Drinking is one of America’s favorite pastimes.
When was the last time you attended a social event where alcohol wasn’t served?
Whether it’s a ball game, BBQ, or birthday party, alcohol is likely to be part of the mix. In moderation, of course, alcohol is an enjoyable way to socialize and relax.
But not everyone is consuming alcohol in moderation.
Have you ever wondered if you’ve got a problem?
The internet is full of quizzes, questionnaires, and self-assessments professing to tell you if you are in fact an alcoholic. Some might suggest that if you’re even pondering the question, the answer is probably “yes.” Denial, of course, makes it hard to see the truth.
What does it mean to be an alcoholic? The Big Book from Alcoholics Anonymous simply says, “We alcoholics are men and women who have lost the ability to control our drinking.”
That’s fairly vague.
The Mayo Clinic defines alcoholism as “a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking.”
Many substance abuse and mental health professionals diagnose according to the criteria in the Diagnostic and Statistical Manual 5 (DSM-5). The DSM-5 now uses the term Alcohol Use Disorder (AUD) with specifiers for mild, moderate, and severe problems. So, a professional can’t technically diagnose you as an alcoholic, but a moderate or severe Alcohol Use Disorder is probably what most people consider an alcoholic. If you have six or more of the following symptoms in a 12 month period, you meet the criteria for a severe AUD and just two or three symptoms warrants a diagnosis of a mild AUD.
- Alcohol is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
- A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
- Craving, or a strong desire or urge to use alcohol.
- Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
- Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
- Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
- Recurrent alcohol use in situations in which it is physically hazardous.
- Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
- Tolerance, as defined by either of the following: a) A need for markedly increased amounts of alcohol to achieve intoxication or desired effect. b) A markedly diminished effect with continued use of the same amount of alcohol.
- Withdrawal, as manifested by either of the following: a) The characteristic withdrawal syndrome for alcohol (two or more of the following: sweating, increased pulse, hand tremor, insomnia, nausea or vomiting, anxiety or agitation, hallucinations, or seizures). b) Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.[i]
The DSM-5 criterion highlights that alcohol (and other substance) problems happen on a continuum. Alcohol abuse tends to be progressive, meaning most alcoholics will progress from mild problems to severe problems over the course of months or years. Left untreated, alcoholism only gets worse.
Another common alcohol-related problem is binge drinking, which usually refers to five drinks in a two-hour period for men (four for women). Binge drinking usually conjures up images of out of control fraternity parties. However, the Center for Disease Control (CDC) published a 2015 report showing that the overwhelming majority of those dying from binge drinking are men over the age of 35.
And although binge drinking is very dangerous, alcoholism isn’t really about how many drinks you have or how many nights a week you drink. We have to get past the negative associations of the term alcoholic.
Most alcoholics aren’t falling down drunks living on Skid Row. They’re professionals. They’re teenagers. They’re fathers. Alcohol doesn’t discriminate.
What you really want to be asking is: What problems are my drinking causing or worsening? How severe are the consequences? How often do they happen? Is alcohol adding or subtracting something from my life? Is alcohol preventing me from being the man, father, husband, son, or employee that you want to be?
Some warning signs that alcohol is negatively impacting your life:
- You miss work or school due to drinking. You call out sick or just don’t show up because you’re busy drinking or sleeping one off. Your work performance suffers. You miss deadlines and get passed over for promotions or raises.
- Your family or friends comment on how much you drink. Other people have noticed that alcohol’s causing problems or that you don’t drink like most people. Maybe they’ve had a “come to Jesus meeting” and expressed their concerns. Or maybe they just make sarcastic jokes about how much you drink. Either way, they’re worried.
- You look forward to drinking or getting drunk. You count down the hours or days until you can have a drink.
- You hide and/or sneak alcohol. You stash alcohol in various places so you’ll be sure to have easy access. You drink on the sly to avoid those critical comments or prying eyes.
- You got a DUI or other alcohol-related legal problems. You’ve put others in danger or hurt them through violence or driving under the influence. You’ve created legal problems for yourself.
- You drink in the morning or alone. Both are signs that you’re no longer drinking socially.
- You use alcohol as a reward. You tell yourself that you work hard; you deserve a six pack come Friday night. You got through an excruciating meeting with the divorce attorney; you deserve to stop at the bar on the way home.
- Drinking is your primary hobby. You’ve given up other interests in favor of or because of your drinking. You don’t bother showing up to venues/events that don’t serve alcohol (or you do your own drinking before you arrive).
- You drink to escape or cope. Alcohol is your go-to way to get through anything stressful – an argument with your wife, a big deadline at work, bills piling up.
- You lie about or minimize how much you drink, how much you spend on alcohol, or the negative consequences.
- Your relationships are suffering. There’s either more conflict in your relationships or you’re disengaged and don’t make an effort to connect emotionally.
- You routinely drink more than you planned or more often than planned. You break promises (to yourself or others) to cut back or quit.
Let’s also remember that denial is a hallmark of addiction. This means that you’re unlikely to be an objective judge of whether your drinking is a problem. Even when armed with the facts, you have a tendency to hear what you want to hear. Taking an honest look at your drinking just may be the most courageous thing you ever do. And you don’t have to do it alone.
Please seek support from one of the resources below or in your own community.
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And please, if you know someone who may benefit from this article or the resources that follow, please share this with them.
Resources:
Harm Reduction, Abstinence, and Moderation Support
SAMHSA National Helpline (24/7) 1-800-662-4357
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[i] American Psychiatric Association, Diagnostic and Statistical Manual 5th Edition, (Washington, DC: American Psychiatric Publishing, 2013), 490-491, 499.
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