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  • Bridget Friedman, LICSW

Is My Drinking a Problem?


Many people find that it can be confusing to sort out whether their alcohol use is problematic. Drinking alcohol is a common and accepted part of American life for many. What is deemed to be “normal” drinking may vary widely depending on your social circles, your family history, age, gender, and other factors.


Alcohol use disorders are diagnosed along a continuum, ranging from mild to severe. There is no hard line between non-problematic and problematic drinking. This fuzzy area in the middle is sometimes called “gray area drinking”.


I find that the simplest question to ask when considering whether there might be an alcohol problem is: “Am I continuing to drink despite knowing that it is causing me to have health problems, relationship problems, difficulty functioning at work or school, or legal problems? If the answer to this question is yes, it may be helpful to consider these other symptoms that may indicate a drinking problem:


1. Do I find myself preoccupied with frequent cravings or thoughts about drinking?


2. Do I feel guilty or remorseful for things I did or said while drinking?


3. Do I have repeated instances of losing control over my drinking – drinking more than I intended to or feeling unable to stop drinking once I have started?


4. Have I made repeated attempts to cut down or control my drinking?


5. Has my alcohol use caused me to experience problems functioning at school, work, or at home?


6. Have I given up important social, recreational, or occupational activities because of alcohol use?


7. Do I use alcohol in situations where it is physically dangerous?


8. Has a family member, friend, employer, or medical professional expressed concern about my drinking?


9. Has my tolerance significantly changed? Does it take significantly more alcohol for me to feel the effects? (Conversely, a significant DECREASE in tolerance in the later stages of alcohol use disorder can also be a warning sign).


10. Do I have blackouts – inability to remember what happened the night before because I was drinking?


11. Do I need a drink first thing in the morning to get myself going?


12. Do I experience withdrawal symptoms if I abstain from drinking (tremors, shakiness, sweating, seizures, hallucinations)?


A common alcohol use disorder screening tool is the AUDIT. If you are interested in taking the AUDIT, you can find a link here:



It can be scary to think about getting help for an alcohol concern. Many people have worries about what it might mean if they decide to take a closer look or make changes to their drinking patterns. What will people think if I stop drinking? Will people assume I have an alcohol problem? Will I still be able to have fun if I stop drinking? Will my friends want to hang out with me if I am not drinking? How will I deal with stress and anxiety without a drink? Do I need to stop drinking completely or is it possible for me to moderate my drinking?


Fortunately, there are more options than ever for support in trying to unravel these questions. Nobody has to do it alone. There is no “right” place to start and no singular path that is best for everyone.


However, before considering making any changes in drinking, there is one very important consideration to pay attention to. It can be very risky (and at times even fatal) to stop drinking “cold turkey” if you have a history of heavy alcohol use. If you have a pattern of daily or near daily alcohol use and / or withdrawal symptoms, it is very important to see a medical doctor for evaluation before discontinuing alcohol use. The doctor will assess what steps are needed to safely detox – the doctor might prescribe outpatient medication to assist with detox at home or they may recommend an inpatient detox program.


I have listed some starter resources below If you would like to explore your relationship with alcohol or make changes in your drinking habits. I have included information about both abstinence based and moderation management approaches. My hope is that this list will include enough options that anyone with questions can find a comfortable place to start looking for answers.


BOOKS:


The Addiction Recovery Workbook: Powerful Skills for Preventing Relapse Every Day by Paula Freedman


Responsible Drinking: A Moderation Management Approach for Problem Drinkers by Frederick Rotgers, Mark Kern, and Rudy Hoeltzel



MUTUAL SUPPORT GROUPS: These groups are free and readily available. The most widely known support group is Alcoholics Anonymous. Most of these groups are abstinence based, meaning that the stated goal is to maintain total abstinence. Moderation Management provides support for those wishing to explore controlled drinking. The following are some popular options:


Alcoholics Anonymous: https://aa.org/



Women for Recovery: https://womenforsobriety.org/




INDIVIDUAL THERAPY: Many mental health professionals (counselors, social workers, psychologists) provide individual therapy for people with substance use concerns. These services are often covered by medical insurance.



SUBSTANCE USE DISORDER TREATMENT: There are a wide range of specialty substance use disorder programs available. Many of them are covered by medical insurance. The process will start with a comprehensive assessment to determine what level of care is needed. Substance use disorder treatment typically involves a combination of group, individual, and possibly family therapy. The treatment recommendation may vary widely –recommendations may range from weekly outpatient sessions up to a residential program that may last for several weeks. The following link provides a listing of licensed substance use disorder programs. It is also helpful to check with your health insurance to see which programs are covered by your specific plan.




MEDICATION ASSISTED TREATMENT: There are now several approved medications used in the treatment of alcohol use disorder. These include medications to reduce cravings (Naltrexone and Campral are two examples) as well as Antabuse (which discourages drinking by creating an unpleasant reaction if alcohol is ingested). Many primary care doctors are comfortable prescribing these medications. Sometimes the primary care doctor will refer to an addiction medicine specialist.

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