It is not always easy to see when alcohol intake has crossed the line from social drinking to problematic drinking. Consuming alcohol to cope with life’s difficulties and avoid or numb emotional discomfort is entering a dangerous space. A problematic relationship with alcohol tends to creep up on us, so it is important to be aware of the warning signs associated to alcohol abuse (problematic drinking) or alcohol dependence (alcoholism) and take the necessary steps to either preserve or restore your physical, psychological and social health.
The terms ‘alcoholic’ or ‘alcoholism’ evoke the stereotypical view of a transiant, homeless individual roaming with and swigging from a bottle hidden behind a vail of a brown paper bag. For some this may be where their alcohol consumption and life circumstances have led them, as some would say they are at ‘rock bottom’. In reality Alcohol is not selective and over time its consumption can become problematic for anyone no matter their social status or position in life. ‘Rock Bottom’ is a choice, there is no need to allow alcohol to take your life from you, before it is recognised as a problem. Generally, the less severe the problem is, the better treatment and health outcomes are. If Alcohol is causing problems in your life, then it is a problem.
Myth: I’m not an alcoholic because I have a job and I’m doing okay.
Fact: You don’t have to be homeless and drinking out of a brown paper bag to be an alcoholic. Many alcoholics can hold down jobs and provide for their families. However just because you’re a high-functioning alcoholic doesn’t mean you are not causing harm to yourself or others. Over time, the effects will catch up with you.
Myth: I don’t drink every day or I only drink wine or beer, so I can’t be an alcoholic.
Fact: Alcoholism is not defined by what you drink, when you drink it, or even how much you drink. It’s the effects of your drinking that define a problem. If your drinking is causing problems in your home or work life, you have a drinking problem.
Myth: I can stop drinking anytime I want to.
Fact: Maybe you can; more likely, you can’t. Telling yourself you can quit enables you feel in control, despite all evidence to the contrary and no matter the damage it’s doing.
Myth: My drinking is my problem. I’m the one it hurts, so no one has the right to tell me to stop.
Fact: The decision to quit drinking is up to you. However, you are deceiving yourself if you think that your drinking hurts no one else but you. Alcoholism affects everyone around you, especially the people closest to you. Your problem is their problem.
Myth: Drinking is not an addiction like drug abuse.
Fact: Alcohol is a drug, and alcoholism is every bit as damaging as drug addiction. Alcohol addiction causes changes in the body and brain, and long-term alcohol abuse can have devastating effects on your health, your career, and your relationships. Alcoholics go through physical withdrawal when they stop drinking, just like drug users do when they quit.
For the remainder of this article we will refer to ‘Alcoholism’ as an ‘Alcohol Use Disorder’. This is the clinical term used to define the illness. As mentioned the terms ‘Alcoholic’ or ‘Alcoholism’ carry a stereotype that for many is stigmatising and can get in the way of reaching out for effective support and treatment.
The DSM-5 (Diagnostic and Statistical Manual of Mental Health Disorders) has moved away from these terms preferring to categorise it as an Alcohol Use Disorder, with a diagnostic scale ranging from mild to severe depending on the level of disruption and harm that is caused by alcohol use. What does all this mean, simply once again, ‘if it’s a problem then it’s a problem’. Personal acceptance can be a barrier to change. Often the reward, whether the ‘high’, moderating the discomfort of ‘withdrawal’, or ‘benefit beliefs’ associated to alcohol use, out-way the ‘beliefs’ associated to the direct impacts of alcohol use. It seems to be the rule rather than the exception that it is those people around us that notice the problem relationship with alcohol and attempt to bring it to our attention. A word of advice ‘listen’.
A term often used to describe this phenomenon is denial. Or more accurately termed from my experience, as the manifestation of a psychological, and physiological dependence associated with shame avoidance. No body generally wants their life to be this way, and behaviour is often incongruent to the individual’s values; shame is the most uncomfortable and isolating emotion of our rich emotional experience. A consequence of this, is that a person will rationalise, and justify their alcohol use, enabling them to continue drinking and avoid the discomfort of facing the problem.
An effective and accurate self-screening tool is the Alcohol Use Disorder Identification Test (AUDIT). Developed by Saunders JB, Aasland OG, Babor TF et al. in collaboration with the World Health Organisation (WHO) to assist in the detection of people with harmful alcohol consumption.
This can be of great assistance enabling you to see where your alcohol consumption is.
If you have taken the Alcohol Use Disorder Identification Test (AUDIT) and find you are in the moderate to high score range, take action now. Making this decision for yourself can allow you to have a future you value and restore your quality of life, there is no need for things to worsen. Call it your ‘rock bottom’, effective treatment works.
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