By Susan Kurlander, Health Educator, Prevention Education
“I don’t abuse alcohol. I look forward to drinking sometimes to relieve stress, to help me deal with the extra work I have to do, or to loosen me up when I’m with friends.”
“I can’t be an alcoholic. I’m too young, too smart, too healthy, too able to control my drinking.”
How many times have we made comments like these about ourselves, or heard them from a friend or family member?
People don’t want to face the stigma of being labeled. It’s easier to minimize the problem and not to seek help if we don’t identify ourselves or someone close to us as being an abuser of alcohol or an addict.
What would happen if we stopped categorizing people and looked instead at a continuum of use? This is what the American Psychiatric Association (APA) is suggesting, believing that this shift would motivate more people to seek the help they need. In an article called “Are You Almost Alcoholic? Taking a New Look at an Old Problem” (“The Atlantic,” April 2012), Joseph Nowinski, Ph.D., and Robert Doyle, M.D.,* describe this proposed change in how we understand alcohol use and abuse.
Until recently, the DSM (Diagnostic and Statistical Manual) identified an abuser of alcohol as someone who is not yet physically dependent on alcohol, but who has experienced severe consequences, such as domestic violence, serious illness, or loss of a job because of poor performance. The addict has been identified as someone whose drinking is synonymous with dependency. Are there gaps between the categories of abuser and addict? Absolutely.
That is why the APA is recommending this shift from labeling or categorizing people to viewing their behavior instead on a broader spectrum. It’s a way of raising our awareness. Using this concept, we realize that all of us fall somewhere on the continuum, which ranges from abstinence to use to abuse to addiction. We also see that people can move along the continuum in either direction.
Nowinski and Doyle identify some signs that a person has moved beyond normal social drinking and is further along the spectrum into “the almost alcoholic zone.”
- Drinks to relieve stress, boredom or loneliness
- Finds drinking makes social situations more comfortable
- Looks forward to drinking and may often drink alone
- Continues to drink even if the alcohol is affecting health or job performance
- Drinks to maintain a “buzz”
- Doesn’t refrain from driving while under the influence
In fact, there can be problems all along the continuum. A person may decide to stop driving after drinking, but alcohol use may still be negatively affecting other areas of his life, such as family relationships or work. It is important for relatives or friends not to think, “Maybe I’m making too much of this,” but to recognize where the problems lie and to address them before they get worse.
Some mental health professionals do not agree with the APA’s new approach. For example, Nowinsky and Doyle mention that critics might see the shift away from categories for alcohol use as “opening the door to over-diagnosing the associated problems.”
Nevertheless, seeing ourselves or loved ones on a continuum of use could open the door to a conversation with someone reluctant to acknowledge that he or she may have a problem with alcohol. Another benefit is that a professional could identify warning signs and provide help earlier, which may prevent devastating consequences down the road. Shifting our perspective from specific labels to a spectrum of use could help more people recognize possible problems and seek help for themselves or their loved ones more readily.
If you or someone close to you would like help with problems related to alcohol use or abuse, you can contact Jewish Community Services, 410-466-9200.
By Susan Kurlander, Health Educator, Prevention Education, Jewish Community Services, Baltimore, MD
*Joseph Nowinski and Robert Doyle are co-authors of “Almost Alcoholic: Is My (or My Loved One’s) Drinking a Problem?” (2012).
To learn more about how JCS can help you solve life’s puzzles please visit our home page or call 410-466-9200.