FAQs
Author, speaker, consultant and website host, Lisa Frederiksen, answers frequently asked questions:
- How can you tell if someone’s an alcoholic?
- Can a person have a problem with drinking and not be an alcoholic?
- Is alcoholism really a disease?
- Can it be cured?
- What can someone do to help a loved one who drinks too much?
- Why do you think there are so many problems related to alcoholism and the problems it causes?
- Do you blame your loved ones for their alcoholism or alcohol abuse and the problems it caused?
- Who will benefit from reading this book or from one of your presentations?
- What made you write this book?
- What do you hope to accomplish by writing and speaking on these subjects?
- What’s the best thing that’s come out of your experiences?
- Do you plan to write more books?
Expanded versions of many of these answers can be found in Lisa’s book, If You Loved Me, You’d Stop!
1. How can you tell if someone’s an alcoholic?
Most people think of drinking as either “normal” or “alcoholic.” What we don’t understand is that there is a whole other “stage” — alcohol abuse (excessive drinking). Alcohol abuse is the term used to describe the various forms of excessive drinking that cause significant risk, harm and distress to the excessive drinker and to his or her family and friends (1) - risk, harm and distress that equals that which is most often associated with alcoholism. These include driving while intoxicated, relationship problems with a spouse, parent, boss, friend or child, suspension from school or absences from work and/or arrests.
So, to answer this question, it is helpful to understand the difference between alcohol use, alcohol abuse (excessive drinking) and alcohol dependence (alcoholism). Alcohol use is also known as “normal” or “moderate drinking.” Alcohol dependence (alcoholism) is an addiction, a disease. Alcohol abuse is when a person continues to excessively drink in spite of the problems their drinking is causing. All alcoholics go through a period of alcohol abuse. Not all alcohol abusers become alcoholics.(2)
As for how you can tell…the World Health Organization (WHO) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) provide assessments. While a medical professional should be the one to conduct the assessment and make the determination, you can do it, too, from your perspective, to see where your loved one’s drinking falls. It is important to understand that you are assessing for your sake – not to get your loved one to “see the light.” But, it does help you to understand what you are dealing with and that can free you to learn more about what you can do about the situation.
And, while you’re going through the assessment, know that one drink in America is defined as:
- a 5 ounce glass of wine
- a 12 ounce beer
- 1.5 ounces (a shot) of 80-proof distilled spirits (scotch, gin, vodka)
As an FYI — the NIAAA defines “normal” drinking (alcohol use) as:
- no more than 3 drinks in a day AND no more than 7 in a week for women
- no more than 4 drinks in a day AND no more than 14 drinks in a week for men
Note: 4 or more drinks on one occasion for women and 5 or more drinks on one occasion for men is considered binge drinking. Binge drinking is not considered “normal” drinking.
2. Can a person have a problem with drinking and not be an alcoholic?
Yes. See the answer to question #1.
3. Is alcoholism really a disease?
Yes. New brain imaging technologies (PET Scans, MRIs) have given scientists and medical professionals tools like never before. They’re now able to see what happens to the live brain of an alcoholic – and what they are showing is significant damage and alterations in the actual structure of the brain. You will learn more about these findings and the disease of alcoholism in my book or through one of my presentations.
No. Alcohol dependence (alcoholism) cannot be cured, but it can be treated – by the alcoholic, not by you.
For those who are alcohol dependent – alcoholics – there is absolutely no quantity of alcohol they can drink, EVER, if they want to recover. Not one, not two, not on holidays nor on special occasions, not after ten years of abstinence. Alcoholics cannot drink. Additionally, as long as an alcoholic drinks any amount of alcohol or thinks they can successfully drink at sometime in the future, there is no amount of willpower nor good intentions that can help them avoid the next problematic drinking episode.
Alcohol abuse (excessive drinking), on the other hand, can be “cured.” The person needs to change their drinking to fall within normal limits or stop drinking if they find they cannot control it. The reason alcohol abuse can be “cured” and alcoholism can only be treated is that alcoholism involves addiction (and that’s a whole other discussion).
