It is a common issue: People who are struggling with alcoholism often don’t recognize that there’s a problem.
Most of the time, those who engage in abuse of alcohol don’t have the tools or ability to notice when drinking has gotten out of control. However, the question eventually arises: “Am I drinking too much?” or “Am I an alcoholic?”
It can help these individuals to have a guide or questionnaire to review, carefully considering the answers to each question. In using this guide, a person can then approach a medical or addiction treatment professional for a formal diagnosis and plan for recovery. The following includes a questionnaire that can serve as just that kind of guide.
Because of this trouble, it may be difficult for individuals to recognize when alcoholism has become a problem. Using a questionnaire like the one below can help people who are trying to determine whether alcohol has become a problem for themselves or a loved one.
The following questionnaire is based on the factors used to diagnose substance use disorders, as defined by the Diagnostic and Statistical Manual of Substance Use Disorders, also known as the DSM-5. This list of behavioral symptoms has been compiled and fine-tuned by psychiatrists, psychologists, and addiction treatment specialists to give medical professionals a standard by which to diagnose substance use disorders like alcoholism.
When going through the questions, note how many receive a “yes” answer:
If only a few answers are “yes,” this doesn’t mean there isn’t a problem. Continued alcohol abuse by those with a mild alcohol use disorder can lead to more severe symptoms and a later diagnosis of alcoholism. Any potential substance use disorder should be taken seriously.
Alcoholism results in a loss of control over drinking.
If a person finds that the amount of alcohol consumed on a regular basis is more than the individual intended to consume, the answer to this question is “yes.”
As explained by the American Society of Addiction Medicine, substance use disorders like alcoholism are chronic conditions which, like other chronic medical conditions such as asthma and diabetes, often result in relapse. This means that people who are struggling with alcohol use disorders may attempt to quit using alcohol and ultimately end up relapsing to alcohol use one or more times.
It is important to note that continued relapse can present a danger to the individual. Not only can alcohol withdrawal itself result in dangerous symptoms, but relapsing to alcohol use can lead to circumstances where overdose – drinking amounts of alcohol that put the person’s health or even life at risk – is more likely to occur. This is because a person’s tolerance for alcohol quickly drops after quitting use; however, when the person returns to use, drinking the large amounts that were consumed before quitting can result in overdose, or alcohol poisoning, where it didn’t previously.
Substance abuse can often become a sticking point in relationships. As described by the American Association for Marriage and Family Therapy, when the amount of alcohol that a person is consuming becomes a concern to loved ones, challenges can arise that include:
The real hallmark, however, is not just that these things are happening, but that the individual struggling with alcohol abuse cannot stop drinking regardless of potential negative relationship consequences.
Another effect of alcoholism on relationships is that the person may have a change in social relationships as a result of drinking. Often, the person will begin to gravitate more toward friends who encourage or participate in the individual’s drinking, and away from those who are critical of the person’s behavior. This can be a self-destructive change, decreasing the person’s motivation to stop consuming alcohol.
People with alcohol use disorders tend to have excessive focus on drinking and on getting alcohol or dealing with the aftereffects of a binge. In fact, this focus may seem to arise at inappropriate times, such as first thing in the morning, or at times when drinking can create a risk or interfere with other important activities. The person may also seem to be thinking about or participating in drinking far more often than seems healthy to outsiders.
On top of this, the individual spends a lot of time recovering from bouts of drinking. Hangovers are a common occurrence, and they may even lead the person to continue drinking to prevent them. In any case, a person who is struggling with alcoholism may find that much more time is lost during the day and night due to drinking and its effects.
Because of the inordinate amount of time spent drinking and dealing with hangovers, a person who is struggling with alcoholism is often unable to keep up with responsibilities at home, work, or school. Perhaps the individual often calls in sick to work because of hangovers. Alternatively, the person may spend too much time drinking with friends and miss homework or work assignments. Drinking may take over time at home, resulting in housework left undone or bills left unpaid.
