Targeting Anxiety to Reduce Alcohol Consumption

Alcohol is often referred to as “liquid courage,” with good reason. Individuals who are nervous in social settings may find the relaxing effects of alcohol helpful. They may feel more at ease and comfortable when they drink. In fact, many people with anxiety, social phobia, and panic issues drink as way to alleviate their stress levels. Unfortunately, these individuals are at heightened risk for developing an alcohol use problem (AUD). Treating individuals with anxiety and AUD is tricky and not always effective. Few approaches target anxiety and focus instead on drinking behaviors. But Matt G. Kushner of the Department of Psychiatry at the University of Minnesota thought that perhaps targeting the anxiety could indirectly decrease the motivation to drink.

To test his theory, Kushner assessed 344 individuals participating in an inpatient AUD treatment program. All of the participants had symptoms of panic, social phobia, or generalized anxiety in addition to AUD. They were randomized to a progressive muscle relaxation training (PMRT) program or a cognitive behavior therapy (CBT) condition designed to address anxiety and decrease the motivation to drink. Four months later, Kushner evaluated 247 of the participants and found that those in the CBT condition had drastically lower levels of alcohol use than the control participants in the PMRT condition.

When Kushner looked at anxiety, he discovered that both groups had similar outcomes with significant reductions in symptoms of anxiety immediately following treatment. However, the CBT participants did have slightly lower levels of anxiety at the four month follow-up. These results suggest that a treatment approach that focuses on reducing anxiety as a means of diminishing motivation to drink may be most beneficial to people with both anxiety and AUD. Also, Kushner believes that neurobiological processes play a role in the outcome of treatment for this segment of the population and that future research should explore this factor in depth. “We envision that advances in our knowledge of treatment and prevention strategies for AUDs among those with anxiety disorders will be furthered by approaches that integrate both psychological and emerging neurobiological perspectives,” said Kushner.

Kushner, M. G., Maurer, E. W., Thuras, P., Donahue, C., Frye, B., Menary, K. R., Hobbs, J., Haeny, A. M., and Van Demark, J. (2012). Hybrid cognitive behavioral therapy versus relaxation training for co-occurring anxiety and alcohol disorder: A randomized clinical trial. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a003130

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  • Marissa

    January 28th, 2013 at 3:14 PM

    Thank you so much for addressing this topic that is so close to me because I am one of those people who literally has to have a shot of as you say liquid courage pretty much anytime I know that I am going to be up against a potentially stressful situation. I am young, I am strong, I am smart and yet this is something that has plagued me since high school. Any time that I perceive that I am going to be faced with something pretty daunting I immediately turn to alcohol, a glass of wine or two to get me through it. I don’t want to have to depend on this because I know that I can do it but then when the time comes I am paralyzed with this fear that I can’t overcome alone. I don’t think that I am an alcoholic but I am scared that it could come to this if I rely on this for too many situations. It’s like I see it, I know it’s happening, but I feel pretty powerless to let it go.

  • vanessa

    January 28th, 2013 at 10:03 PM

    so important to identify and differentiate these people from others who are dependent on alcohol for reasons other than anxiety.. and without differentiating if the same old methods are tried then it obviously is not going to produce any significant results.. so important to know what the cause behind the dependence is.. an appropriate method can then be adopted and the maximum benefits and best results can be obtained. also very encouraging to see the good results that CBT produces in this too.. seems like it does have the cure for quite a few issues.

  • meg hayes

    January 29th, 2013 at 4:06 AM

    Must be hard with some drinkers to pinpoint that it is not so much the drinking that is the big issue with them, but that rather they need to focus on whittling away at their anxiety instead, that if they are able to do that then potentially they could kill two birds with one stone. They will be happier and healthier and will not need to have excess alcohol in them to make a move. The challenge is having more people see that it is not necessarily the alcohol they are addicted to but that it has just become a response of the stress that they are feeling on a day to day basis.

  • ROSS

    January 29th, 2013 at 3:15 PM

    I know so many people that take to alcohol to cope with their anxiety..they may not want to admit it but it is pretty obvious.

    They have chosen it as a crutch for themselves.. but what they do not realize is that this crutch is slowing eating them up from the inside. is it really a support if it is causing harm to you?!

    How is it that their judgement is so clouded? is it due to the anxiety itself or due to alcohol being viewed as a good solution to it?!

  • danny

    January 30th, 2013 at 6:15 AM

    closing your eye to things is not gonna make them go away..drinking to rid your mind of anxiety is not gonna help either.

    it’s like your willingly increasing the dangers for yourself by turning to alcohol to cope with anxiety.why it may even make anxiety worse in the long run seeing how alcohol affects your mind and body..they need to learn and know better.

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