If you think you have a problem, the chances are you probably do.
Updated: Jan 6
In my opinion, the way we think about problematic alcohol consumption needs to change and the language we use around it also needs to change. One of the reasons people don’t know or believe they or someone they know has a problem with alcohol is because our widely accepted understanding of what constitutes an alcohol problem is very narrow and not supported in research or practice.
When we think of problem drinking we often think of or use the term ‘alcoholic’. The problem with this word is that there is a mental image that appears in most people’s minds of what that looks like. Often, this is someone who is down and out in life who is drinking from dawn ‘til dusk.
There was once a notion that only certain types of people could fall prey to the addictive properties of alcohol and that alcohol was safe as long as you were not genetically predisposed to becoming addicted. Sadly, despite being refuted this notion still forms the basis of many people’s thoughts on the dangers alcohol and hence many people don’t understand that given the right circumstances, anyone can fall prey to alcohol’s addictive properties.
“What is the "classic disease concept of alcoholism"? First proposed in the late 1930s, it goes like this. Alcoholism is a specific disease to which some people are vulnerable. Those who are vulnerable develop the disease if they take up drinking. From apparently normal social drinking, they progress to drinking ever greater amounts... versions of the classic disease concept remain a dominant theme in the public's thinking about alcohol abuse. And yet, no leading research authorities accept the classic disease concept.”
Herbert Fingarette in ‘Heavy Drinking; The Myth of Alcoholism as a Disease’
If the disease model were correct, it should then follow that a person would exhibit problematic drinking patterns from first consumption and use of alcohol. However, this is seldom the case. People can drink in a sensible and controlled manner for years before ever reaching a point at which something triggers problematic behaviour.
When we use the term ‘alcoholism’ we also put the problem on the person and not the drug. We assume it’s the person’s fault that they have an issue with alcohol. We don’t use the term ‘cigarette-aholic’ for smokers. We give credence to the fact that nicotine is an addictive substance.
The trouble with alcohol is that not only is it an addictive drug it is also widely socially acceptable and heralded as needed in human life in certain cultures around the world, including here in the UK. I often see various memes on social media which downplay the seriousness of problematic alcohol consumption and encouraging it’s use for pleasure.
One of the reasons that alcohol is problematic for us as humans is the way in which it triggers our brain’s pleasure centre.
How many times have you been out on a night out and got so drunk that you ended up with the most awful hangover the next day? During the time you were feeling poorly with your hangover you vowed never to drink again, yet the next time your friends invited you out to drink you, you gleefully accepted and went out drinking anyway!
Although you’d think that avoiding danger and bad feelings would override feelings pleasure, or in this case avoiding a hangover would override choosing alcohol, sadly the brain chooses pleasure more often than not.
Alcohol stimulates the brain’s pleasure and reward system. When the pleasure-reward system is activated positively, part of the brain’s circuitry records what caused such feelings of pleasure in order to be reminded of it for future reference when a hit of good feeling is felt necessary by the brain. (Note, this is a very unsophisticated account of what happens but this describes the process in very simplistic terms.)
When we live in a culture where alcohol is deemed a necessary part of social interaction and as an accepted coping mechanism for stress, if the brain seeks that hit of feeling good it is easy and widely acceptable for us to turn to alcohol to find it.
If you have experienced any negative side effects with consuming alcohol, from evil hangovers to a pattern of drinking you are not comfortable with, you might think it should be easy to consciously stop yourself from drinking. However, the pleasure-reward system of the brain is operated by our unconscious mind. As Professor Steve Peters in his book ‘The Chimp Paradox’ discusses, the unconscious mind is significantly more powerful than the conscious mind and therefore the unconscious mind wins over rational thought and pleasure wins over pain.
This is why when someone has a problematic pattern of alcohol consumption, the pleasure-reward system wins over thoughts and desires of giving up drinking.
It is not as simple as just employing more will power.
A new model of problematic alcohol consumption
I would like to see the full spectrum of problematic drinking being more widely discussed and publicised. This includes expanding language and knowledge around different types of problematic drinking patterns.
