STEP TWO. SELF ASSESSMENT. DO I NEED HELP?
It’s A Disease: That’s Why There’s A Cure.
In its policy statement on Alcoholism as a Disease, the American Medical Association (AMA) states that it ‘urges change in federal laws and regulations to require that the Veterans Administration determine benefits eligibility to require on the basis that alcoholism is a disease’. The issue of whether of not ‘alcoholism is a disease’ is most relevant in terms of funding. If patients have ‘a disease’, then it is is easier to obtain paid access to treatment through private and public health insurance programs. The American Medical Association considers alcoholism to be an ‘illness characterised by significant impairment that is directly associated with persistent and excessive use of alcohol. Impairment may involve physiological, psychological or social dysfunction’. The amount you drink is not the crucial issue – it is a question of what happens when you do and that is why it is said, ‘If you have problems when you drink, you have a drinking problem’. One of the problems is simply the impairment produced by intoxication. Other problems are caused by the fact that alcohol tends to accentuate whatever we are feeling at the time we drink it. If we are feeling happy and talkative, we may feel more intensely elated and talkative. But it can also accentuate feelings of depression and despair. And if we are angry or aggressive, alcohol can exaggerate those feelings while interfering with the good judgment need to keep out of a fight. On the other hand, much of what distinguishes alcoholics is what happens when they do not drink. How severe does craving become? Some of the Mediterranean-style alcoholics do not know they are alcoholics until they try stopping and find it impossible. This is probably the most important sign of alcoholism: the inability to remain abstinent.
Alcoholism is a ‘progressive disease’ that has been described in stages. Do any of these stages apply to you? Are you in the early or middle stages? Do you have a loved one or friend to whom any of these apply? Begin thinking about your drinking in terms of these stages:
- You are beginning to experience problems with your drinking. You become preoccupied with drinking, start sneaking drinks, and feel some guilt about your drinking behaviour.
- You sometimes become intoxicated, and may have had blackouts – not remembering what you said or did while drunk.
- You look forward to drinking sessions, associate with other heavy drinkers, and are less interested in activities that do not involve drinking.
- Friends and family are concerned about your drinking, and drinking interferes with your work – for instance, you being calling in sick because of a hangover.
- You experience withdrawal symptoms such as tremors, depression, and anxiety when you stop drinking.
- You may or may not openly acknowledge it, but drinking has become a problem for you.
- You are unable to manage your drinking. Even though you wish that you could drink less, you find yourself drinking compulsively.
- You begin to use alcohol as an antidepressant but find that drinking results in hangovers, which make you even more depressed.
- You begin to have health problems, and your doctor may recommend you drink less or stop altogether.
- You may miss workdays and lose your job, get convicted of drunk driving, or get into alcohol-related conflicts with loved ones and friends. You start having alcohol-related medical problems such as liver inflammation, heart disease, or diabetes.
- Withdrawal symptoms – tremors, depression, and anxiety – as the alcohol wears off are now a regular part of your life.
- Your life is now totally unmanageable.
- You may have hepatitis, cirrhosis, pancreatitis, high blood pressure, and internal bleeding.
- Deep depression, sleep disorders, and memory problems are prominent. If you have been drinking many years, your memory may become impaired by Wernicke-korsakoff Syndrome, a condition that results in permanent brain damage. In The man Who mistook His Wife for a Hat, Oliver Sacks describes how one of his patients thought he was living decades earlier because years of drinking had erased entire portions of his memory.
- You may experience hallucinations, convulsions, and have brain seizures know as delirium tremens (DTs) when you stop drinking. This can be fatal and you need medical attention urgently.