Most of the good points were hit already but I will add that I am an alcoholic and 4 years sober...I can tell you that:

I would wake up daily and almost immediately start to think/plan where I was going to drink that day and how I was going to hide it from my family.

Drinking came very close to destroying my marriage, left me in a huge financial hole and took its toll on my health.

It is a miracle and by the grace of God I am not in jail, dead or killed someone. There are more times than not when I would "time travel" and have no recollection how I got home.

I know that if I have so much as a sip of alcohol I will turn into the Tasmanian devil and it will start all over again.

My neighbor gets home from work everyday and pulls his car in the garage. He gets out and grabs a beer out of his beer fridge in the garage and goes inside. And after that if you see him outside, he has a beer in hand. That’s an alcoholic to me. You just know he’s been thinking about those beers all day long.

The American Psychiatric Association's most recent thinking on the issue, via the DSM-5, captures many of the findings in this thread. The 11 criteria (applicable to all substance use disorders) can be categorized into 1) loss of control (e.g. drinking more than you intended, spending more money than intended), 2) social impairment (e.g. missing work, failing to meet family obligations), 3) continued use despite known or realized risk (e.g. use despite worsening health, use despite operating heavy machinery), and 4) signs of physical dependence (e.g. drinking to avoid the shakes, experiencing withdrawal when abruptly quitting).

These 11 criteria are generally considered over a 12 month period. Those substances without a recognized withdrawal syndrome are slightly modified. Meeting 2 criteria qualifies for a use disorder. The more criteria that are met, the more severe the disorder. Of course, the severity in an individual can change over time. The DSM does not take AA's stance that once an alcoholic, always an alcoholic, but it does not go out of its way to refute it either. While abstinence may be encouraged in a number of patients, some studies show that the majority of those who no longer meet criteria for a use disorder are not abstinent, but rather have cut down. Thus, you'll find that some treatment strategies for alcohol use follow a harm reduction philosophy.

-Daniel

quote:

Originally posted by Dan:
The American Psychiatric Association's most recent thinking on the issue, via the DSM-5, captures many of the findings in this thread. The 11 criteria (applicable to all substance use disorders)

For those of you interested in the full DSM-5 11 Criteria for diagnosing a substance use disorder. (I meet virtually all criteria f0r sugar/carbs.)

Criteria for a Substance Use Disorder
Substance use disorders are classified as mild, moderate, or severe, depending on how many of the diagnostic criteria you meet. The 11 DSM-5 criteria for a substance use disorder include:

1. Hazardous use: You've used the substance in ways that are dangerous to yourself and/or others, i.e., overdosed, driven while under the influence, or blacked out.

2. Social or interpersonal problems related to use: Your substance use has caused relationship problems or conflicts with others.

3. Neglected major roles to use: You've failed to meet your responsibilities at work, school, or home because of your substance use.

4. Withdrawal: When you've stopped using the substance, you've experienced withdrawal symptoms.

5. Tolerance: You've built up a tolerance to the substance so that you have to use more to get the same effect.

6. Used larger amounts/longer: You've started to use larger amounts or use the substance for longer amounts of time.

7. Repeated attempts to control use or quit: You've tried to cut back or quit entirely, but haven't been successful.

8. Much time spent using: You spend a lot of your time using the substance.

9. Physical or psychological problems related to use: Your substance use has led to physical health problems like liver damage or lung cancer, or psychological issues, such as depression or anxiety.

10. Activities given up to use: You've skipped activities or stopped doing activities you once enjoyed in order to use the substance.

11. Craving: You've experienced cravings for the substance.

Being Diagnosed With a Substance Use Disorder:
In order to be diagnosed with a substance use disorder, you must meet two or more of these criteria within a 12 month period. If you meet two or three of the criteria, you have a mild substance use disorder. Four to five is considered moderate, and if you meet six or more criteria, you have a severe substance use disorder.

This message has been edited. Last edited by: Fenris,

Read my last post. It is very important. Members who believe they might be alcoholic, should take note. This is a serious medical issue. It is not shameful in any way.

quote:

Alcoholics who successfully quit drinking are still alcoholics. They just figured things out. That is a very hard thing to do. It is a brain chemistry and also a familial genetic historic condition. First and foremost it is a dangerous physical addiction issue. A daily drinking alcoholic should not quit "cold turkey". That can kill a man. It is more dangerous to suddenly quit daily alcohol intake vs opioids. Anyone reading this who is a daily heavy drinker should consult with a medical professional before quitting. You must taper off, and ideally with medical help, perhaps with a Benzo script. Do not do a cold turkey quit. That is very dangerous. I am sure we have a few MD's on SF that can chime in.

