Am I an alcoholic? Do I drink too much? Is my drinking out of hand? These are questions that people may ask themselves if they are unsure if they have a healthy relationship with alcohol. This question is more common than people may think, as the line between casual drinking and problematic drinking can easily be blurred and crossed. Having a problem with alcohol is not a black and white issue, but rather is an issue that often lies within a grey area. People are so used to categorizing individuals into two categories, “normal drinkers” and “alcoholics,” that they forget to recognize that there is a wide spectrum of individuals who consume alcohol, many of whom may not fall into the stereotypical extremes.
Why is it sometimes difficult to know if there is a problem with alcohol?
It is not uncommon for individuals to question their relationship with alcohol, or to wonder if their loved one has a problem with alcohol. Of all the mind- and mood-altering substances (benzodiazepines, opioids, nicotine, amphetamines, etc.), alcohol is often the most difficult for individuals to determine if they have crossed that line into problematic drinking, or what is commonly referred to as alcoholism.
This uncertainty is largely in part due to alcohol’s social acceptance, which often even comes with encouragement to drink. For example, at social functions there are often more questions asked when an individual refrains from drinking alcohol than when they do. In lieu of interrogation, you may also be asked several times, “Are you sure you don’t want a drink?” Oddly, in such instances, there may be more stigma when a person is abstinent than when they are joining in the drinking.
Individuals may also question their relationship with alcohol because they are not what they envision an “alcoholic” to be, and therefore their relationship with alcohol must be ok. They have a successful career, take care of their health, have healthy relationships, manage responsibilities, etc. It is true that such standards are often negatively impacted by alcohol, however, they do not have to be in order to discern that there is an alcohol problem.
Examples of blurred lines
Perhaps your drinking behavior is always “normal” and you are always able to stop when you plan to. You have what many consider to be good self-control and self-awareness. But maybe there was that one time when you just couldn’t stop or didn’t want to stop. Let’s look at it with this analogy. Imagine there is a car for sale that is perfect, the only problem with it is that 1 out of 5,000 times the brakes might not work. Would you buy that car? Probably not. So why take life threatening chances when it comes to your alcohol consumption?
Or let’s consider this scenario. A successful individual has a long day at work, comes home to spend time with their family, puts their little children to bed, and then unwinds at the end of the night with one small glass of wine. One small glass, never more. They do this every night. It is deserved, and how they like to unwind after a long hard day. Most people would not consider this to be a problem, and from what we know about this individual thus far, it may not be. However, one night they are out of wine, so they choose to just relax with a book or watch a movie, and maybe have a sparkling water to quench their thirst or chamomile tea to self-soothe. However, they find themselves being stressed, anxious, or thinking of that glass of wine. They may be unable to focus on the book or movie as their attention is constantly drawn back to how much they want a simple small glass of Cabernet Sauvignon. Now there might appear to be some kind of problem.
Furthermore, such instances of one night that “went too far” or one night that they really craved a glass of wine may be looked at as isolated events. Such perspectives are often taken by individuals who receive a DUI or DWI. They had one too many drinks and made one bad decision. This may be true, however, most individuals do not receive a DUI or DWI their first time of drinking and driving by bad luck. According to the Centers for Disease Control and Prevention (CDC), the average convicted drunk driver has driven drunk 80 times before they were caught.
We can go on and on of examples which may blur the lines between “normal drinking” and problematic drinking. Public health campaigns such as Sober October and Dry January are a couple examples of global movements that encourage people to look at how and if their alcohol consumption may be impacting their wellbeing. The campaigns encourage individuals to be abstinent from alcohol during those months. During that time, some may find it much more difficult to remain abstinent for an entire 30-days than originally anticipated.
Any cravings or urges to drink may be a sign that you are more reliant on alcohol than you may have previously thought. Likewise, if you experience an increase in stress, anxiety or depression during that time it may be a sign that you relied on alcohol to cope with such underlying mental health issues. A 30-day abstinence pledge, regardless of the month, is a great way for individuals to reflect on their relationship with alcohol.
What is an alcoholic?
Let’s discuss the use of the term “alcoholic.” The word alcoholic itself can be extremely stigmatizing, as it often conjures up notions of an individual slurring their speech, smelling like alcohol and stumbling around. The term alcoholic is not formally used by addiction specialists or mental health professionals, but the term is more widely accepted and even encouraged in many alcohol recovery communities.
