Am I an alcoholic?

[talkhealth]

Hi experts,

A common query that we often hear from our visitors is a variation of:

"I don't need a drink during the day and only have 2 or 3 glasses of wine a night, and never measure units. My family think that i'm an alcoholic. Do you think I should be worried?"

What would you say to people who are in a similar situation to this?

Thanks,

[Gary Turner]

Hi! I would answer:

The fact that your family has raised this concerns me - perhaps you want to have a look at your drinking habits from their perspective, and see if it really is a problem? If it is, perhaps that's the time to start cutting back a bit...

If it doesn't appear to be a problem do a little analysis of yourself. Is any area of your drinking causing a problem for you? Sleep issues? Tired during the day? Self-talk telling you that "you need a drink"? Lack of concentration? Shakes? Flushed face? Are you quite happy to go a day without drinking? What do you actually drink for - is it the drink, or what the drink does for you? And all the other signs of the psychological, behavioural and health effects of smoking. Remember to it is quite possible to be a 'fully functioning alcoholic'.

If you answer honestly, you may find that you are having tendencies towards being an alcoholic. In which case, easier to stop now and cut back rather than allow the situation to get worse.

If you consider all is still OK, then please continue to monitor yourself - it is so much easier to cut back before the situation gets worse.

You do drink quite a lot - and whereas I am not a fan of the science behind the 'units for men and women' it does appear that the level of alcohol you are drinking will have adverse health effects, the amount will have adverse physiological effects on your body and mind - in other words, I would prefer it (from my opinion and perspective) if you cut back, preferably to maybe only one drink (get more expensive 'layered and textured' wine where you can appreciate in smaller sips and make it last longer?) and having a couple of days without drinking during the week. At this current level of drinking it should be quite possible to do so.

[saraht]

This is a theme that comes up time and time again with the women who I see. Most especially with wine, and although two or three glasses sounds moderate, very often three glasses, 250ml represent a bottle, so to drink these amounts on a daily basis represents 70 units a week. Very few people ever measure their drinks out, so if you are drinking this amount it is certainly hazardous drinking and would need to be addressed.

Additionally, three small glasses of wine each evening for example, increases the risk of breast cancer by 50%, so apart from the direct consequences of drinking too much there are many indirect ones. If the person is drinking home alone too, which has become the norm for so many over the last decade, then I would also advise that becoming alcohol free for at least four nights a week would be appropriate.

At this stage, I would suggest that this is habitual dependent drinking, and it would be wise to intervene before the problem becomes a real physical need and develops into full blown alcoholism.

[Dr Kostas Agath]

The short answer to the question is: "You should further discuss your circumstances with a professional such as your GP"

The long answer is this:
Alcoholism is an umbrella term that, in every day life, implies that someone is not coping well with the amount and frequency of their drinking. Within that context, and without an assessment by a professional it is difficult to assess the effect of someone's drinking on their physical health, mental health and social activities.

Alcohol consumption could lead to many problems. Some of them could manifest soon after drinking (for example: domestic violence, accidents, driving whilst intoxicated, self-harm) whilst others develop later (for example: ulcers, liver problems, DTs).

Drinking only at the end of the day is NOT evidence that someone does not have problems with Alcohol; drinking only at the weekend is NOT evidence that someone does not have problems with Alcohol. The assessment on whether there is a problem with Alcohol drinking is a complex one, but in most cases a professional could reach a diagnosis and suggest action within one meeting.

If people who know us well raise concerns about our drinking, we should listen and ask our GP for advice. It might indeed be that our relatives and friends over-react; but in a few cases they will have a better picture of our drinking than ourselves. In those cases, the earlier we seek help the better the outcome for us.