Ep. 85: Dr. Robert Leeman — How to Develop a Healthier Relationship With Alcohol

My guest this week is Dr. Rob Leeman, who specializes in research on alcohol use among adults. Rob has been a good friend of mine for the past two decades, since we met in graduate school in 2001. He’s a real expert on alcohol and addiction, and he shared from his wealth of knowledge in this discussion.

There are a lot of important takeaways here—things like the effects of alcohol on anxiety and sleep, the relation between trauma and alcohol use, effective treatments for reducing alcohol consumption, and the best ways to minimize our kids’ risk for having problems with alcohol. Other topics we covered included:

  • What led Rob to alcohol research
  • Why people vary in how easily they can control their drinking
  • How common problematic drinking is in the college years
  • Factors in whether a person transitions from binge drinking to problems with alcohol
  • The problems that often come from using alcohol to reduce anxiety
  • The role of negative reinforcement in alcohol use (negative reinforcement means a behavior is more likely because it led to the reduction of a negative state like anxiety)
  • The role of unconscious motivation in our drinking behavior
  • Whether addiction generalizes from alcohol to other domains (e.g., sex, food)
  • Reasons to encourage moderate drinking vs. abstinence
  • The role of Motivational Interviewing principles in reducing alcohol consumption
  • The limited use of the “alcoholism” label
  • The overlap between drinking and smoking
  • The importance of reducing cues for drinking when trying to avoid alcohol
  • The strong links between alcohol and common events like parties and weddings
  • The limited evidence for the purported health benefits of moderate alcohol consumption
  • The effects and risks of “pre-gaming”
  • The value of interventions that reduce drinking by even a single drink per drinking episode
  • Technologies that might help in reducing dangerous levels of drinking
  • “Maturing out” of excessive alcohol consumption
  • The effects of alcohol on weight and attempts at weight loss

One note about the audio for this episode: When I updated my software it reset my microphone settings so the audio quality isn’t as good as usual. As you’ll hear, the quality is fine, and you probably won’t even notice the difference as you get into the conversation.

Rob mentioned Dr. Katie Witkiewitz (psychology professor at the University of New Mexico) in our conversation; see this post from her Twitter feed for a summary of drinking risk associated with different levels of alcohol consumption. Rob noted that she’s a good Twitter follow if you’re interested in this area. 

He also suggested checking out the Rethinking Drinking site through the National Institute on Alcohol Abuse and Alcoholism. It offers information about drinking levels, signs of a problem, and tools to change drinking behavior.

Robert Leeman, PhD, completed his doctorate in psychology at the University of Pennsylvania and a fellowship in substance abuse at Yale University. He is currently Associate Professor and the Mary F. Lane Endowed Professor in the Department of Health Education and Behavior at the University of Florida, and Adjunct Assistant Professor of Psychiatry at the Yale School of Medicine.

Rob’s primary research interest is in relationships between various difficulties with self-control and addictive behaviors, particularly alcohol use, though he’s also done research on opioid misuse, tobacco use and gambling.

Rob and his lab are testing novel interventions and learning more about risk factors for substance misuse, particularly in adolescent and young adult populations. His research has been supported for years by major grants, including from the National Institutes of Health.

Find out more about Rob and his work on Twitter and on the EDGE Lab webpage and Twitter account.

2 thoughts

  • Hi, tremendously timely piece by Seth on WebMD that led me to your website. Why? I had already let my drinking at home in 2019 and early 2020 escalate, and when the lockdown hit me in late February, early March, I really got scared! So, I quit, cold turkey, with last alcohol 3/4/20, eight weeks ago today! I was so worried what a stay at home would do! Scared me to death! I feel so good, but I I know I am fragile, like Seth said about thinking about it once in a while, but fortunately the “I got to have a drink to go to sleep” has diminished greatly.
    Charles Barkley said it! You said it! Thanks!

    • Thank you for your kind comments, Michael, and I’m really glad to hear it was helpful. I’m glad you were okay with the cold turkey process——from your email I’m sure you know the potential dangers for those who are drinking heavily (just wanted to mention that as a cautionary note for others). It sounds like you’re enjoying greater freedom, which is awesome.

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