careful planning of social activities that are linked to involve drinking and consumption of alcohol-free drinks (6). These are common behaviour change techniques that can be applied to other health conditions (i.e. healthy behaviour substitution, goal setting, self-monitoring and social support).

Commonly used self-assessment tools for at risk drinking include the CAGE and AUDIT questionnaires

CAGE questionnaire

https://www.hopkinsmedicine.org/Opens new window

• Have you ever felt you should Cut down on your drinking?

• Have people Annoyed you by criticizing your drinking?

• Have you ever felt bad or Guilty about your drinking?

• Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover (Eye opener)?

Item responses on the CAGE questionnaire are scored 0 or 1, with a higher score an indication of alcohol problems. A total score of 2 or greater is considered clinically significant.

AUDIT questionnaire

https://auditscreen.org/Opens new window

For any questions you may have regarding abstaining from alcohol or any other medical condition, you should always seek the immediate or timely advice of your physician or other qualified health care provider.

January is a great time to reflect on the past year and focus on the future. Improving and sustaining your personal wellness includes goal setting, healthy habits, action, and purpose. If you or others are concerned about your level of alcohol consumption – then try the “One, one and one”! Living well often means keeping things simple and avoiding excess. As goes the common saying, “Moderation is best in all things.”

Wishing you all a Happy, Healthy and Successful 2022!

References

1. Pandemic and Alcohol Consumption - https://pubmed.ncbi.nlm.nih.gov/33280423/Opens new window; https://pubmed.ncbi.nlm.nih.gov/34159674/Opens new window

2. Health effect of alcohol - https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-bodOpens new windowy; https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htmOpens new window;

3. “Dry January Canada” (MADD, 2021) https://dryjanuarycanada.ca/Opens new window
   “Dry Feb” (Canadian Cancer Society, 2021) https://www.dryfeb.ca/Opens new window
   Global Dry January campaigns - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916250/#CR9Opens new window

4. Health effects of Short Term Abstinence - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5942469/Opens new window; https://pubmed.ncbi.nlm.nih.gov/26690637/Opens new window

5. Has increased participation in the national campaign “Dry January” been associated with cutting down alcohol consumption in England - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504198/Opens new window

6. Benefits of temporary alcohol restriction - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995140/#CR9Opens new window