Anxiety and self medication with alcohol

This chapter addresses the question: Is the moderate consumption of alcohol to control day-to-day anxiety symptoms a sensible strategy, even in the long-term? Large proportions of people drink alcohol for various reasons, only one of which may be to reduce anxiety. In alcohol research, anxiety and other emotional states are often framed in terms of negative affect but there are also positive affective states that can motivate drinking. Reducing anxiety, however, is a particularly powerful motive. Knowledge on motives for drinking in non-clinical populations helps contribute to the broader body of research seeking to differentiate between problem and non-problem drinking. Research on drinking motives is increasingly located within the framework of the Self-Medication Model or the Drinking Motives Model. The Self-Medication Model mainly focuses on drinking to reduce negative affect, and the Drinking Motives Model considers motives for drinking in terms of both positive and negative affect. The four common drinking motives in this framework are the enhancement and social motives, each for improving positive affect, and the coping and conformity motives, each for reducing negative affect. The coping motive is the best predictor (within the motives model) of problem drinking. Motives and drinking behaviours interact with type of mood or emotional state, as well as expectations about the effects of alcohol. Thus, drinking to reduce anxiety may put people at risk more so when other factors, such as high expectancy or an anxiety disorder, are present. Drinking to enhance wellbeing appears less problematic, but research is not consistent in this regard. The motives model has application to other areas of consumption and wellbeing. It provides a useful pathway to consider the broader set of variables that impinge on consumption and over-consumption of food, alcoho and other drugs.