There is this common misconception that you need to be a “fall-down drunk” in order to qualify as someone who has a drinking problem. However, alcohol problems are more common than you might think. More than 14.5 million Americans have alcohol use disorder, and some folx may not even know that their drinking habits fall more into the category of “problematic” than “normal.”
That’s because alcohol use disorder exists on a spectrum: from gray area drinking—having a few more drinks than you intended but still working and maintaining your responsibilities—to more acute drinking, causing blackouts or necessitating medical intervention. The reality is that society only deems drinking a “problem” when the consequences are overt and life-altering. In reality, drinking can be problematic well before hitting the socialized “rock bottom” we’ve been fed throughout the years.
At Tempest, we believe that anytime is a good time to stop drinking, problematic or not, and we wanted to arm people with the information they need to figure out whether or not going alcohol-free—problematic drinking or not—makes sense. Two social workers, Ahmed Hosni, MSW, and Brooke Houser, LCSW-C, help break down the spectrum of alcohol use, how pervasive it is, and how to get ahead of problematic drinking before it becomes an issue.
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What is the alcohol use disorder spectrum?
Heavy alcohol use is defined as more than four drinks a day or more than 12 drinks per week for a person assigned “male” at birth, and three or more drinks per day, or more than seven drinks per week for someone assigned “female” at birth.
According to our experts, alcohol use—or misuse—can look different for everyone. Many people, even though they might consider their drinking normal, don’t realize that they’re drinking more than the amount deemed “safe.” Because of this, professionals diagnose alcohol use disorder on a spectrum rather than using a “one-size-fits-all” approach, explains Houser.
“The spectrum of alcohol use disorder ranges from mild to severe and is dependent on how pervasive alcohol use is in someone’s life.”
She explains, “Someone on the mild end of the spectrum may find themselves drinking more than they planned when they go out or may find it hard to relax in social situations without drinking. On the severe end of the spectrum, we often see serious health issues due to alcohol use like withdrawal or organ damage.”
When asked why there is a lack of knowledge about the lower end of problematic drinking, Houser said, “There is a pretty wide range between the two ends of the AUD spectrum,” she says. “When we think of AUD, we tend to think of those symptoms on the higher end of the spectrum which leads to AUD going undiagnosed in a lot of more mild cases.”
How to spot a drinking problem
Having awareness of problematic drinking is the first step in seeking help, but for many, alcohol misuse can go unnoticed for a long time.
In Houser’s opinion, drinking problems tend to appear at later stages, and that those closest to us often notice first. She believes that most people are unaware they may have a drinking problem until they are on the moderate to severe end of the AUD spectrum.
“The main reason for this is that people tend to increase their drinking gradually over time,” she says. “It is likely that someone else may notice a drinking problem before we notice it ourselves. People with a larger support system may be alerted faster by loved ones, friends, or an employer who notices a change in behavior.”
Others might not recognize the impact of their alcohol use until it impacts other areas of their life, like experiencing a medical issue or failing to complete daily responsibilities.
“Things like cultural norms, support systems, and genetic differences in how we metabolize alcohol can all play a part in when someone realizes they may have a drinking problem,” Houser explained.
Hosni contends that awareness is relevant to each person’s experience. “One’s gender identity, sexuality, socioeconomic status, race and ethnicity, cultural upbringing, current community, and their stage in life play a huge role in shaping a person’s experiences and determining what beliefs and behaviors are developed regarding alcohol use,” he says.
Let’s take the example of drinking at college.
“High levels of alcohol use and even binge drinking is a part of many campus cultures at universities across the world, and students participating in this aspect of the student experience is often viewed as normal or to be expected,” explains Hosni. “However, if you begin to compare the experiences of students on campus with different identities but similar drinking patterns, you can begin to see how their experiences can differ which will change the point they gain awareness that their alcohol use may be problematic.”
For example, people with more financial resources are more easily able to navigate the consequences of drinking—in this example, paying a fine, and retaking classes. Whereas those with less financial resources may struggle.
“Students with less financial means who experience these problems often are unable to recover financially causing them to be separated from the university or the experience of these consequences have a greater impact on them and hastens their realization that the choices they are making regarding alcohol use may be negatively impacting their life.”
Hosni underlines the importance of being aware of intersecting identities in gaining awareness around one’s drinking problems. “For each aspect of a person’s identity, more nuance is added to this question which is why it is important to meet folx where they are at and be flexible as a person hoping to be supportive,” he explains.
Common (and sometimes hidden) symptoms of AUD
There are several common symptoms of problem drinking and they impact your life and well-being in many ways. Many of them, though, can go unnoticed.
Houser says that anxiety is a common and normalized symptom of AUD. “You may feel yourself needing to drink to decrease anxiety before a social event or notice yourself feeling frustrated when your access to alcohol is less than expected.”
She also contends that another often overlooked symptom is how much a person may be incorporating alcohol into their daily routine.
“Many people begin drinking socially or on special occasions but slowly increase to daily or near-daily use. While a glass of wine with dinner can be relaxing, it can quickly increase into three or more drinks a night.”
Hosni points to the physical signs of alcohol misuse, including hangovers, which he says “is the most common form of withdrawal symptom.” However, in his experience, people shrug off hangovers as normal or to be expected.
Problem drinking also creeps into life by causing issues with everyday tasks. You might find that you’re experiencing difficulty managing work, school, or personal responsibilities. Hosni says that this can result in relationship problems and giving up things and activities that once were enjoyable in favor of drinking.
How to create mindfulness around drinking
Being more aware of how often and how much you drink is an important step to preventing or decreasing misuse. The experts recommend a number of ways to increase mindfulness:
- Take a break from drinking, whether for a week, month, or longer
- Measure shots with a measuring glass
- Pour your drink into a clear glass, to notice the volume and duration of your drinking
- Use an app to monitor your drinking
- If you go out drinking determine beforehand how much you want to drink and stick to it
- Ask yourself “How much money do I want to spend on drinks this week/month?”
- Ensure you eat healthy and nutritious meals before drinking, snack during drinking, and continue drinking water throughout the night, which can minimize the negative impact alcohol can have on one’s physical wellbeing.
When to seek help for your drinking
I asked our experts when a person should seek help with problem drinking and their advice was to seek help if you find yourself questioning your alcohol use or you observe that alcohol is negatively impacting your life.
One way a person may identify that they need help is if they try the mindful drinking suggestions above but are unable to cut back or stop drinking. You may also want to seek help if a loved one or friend raises concerns about your drinking
“It’s always a good idea to get a second, professional opinion before you dismiss them,” says Houser.
You can reach out to a therapist or medical professional and you don’t need to wait until it gets out of control. “You don’t need to have a serious problem in order to get help,” says Houser.
A word of caution: If you are a heavy drinker, it’s highly important to get medical help from a trained professional to prevent serious symptoms of alcohol withdrawal.
“Being proactive and addressing potential pitfalls can help one avoid many unpleasant experiences while redefining the role alcohol plays in their life and allowing them to move forward and thrive,” says Hosni.
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Drinking is a problem if it no longer fits in with your lifestyle. You don’t have to experience serious consequences or have someone point out that your drinking is affecting your life to stop using alcohol. If you simply want a healthier way to socialize, deal with problems, or have fun, that’s reason enough. If you’re interested in diving deeper into how alcohol affects your life, but you’re not sure stopping is the right answer, download our free app Rethink with Tempest.