5. What can someone do to help a loved one who drinks too much?
- Learn as much as you can about the disease of alcoholism and about alcohol abuse and what constitutes normal drinking.
- Learn as much as you can about what happens to you (and other family members) by virtue of growing up with or living with an alcoholic or an alcohol abuser. This will help you to become open to ways to make your life more enjoyable whether your loved one stops drinking or not.
- Learn to talk openly and honestly about what’s going on and thus stop the denial. It really is “that bad” – whether it’s alcohol abuse or alcohol dependence (alcoholism).
My book offers many suggestions. You’ll find similar information on my blog, www.breakingthecycles.com.
6. Why do you think there are so many problems related to alcoholism and the problems it causes?
Denial. Shame. Lack of knowledge and understanding.
I think the denial comes into play because of society’s inaccurate view of alcoholism as a shameful lack of willpower. This view drives the alcoholic and his or her loved ones to continue making one Herculean attempt after another to battle the disease – (and long before the disease, the alcohol abuse) – in isolation.
Additionally, society is even more silent on what is happening to the family and friends who love the alcoholic or alcohol abuser (a.k.a. “codependents”) and presumes that if the drinking stops, then all should be well with them, too. This is another gravely destructive assumption. I, myself, had been living with alcoholics and/or alcohol abuse and the family disease of alcoholism for some thirty-five years before I finally admitted, “I need help!
7. Do you blame your loved ones for their alcoholism or alcohol abuse and the problems it caused?
Not any more. I used to. That’s why I wrote this book and am hosting this website so that others don’t need to suffer in silence. Until we start to honestly and opening talk about alcohol abuse and alcoholism, treating the latter the way we treat other diseases, the staggering statistics of our silence will continue [statistics such as: more than half of Americans report having a close family member with a drinking problem (3), more than half of those with a lifetime history of alcohol abuse or dependence also suffer from a mental health illness -- which cannot be treated effectively until the drinking is stopped (4), roughly one in four American children are exposed to a family alcohol abuse (5), addiction or both before the age of 18 and someone dies in an alcohol-related vehicle crash every 31 minutes (6)].
8. Who will benefit from reading this book or from one of your presentations?
This book or one of my presentations can benefit everyone whose life has been negatively impacted by alcohol, as well as others whose work can help us break the cycles and change the conversations about all of the issues surrounding alcohol abuse and alcoholism. Here are some suggestions:
- Pediatricians – who can help children and teens who are starting to drink or who have a family member who does.
- Internists – who can make better alcohol use assessments and read the “red flags” to identify the true cause of a patient’s ailment.
- Alcoholics, alcohol abusers – who will learn what can or has happened to their brains and to their loved ones who have been affected by their drinking.
- Lawmakers – who can make more effective legal and public policy decisions, such as labeling (think California’s 2008 fast food calorie labeling law), social host laws and insurance parity for addiction and codependency treatment.
- Parents – who will find invaluable information if they have a child grappling with a drinking problem or a spouse whose drinking is affecting the family’s dynamics and their co-parenting.
- Teachers, administrators and school counselors – who will learn why drinking affects the brain under 21 differently than the adult brain; plus gain a better understanding of what students might be going through if a sibling or parent is drinking too much, helping to pave the way for different approaches to student discipline.
- Family law attorneys and child protective services personnel – who will learn how difficult co-parenting can be when one parent drinks too much and who will better understand the family dynamics the child has been living in when excessive drinking is present.
- Domestic violence center employees and volunteers – who can use this book to help victims of domestic violence understand the role a loved one’s excessive drinking may play in their struggle.
- Mental health professionals – who help with therapy treatments for all concerned, as well as those needing to understand the concepts and prevalence of dual diagnoses and co-addictions.
- Treatment center personnel – who can use it to help family members of the clients they treat for alcoholism better understand the disease, as well as help their clients – the alcoholics – better understand what their family members have been through.
