Tuesday, March 30, 2010

How Do You Know If You're An Alcoholic?


Now that I've started blogging about recovery, I'm starting to get questions from friends about how I came to realize I was ... well, a drunk! Or they're concerned about people they know or their own family members. There are all kinds of little "tests" online that purport to assess one's likeliness to be alcoholic, but the problem is, sometimes those simply say: "If you answered 'yes' to any of these questions, you are in danger of being an alcoholic!" I used to roll my eyes at those because anybody can probably answer "yes" to at least one of the questions. The average college student might even answer "yes" to several of them, but they're not necessarily alcoholics. They're just in a kind of occasional binge-drinking stage that they'll eventually grow out of.

An alcoholic is somebody who doesn't grow out of it.

But, for whatever it's worth, here's one test that isn't too bad of an indicator, if you answer the questions honestly: Michigan Alcoholism Screening Test. For the alcoholic who may be trying to "prove" he's not, though, that's a big if.

True, there are some people whose problem is pretty obvious. They're the ones who can't hold down a job because they can't put the booze down long enough to work, or they get bad hangovers so often they're constantly calling in sick and getting fired. Or, they show up at work, but they're so bad-tempered (because they feel like crap) that they constantly pop off at the mouth and they wind up fired. They can't stay in a stable relationship because of the constant fighting. They're generally happy drunks at first who get argumentative when they've had too much. Consequently they may have been in and out of jail (having periods of sobriety when incarcerated) for assault or for petty crimes or for other, illegal, drug use. They may go on the wagon every now and then but somehow always seem to fall back off. They tend to hang out in bars a lot, and their friends are heavy drinkers.

Harder to spot are the "higher functioning" alcoholics. I was one of those, and it took until I was 47 before I finally had to admit I was more than just "a problem drinker." Never had a DUI, never lost a job, never had a relationship break up solely due to my drinking (though it played a part, you bet), never was in jail, and not all of my friends are drinkers. I was, rather, a closet drinker and good enough at it that many people were surprised to find out I had an alcohol problem. (Others weren't surprised at all.) I did a lot of drinking alone. I was pretty good about tossing empties in the trash and getting them down to the recycling before Chelle got home. I was a big liar about how much I actually consumed. (For the curious: on average, I'd have about 15 drinks per drinking episode. And I mixed 'em up. I'd start with a couple cocktails, switch to beer, have wine with dinner, then a few more cocktails or port afterwards. Sometimes if I didn't feel drunk enough, I'd sneak a quick shot or two of vodka or of Chelle's bourbon.) What I would admit to was having maybe...oh, four or five.

So, how do you tell if you're not really sure, and when it seems as if everybody on the planet is way too quick to diagnose you just because you overdo it every now and then (the bastards)?

One sign is blackouts. If you regularly "lose" your memory of a drinking episode, or part of your memory of the night before (a "brownout"), that's a pretty solid sign.

Problem is, not all alcoholics have blackouts. I met several in rehab who'd never had a blackout in their lives. (But I never met anyone who has regular blackouts who isn't an alcoholic.)

Other signs you may be developing, or have developed, a physical dependency on alcohol: Does your blood pressure run a little high? Do you get morning or night sweats? Do you shake a little (even just a little tremor) in the mornings after a drinking episode? If you're really, really addicted, then you might have a seizure after suddenly stopping drinking, and that can be dangerous. Hallucinations, too. Anyone who is physically dependent needs to detox in a hospital because this intense a withdrawal can make you die. There was a guy in rehab who had a seizure and had to be rushed to the hospital. A few months ago, I came out of an AA meeting, and a heavy drinker who'd tried stopping on his own was down on the sidewalk in the middle of a seizure.

As for me, I was not so addicted I needed a medical detox. The most that happened for me was severe hangovers (a hangover, after all, is withdrawal from alcohol), occasional morning tremors, and sweats. (I used to write the sweats off as perimenopause and the tremors as low blood sugar. I was kidding myself.)

I've mentioned sneaking drinks, drinking alone, lying about how much you drink, hiding bottles. Other things to look for: is there alcoholism in your family? Have you tried controlling or managing your alcohol consumption by doing things like switching to beer only or wine only, or drinking only on weekends, or only after 5pm? When you start drinking, does it make you anxious or uncomfortable if you have to stop after only two or three? Do you plan when you can have an opportunity to drink? Have other people expressed concern about your drinking? In short, are there numerous signs that there's a problem, but you have some "excuse" to explain away each of them?

Then there's the issue of, are you a problem drinker, or are you an alcoholic? Any alcoholic is probably going to first argue he or she merely has a problem that they can get under control. Various theories exist about problem drinkers learning to moderate their drinking. My Dad did it. He had lost his driver's license for a DUI, and then his job as a consequence because he couldn't drive (impossible for a salesman). That was enough to shake some sense into him, and he was able to stop for a while and then took to drinking on Saturday nights only. He did get drunk every now and then, but it wasn't enough to be a big deal. However, he did "check out" of living a full life... he spent the week with his head in a book or watching TV after dinner every night and never interacted with his own kids. So he didn't really treat the underlying psychological issues that led to his abuse of alcohol to begin with. He became what we call a "mostly dry drunk." He still thought and acted like an alcoholic in many ways by being emotionally unavailable; he just didn't drink all that much any more.

Some psychiatrists will say that some heavy drinkers, if they haven't been abusing so long that they're addicted to the booze, can "re-teach" themselves to drink in moderation. That's the path I certainly tried to follow for a while, but it just never worked for me. Inevitably I'd spiral out of control and step up the pace again and return to drinking pretty much every other day and all weekend long. (My drunkalogue is here.)

If you're not convinced you're an alcoholic or think you can control your drinking--you just need to truly put your mind to it--then the only thing you can do is give it a whirl. If you succeed, great! If you don't, though, and after a time you keep slipping and overindulging, then it may be time to admit defeat and stop altogether.

If you can reach that conclusion without having to hit the bottom of rock bottoms, you're lucky. Some never do. It takes cirrhosis or something life-threatening to get them there. But I'll close this with a couple thoughts. When was the last time you had a drink? An alcoholic always knows. A normal drinker will have to think about it. Normal drinkers never wonder if they have a problem. If you've been really concerned that you might be an alcoholic, chances are pretty good that you are.

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