Almost every day someone will enter my office and ask, “Am I an alcoholic?” or, “Do you think I have a problem with alcohol?” and sometimes, “My partner says I drink too much.”
Alcohol is a drug that has its claws deep in Australian life. If you’re happy, sad, bored, have won a promotion, lost a family member, bought a house or graduated from university, these can all be seen as reasons to drink. Drinking is so common that if a person says they don’t, this lends itself to usually negative and intrusive comments.
The lines become blurred when it comes to deciding if a person has a problem with alcohol and whether they have developed an alcohol use disorder (formerly known as alcohol dependence). This is colloquially known as being an alcoholic – a term we avoid in addiction psychiatry. It’s not surprising to hear that people with AUD are told their drinking is a problem by family, partners or work colleagues. Depending on your upbringing, cultural background and exposure to alcohol, you may believe that drinking a six-pack of beer most days is “normal” and that problem drinking is when you start drinking litres of cask wine daily.
AUD is a term from the Diagnostic and Statistical Manual of Mental Disorder. It’s defined as a problematic pattern of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of 11 criteria within a 12-month period. Some of the criteria are: alcohol taken in larger amounts than intended; having a strong desire to use alcohol; increased time spent obtaining alcohol; tolerance – increasing amounts of alcohol are used to achieve intoxication; and experiencing withdrawal symptoms when alcohol is ceased.