Alcoholic, binge, or sensible? Part 1

Broadly speaking you will fit into one of these three categories, though you may well not like the description. In fact you’d be right not to, they are all spurious if not misleading terms.

When it comes to discussing types of drinkers, we are faced with a proverbial minefield of misleading, confusing and awkward set of terms. The issue for those who need to ‘correctly’ identify drinkers into categories is that the most common phrases are often the most unhelpful. To start, I would question whether encouraging ‘sensible drinking’ could be likely to induce a counter-effect. To those of us that like a good jolly, could being told to be ‘sensible’ in one’s supping could sound provokingly dull to the point of inducing the opposite response?

More exciting terms like ‘binge drinking’ or ‘alcoholic’ certainly catch the ear and probably conjure up some vivid images. But in many cases neither terms are helpful or well-defined (try asking a group of friends what they mean). Labelling someone ‘an alcoholic’ is clearly unfavourable due to its loaded and negative connotations. An important point to note is that in medical terms, ‘alcoholism’ is not recognised by most health authorities (such as the World Health Organization). What we are actually referring to is ‘alcohol dependence’. Admittedly, it doesn’t roll off the tongue so well, but on reflection it should be clearer to clarify what we’re actually talking about.

Alcohol dependence broadly means a strong desire to drink coupled with a difficulty in controlling its use. Common factors identifying dependence are not confined to physical problems like withdrawal or tolerance. Feelings of guilt, remorse or relationship or life problems amongst regular drinkers will often indicate dependence. More broadly, addiction is commonly characterised by the continuation of a harmful behaviour, despite negative consequences.

Where am I going with all this? I would say that most of those within the estimated 1.6 million dependent drinkers have seemingly regular lives and so fall way off mark of what people tend to perceive as ‘an alcoholic’. Most have probably not contemplated the thought of being ‘alcohol dependent’, not least because they have a job, a family, friends etc.  But importantly they are more likely at a stage of early or mild dependence, and should respond well to brief behavioural treatment or support. Many in fact will successfully recover on their own or without professional help – should of course they themselves accept a change is for the best. *Note that anyone with more severe dependence must seek professional help before cutting down – severe alcohol withdrawal can be fatal.

We should therefore avoid using the term ‘alcoholic’ where possible, unless perhaps someone chooses that term themselves such as a fellow of Alcoholics Anonymous (AA). Whilst many people’s perception of ‘alcoholism’ may be sufficiently similar to the criteria for severe alcohol dependence, language is all important. Alcoholism has evolved predominantly negative connotations which, with the intriguing exception of its use within AA, are counter-productive for those trying to overcome alcohol dependence. However it should not sound so stigmatizing.

Many people will arguably have an ‘addiction’ (another tricky term) of some sort in their life; tobacco, compulsive eating, caffeine (debatable), a pricey gambling habit… or a few drinks too often. In today’s stress-filled world, no-one should feel ashamed to find themselves becoming dependent on something along the road. When someone does recognise an early problem, they should feel supported and empowered to change. If not, feelings of guilt or shame are more likely to induce denial and the problems may worsen. The language of ‘alcohol problems’ is therefore instrumental.

On a final note, we should recognise that the majority of ‘alcohol problems’ are not caused by the small minority of dependent drinkers. Soon we’ll explore ‘binge drinkers’, and perhaps why not to tell them to drink ‘sensibly’…

Ciao for now!

Want to assess your own drinking? You can do an online self-assessment here which is based on the validated AUDIT alcohol screening tool. For further UK help and advice see here or call Drinkline anytime on 0800 917 8282.

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