What Defines an Alcohol Problem?

Reader’s Question

I am a 39-year-old male who is confused as to what determines an alcoholic. I’ve taken a few of the tests available online, answering the questions as honestly as I can, and have been delivered a variety of conclusions.

In a nutshell, I consider myself a social drinker, however, I have a brother who is concerned about me because he is a recovering alcoholic and is convinced that I am in denial. Here are the basic facts: I drink with friends, usually one day out of the week (a weekend day) and oftentimes end up drunk. I can get inebriated rather quickly on wine and with beer, it may take a bit longer. I usually do not indulge in hard alcohols (unless it involves an occasional green apple martini!). I find that once I have eaten, I am no longer interested in drinking… therefore, I tend to put off eating until I’m finished drinking. I’ll drink 2-4 glasses of wine on the day I choose to drink, or perhaps 3-5 beers. I have never been able to drink two consecutive days. I realize that I’m not fond of the taste of alcohol, and drink specifically for the “mind-altering” effects. I’ve been told that this is dangerous, as it is typical of alcoholic behavior. Could you shed some light here for me please? I realize, with alcoholism in the family, I have a much higher need to be worried; however, with the definition as my brother sees it… almost all Italians, and Irish folks could be considered alcoholics. Keep in mind, I’ve never had problems with friends nor has it interfered with my work schedule…

I’m truly clueless in this area.

Thanks for your help!

Psychologist’s Reply

The mental health criteria for alcohol dependence/addiction first describes a maladaptive pattern of abuse, leading to clinically significant impairment or distress as suggested by:

  • tolerance or requiring more alcohol for the same effect
  • withdrawal syndrome
  • use in increasingly larger amounts
  • a persistent desire or unsuccessful efforts to cut down
  • spending a great deal of time in activities necessary to obtain alcohol or use alcohol, creating a “drinking lifestyle”
  • giving up or reducing important social or personal activities due to alcohool use
  • continued use despite experiencing negative consequences such as physical illness, job loss, relationship problems, etc.

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While the above is the list of mental health criteria, alcohol and substance addiction programs often have different criteria. Many recovery programs have a lower “bar” or criteria in their attempts to identify people who may be at-risk for alcohol or substance-abuse problems. As you mention, a history of alcoholism in the family may place you at-risk for alcohol problems in the future. It’s wise to monitor your alcohol consumption and remain alert for any increase in your alcohol use or lifestyle pattern. Social drinking often turns into problem drinking when we find ourselves scheduling our social activities around alcohol for example.

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