These responsibilities don’t go away, and consequences can include disciplinary actions at school or work, a lost job, poor grades, or other external consequences. It also may result in financial difficulties or an unhealthy living environment, which can also contribute to relationship issues. If, in the face of all of this, the individual still cannot stop drinking, alcoholism is likely an issue.
Similar to the above, a person who has become dependent on drinking may stop participating in enjoyable activities or hobbies. An avid athlete may give up sports to spend more time at the bar. A parent may miss a child’s performances or games due to drinking bouts or hangovers.
Taking inventory of how the individual’s time was spent before alcohol use and comparing it to how time is spent now can help to determine whether alcoholism has become a factor. This can appear to be a change in personality and preferences – behaviors that can be a strong indicator that alcoholism is present.
Long-term effects of alcohol abuse can cause physical and psychological health issues other than alcoholism itself. Physical conditions are caused by alcohol toxicity and the ways alcohol affects how body systems function. Negative effects on the brain, such as those described by the National Institute on Alcohol Abuse and Alcoholism, have to do with brain damage and alcohol’s effects on brain chemistry. Resulting mental and physical health problems include:
A person who has been drinking large amounts of alcohol regularly and is seeing these issues develop may find excuses to keep from connecting the problems to the alcohol use. On the other hand, the person may simply ignore the connection. However, if physical and emotional issues are known to be connected to drinking and the person still cannot control alcohol use, alcoholism could be the reason.
As mentioned above, people with alcohol use disorders often spend more time drinking than is appropriate, and this may involve drinking in situations where it can be dangerous. This includes drinking before driving, when using dangerous machinery, or before participating in a risky sport or activity. Drinking in risky situations can include sexual encounters too; in fact, a study from the Journal of Studies in Alcohol and Drugs demonstrated that level of intoxication was the sole motivating factor in sexual risk-taking for female college students.
Alcohol consumption relaxes a person’s usual inhibitions, making it more likely that the person will participate in activities that would normally be avoided. The result can be injury, illness, or even death as a result of drinking alcohol and taking undue risks on a regular basis.
Regular and heavy substance abuse over time can result in a condition called tolerance, as described by the University of Rochester, where the effects of alcohol do not seem to be as strong as they were when the person first started drinking. This may manifest as the person needing to have more alcohol to feel the same euphoric effects that used to occur with just one or two drinks.
Tolerance means that alcohol use has begun to disrupt the brain’s chemical pathways, a sign that the brain is beginning to become dependent on the presence of alcohol for those pathways to function. This, in turn, is a precursor to alcoholism, and it can continue to occur to a degree after alcoholism has developed.
Many of the above behaviors follow a key symptom of alcoholism: cravings. When the person is not engaging in alcohol use, urges to drink may become uncontrollable, leading the person to seek out an opportunity to drink. Sometimes, these cravings may be triggered by certain situations, such as stress or being with people who encourage heavy drinking. Whether the triggers are positive or negative, they result in an uncontrollable urge to drink.
Cravings are also the strongest contributor to relapse when the person tries to stop drinking. Often, cravings that arise from unrecognized triggers are most likely to keep the person from being able to maintain long-term sobriety.
Cravings are not the only symptom of alcohol withdrawal – a syndrome described by American Family Physician. Other symptoms include:
The longer a person has been drinking heavily, the more severe these withdrawal symptoms can be if the person tries to stop drinking. The most severe withdrawal symptom is called delirium tremens, a condition that can result in confusion, delirium, fever, seizures, coma, and death.
These symptoms feel like a hangover, but they can be much worse. If the individual feels these symptoms whenever an attempt is made to quit drinking, alcoholism is incredibly likely. Treatment should be sought immediately to prevent the potential for severe symptoms to occur. Individuals should not attempt to quit drinking on their own as the symptoms of alcohol withdrawal can be life-threatening; medical assistance is required.
If this questionnaire has unveiled the possibility that even a mild alcohol use disorder is present, it is important for the individual to seek out a treatment professional for a thorough diagnosis and assistance in managing the disorder. Because the risk of a more severe disorder can lead to any or all of the risks described above, professional assistance is mandatory. Getting help early can prevent the individual from experiencing severe consequences of drinking or disrupting the lives of loved ones.