Without this we are stuck with the model and stereotype of alcoholism as the only problematic pattern of alcohol misuse.
If more problematic drinking patterns are understood, more people would be able to get support from those around them. Or, better still, recognise the signs early enough themselves such that fewer people then end up with a pattern that would be deemed dangerous for health.
All too often we think of problematic drinking as someone drinking excessive amounts of alcohol day-in-day out. When in reality, problematic drinking can be as simple as drinking a glass or two of wine every day. We are all aware that drinking to excess is not good for us, but counter to popular belief, the latter level of drinking is also unsafe for human health.
When your desire for alcohol has reached a point where you feel you need it, either to relax or to cope in situations you are not comfortable in, the likelihood is that your drinking has reached a level on the problematic drinking continuum.
A tale from my own experience
With problematic drinking or alcohol addiction it is not a case of once you have a problem it looks one way and one way only. It is a spectrum and, due to the way in which the body builds a tolerance to alcohol meaning the more tolerant you become the more alcohol you require to get the same feeling, it is often a downward slope.
When I opened up to people about my drinking they would often struggle to understand why I thought I had a problem or why I couldn’t just stop.
I was never a fan of alcohol and drank very little in my teens and early twenties. It always baffled me as to why countless people wanted to save their hard-earned money to waste it on a weekend getting drunk and out of control on alcohol.
At the point I recognised I had a problem, I wanted more than anything to stop drinking. However, it just wasn’t as easy as saying or believing that I wanted to stop.
If someone with as little interest in alcohol as I have ended up with a problem, believe me, that given the right circumstance, anyone can succumb.
My problematic drinking also didn’t come on all in one go. It wasn’t like I used alcohol for sleep a couple of times and boom I had this problem. No, it was an issue that got progressively worse over time. It was as if it snuck up on me!
At the start when I began using alcohol for sleep, I could go very long periods without feeling like I needed a drink to help. It then went to needing a little night cap more often than not. Eventually ending in I couldn’t stop myself from having a drink every night to get to sleep.
There was also a period where I noticeably felt things change. I went from always being able to control how many drinks I consumed to a Russian-roulette-style of never knowing if one drink would turn into more.
I physically felt a shift in my mind and I now believe I will never be able to sensibly drink because of how alcohol has changed my brain and how it now responds to alcohol.
The paradox for many who I spoke to about my problem, was that I wouldn’t drink during the day. In fact, if you ask people who knew me through that time period, most would have seen me as someone who didn’t drink much. I would regularly go out to the pub with friends in an evening and not have a single alcoholic beverage. Hence it seemed difficult to get understanding from others as they did not see me going through the daily struggle that I was going through.
The pub and socialising were not triggers for me. Anxiety around sleep was my trigger and hence in a pub surrounded by alcohol I could quite happily leave it. But at home, at night in my room worrying about getting to sleep and it was a very different story.
It frustrated me that I didn’t feel taken seriously when I contacted professional services about my problem. It felt like I needed to have a serious problem and be down and out on my life before my problem would be recognised and supported to get help.
It was incredibly frustrating to not be able to gain understanding from anyone around me.
My advice to others is:
Educate yourself on the effects of alcohol on the body. I highly recommend Professor David Nutt’s book ‘Drink’ for this. Whether or not you think your drinking is problematic, it will change your views on alcohol safety for human consumption and allow you to re-assess what level of consumption you think would be healthy for you.
If you think your drinking is problematic, the chances are it probably is. Speak to someone now before it carries along the continuum to point where your health is severely compromised. The sooner you can get control back, the better.
If someone you know thinks they have a problem with alcohol, accept their perspective on it. Listen to them. Believe them. And if you have the capacity to support them to seek help, please do.
I ask all readers to be respectful. This is an honest and heart-felt account of the struggle I incurred.
I thank you in advance for your respect and kindness and I encourage you to sign up to my mailing list so I can notify you about new blog updates.
If you are struggling with how much alcohol you are consuming or if you would like to talk further on the subject please get in touch. Your conversations with me will remain confidential. Please note that I am not a therapist but I can support you to find a way to address any issues you may be having with alcohol.