- Loved ones of the person who drinks too much – which includes more than half of all American men and women and one in four of America’s children.
9. What made you write this book?
It took until I was 49 years old to get help and that was the result of one of my loved ones entering a residential alcohol treatment program. The program had a strong family component, which is how I finally started to come to grips with what had happened to me and that there were behaviors I’d adopted over the years in order to cope — behaviors that were not helping my loved one nor others in my family nor myself. It was in coming to grips with my behaviors that I could change my life.
10. What do you hope to accomplish by writing and speaking on these subjects?
I hope to use my experiences and years of research, individual therapy, interviews, family therapy, AlAnon and conversations with others whose lives have been affected by someone’s drinking, to help others so they don’t have to spend decades living with it and slowly eroding the quality of their lives.
To that end, I hope to change (and in some cases, simply start) the conversations surrounding alcohol abuse, alcoholism, underage drinking and codependency, the same way we changed those surrounding cancer, AIDS and smoking. In the 1950s, for example, the word, “cancer” was not mentioned – it was called “the Big C.” But today, we’re raising millions of dollars to fight it. In the 1980s, no one wanted to talk about AIDS, while thousands were dying. Again, that’s not true, today. In the early 1970s, most people smoked cigarettes, drove cars without seat belts, road bicycles without helmets and hadn’t heard of an infant car seat. Yet, new information and talking about these activities convinced millions of Americans to stop smoking cigarettes and outlaw smoking in public places. New information and talking about it led to the passage of laws to require bike helmets until age 18, seat belts for everyone and car seats for children ages 4 and under.
That’s what new information AND talking about it can do and that’s what my book, presentations and this website are all about. Together – openly discussing all of the issues surrounding alcohol abuse and alcoholism WITHOUT shame, guilt and denial – we can break the cycles and bring about similar understanding and change!
11. What’s the best thing that’s come out of your experiences?
The quality of my life has improved dramatically. I can honestly say that I’ve never been happier, more fulfilled and more at peace with myself and with “life” as it comes.
12. Do you plan any more books?
Yes, I’m currently working on two other books, with three more to follow:
Loved One In Treatment: Now What? (2010)
Alcohol and the Brain: 10 Things We All Ought To Know (2011)
How To Co-Parent When a Loved One Drinks Too Much (2012)
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©2008-09 Lisa Frederiksen The purpose of the responses to these FAQs is to provide information. Every effort has been made to make these answers as accurate as possible, but no warrant of fitness is implied. The information provided is on an “as is” basis and readers should consult a therapist, attorney, treatment center program manager, medical doctor and/or other professional for dealing with emotional and/or legal issues or if seeking advice.
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(1) Babor, Thomas F., John C. Higgins-Biddle, John B. Saunders and Maristela G. Monteiro, AUDIT (The Alcohol Use Disorders Identification Test), World Health Organization (WHO), page 5, <http://whqlibdoc.who.int/hq/2001/WHO_MSD_MSB_01.6a.pdf>
(2) Ibid
(3) NIH Publication No. 96-4153,”Alcoholism, Getting the Facts,” U.S. Department of Health and Human Services, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism (NIAAA), Revised 2004.
(4) “Alcohol and Drug Abuse, Addiction and Co-Occurring Disorders,” National Mental Health Association, 2007, <http://www1.nmha.org/substance/index.cfm>
(5) “The People Hurt Most By Alcohol Don’t Even Drink,” The Legacy Foundation, 2007,
<http://www.thechildrensplaceprogram.org/statistical_data.php> Their source: American Journal of Public Health, January 2000, National Association for Children of Alcoholics.
(6) NHTSA 2006 / National Center for Injury Prevention and Control.
(7) Abramson, Hilary, “The Flip Side of French Drinking,” The Marin Institute (Winter 2000)
< http://www.marininstitute.org/alcohol_policy/french_drinking.htm>
