Am I an Alcoholic?

The internet is full of quizzes, questionnaires, and self-assessments looking to answer the question “am I an alcoholic”? The answer, it seems, depends on who you ask.

Let’s begin by trying to define the term alcoholic. Alcoholics Anonymous simply says, “We alcoholics are men and women who have lost the ability to control our drinking“ (The Big Book).

And the Mayo Clinic defines alcoholism as “… a chronic and often progressive disease that includes 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 (physical dependence), or having withdrawal symptoms when you rapidly decrease or stop drinking. If you have alcoholism, you can’t consistently predict how much you’ll drink, how long you’ll drink, or what consequences will occur from your drinking.” (http://www.mayoclinic.org/diseases-conditions/alcoholism/basics/definition/CON-20020866)

Professionals diagnose according to the criteria in the Diagnostic and Statistical Manual 5 (DSM- 5). The DSM-5 now uses the term Alcohol Use Disorders with specifiers for mild, moderate, and severe problems. So, a professional can’t technically diagnose you as an alcoholic. I think the DSM-5 criteria highlight that alcohol (and other substance) problems happen on a continuum. These problems tend to be progressive, meaning many will begin with mild problems and over months of years progress to having severe problems.

Another common alcohol-related problem is binge drinking, which usually refers to 5 drinks in a 2 hour period for men (4 for women). We usually associate this type of drinking with college students. However, the Center for Disease Control (CDC) just published a 2015 report showing that the overwhelming majority of those dying from binge drinking are men over the age of 35 (http://www.cdc.gov/vitalsigns/alcohol-poisoning-deaths/index.html).

My training emphasized that alcohol problems are not so much about the quantity or frequency of drinking, but more defined by the negative consequences of the drinking and fact that you continue to drink despite having negative consequences. Now, of course, the more frequent and larger the amount of alcohol, the more likely you are to suffer negative consequences. Negative consequences can include anything from hangovers or arguments to a DUI or poor job performance. Let’s also remember that denial is also a hallmark of addiction. This all means that you are unlikely to be an objective judge of whether your drinking is a problem. Even when armed with the facts, we have a tendency to hear what we want to hear. We have to get past the negative associations of the term alcoholic. What you really want to be asking is: What problems are my drinking causing? How severe are the consequences? How often do they happen? And because we don’t usually recognize denial in ourselves, it is often helpful to listen to what your friends, family, or coworkers are saying about your drinking. If you’re still not sure, I invite you to call my office to set up an appointment.

Sources and Resources:

http://www.mayoclinic.org/diseases-conditions/alcoholism/basics/definition/CON-20020866

http://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm

http://www.cdc.gov/vitalsigns/alcohol-poisoning-deaths/index.html

http://www.aa.org/ The Big Book of Alcoholics Anonymous

DSM-5, American Psychiatric Association, 2013.

Dr. Sharon Martin, LCSW

Sharon Martin, a licensed counselor and psychotherapist in Northern California, specializes in helping adult children of alcoholics and others who struggle with anxiety, perfectionism, and self-criticism. She has a private psychotherapy practice in CA where she is available for online counseling. Sharon is also the author of The CBT Workbook for Perfectionism and write the blog Conquering Codependency for Psychology Today.