What Is Problem Drinking?
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What is too much drinking? That depends on whomyou ask. Some will say, “I drink every day, but I don’t drink during the day.” And,others say, “The only problem I have is that bars close at four, and I have tostop drinking.” Or, “Just as long as I am able to go to work/school and attend tomy life, I can drink just as much as I want.” But, it’s difficult to admit thatone feels that they do not have control over something outside themselves. So,until something concrete and negative happens, most people learn to live with the vague anxiety of feeling powerless.
I think many people, including myself, weresurprised by this guideline from the National Institute on Alcohol and AlcoholAbuse on problem drinking. Bytheir measure most people I know in New York City between the ages of 20 to 50 areproblem or binge drinkers. But, most of these people are not alcoholics either.Personally I don’t know anyone who has been to detox or rehab*. I’ve worked asa social worker with many clients who have been in and out of inpatient andoutpatient drug and alcohol treatment programs, and so I know what alcoholismand addiction looks like. Most of my peers would fall into the problem orhabitual drinker category at some point in their lives, but they would not beclassified as alcoholics.
So why is habitual, mindless, heavy or riskydrinking a problem? With every behavior there is a consequence, andconsequences of unchecked alcohol consumption are very real and can pervadeevery aspect of life. Common issues are: vague discontent and unhappiness (depression,maybe not in the clinical sense); poor health due to bad diet and excessivealcohol, smoking while drinking and lack of exercise; frequent hangovers; beinglate or missing work or school; regret over one’s behavior while drunk – beingexcessively emotional, aggressive or sexual; use of other drugs such as cocaine,further lowering inhibition leading to poor decision making; fighting withpartners about drinking or other problems caused by drinking.
As a result of these and other reasons, problemdrinkers try to cut back or stop but often without success. Because problemdrinkers have difficulty controlling alcohol intake, they may intend to havejust a drink or two, but after the two they find themselves not wanting or ableto stop. And, happy hour becomes an all-night drinking session or binge. And for problem drinkers, drinkinghappens most nights of the week, although not heavily every time.
To be continued…
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*Detox takes place in a hospital or medicalsetting for the duration of a short week. For severe alcoholics medicallysupervised alcohol withdrawal is necessary as seizures and other seriouscomplications may occur when a body, long immune to the presence of alcohol, issuddenly without it. For this reason, anti-anxiety medications, such as Xanax,Valium and Librium, are often prescribed. The singer Amy Winehouse’s death wasprobably a result of unsupervised withdrawal.
Rehabs are usually 28 days long, althoughdepending on severity and finances stays can be longer. I’ve worked in afacility that wasn’t much different from jail; many of its clients, mostlyformer heroine addicts, were mandated to drug treatment in lieu of serving yetanother stint in jail for drug-related charges. Most of these clients wereMedicaid eligible and stayed anywhere between three months to two years. Privateinsurance does provide inpatient substance abuse treatment, but they ususally restrictthe duration of treatment to 28 days. However, if you are financiallyable, treatment options are plentiful. After the initial medically supervised withdrawal (what happensin a detox) a treatment team addresses the psychological aspect of addiction. Through groupand individual therapy long exploration into the how’s and why'sof addiction, in addition to strategies to prevent relapse, are explored These programs aredesigned to prepare for maintaining abstinence – a life of sobriety. Ideally,this would be just the beginning of psychotherapy, which should continue post-rehab.