Beverages containing ethyl alcohol are legal for adults over the age of 21 in most areas of the United States. There still are some dry counties in the country.
The use of alcoholic beverages is ingrained in American culture. Alcohol is consumed regularly in many social situations and business interactions, and as a way to relax.
Alcohol is also a major substance of abuse, and regular alcohol use carries a serious potential for the development of a substance use disorder and a serious physical dependence syndrome. Chronic use of alcohol is also linked to an increased risk of developing numerous disorders and diseases.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2017:
The levels that are normally used to define heavy drinking indicate that men should limit their weekly intake of alcohol to fewer than 15 alcoholic drinks, whereas women should limit their weekly intake to fewer than eight drinks.
Binge drinking can be a serious issue. For men, this means consuming five or more drinks on the same occasion, and for women, this means drinking four or more drinks on the same occasion.
There are some alternatives to drinking for individuals who want to engage in healthier activities or stop abusing alcohol. However, there are no legal alternatives that can be used as a substitute for alcohol that will provide the same feelings of intoxication that most people who abuse alcohol seek.
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There are numerous reduced alcohol beverages, such as beer and sparkling juices, on the market. These beverages are designed primarily to be an alternative to drinking alcohol for people who still want to experience social activities where alcohol is typically consumed.
These beverages vary in the actual amount of alcohol that is in them. Nonalcoholic beer contains a minor amount of alcohol, whereas most sparkling juices contain no alcohol at all.
Many people do not find them to be a satisfactory substitute for an alcoholic beverage. This is because they do not produce the same sensations that drinking alcohol does. Nonetheless, these are available if an individual wishes to use them.
Drinking beverages with any level of alcohol in them, even the very small amounts of alcohol that are contained in some nonalcoholic beer, is frowned upon by addiction treatment professionals.
Someone in recovery from an alcohol use disorder should not consume alcohol in any amount.
Other alternatives to alcohol are available.
The goal for someone drinking these nonalcoholic beverages is to stimulate the ritual of drinking without consuming alcohol. Someone in recovery from an alcohol use disorder would not be encouraged even to attempt to reproduce the ritual of drinking alcohol for fear that this activity would be a trigger for relapse.
Many people claim to use alcohol as a method to relax or deal with the stress that they encounter in everyday life. Social use of alcohol may actually provide stress relief through its mechanism of action (primarily affecting the increase in the inhibitory neurotransmitter gamma-Aminobutyric acid and reducing levels of excitatory neurotransmitters).
People who drink excessive amounts of alcohol or use the substance frequently will actually experience an increase in stress. Individuals who have a formal diagnosis of an alcohol use disorder should obviously not engage in any type of alcohol use to address any situation.
According to the book Stress Reduction and Prevention, individuals who are looking to replace their use of alcohol with some other activity can relieve stress and induce feelings of relaxation through several alternatives.
Alcohol is classified as a central nervous system (CNS) depressant substance that works by slowing down the activity of the neurons in the brain and spinal cord. Numerous other central nervous system depressant substances have similar effects to alcohol. These include:
The use of any of the above-listed drugs for recreational purposes is prohibited, as the majority are controlled substances and require a prescription from a physician. Physicians do not prescribe benzodiazepines or opiates for recreational purposes.
Using any of these substances would simply be the act of replacing one substance of abuse with another substance of abuse.
In some states, cannabis products have now been legalized for medicinal and recreational use. Although the misuse of cannabis can lead to a formal substance use disorder (a cannabis use disorder), some individuals may find that cannabis products can produce sensations that are similar to alcohol use. However, individuals with alcohol use disorders who are in recovery should not begin using cannabis products unless they are instructed to do so and under the supervision of a physician. They are at an increased risk to develop a substance use disorder to any potentially addictive substance.
Some individuals endorse the use of certain types of herbal teas, the amino acid tryptophan, and other natural substances as replacements for alcohol. In some cases, there may be some potential dangers. With herbal substances, there is no significant monitoring of the types of ingredients in these products, and individuals should be wary of them. As a precaution, it is always best to inform your physician of any herbal substances you are considering.
Research into developing substances that are alcohol alternatives is ongoing. There have been studies investigating the use of what are called partial agonists, which are substances that mimic the effects of certain drugs (like alcohol) on certain neuron receptor sites, but they do not produce the full effect of the drug. In theory, these substances might produce effects similar to the drug, but they carry a significantly decreased risk of abuse or other detrimental effects.
There have been several substances that have been in development, but they are not available. It may be years before any such substance is available. At the current time, there are no drugs that are safe alternatives to alcohol, meaning there are no drugs that provide the same intoxicating effects as alcohol that are not potential drugs of abuse.
The best alternatives to drinking alcohol are nonalcoholic beverages such as sparkling juices or club soda, or lifestyle changes like engaging in exercise, meditation, or progressive relaxation. Individuals who have chronic alcohol abuse issues should not turn to other drugs or beverages that contain very small amounts of alcohol in an attempt to substitute their use of alcohol.
(October 2018). National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration. from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2017/NSDUHDetailedTabs2017.pdf
(July 2015). A Review on Alcohol: From the Central Action Mechanism to Chemical Dependency. Revista da Associação Médica Brasileira. from https://pdfs.semanticscholar.org/eb40/acac6023a4a7003c672e1c445a37e643eea9.pdf