Time and again, the calls, emails and blog post comments I receive are centered around the difficulty the person has experienced in finding help for a drinking problem, whether it’s their own or a loved one’s. And it is often this time of year, after a holiday season filled with work, social and family gatherings in which heavy drinking is big part of the celebrations, that people are combing the Internet for answers.
KEY REASONS FINDING HELP FOR A DRINKING PROBLEM IS DIFFICULT
Based on my 14+ years working in this field, I’ve identified the following four key reasons people have so much difficulty finding help for a drinking problem.
Not Understanding the Label Doesn’t Matter
Time and again people write, call or comment on a blog post to share the things their drinking loved one has or hasn’t done, such as hiding bottles, breaking promises, getting a DUI, driving the kids while drinking, passing out, ruining the holiday meal by being loud and belligerent, etc. [If you read through the comments on these three posts of mine, “Detach. Detach With Love. You’ve Got to Be Kidding!,” “Fears for Children When Divorcing an Alcoholic,” and “Hidden Half-Empty Bottles – Should I Dump Them Out or ???,” you’ll see what I mean.]
Over the course of my exchanges with these people, they’ll push for a label, asking me, “Is s/he an alcoholic?”or they’ll proclaim their loved one can’t be an alcoholic because “She doesn’t drink everyday” | “He only drinks on the week-ends.”| “He goes to work everyday.” They want a hard and fast answer because they want me to tell them how to fix it. And I get it. I was there myself on many, many occasions as I struggled to “make” a loved one stop drinking so much during the four-plus decades in which I dealt with secondhand drinking. But as I explain to them, I’m not qualified to diagnose them or their loved one. Only a medical professional trained in addiction medicine can do that. But I can share the latest research that explains it’s not the label: alcoholic* or alcohol abuser* or binge drinker that matters, it’s the simple answer to these two questions: “Do they exceed the low-risk drinking patterns suggested by the NIAAA?,” and “Do their behaviors change when they drink?” If their answer is, “Yes,” then drinking is likely a problem because the ethyl chemical in alcoholic beverages changes how the brain works, which in turn changes a person’s thoughts, feelings, and behaviors. This leads to reason #2…
Not Understanding the Basics of How the Brain Works
Unless you understand the basics of how the brain works, it’s difficult to understand, let alone appreciate, how the ethyl alcohol chemical in alcoholic beverages chemically and structurally changes the way it works, which in turn changes the way brain cells communicate with one another, which in turn changes a person’s thoughts, feelings, and behaviors. These changed thoughts, feelings, and behaviors typically aren’t the “real” person coming out, unless that’s how they think, feel, and behave when sober. Rather they are the changes caused by interrupting the brain’s normal neural network functioning.
For some of the scientific concepts to counter this reason, please check out Here’s to Neural Networks and Neurotransmitters: Keys to Brain Health and Understand Brain Maps | Change a Habit | Change Your Life
Not Understanding the Majority of People with a Drinking Problem are not Alcoholics*
This is often a surprise to people. It’s also a relief. In fact, according to NIAAA’s Rethinking Drinking website (you’ll get these results yourself if you anonymously answer the “What’s Your Pattern?” Qs), the majority of American adults don’t drink at all or always stay within low risk limits and of those who exceed these limits, the majority are considered alcohol abusers vs alcoholics. Here’s a reprint of NIAAA’s graphic:
Notice I differentiated between alcohol abusers* and alcoholics*. The reason for this distinction is that “stopping” is different depending on which one it is. For the alcoholic*, they have the brain disease of addiction and must stop drinking all together for it is the alcohol that triggers their brain disease. For the alcohol abuser*, it is possible they can can learn to “re-drink” – to bring their drinking pattern within “low-risk” limits. And that’s because they have not crossed the line from alcohol abuse to alcoholism. Check out my eBook, “Crossing the Line From Alcohol Use to Abuse to Dependence.” This post may also help as it sheds light on the “process” – how a person develops the brain disease of addiction (of which alcoholism is but one), “Want to Prevent Addiction? Assess Your Risk Factors.”
But again, it’s not the label that matters because excessive drinking patterns lead to “approximately 88,000 deaths each year in the United States…,” according to the CDC as reported in their Alcohol Use and Your Health Fact Sheet accessed 1.8.18.
