If you’re wondering, “Am I an alcoholic?,” a good rule of thumb to remember is that those who don’t have a drinking problem don’t sit around and wonder if they do.
But even if you do, it’s important to recognize that there are different stages of alcoholism, which itself isn’t even a medical diagnosis. (For the purposes of science and medicine, it’s referred to as an alcohol use disorder.) Not every individual who struggles with a drinking problem is homeless, spending his or her days drinking cheap wine out of a brown paper bag. Alcoholics come from all walks of life, and what matters most, if you find yourself asking the question “am I an alcoholic?” more often than not, is figuring out the answer, and then deciding to do something about it.
Because you’re not alone: According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), “In 2019, 25.8 percent of people ages 18 and older (29.7 percent of men in this age group and 22.2 percent of women in this age group) reported that they engaged in binge drinking in the past month, and 6.3 percent (8.3 percent of men in this age group and 4.5 percent of women in this age group) reported that they engaged in heavy alcohol use in the past month.”
And even more alarming: According to key indicators from the 2019 National Survey on Drug use and Health, 21.6 million people needed substance abuse (including alcohol) treatment in the past year, but only 4.2 million of them received any kind … and only 1 million of those at a specialty alcohol rehab.
Am I An Alcoholic: What Does That Even Mean?
In order to answer the question of “am I an alcoholic?,” it’s a good idea to define what, exactly, “alcoholic” even means. As previously mentioned, science has moved away from the term “alcoholic” and “alcoholism” for a number of reasons, according to the self-help organization SMART Recovery:
- “Alcohol problems are not a ‘yes’ or ‘no’ issue. You don’t need to be at ‘rock-bottom’ to experience alcohol problems and want to change. It’s important to remember that drinking problems can exist at any point on a scale between ‘none’ and ‘severe.’ Once someone recognizes drinking is causing problems in their lives, the decision to change may come easier.”
- The term ‘Alcoholic’ carries lots of cultural baggage and stigma. Historically substance misuse has been treated as a moral failing rather than a serious mental health condition. Thinking about yourself or a loved one as an ‘alcoholic’ is a limiting and pejorative approach that often downplays the fact that unhealthy alcohol use and alcohol use disorder are health conditions that can be resolved.”
That being said, while the more acceptable question might be “do I have an alcohol use disorder?,” most people who think they have a drinking problem are going to ask of themselves, “Am I an alcoholic?” So let’s agree that the terms are interchangeable but break down the nuances. According to Harvard Health Publishing, an arm of Harvard University, “excessive alcohol use causes symptoms affecting the body, thoughts and behavior. A hallmark of the disorder is that the person continues to drink despite the problems that alcohol causes. There is no absolute number of drinks per day or quantity of alcohol that defines an alcohol use disorder, but above a certain level, the risks of drinking increase significantly.”
The NIAAA has attempted to made some rudimentary definitions when it comes to excessive alcohol use, however, associated with two patterns of alcohol consumption:
- Binge drinking, “a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 percent — or 0.08 grams of alcohol per deciliter — or higher. For a typical adult, this pattern corresponds to consuming 5 or more drinks (male), or 4 or more drinks (female), in about 2 hours.”
- Heavy alcohol use, which means “for men, consuming more than 4 drinks on any day or more than 14 drinks per week,” and “for women, consuming more than 3 drinks on any day or more than 7 drinks per week.”
Again, it’s important to note that these numbers aren’t hard and fast rules: Not everyone who drinks like this, or more, suffers from an alcohol use disorder, or AUD. However, as the NIAAA adds: “Binge drinking and heavy alcohol use can increase an individual's risk of alcohol use disorder.”
Am I An Alcoholic: What Are the Signs?
If you’re trying to determine whether your drinking is problematic, ask yourself this: Why is this a question? Most likely because you’ve noticed signs that point to it as such. Some of you, undoubtedly, know full well that you have a drinking problem; others may not be sure, but one of the ways in which an AUD is diagnosed is through a series of 11 yes or no questions.