^^^^
I would not do ANY benzodiazepine script on an outpatient basis EVER. Benzos have a worse detox than alcohol. Tapering with a benzo along with B 12 injections and complete blood work should ONLY be done on an inpatient basis under medical supervision. Obviously AA should be a part of the treatment protocol as well as appropriate therapy.

The GOLD standard for alcohol dependence is a 90 day residential program. These are the current clinical guidelines. Most inpatient programs use AA extensively in their programs.

quote:

Originally posted by ZSMICHAEL:

quote:

Alcoholics who successfully quit drinking are still alcoholics. They just figured things out. That is a very hard thing to do. It is a brain chemistry and also a familial genetic historic condition. First and foremost it is a dangerous physical addiction issue. A daily drinking alcoholic should not quit "cold turkey". That can kill a man. It is more dangerous to suddenly quit daily alcohol intake vs opioids. Anyone reading this who is a daily heavy drinker should consult with a medical professional before quitting. You must taper off, and ideally with medical help, perhaps with a Benzo script. Do not do a cold turkey quit. That is very dangerous. I am sure we have a few MD's on SF that can chime in.

^^^^
I would not do ANY benzodiazepine script on an outpatient basis EVER. Benzos have a worse detox than alcohol. Tapering with a benzo along with B 12 injections and complete blood work should ONLY be done on an inpatient basis under medical supervision. Obviously AA should be a part of the treatment protocol as well as appropriate therapy.

The GOLD standard for alcohol dependence is a 90 day residential program. These are the current clinical guidelines. Most inpatient programs use AA extensively in their programs.

You might not, and perhaps for good reason, but plenty do. It's true, alcohol withdrawal can be lethal, but to suggest that use of benzodiazepines puts the patient at greater risk, specifically due to withdrawal from that agent, assumes a lot about the patient and the situation. There are many evidence-based protocols which have been successfully used on an outpatient basis to manage alcohol withdrawal. Some involve benzos. Some folks will require inpatient management, but not all, and detox itself does not require 90 days. It's worth saying for those who can't access, afford or spend the time a 90 day rehab stint takes. I wouldn't want anyone who wants to quit to think that he's out of luck because the gold standard isn't an option for him.

quote:

Originally posted by ZSMICHAEL:

quote:

Alcoholics who successfully quit drinking are still alcoholics. They just figured things out. That is a very hard thing to do. It is a brain chemistry and also a familial genetic historic condition. First and foremost it is a dangerous physical addiction issue. A daily drinking alcoholic should not quit "cold turkey". That can kill a man. It is more dangerous to suddenly quit daily alcohol intake vs opioids. Anyone reading this who is a daily heavy drinker should consult with a medical professional before quitting. You must taper off, and ideally with medical help, perhaps with a Benzo script. Do not do a cold turkey quit. That is very dangerous. I am sure we have a few MD's on SF that can chime in.

^^^^
I would not do ANY benzodiazepine script on an outpatient basis EVER. Benzos have a worse detox than alcohol. Tapering with a benzo along with B 12 injections and complete blood work should ONLY be done on an inpatient basis under medical supervision. Obviously AA should be a part of the treatment protocol as well as appropriate therapy.

The GOLD standard for alcohol dependence is a 90 day residential program. These are the current clinical guidelines. Most inpatient programs use AA extensively in their programs.

Benzo scripts are frequently used for short term detox use, to taper off alcohol dependency. In-patient SOP. Typically Diazepam on a one week taper. Consult your doctor.

AA is not best for everyone. Smart Recovery is an alternative. AA preaches a "higher power" and that is fine for many, but not for all. The most important thing is to realize you have a problem and then to talk to your doctor and your family, and proceed. You can do it. Do not be ashamed.

Not to be glib, but anyone who has to ask the question "Am I an alcoholic" is almost certainly an alcoholic. The same is true if you're pondering the question "Are they an alcoholic" of a friend or relative.

quote:

Originally posted by parabellum:
Not to be glib, but anyone who has to ask the question "Am I an alcoholic" is almost certainly an alcoholic. The same is true if you're pondering the question "Are they an alcoholic" of a friend or relative.

I apply this type of logic to elderly drivers. If you are asking the question, it could be time.

quote:

Originally posted by JonW123:
What do you all think about "drinking alone" as a symptom of alcoholism?
I've pondered that and am interested in opinions.