Excessive drinking includes binge drinking, heavy drinking, and any drinking by pregnant women or people younger than age 21.
Binge drinking, the most common form of excessive drinking, is defined as consuming
- For women, 4 or more [standard] drinks during a single occasion.
- For men, 5 or more [standard] drinks during a single occasion.
A standard drink contains 0.6 ounces (14.0 grams or 1.2 tablespoons) of pure alcohol. Generally, this amount of pure alcohol is found in
- 12-ounces of beer (5% alcohol content).
- 8-ounces of malt liquor (7% alcohol content).
- 5-ounces of wine (12% alcohol content).
- 1.5-ounces of 80-proof (40% alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whiskey).4
Heavy drinking is defined as consuming
- For women, 8 or more [standard] drinks per week.
- For men, 15 or more [standard] drinks per week.
Most people who drink excessively are not alcoholics or alcohol dependent. (Source: CDC’s Alcohol Use and Your Health Fact Sheet accessed 1.8.18.)
Not Realizing Your Doctor Is Likely Not Trained to Identify or Treat Alcohol Use Disorders*
David Sheff wrote in his May 8, 2017 article on PsychologyToday.com, “Sobering Truth About Addiction Treatment in America,” “A recent ASAM survey of two thirds of U.S. medical schools found that they require an average of less than an hour of training in addiction treatment.” As such, talking to your primary care doctor will likely prove less than satisfactory in getting the answers you need for finding help with a drinking problem. But the National Institute on Alcohol Abuse and Alcoholism offers a new tool…
There is SO MUCH great information on this new website. For example: How to Spot Quality Treatment provides key criteria you’ll want to find in a treatment provider’s program, and How to Search and What to Ask gives you specifics for narrowing your search decision. Search for Addiction Therapists and Search for Addiction Doctors can help you find specialists trained in helping people with a drinking problem (as well as their families).
Don’t wait. The longer a person continues an unhealthy drinking pattern, the worse the problem can get and the more difficult it can be to change.
And as always, contact me with your questions. Start by emailing me at lisaf@BreakingTheCycles.com to schedule a phone call. There is no charge for these kinds of calls.
Note About the Terms Alcoholism and Alcohol Abuse
Until May 2013, it was common to use the terms, alcohol abuse and alcoholism, because it’s how they were classified in the 4th edition of the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). This manual, updated now and then as a new edition, is for use by clinicians to give them a common language with which to understand, diagnose, and talk about a wide range of mental health conditions. Alcohol abuse and alcoholism were two of those conditions.
In May 2013, the 5th edition was released, DSM-5. This revised edition put both alcohol abuse and alcoholism into one disorder classification and called it “alcohol use disorder (AUD).” Within the AUD, there are three sub-classifications: mild, moderate, and severe.
Source: National Institute on Alcohol Abuse and Alcoholism (NIAAA). “Alcohol Use Disorder: A Comparison Between DSM-IV and DSM-5.” Reviewed July 2016, NIH Publication No. 13-7999. Accessed October 26, 2017. https://pubs.niaaa.nih.gov/publications/dsmfactsheet/dsmfact.pdf
When talking about both alcohol and other drugs, the term is substance use disorders (SUD).
I’ve chosen, however, to continue using society’s more commonly used terms, alcohol abuse and alcoholism, for two reasons. The first is because these are the terms most people know and use. The second is to make the distinction easier to explain and understand because the way a person stops their alcohol abuse is different than the way a person develops and treats their alcoholism. Yet, alcohol abuse or alcoholism have something hugely significant in common – drinking behaviors – the behaviors that can be so destructive to family members and friends’ physical and emotional health and quality of life, co-workers and society at large.
Note About the Terms Alcoholic and Alcohol Abuser
As part of this new brain science is the use of new language to describe a person who has the brain disease of alcoholism. The effort now is to refer to individuals with alcoholism as “a person with alcoholism.” This helps to remove the stigma, misinformation and shame that surrounds this disease and typically keeps people from seeking the help they need. It’s the idea of the individual is a person with a disease. They are not their disease.
As with the above, I continue (for now) to use the terms alcoholic and alcohol abuser because the way these drinking patterns are treated or changed varies greatly and is explained below.
©2018 Lisa Frederiksen