You like to unwind after work with a big glass of Chardonnay. You’re apt to knock back a couple vodka sodas at happy hour with the girls. You don’t drink every day, so therefore you don’t have a drinking problem—right? Well, not quite. As it turns out, your boozing habits could be more dangerous than you realize.
The culture of the “almost alcoholic” is a growing problem, says Dr. Joe Nowinski, Ph.D., an internationally recognized clinical psychologist and co-author of the book, ALMOST ALCOHOLIC: Is My (Or My Loved One’s) Drinking a Problem. In the book, Nowinski and co-author Robert Doyle, MD, define almost alcoholics as a growing number of people whose excessive drinking contributes to a variety of problems in their lives.
“These people have moved beyond what is generally considered low-risk drinking and into a dangerous territory that borders on alcoholism,” he says.
Although the prevailing view of alcoholism is defined strictly in terms of black and white—e.g., you’re either alcoholic and need treatment, or you aren’t alcoholic and don’t need treatment—many health professionals are now interested in the hazardous “gray zone” that falls between low-risk drinking and full-fledged alcoholism. “There’s been a move to abandon the categorical view of alcohol disorders in favor of a broad spectrum,” says Nowinski, noting that the American Psychiatric Association has recently updated their Diagnostic Standard Manual to reflect this more nuanced view of alcohol abuse.
In today’s world, drinking is more ubiquitous than ever. TV shows like Mad Men glamorize a hedonistic culture of smoking and boozing, and trendy craft cocktails are all the rage in upscale restaurants and bars. Given the widespread popularity and acceptance of alcohol, it can be easy to overlook alcohol’s potentially adverse effects on social, psychological and physical wellbeing. As a result, drinking problems might go unnoticed, explained in endearing terms such as “lush” or “wino” or “lightweight.”
But the consequences of alcohol abuse can be debilitating. “The problem is that many people fail to connect the dots,” Nowinski says. “They are reluctant to admit that many of their problems—weight gain, hypertension—are linked to alcohol.”
According to a recent report by the CDC, excessive alcohol use is the third leading lifestyle-related cause of death in the United States, responsible for approximately 88,000 deaths each year. What’s more, one in six U.S. adults admits to binge drinking (defined as five or more drinks in a sitting for men, and four or more drinks in a sitting for women) at least 4 times a month. In the short-term, alcohol can increase the risk of injuries, violence, risky sexual behavior, alcohol poisoning and alcohol-related birth defects. In the long-term, excessive drinking can lead to the development of certain chronic diseases, neurological impairments and social problems. These include:
- Neurological diseases, including stroke and dementia.
- Cardiovascular problems, including heart disease, hypertension and atrial fibrillation.
- Psychiatric problems, including depression and anxiety.
- Certain types of cancer, such as breast cancer and colon cancer.
- Liver diseases, including cirrhosis.
- Social problems, such as diminished job performance, marital stress and lost productivity.
Unfortunately, problem drinking isn’t always easy to spot. It doesn’t necessarily mean that a person is starting off the day with a shot of whiskey or regularly getting into bar fights on Friday nights. Rather, individuals who fit the “almost alcoholic” mold often display more subtle, sneaky symptoms. Below, Nowinski outlines some of the telltale warning signs of problematic drinking:
Do you consistently drink alone? If you regularly drink by yourself, this might be indicative of an alcohol problem.
Do you drink to relieve stress? Needing 2 or 3 drinks every night in order to unwind and de-stress is symptomatic of problematic drinking.
Do you drink to alleviate physical or emotional pain? People who drink to mask chronic pain—whether it’s an aching back or perpetual feelings of loneliness—might be setting themselves down a dangerous path. “That’s why drinking problems are becoming epidemic among the elderly population, many of whom are widowed or divorced,” Nowinski notes.
Do you look forward to drinking? “It might be a red flag if a person continually anticipates coming home and having that first drink,” Nowinski says.
Have your relationships suffered? “There may be marital conflict as a result of the drinking, or performance at work will begin to suffer,” Nowinski says.
Are your sleep patterns disrupted? People often rely on alcohol as a sleep aid, but it can have the opposite effect. “One of the symptoms of almost alcoholism is a disrupted sleep cycle that then leads to a loss of energy and vitality,” Nowinski says. “People feel chronically tired and sluggish.”
Do you get uncomfortable in social situations where there is no alcohol? At social gatherings, do you get anxious when there’s no booze in sight? Do you rely on beverages to help you “open up” and become more sociable?
If you are troubled by your drinking habits and want to scale back, there are a number of simple lifestyle and behavioral tweaks you can make. For example, Nowinski recommends gravitating toward friends who are non-drinkers or moderate drinkers. He also suggests practicing drink refusal skills, or learning how to say no when somebody offers you a drink. “Sometimes that means making up something that people won’t question—such as, ‘I’m not drinking because I’m trying to lose weight,’” Nowinski says.
Bottom line? The occasional beer or glass of wine isn’t likely to yield any serious long-term damage. As long as you don’t frequently overindulge, alcohol can be a part of a healthy—and fun!—lifestyle. But if you are worried that alcohol is beginning to take over, you might want to take stock of your behavior and consider a change of course.
“We’re not trying to tell everyone that they can’t have any alcohol, or that everyone needs to abstain from alcohol,” Nowinski says. “But we do think it’s important to assess your patterns of alcohol use and evaluate its impact on your personal well-being.”