Few terms inspire more shame and fear than “Alcoholic.” And with the way addictions are talked about and portrayed in the media, it’s little wonder why. Whether people come down on the side of it being the result of moral laxity or a disease that can strike at any time and not be controlled, the end result is that if you are worrying about the results of your drinking, the common conceptions of who an Alcoholic is are to be avoided if you’re ever going to be able to look yourself in the mirror.
While there is a clear set of diagnostic criteria to differentiate Alcohol Dependence (what we might refer to more commonly as alcoholism) from Alcohol Abuse (a pattern of problematic use of alcohol), I have found that what’s most meaningful to people isn’t what category they fall into, if any. Yes, we need labels to help guide research and treatment, and we usually give things names if they are important. However, the focus I take with the people I see is helping them to figure out how their drinking (or other addictions) is impacting the rest of their life.
This is the litmus test: how much is it getting in your way? Are you having arguments with people about your drinking, or some of the things you’ve done while drinking? Are you finding yourself in situations that, upon reflection, SHOULD NEVER HAVE HAPPENED? Are you spending time with people you enjoy, or are these people giving you occasion to tip the elbow? Can you enjoy social events without a glass in our hand? Are you hungover at work? How much time are you spending drinking or recovering from drinking? Are you known among your social group as someone who is always drinking or drunk? These are the kinds of questions to be asking, rather than making comparisons between yourself and the picture of who and what an alcoholic is, in your mind. Those comparisons usually result in, “I’m not that bad,” and then you dismiss whatever quality of life issue (big or small) that drinking may be bringing into your life.
The focus on the label—am I an Alcoholic?—and the fear that the answer could inspire can lead people to stop asking the more important questions about how they might re-work their relationship with alcohol. And no wonder. If you are drinking despite it making a mess of your life, chances are the booze is filling a pretty important need for you that will still need to get met if you stop drinking. The needs don’t go anywhere, and can even intensify if your approach is to just stop drinking, without finding other ways to address those underlying needs.
What we know about treatment outcomes for problem drinking is that the results for any kind of treatment average out to be about the same in the long term, especially if people seek out help early on. And different kinds of help offer different kinds of benefits. Detoxification Centres are great if you’re a perpetual drinker who physically cannot function without alcohol in your system, because they’ll medically treat you so that you don’t have a seizure as your body responds to alcohol withdrawal. You won’t get “treatment” in detox, but if you’ve ever had a seizure or talked to someone who has, you will know how they are. Self-help groups are a great resource for having social connections that can connect with your experiences. These can also be a fantastic support system for crises, as it’s typical in these kind of groups for members to lean on one another when feeling overwhelmed. Psychological treatment with someone who is a specialist in addictions is an effective way to begin to address the what difficulties are leading you to drink so you can better manage without alcohol.
Treatment doesn’t have to be expensive, either. Private services usually allow you to be seen more quickly, but the cost isn’t a comment on value. I’ve worked in both public and private settings, and the only thing that people get differently from me in the private sector is that they don’t have to wait to see me. Check out these links for publicly funded services in Ontario http://www.drugandalcoholhelpline.ca/ and in Quebec http://www.toxquebec.com. Or get on the interwebs and search for something similar wherever you live.
Whether you seek out a self-help program, therapy or both, research shows that the results are about the same down the road. There may be a lot of debate about what kind of help is the best, but really, it’s the getting help that matters. And figuring out what kind of help is right for you may take some work in terms of trying things out—you might like the people in one self-help group but not another, and the same goes for how you might feel with different therapists. It’s okay (good even!) to try a few on for size if you feel like you aren’t finding just the right fit. Some people find 12 step groups really helpful, while others can’t think of anything they’d like to do less than sit in a room full of people with problems, and would prefer to be able to talk one-on-one with a specialist. The good news is that, like with most things in life, if you find something that’s a better fit for you, it’s more likely to work out in your favour. And there’s no rule that says you can’t do multiple things that work for you…in fact, that’s likely to address more of your needs, simultaneously.
Regardless of what treatment you think sounds best for you, it’s more valuable for you to focus on what problems the drinking is causing, and what needs the drinking is filling, rather than on whether or not you’re a capital-A Alcoholic. This might also help you to take the judgment, self-criticism and shame out of the therapeutic work. That way you can spend your energy on making changes in your life and relationships that YOU WILL ACTUALLY LIKE regardless of whether you’re having cocktails or mocktails.