Concern about your drinking may indicate a problem

By Anthony L. Komaroff, M.D.

DEAR DOCTOR K: I started drink­ing more dur­ing the hol­i­days. It seemed nat­ural, as there were so many par­ties and happy hours. But the hol­i­days are long over, and I haven’t cut back. Could I have a problem?

DEAR READER: You ask a dif­fi­cult ques­tion. What con­sti­tutes “healthy” ver­sus “harm­ful” drink­ing can vary quite a bit from per­son to per­son. So where is the line between social drink­ing and prob­lem drink­ing? Does drink­ing every day or drink­ing a cer­tain amount indi­cate a problem?

Here’s the bot­tom line: If your pat­tern of drink­ing cre­ates dif­fi­culty for you per­son­ally, socially or at work, then your drink­ing is likely harm­ful to your health.

Hav­ing said that, I’ve known peo­ple who drink through­out the day and have liver and other prob­lems because of it. Yet they would tell me that drink­ing wasn’t inter­fer­ing with their fam­ily or work life at all. Maybe that’s the way it seemed to them, but their drink­ing was on its way to mak­ing them suf­fi­ciently sick that it later seri­ously inter­fered with their lives.

If you’re not sure if you might have a drink­ing prob­lem, answer a few ques­tions about your drink­ing habits. Sev­eral screen­ing tests can help deter­mine whether you might have a drink­ing prob­lem. (I’ve put two of the tests, the CAGE ques­tion­naire and the AUDIT, on my web­site, AskDoctorK.com.)

Alco­hol use occurs along a spec­trum. Alco­hol depen­dence is the most severe type of alco­hol mis­use. It is marked by com­plete loss of con­trol over drink­ing behav­ior. You’re pre­oc­cu­pied with drink­ing and have a strong desire to drink. You start to tol­er­ate alco­hol; you don’t get tipsy as eas­ily. You start to feel a lit­tle ner­vous and shaky sev­eral hours after your last drink, and you learn that another drink can quiet the shakes.

Alco­hol abuse is a milder prob­lem. You don’t have the same com­pul­sion or phys­i­cal need to drink as those who are depen­dent on alco­hol. But you do drink exces­sively — and if you keep drink­ing exces­sively, you are very likely to go on to alco­hol dependence.

Even if you aren’t suf­fer­ing from alco­hol depen­dence or abuse, your drink­ing still could be cause for con­cern. I’ve known peo­ple who just “loosen up” enough that they start to say things they may not mean, and surely should not say — to their spouses, friends, co-workers or bosses. Their drink­ing still is haz­ardous to their home and work life, and to fam­ily and friends. It also puts them at risk for devel­op­ing more seri­ous prob­lems with alco­hol down the road.

The fact that you were con­cerned enough about your drink­ing to ask me about it is a red flag. Talk to your doc­tor about your alco­hol use. If you do have a prob­lem, you can work with your doc­tor to deter­mine the best treat­ment options for you.

(Dr. Komaroff is a physi­cian and pro­fes­sor at Har­vard Med­ical School. To send ques­tions, go to AskDoctorK.com, or write: Ask Doc­tor K, 10 Shat­tuck St., Sec­ond Floor, Boston, MA 02115.)

Posted by Guest 2 Columnist on Feb 25 2013. You can follow any responses to this entry through the RSS Feed. Both comments and pings are currently closed.