Ask yourself these, and answer honestly. In the past year, have you:
In the past year, have you:
- “Had times when you ended up drinking more, or longer than you intended?
- “More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
- “Spent a lot of time drinking? Or being sick or getting over the aftereffects?
- “Experienced craving — a strong need, or urge, to drink?
- “Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
- “Continued to drink even though it was causing trouble with your family or friends?
- “Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
- “More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
- “Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
- “Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
- “Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?”
According to the NIAAA, answering “yes” to two or more of these questions indicates a diagnosis of an AUD, but even then, that’s not enough to answer the question of, “Am I an alcoholic?” The scale of AUD is categorized as being mild (answering yes to two or three questions), moderate (yes to four or five questions) or severe (yes to six or more).
And even then, those questions, as Harvard Health Publishing points out, don’t fully encompass the broad spectrum of problems that an AUD can cause. “A person with alcohol use disorder has come to rely on alcohol physically, psychologically and/or emotionally,” according to the university. “The brain adapts to the presence of alcohol and undergoes persistent changes. When alcohol use suddenly stops, the body is not accustomed to being alcohol free. The internal environment changes drastically, causing symptoms of withdrawal.”
And the external environment can be affected as well, the writers continue: Alcohol can:
- “Increase the risk of depression and suicide;
- “Play a role in violent crimes, including homicide and domestic violence;
- “Lead to traffic accidents;
- “Lead to unsafe sexual behavior;
- “Increases the risk of liver disease (hepatitis and cirrhosis), heart disease, stomach ulcers, brain damage, stroke and other health problems; and
- “In pregnant women who drink alcohol, there is also the danger that the child will develop fetal alcohol syndrome.”
So I Think I Have a Problem. What Now?
Like all health issues, once you determine there’s a problem, the next step is in figuring out how to solve it. If the answer to asking “am I an alcoholic?” is yes, then you’re faced with two choices:
- Ignore it and continue to drink; or
- Seek help to stop and change your habits and patterns so that you stay stopped.
Now, if you’re asking “am I an alcoholic?,” you may find it perplexing to consider ignoring the answer, but go back and look at the numbers of individuals who needed treatment in 2019 vs. the ones who actually received it. A great many of them, of course, were unable to get it because of financial or other considerations, but the National Survey also points out something particularly eye-opening: In 2019, the No. 1 reason for “not receiving substance use treatment among people aged 12 or older with a past year SUD who did not receive treatment at a specialty facility and perceived a need for treatment?” “Not being ready to stop.” Almost 40 percent of those who fell into that category weren’t ready to do something about their problem.
The question is, are you? As the American Psychological Association (APA) points out, some problem drinkers — likely with the diagnosis of a mild AUD — are able, “with the support of family members or friends … recover on their own.”
“However, the APA adds, “those with alcohol dependence usually can't stop drinking through willpower alone. Many need outside help. They may need medically supervised detoxification to avoid potentially life-threatening withdrawal symptoms, such as seizures. Once people are stabilized, they may need help resolving psychological issues associated with problem drinking.”
It's important to note that a great many individuals with an AUD do have several psychological, and even psychiatric, issues, but they’re not always fully aware that their drinking may be connected to those problems. Abuse and trauma are emotional wounds that, if unaddressed, never fully heal, and a number of addicts and alcoholics find that substances help numb the pain of those wounds … but they don’t connect the two until they begin to do some work in a comprehensive drug and alcohol treatment center.
Still others may have little or no emotional and mental issues — but for a number of reasons, their drinking has gotten out of control. They, too, need the support of a treatment program that can help stabilize them off of alcohol and provide them with coping skills necessary to replace the habit that was their alcohol consumption.
Regardless of what drives a drinking problem, the most important follow-up question to asking “Am I an alcoholic?” is, if the answer is yes, ask yourself, “What am I going to do about it?” And while “nothing” is certainly your prerogative, choosing “something,” especially if that something means sobriety, can vastly improve your quality of life.