Setting achievable goals & the ‘dose effect’

19 Feb

Paracelsus 2Mentioning either ‘units’ or the ‘guidelines’ alone can trigger a sceptical response from a drinker. I’m sure you’ve heard someone protest that “units are confusing” or that they “don’t believe the guidelines”. How should we respond to such statements or beliefs?

Firstly we should accept that people may have ambivalent attitudes about their drinking and may appear dubious or dismissive of health advice we may offer. They may also be right; units can be confusing and hard to keep track of, and we can’t take a ‘one size fits all’ health guideline too literally.

However the principle behind understanding units and applying these to the guideline is important. Consuming any drug – including alcohol – can be considered in terms of the ‘dose effect’ (or the dose-response relationship). Essentially, the greater the dose consumed, the greater the chance of unwanted (as well as perhaps wanted) effects. The recommended guidelines therefore set out the approximate ‘dose’ (in units) which alcohol can be consumed with a low risk of negative effects.

how muchA crucial consideration here is that there is no clear ‘threshold effect’, or no point at which the dose the longer matters. Put simply, the more you drink, the greater the risks . This is important because even if someone says ‘forget the guidelines, I’m never going to stick to them’, they still may be open to considering the fact that 5 pints is still less risky than 6.

There is evidence that some people who drink to get drunk only consider their ‘limits’ in terms of behaviour and whether they are ‘in control’. As such, health guidelines may not feel relevant for them. But emphasising that reducing health or behavioural risks still applies in terms of how much they drink. One message that has been found to be possibly more appealing is to try and ‘drink 2 less’, rather than perhaps ‘only drink 2’! And perhaps more importantly, it may feel much more achievable.

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One Response to “Setting achievable goals & the ‘dose effect’”

  1. derynbishop February 20, 2015 at 1:07 pm #

    I agree, understanding people’s perceptions of how much is too much, or the dose related effect is the first real challenge. I remember working with a client, years ago, who insisted he was not drinking (contrary to the evidence of his worsening health). When he did finally describe his daily intake of a few pints and I asked him why he had maintained that he was abstinent for so long, his reply was “That’s not what I call drinking”

    Add to the confusing picture of which limit applies best to you because of your age group, ethnicity, family history, state of pregnancy, medical co-morbidities and the fact that health harms are often latent, it’s no wonder that people become turned off to talking about alcohol.

    I do remember that the first Drinkwise campaign back in the 1990’s did seem to have some impact on public familiarity with units, although scarcely impacted on harmful consumption. I still meet a lot of professionals who are aware of Units but actually not what units translate into in terms of drinks that people actually consume. This can’t be helping to get a consistent message across

    I do agree that we need to find a common language with which we can start some conversations with people about alcohol that are meaningful to them

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