People drink for all sorts of reason. Some reasons are to socialize, celebrate and relax. Other times people use alcohol as a form of self-medication to help them manage stress, anxiety or to use it to distract them from unpleasant or unhappy situations in their life.

Alcohol has a strong effect on people and many people may start to question whether they have a problem with alcohol, especially if loved ones, co-workers or friends start to point out how their drinking is a creating a problem for their interaction with them.

Many people come to me with greatly misinformed ideas about what constitutes an alcoholic. Many people tend see it very black and white, either I'm okay with alcohol or I'm an alcoholic. The reality of alcoholism or Alcohol abuse disorder (AAD) is that it is more a grey scale on a continuum from abstinence to full blown alcoholism.

Some INCORRECT ideas that people hold that they use to comfort themselves or their spouses that they are NOT an alcoholic or have a problem are the following:

I can go a week or a month or some limited defined period of time without drinking

I only binge drink on the weekend and not during the week

I can hold my job and drink

I don't beat my spouse (i.e. Alcoholics beat their spouses) while drunk

Even though I lose control of my drinking there are times when I can control it (basically when the cost is so high to getting wasted the person will control, where as other times they cannot)

The drinker will only quite or abstain for their partner, but then after a period will ask their partner permission to drink, putting their partner in lose-lose position. If partner says YES they are now to blame for the person's drinking and getting drunk. If the partners say NO, they are bitch or asshole controlling the drinker. Typical symptoms of problem drinking are that the drinker doesn't take responsibility for their drinking, they blame others or situations that CAUSE them to drink, which is silly, the only person putting a drink the person's mouth is the problem drinker.

These are incorrect assessments and look at problem drinking from a wrong term. Yes, alcoholics or problem drinkers can go for short periods where they can avoid drinking only to be followed by big drinking. This is a sign of a problem.

It is important to understand that the path to full blown alcoholism is laid by a path of long problematic drinking. It is not an all or nothing state and some people may take a few years to many years to develop full blown alcoholism. This does not mean that until you are a full blown alcoholic you will have no problems.

How alcohol effects each person is different. Not all people who drink will eventually become alcoholics. Alcohol's effects vary from person to person, depending on a variety of factors, including:

How much you drink

How often you drink

Your age

Your health status

Your family history

According to the National Institute of Mental Health, in the United States, Alcohol use disorders are medical conditions that are diagnosed when a patient's drinking causess distress or harm to self or those in contact with them. So with this definition, if you are starting get feedback from those you love that its causing a problem, this is an indication you probably have a problem. You can have a problem, without being an alcoholic.

To be considered an Alcoholic, which is the most serious of the Alcohol Abuse Disorder problems you must have the systems of:

Craving—A strong need, or urge, to drink.

Loss of control—Not being able to stop drinking once drinking has begun.

Dependence—Withdrawal symptoms, such as nausea, sweating, shakiness, and negative emotional states such as anxiety, after stopping drinking.

Tolerance—The need to drink greater amounts of alcohol to feel the same effect.

People who are alcoholic often will spend a great deal of their time drinking, making sure they can get alcohol, and recovering from alcohol’s effects, often at the expense of other activities and responsibilities.

Although people who abuse alcohol are not physically dependent, they still have a serious disorder. They may not fulfil responsibilities at home, work, or school because of their drinking. They may also put themselves in dangerous situations (like driving under the influence) or have legal or social problems (such as arrests or arguments with family members) due to their drinking.*

So looking at Alcohol Abuse Disorder Client's will have the following symptoms:

Alcohol is taken in larger amounts or over a longer period than was intended (this would be symptoms of tolerance and could be binge drinking, when a person plans to have a couple drinks, but cannot stop and ends up have a lot more than planned)

There is a persistent desire or unsuccessful effort to cut down or control alcohol use. (Again the PERSISTENT desire. This mean drinkers want to control their drink but can't. Often people will enlist the help of their spouse, or will set arbitrary times when then they can drink, like not till 5pm, or they will create rules to control their drinking that fail more times than they work).

A great deal of time is spent in activities necessary to obtain alcohol, use alcohol or recover from its effect. (So this is where people only want to hang out with people who like to drink, they are less likely to go to events or hang out with people where no alcohol is going to be served, they will organize their day, week or month to ensure that they have drinking time. They will often fiercely protect their recover or hang-over day).

Craving or a strong desire or urge to use alcohol. (Often people confuse this with what they imagine an alcoholic would look like. People may feel anxious, nervous, irritated or cranky or unable to sit still. They may start watching the clock to see if it is “time to drink yet” they may start bartering with self or their loved one that they put in charge of their drinking. This is all symptoms of craving).

Recurrent alcohol use resulting in a failure to fulfil major role obligations at work, school, or home. (again, this would be related to you go out and binge drink and the next day on a weekend you cannot watch the kids or do planned family activities as intended, you go to work late, your forget important inform for family or work, you take longer to do easy tasks, normally every day activities are not performed in the same effective manner).

Important social, occupational, or recreational activities are given up or reduced because of alcohol use (this is often where people stop socializing with certain non-drinking people or may stop exercising or taking care of their physical health because alcohol gives them faster relief. As drinking dependency gets worse, people stop eating healthy, eat significantly less or poorer quality “hangover food”)

Alcohol use is continued despite knowledge of having persistent or recurrent physical or psychological problems that are likely to have been caused or exacerbated by alcohol (again this is a drinker that despite knowing they'll be sick the next day or will face serious consequences with a spouse, child, co-worker or employer will continue to choose the harmful behaviour)

Tolerance as defined by either of the following: A need for markedly increased amounts of alcohol to achieve intoxication or desired effect A markedly diminished effect with the continued use for the same amount of alcohol.

Withdrawal, as manifested by either of the following: The characteristic withdrawal syndrome for alcohol of shakes, sweats, serious craving and preoccupation to obtain alcohol Alcohol (or closely related substance such as benzodiazepine) is taken to relieve or avoid withdrawal symptoms.



So as you can see a problem drinker will experience many problems of physical, psychological and social problems without technically being an Alcoholic.

Basically you have a problem if you have the following:

People important to you are complaining about how your drinking is affecting you

You cannot drink the way you used to, so even if you can go a few days or weeks without drinking but then you binge drink and cannot stop once you start, you have a problem.

You are willing to defend and protect your drinking even in the face of serious consequences of drinking such as being late for work, missing important deadlines, serious fights with your spouses or commitments not kept due to drinking, health consequences ie hangovers that prevent you from keeping your commitments

You rationalize and justify your use to yourself and your loved ones

You keep trying to control it without success and look for things outside of you to control the drinking rather than yourself, such as a time on a clock (ie I can drink after 5pm) making your spouse responsible for your drinking, drinking in only certain areas, drinking only certain type of alcohol ie beer only no wine or hard liquor. These are serious problem behaviours.

If you want help reviewing your options, you can call us for help to work with you to determine your next steps and options. Call 90307239 or email us.