Worried About Someone’s Drinking – What Can You Do?

Worried about someone’s drinking? Watching a friend or relative change when they drink and then not being able to stop the drinking that’s causing the changes can be crazy-making. What can you do? Is it any of your business? What if they get mad?

What can you do if you’re worried about someone’s drinking?

One of the hardest aspects of loving or being a close friend of someone who drinks too much Worried About Someone's Drinking - What Can You Do?is “knowing” whether they really do. What I mean is that we can get so hung up on any one of the many definitions of what is too much that we go around and around in our own minds and in arguments with our loved ones – all the while focusing on that instead of what is.

The reason it may be useful for you to assess your loved one’s alcohol use is to help you understand what it is that you know. It is not so you can make your loved one stop drinking nor help them see the slippery slope they are headed down (although they may be open to the information and to making their own assessment). Rather, assessing helps you understand the difference between alcohol use (considered normal drinking), excessive drinking (a.k.a. alcohol abuse) and dependence (a.k.a. alcoholism or an addiction to alcohol), giving you a solid reference point for your own situation.

Assessing Your Loved One or Friend’s Drinking – is it a problem?

The following assessment was developed and evaluated over a period of two decades by the World Health Organization’s (WHO) Department of Mental Health and Substance Dependence. It is called AUDIT (the Alcohol Use Disorders Identification Test).(1) It was created primarily for health care practitioners around the world as a simple method of screening for excessive drinking. Other professionals who work with people who seem to have alcohol-related problems also find it useful.(2)

To complete the assessment, mark the answer that best applies to your perception of your loved one’s drinking. In other words, the “you” is your loved one. [Don’t forget, the “size” of a drink matters. A drink is defined as 5 ounces of wine OR 12 ounces of beer OR 1.5 ounces of 80-proof spirits (vodka, scotch).]

1. How often do you have a drink containing alcohol?
(0) Never
(1) Monthly or less
(2) 2 to 4 times a month
(3) 2 to 3 times a week
(4) 4 or more times a week

2.  How many drinks containing alcohol do you have on a typical day when you are drinking?
(0) 1 or 2
(1) 3 or 4
(2) 5 or 6
(3) 7, 8, or 9
(4) 10 or more

3.  How often do you have six or more drinks on one occasion [note: this is known as binge drinking, and in the U.S., binge drinking is five or more drinks on one occasion for men and four or more drinks on one occasion for women]?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily

4.  How often during the last year have you found that you were not able to stop drinking once you had started?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily

5.  How often during the last year have you failed to do what was normally expected from you because of drinking?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily

6. How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily

7.  How often during the last year have you had a feeling of guilt or remorse after drinking?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily

8.  How often during the last year have you been unable to remember what happened the night before because you had been drinking?
(0) Never
(1) Less than monthly
(2) Monthly
(3) Weekly
(4) Daily or almost daily

9. Have you or someone else been injured as a result of your drinking?
(0) No
(2) Yes, but not in the last year
(4) Yes, during the last year

10.  Has a relative or friend or a doctor or another health worker been concerned about your drinking or suggested you cut down?
(0) No
(2) Yes, but not in the last year
(4) Yes, during the last year

Now, look at the numbers in the ( ) for each answer you’ve circled and total those numbers. According to AUDIT, total scores between 8 and 19 indicate alcohol abuse (excessive drinking). Total scores 20 and above indicate alcohol dependence (alcoholism).(3) A score of 0-7 indicates drinking at moderate levels. This is also known as “normal” drinking or “alcohol use.”


CAUTION
: The AUDIT goes on to say that in the absence of a trained professional conducting this questionnaire (as he or she knows how to ask the question and interpret the answer or dig more deeply for an accurate answer), these guidelines and scoring must be considered tentative — NOT definitive.  Additionally, the AUDIT notes that in an [“official”] evaluation, it matters on which questions points were scored. So it’s important to review the entire AUDIT document and not to draw any firm conclusions.

So, Why Assess?

According to the AUDIT,

  • “the bulk of harm associated with alcohol occurs among people who are not dependent [but rather engage in excessive drinking (alcohol abuse)].
  • “people who are not dependent on alcohol (alcoholics) may stop or reduce their alcohol consumption with appropriate assistance and effort. Once dependence [addiction/alcoholism] has developed, cessation of alcohol consumption is more difficult and often requires specialized treatment.
  • “Although not all hazardous [excessive/alcohol abuse] drinkers become dependent, no one develops alcohol dependence [alcoholism] without having engaged for some time in hazardous alcohol use.”4)

So now what?  For answers to this question and additional information that will be extremely helpful if you are grappling with a loved one’s drinking, consider buying my book, If You Love Me, You’d Stop! What You Really Need To Know When A Loved One Drinks Too Much.

_________________________________

(1) Babor, Thomas F., et. al., World Health Organization (WHO), “The Alcohol Use Disorders Identification Test, Guidelines for Use in Primary Care, Second Edition,” <http://whqlibdoc.who.int/hq/2001/WHO_MSD_MSB_01.6a.pdf>

(2) Ibid, p.2

(3) Ibid., pgs. 17, 29 and 20

(4) Ibid., pgs. 5-6

©2009 Lisa Frederiksen

Lisa Frederiksen

Lisa Frederiksen

Author | Speaker | Consultant | Founder at BreakingTheCycles.com
Lisa is the author of hundreds of articles and 11 books, including "If You Loved Me, You'd Stop!," "Addiction Recovery: What Helps, What Doesn't," and "Secondhand Drinking: the Phenomenon That Affects Millions." She is a national keynote speaker with over 25 years speaking experience, consultant, and founder of BreakingTheCycles.com. She has spent more than 14 years studying 21st century brain research in order to write, speak, and consult on substance use disorders prevention, intervention and treatment; mental disorders; addiction (aka substance use disorders) as a brain disease; adolescent addiction treatment vs adult addiction treatment; effective treatment for co-occurring disorders (having both a substance use and mental disorder); secondhand drinking | drugging; help for the family; and related subjects. In 2015, she founded SHD Prevention, providing training and consulting to companies, public agencies, unions, nonprofits and other entities to address the workplace impacts of employee secondhand drinking and alcohol misuse.

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