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Handling urges to drink

Plan ahead to stay in control

As you change your drinking, it's normal and common to have urges or a craving for alcohol. The words "urge" and "craving" refer to a broad range of thoughts, physical sensations, or emotions that tempt you to drink, even though you have at least some desire not to. You may feel an uncomfortable pull in two directions or sense a loss of control.

Fortunately, urges to drink are short-lived, predictable, and controllable. This short module offers a recognize-avoid-cope approach commonly used in cognitive behavioral therapy, which helps people to change unhelpful thinking patterns and reactions. It also provides worksheets to help you uncover the nature of your urges to drink and to make a plan for handling them.

With time, and by practicing new responses, you'll find that your urges to drink will lose strength, and you'll gain confidence in your ability to deal with urges that may still arise at times. If you are having a very difficult time with urges, or do not make progress with the strategies in this module after a few weeks, then consult a doctor or therapist for support. In addition, some new, non-habit forming medications can reduce the desire to drink or lessen the rewarding effect of drinking so it is easier to stop.

Recognize two types of "triggers"

An urge to drink can be set off by external triggers in the environment and internal ones within yourself.

  • External triggers are people, places, things, or times of day that offer drinking opportunities or remind you of drinking. These "high-risk situations" are more obvious, predictable, and avoidable than internal triggers.
  • Internal triggers can be puzzling because the urge to drink just seems to "pop up." But if you pause to think about it when it happens, you'll find that the urge may have been set off by a fleeting thought, a positive emotion such as excitement, a negative emotion such as frustration, or a physical sensation such as a headache, tension, or nervousness.

Consider tracking and analyzing your urges to drink for a couple of weeks. This will help you become more aware of when and how you experience urges, what triggers them, and ways to avoid or control them. A sample tracking form is provided below.

Avoid high-risk situations

In many cases, your best strategy will be to avoid taking the chance that you'll have an urge, then slip and drink. At home, keep little or no alcohol. Socially, avoid activities involving drinking. If you feel guilty about turning down an invitation, remind yourself that you are not necessarily talking about "forever." When the urges subside or become more manageable, you may decide to ease gradually into some situations you now choose to avoid. In the meantime, you can stay connected with friends by suggesting alternate activities that don't involve drinking. (Also, see the module on building drink refusal skills.)

Cope with triggers you can't avoid

It's not possible to avoid all high-risk situations or to block internal triggers, so you'll need a range of strategies to handle urges to drink. Here are some options:

  • Remind yourself of your reasons for making a change. Carry your top reasons on a wallet card or in an electronic message that you can access easily, such as a mobile phone notepad entry or a saved email. (Visit the pros and cons page to list and sort your reasons.)
  • Talk it through with someone you trust. Have a trusted friend on standby for a phone call, or bring one along to high-risk situations.
  • Distract yourself with a healthy, alternative activity. For different situations, come up with engaging short, mid-range, and longer options, like texting or calling someone, watching short online videos, lifting weights to music, showering, meditating, taking a walk, or doing a hobby.
  • Challenge the thought that drives the urge. Stop it, analyze the error in it, and replace it. Example: "It couldn't hurt to have one little drink. WAIT a minute—what am I thinking? One could hurt, as I've seen 'just one' lead to lots more. I am sticking with my choice not to drink."
  • Ride it out without giving in. Instead of fighting an urge, accept it as normal and temporary. As you ride it out, keep in mind that it will soon crest like an ocean wave and pass.
  • Leave high-risk situations quickly and gracefully. It helps to plan your escape in advance.

Plan to handle urges to drink

The links below will take you to forms for tracking your urges to drink and planning ways to handle them in the future.

This module is adapted from the Combined Behavioral Intervention Manual: A Clinical Research Guide for Therapists Treating People with Alcohol Abuse and Dependence. It can be used with counseling or therapy and is not meant as a substitute for professional help. If you choose to try it on your own and at any point feel you need more help, then seek support (see Help Links). The full 330-page manual (NIH Publication 04-5288) can be ordered for $10 using this form (PDF 198KB).
Take it with you - [screenshot of Rethinking Drinking cover] - Download or Order this 16-page booklet, Rethinking Drinking: Alcohol and your health
Take it with you

The 16-page booklet, Rethinking Drinking: Alcohol and Your Health

Is your "lite" beer light in alcohol?

