a person is pouring a glass of red wine from a wine bottle

What’s Wrong Wednesday: I Don’t Have A Problem With Alcohol!!

“People are drinking at a level that’s putting themselves and others at risk of harm, even if they’re not necessarily meeting criteria for alcohol dependence or for the disease of alcoholism,” says Dr. Bob Brewer, who leads the alcohol program in the National Center for Chronic Disease Prevention and Health Promotion at the CDC.

Having an occasional beer or wine with dinner, or a drink in the evening, is not a health problem for most people. Drinking alcohol in moderation generally is not a cause for concern for most people.  It’s safe to say that at some point in their lives, almost anyone who drinks will have at least one embarrassing or unpleasant experience with alcohol. Whether it’s a fight, becoming physically ill, hooking up with someone they regret, or just a crushing hangover, most people will vow to never do it again, and they don’t. If you find yourself vowing to never do it again, but have the same experiences over and over, chances are you have a problem with alcohol. Same goes for a friend who seems to have an endless variety of unpleasant experiences while drinking–yet can’t seem to alter their drinking patterns to prevent them.

Alcohol dependence is characterized by multiple symptoms, including tolerance, signs of withdrawal, diminished control over drinking, as well as cognitive, behavioral, and/or physiological symptoms that suggest the individual continues to drink despite experiencing significant alcohol-related problems.

Alcohol abuse, on the other hand, is a when an individual drinks despite alcohol-related physical, social, psychological, or occupational problems. Alcohol abuse does not necessarily entail a consistent pattern of heavy drinking, but is defined by the adverse consequences associated with the drinking pattern.

Problem drinking is used to describe nondependent drinking that results in adverse consequences for the drinker. In contrast to the dependent drinker, the problem drinker’s alcohol problems do not stem from compulsive alcohol seeking, but often are the direct result of intoxication. Problem drinking represents a broader category than alcohol abuse disorder. The problem drinker may or may not have a problem severe enough to meet criteria for alcohol abuse disorder.

 Even small amounts of alcohol consumed during pregnancy or in combined with certain medications may result in significant adverse consequences and therefore constitute risky drinking.

 While problem drinkers are currently experiencing adverse consequences as a result of drinking, risky drinkers consume alcohol in a pattern that puts them at risk for these adverse consequences. Risky drinking patterns include high-volume drinking, high-quantity consumption on any given day, and even any consumption, if various medical or situational factors are present. Consumption is quantified in terms of standard drinks, which contain approximately 14 grams, or .6 fluid ounces, of pure alcohol. Risky drinking can be determined by identifying one or more of the patterns below:

Continuum of Alcohol Problems Column 1: At Risk for Alcohol Problems: Risky Drinking A. Current drinking patterns (amount or situation of drinking) place drinker at risk for adverse consequences. B. Is not already experiencing consequences due to drinking behavior. C. Does not meet criteria for Alcohol Dependence. Column 2: Mild to Moderate Alcohol Problems: Problem Drinking A. Experiencing adverse consequences due to drinking behavior. B. Does not meet criteria for Alcohol Dependence. Column 3: Moderate to Severe Alcohol Problems: Alcohol Abuse DSM-IV Criteria: One or more of A-D in the past 12 months and E. A. Role impairment.  B. Hazardous use.  C. Recurrent legal problems related to alcohol. D. Social or interpersonal problems due to alcohol. E. Does not meet criteria for Alcohol Dependence. Column 4: Severe Alcohol Problems: Alcohol Dependence DSM-IV Criteria: Three or more of A-G during the same 12-month period. A. Tolerance B. Alcohol withdrawal signs or symptoms. C. Drinking more or longer than intended. D. Persistent desire or unsuccessful attempts to control use. E. Excessive time related to alcohol. F. Reduction in social, recreational, or work activities due to alcohol.

 

 

 

 

 

 

ALCOHOL PROBLEMS: THE COUPLE AND FAMILY CONTEXT
When someone experiences alcohol problems, the negative effects of drinking exert a toll, not only on the drinker, but also on their partner and other family members.  Recent data suggest that approximately one child in every four (28.6%) in the United States is exposed to alcohol abuse or dependence in the family.

One of the clearest demonstrations of how alcohol use negatively impacts the family is the widely documented association between alcohol use and interpersonal violence. Family problems that are likely to co-occur with alcohol problems include:

  • Violence
  • Marital conflict
  • Infidelity
  • Jealousy
  • Economic insecurity
  • Divorce
  • Fetal alcohol effect

Drinking problems may negatively alter marital and family functioning, but there also is evidence that they can increase as a consequence of marital and family problems. Thus, drinking and family functioning are strongly and reciprocally linked. Not surprisingly, alcohol problems are common in couples that present for marital therapy, and marital problems are common in drinkers who present for alcohol treatment.

The Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline, 1-800-662-HELP (4357), is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information.

https://www.samhsa.gov/find-help/national-helpline

National Institute on Alcohol Abuse and Alcoholism, https://pubs.niaaa.nih.gov/publications/niaaa-guide/

[image description: a person is filling a glass with red wine from a wine bottle]

a person is pouring a glass of red wine from a wine bottle
Glass of wine (Dreamstime/TNS)