How do I know if I have a drinking ‘problem’?

3 Oct

Many of us question whether we have a problem wtih alcohol and find ourselves googling whether we might be an alcoholic, particularly after a heavy session. And it can be hard to find definitive answers out there.

It might surprise you to know that the term alcoholic is considered outdated, unhelpful and actually isn’t a medically correct term to use.

Many people find the label ‘alcoholic’ prevents them from help seeking as it the associations with the word are of someone who has hit rock bottom and experienced significant loss in their lives - financially, professionally, physically, environmentally and in their relationships.

They simply don’t identify with it.

In the Diagnostic and Statistical Manual (5th version) which is used by psychiatrists and psychologists to diagnose in a standarised way, the correct term is alcohol use disorder (AUD).

Alcohol Use Disorder is considered a spectrum of sorts; as it runs from mild to moderate to severe.

In reality, people with alcohol use disorder may have a physical and psychological dependence/addiction with alcohol but not experience those significant losses, particularly not at the milder end of the scale.

So, do you have a problem with your alcohol use?

Simply, there’s a medical way to answer this question, and there’s a maybe more helpful way to answer. If you want the medical, feast your eyes over the next section, if you want to go straight to the crux of it, scroll on down.

We know that there is no safe level of alcohol consumption. However the official Australian guidelines recommend that:

to reduce the risk of harm from alcohol-related disease or injury for healthy men and women, drink no more than 10 standard drinks per week and no more than 4 standard drinks on any one day.

If you want to get the ‘official’ medical answer the following questions from the DSM-5 (latest version) and find out. The presence of at least 2 of these symptoms indicates Alcohol Use Disorder (AUD).

In the past year have you:

Had times when you ended up drinking more, or longer, than you intended?
More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
Spent a lot of time drinking? Or being sick or getting over other aftereffects?
Wanted a drink so badly you couldn’t think of anything else?
Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
Continued to drink even though it was causing trouble with your family or friends?
Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure? Or sensed things that were not there?

Scoring:

The severity of the AUD is defined as:

A mild alcohol use disorder is defined as the presence of 2-3 of the above symptoms.
A moderate alcohol use disorder is defined as the presence of 4-5 of the above symptoms.
A severe alcohol use disorder is defined as the presence of 6 or more of the above symptoms.

But what about in the ‘real world’?

You can see it actually doesn’t take much to fall into the category of mild alcohol use disorder.

Even people who consider themselves to be pretty sensible drinkers might fall on the AUD spectrum, and this is where people often dismiss these types of criteria.

Because it’s a bit like eating your 5 portions of fruit and veg or making sure you get 30 minutes exercise every day.

We all know what we should be doing according to some boffin in a lab, but as humans we often don’t want to.

We are hard wired for pleasure and for eating that fifth cookie and flirting with life choices we know we probably would be best not to, but we do anyway. This is part of what it is to be human.

Besides, most of us absolutely loathe being told what to do. Judged, made to feel ‘less than’, that somehow we are failing. I know I certainly do! We want to be in control of our lives and decide what is right for us, not some ‘do gooder’ or held to some impossible standards.

So, we often will sweep things that are uncomfortable under the carpet and so the cycle continues while we flip flop between thinking we don’t have a problem and then that maybe we do after all.

Maybe more important questions to ask yourself honestly could be:

‘is alcohol serving me?’
‘is alcohol impacting the way I live my life? Am I showing up as the person I want to be (as a parent, as a partner, in my career, in my mental/physical health)?’
‘is alcohol taking more from me than it is giving?’
‘is alcohol a two faced friend? is it pretending to be my mate and then secretly stabbing me in the back?’.

And, if you’re asking yourself whether you have a problem with alcohol, then consider this:

people who don’t have a problem with alcohol don’t question whether they have a problem with alcohol.

That really is the bottom line.

I play the pokies maybe once a year, if that. I don’t spend time even contemplating whether I have a problem with gambling because I know I don’t. It doesn’t even enter my mind.

Ultimately, the label of whether you are or aren’t an alcoholic is less important in many respects than how you feel about your drinking. If you are regularly feeling physically and mentally awful, cloaked in shame, guilt and remorse about your drinking then it’s probably time to take a closer look at it.

If this resonates with you, there is lots of help out there! Go to my free resources page, go to your GP or contact me.

But perhaps more importantly, be honest with yourself.

Sources:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Australian Drug and Foundation: https://adf.org.au/reducing-risk/alcohol/alcohol-guidelines/

An online version of this test is available here: https://adis.health.qld.gov.au/getting-support/self-assessment/alcohol