Not necessarily. Although they have fewer calories, many light beers have almost as much alcohol as regular beer—about 85% as much, or 4.2% versus 5.0% alcohol by volume, on average.

Check the alcohol content of your beverage. Malt beverages are not required to list their alcohol content on the labels, so you may need to visit the bottler's Web site.

See What's a standard drink?

How many "drinks" are in a bottle of wine?

A typical 25-ounce (750 ml) bottle of table wine holds about 5 "standard" drinks, each containing about 5 ounces. This serving size of wine contains about the same amount of alcohol as a 12-ounce regular beer or 1.5 ounces of 80-proof spirits.

Get to know what 5 ounces looks like by measuring it out at home. That way you can estimate how many standard drinks you're being served in a restaurant or bar that uses large glasses and generous serving sizes.

See What's a standard drink?

Mixing alcohol with certain medications can cause nausea, headaches, drowsiness, fainting, a loss of coordination, internal bleeding, heart problems, and difficulties in breathing. Alcohol can also make a medication less effective. For more information, see Harmful Interactions: Mixing Alcohol with Medicines.

Examples of medical conditions for which it's safest to avoid drinking include liver disease (such as from hepatitis C), bipolar disorder, abnormal heart rhythm, and chronic pain.

Among the dangers of underage drinking:

Even moderate amounts of alcohol can significantly impair driving performance and your ability to operate other machinery, whether or not you feel the effects of alcohol.

Heavy drinking during pregnancy can cause brain damage and other serious problems in the baby. Because it is not yet known whether any amount of alcohol is safe for a developing baby, women who are pregnant or may become pregnant should not drink.

Highest risk

About 50% of people who drink in this group have an alcohol use disorder.

Increased risk

This "increased risk" category contains three different drinking pattern groups. Overall, nearly 20% of people who drink in this category have an alcohol use disorder.

Low-risk drinking

Only about 2% of drinkers in this group has an alcohol use disorder.

A U.S. "standard" drink contains about 0.6 fluid ounces or 14 grams of "pure" alcohol. That's the amount in 12 ounces of regular beer, 5 ounces of table wine, or 1.5 ounces of 80-proof distilled spirits.

Low risk drinking levels - On any single day: Men, no more than 4 drinks on any day. Women, no more than 3 drinks on any day. Per week: Men, no more than 14 drinks per week. Women no more than 7 drinks per week.

Distilled spirits include vodka, whiskey, gin, rum, and tequila.

Light to moderate drinking

Heavy or at-risk drinking

Low-risk drinking

Men: No more than 4 drinks on any day and no more than 14 per week

Women: No more than 3 drinks on any day and no more than 7 per week

People with a parent, grandparent, or other close relative with alcoholism have a higher risk for becoming dependent on alcohol. For many, it may be difficult to maintain low-risk drinking habits. For more information, see A Family History of Alcoholism: Are You at Risk?

Pace yourself: It's best to have no more than one standard drink per hour, with nonalcoholic "drink spacers" between alcohol beverages. On any day, stay within low-risk levels of no more than 4 drinks for men or 3 for women. Note that it takes about 2 hours for the adult body to completely break down a single drink. Do not drive after drinking.

For comparison, regular beer is 5% alcohol by volume (alc/vol), table wine is about 12% alc/vol, and straight 80-proof distilled spirits is 40% alc/vol.

The percent alcohol by volume (alc/vol) for distilled spirits is listed on bottle labels and may be found online as well. It is half the "proof," such that 80-proof spirits is 40% alc/vol.

Convert proof to alc/vol

Enter in the proof of the alcohol in the left field to automatically calculate the alc/vol.


Convert to fluid ounces

Enter in the measurement in milliliters in the left field to automatically calculate the amount in fluid ounces.