Transcript
The question that has been posed is what is alcoholism. The good news for people is that alcoholism is a term that doesn’t exist anymore and that seems very curious to people. We used to diagnose alcohol in two categories: alcohol abuse or alcohol dependence. Now, with the publication of DSM5, which is the manual that we use for psychiatric and psychological diagnoses, now alcohol use has been categorized as alcohol use disorder rather than alcohol abuse or alcohol dependence. Alcohol use disorder now is categorized on a continuum of mild, moderate, or severe so you can use alcohol and not fall into any of these categories. However, with alcohol use disorder really implies there’s some problem with the alcohol use that you have. There are 11 criteria within alcohol use disorder. Mild alcohol use disorder is defined as meeting two to three criteria. Moderate alcohol use disorder is meeting four to five criteria and severe alcohol use disorder is meeting six or more criteria. The most severe criteria is when you have tolerance or withdrawal. Tolerance is defined as when you need more and more alcohol to actually get the same effect and when you have an alcohol use disorder, the desired effect is usually being drunk so when you have tolerance, it means you have to keep drinking more and more to get the same affect, not to get drunker, but to get as drunk as before. Withdrawal is when you have actual physical symptoms if you stop drinking, which can be quite dangerous. So sometimes when people speak to me about their alcohol use and they want to stop, I actually, unless they’re willing to come and see a physician and be evaluated for withdrawal protocol, which is using medication, I tell them not to stop drinking because that could be much more dangerous than continuing to drink. The most severe symptom of withdrawal can be seizures, which can be life threatening. And then there’s milder symptoms of shaking, sweating, nausea, vomiting when you stop but withdrawal can be medically quite dangerous and sometimes people really forget that. Moderate alcohol use disorder is when there’s again, four to five symptoms which can be symptoms where you drink more than you intend to drink, where you may set out thinking, I’m just going to have a couple of drinks with friends and then you end up drinking and getting drunk when you really don’t intend to. And most of us, particularly in college, we always knew the guy or the girl who were always the last person standing and the one’s who when everyone else was done, they would keep going. Those are the people who may fall into that moderate category but as they progress in life, you can be a moderate alcohol use disorder but really progress into severe and that’s what people need to remember, that alcohol use disorders often are progressive. Sometimes stay as having a mild disorder but more often, people do progress and have a more severe disorder. So that really is how we define alcoholism today.
