Because of the promise of anonymity, A.A. doesn’t track its members or conduct research. Some studies have found that many members find support for healthier habits from a like-minded group of nondrinkers. But a systematic review found “no conclusive evidence to show that A.A. can help patients to achieve abstinence.”

Research shows that many problem drinkers — those who repeatedly drink more than they intend, sometimes have physical or psychological consequences from overdrinking, and may have difficulty controlling themselves — could benefit from brief interventions and practical advice about how to set better limits and change their drinking by cutting back.

Women increasingly need help, as their drinking has escalated. Women are being stopped more for drunken driving than they were two decades ago. They’re also the biggest consumers of wine, buying the larger share of the 856 million gallons sold in the United States in 2012. These women are drinking partly because alcohol is a socially respectable way to slog through the smartphone-tethered universe of managing demanding careers, aging parents, kids’ activities and relationships at once. And while it’s not healthy to pour yourself a third or fourth glass every night, it doesn’t mean you’re powerless to do anything about it.

Elsewhere in the developed world, doctors treat drinking problems with evidence-based tools that best match the client’s needs. Many are prescribed drugs such as naltrexone, an opioid antagonist approved by the Food and Drug Administration in 1994 to treat alcohol use disorders. It blocks the signals released when consuming alcohol.

American doctors typically prescribe drugs with the goal of abstinence. Yet in Finland, the American psychologist John David Sinclair pioneered a radically different protocol for naltrexone: he instructs patients to take the drug — which is available generically — an hour before drinking. Mr. Sinclair calls his method “pharmacological extinction.” When people drink while taking naltrexone, the drug blocks the rewards produced by drinking and the cravings diminish. In published research, Mr. Sinclair has claimed a 78 percent success rate in reducing drinking. A drug similar to naltrexone, nalmefene, was recently approved in Europe to help heavy drinkers moderate their habits.