In Alcoholics Anonymous, the largest mutual-help recovery community for alcohol, the first step is accepting that you are an alcoholic and identifying yourself as such. Some find the term empowering and helpful while others may find it self-deprecating and damaging. To be clear, in order to recover from an alcohol dependence, one does not have to use the term alcoholic or identify as such. However, if it is helpful for you to identify as an alcoholic, by all means do so. Other terms that may be used are problem drinker, binge drinker, heavy drinker, or an individual with an alcohol problem or who abuses alcohol. The terminology used is not nearly as consequential as identifying and accepting the problem itself, no matter how small.
When should I get help for my alcohol problem?
Clinically, the term Alcohol Use Disorder is ascribed to an individual who meets the criteria for being diagnosed with an alcohol dependence. Alcohol Use Disorder is diagnosed on a spectrum of mild (2-3 symptoms present), moderate (4-5 symptoms present) and severe (6 or more symptoms present). The criteria are listed as follows, however, please be sure to never self-diagnose. It is always best to be assessed by an addiction specialist or therapist specializing in alcohol use disorders, as diagnosis is much more complex than simply checking off symptoms.
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? Or other such disruptions to your life?
- 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?
What if I am still having trouble determining if I have a problem with alcohol?
Having a problem with alcohol or calling oneself an alcoholic often comes with a great deal of shame and embarrassment along with a host of other negative feelings that are perpetuated by the stigmatic nature of addiction. Instead of asking yourself if you have a problem with alcohol, try asking yourself if alcohol is interfering with your life, or if alcohol is serving you to live your best life. Think in terms of all life areas from physical, mental and spiritual health to career, relationships, sleep hygiene and general life areas. Ultimately it is up to you to decide if you have a problem with alcohol, and if you want to do something about it.
If you are interested in reading more about discerning if you or a loved one has a problem with alcohol, please read “How Do I Know If I or a Loved One Has a Problem with Alcohol?”
What should I do if I do think I have a problem with alcohol?
Many are unable to come to terms with their problematic drinking or admit that they have a problem with alcohol, and once they do get to that point of admittance many more are unwilling to do something about their problem. So foremost, do not be hard on yourself. You have reached a point that many do not reach, only to continue to spiral downward. If you are able to identify that you have a problem with alcohol, and are willing to do something about it, you have already taken one of the most difficult steps towards recovery.
Depending on the severity of your alcohol problem (frequency, quantity, duration, etc.) and past history (attempts to stop in the past, rehabilitation attempts, etc.), you may be able to stop drinking on your own. However, if you are a regular heavy drinker, you may need a professional medical detox from alcohol. Withdrawing from alcohol can be extremely dangerous and even fatal. As such, always err on the side of caution if you are a frequent and heavy drinker by seeking out an addiction psychiatrist and/or alcohol detox.
Unfortunately, relapse rates for alcohol are extremely high, with up to 60% of individuals relapsing within the first 30 days and up to 85% relapsing within the first year. As such, it is often suggested to seek out an addiction specialist such as an addiction psychiatrist, addiction psychologist, addiction therapist or other such licensed mental health counselor specializing in addiction. Furthermore, sober coaches and sober companions are extremely beneficial as they can help you navigate day-to-day life with an on-hands approach.
To find an addiction specialist near you, simply do an online search for one in your area. For example, if you live in the Upper East Side of Manhattan try searching for “Addiction Treatment Upper East Side Manhattan.” If you have trouble finding an addiction professional, try calling your insurance provider or the national substance abuse and mental health lifeline at 1-800-273-TALK for referral sources.
We have also put together some guides to help you navigate an alcohol or drug dependence for yourself or a loved one. For more information please read, “My Loved One Has an Addiction, What Do I Do? – A Guide to Help You Navigate Recovery,” or “A Guide to the Different Pathways of Addiction Recovery.”
For more information on NYC addiction treatment and to find the best addiction counselor, or for general therapy and mental health, or to inquire about Family Addiction Specialist’s private concierge sober coach Manhattan, recovery coach Manhattan, sober companion Manhattan, Manhattan addiction therapy services and/or our Manhattan teletherapy services (online therapy/virtual therapy), as well as our Manhattan hypnosis services in New York City please contact our undisclosed therapy office location in the Upper East Side of NYC today at (929) 220-2912.