Yes if you're like me.
Not gonna lie and I saw it on another post in this thread but didn't copy it.
"A problem shared is cut in half" I think it said.
Mine is every night. Do I drink until I'm drunk? No, but I drink every night.
I work 2nd shift which basically killed my social life, what I had anyways.
Earlier this year I got tired of most of the people in my life, except family, and told everyone to fuck off. There was to much drama and bullshit and I'm too old for it.
Daughter moved out of the house in 2018. She still comes and visits but infrequently.
Just the dog and me now.
So I filled the void with alcohol and food. I know it's wrong.
So Jon, the answer to that is yes depending on circumstances.

quote:

Originally posted by joatmonv:

quote:

Originally posted by JonW123:
What do you all think about "drinking alone" as a symptom of alcoholism?
I've pondered that and am interested in opinions.

Yes if you're like me.
Not gonna lie and I saw it on another post in this thread but didn't copy it.
"A problem shared is cut in half" I think it said.
Mine is every night. Do I drink until I'm drunk? No, but I drink every night.
I work 2nd shift which basically killed my social life, what I had anyways.
Earlier this year I got tired of most of the people in my life, except family, and told everyone to fuck off. There was to much drama and bullshit and I'm too old for it.
Daughter moved out of the house in 2018. She still comes and visits but infrequently.
Just the dog and me now.
So I filled the void with alcohol and food. I know it's wrong.
So Jon, the answer to that is yes depending on circumstances.

If you are drinking alone every night, it is an issue. We care about you. Please take steps to stop this. Try drinking one or two nights per week. If you can not do that, seek help. It will only get worse. Alcoholism is progressive. It is insidious.

Im my case, it was the AA reasons. Plus almost all of those Fenris cited above.

I quit several times. The second to last time was with AA. The last time (20+ years ago, through today) was by myself, but full well understanding the AA principle of I can't have that first drink.

I still dream about drinking every once in a while. I am able to drink non-alcoholic beer, because I do like the taste, but a 6-pack of it lasts a month or two because I don't "have" to have it.

quote:

Originally posted by IntrepidTraveler:
Im my case, it was the AA reasons. Plus almost all of those Fenris cited above.

I quit several times. The second to last time was with AA. The last time (20+ years ago, through today) was by myself, but full well understanding the AA principle of I can't have that first drink.

I still dream about drinking every once in a while. I am able to drink non-alcoholic beer, because I do like the taste, but a 6-pack of it lasts a month or two because I don't "have" to have it.

The physical cravings are only half the problem. The easy part. The mental issues are much harder to overcome. Life-long habits are very hard to change. But you can do it!!

quote:

Originally posted by fpuhan:
The book Alcoholics Anonymous provides the definitive answer: An alcoholic is someone who has "lost the power of choice" over the first drink.

It's not necessary for an alcoholic to drink every day. My late wife was a binge drinker, who could go for long stretches of time without taking a drink. But when she picked up a drink, she wouldn't stop until she was obliterated. It finally killed her.

The general consensus is that alcoholism is both a mental obsession and a physical compulsion; the mind says "You need to drink" and the body says, "You can't stop drinking." Even A. A., perhaps the most successful approach to a solution, has not been able to determine the cause.

Years ago, the Mayo Clinic published a list of the top causes of death in the U. S. Alcoholism was listed as #4, behind heart disease, cancer and accidents, adding that when you calculate the other directly related causes (suicide, auto accidents, etc.), alcoholism was probably higher on the list.

fpuhan nailed it. You have solid knowledge/reference to the Big Book.
Mental obsession AND physical compulsion (or craving) combined, loss of choice leading to physical dependence on the substance.
There are also specific behaviors that accompany this.

quote:

Originally posted by parabellum:
Not to be glib, but anyone who has to ask the question "Am I an alcoholic" is almost certainly an alcoholic. The same is true if you're pondering the question "Are they an alcoholic" of a friend or relative.

I was the last one to know I was an alcoholic.
True story.

quote:

Originally posted by Dan:

quote:

Originally posted by ZSMICHAEL:

quote:

Alcoholics who successfully quit drinking are still alcoholics. They just figured things out. That is a very hard thing to do. It is a brain chemistry and also a familial genetic historic condition. First and foremost it is a dangerous physical addiction issue. A daily drinking alcoholic should not quit "cold turkey". That can kill a man. It is more dangerous to suddenly quit daily alcohol intake vs opioids. Anyone reading this who is a daily heavy drinker should consult with a medical professional before quitting. You must taper off, and ideally with medical help, perhaps with a Benzo script. Do not do a cold turkey quit. That is very dangerous. I am sure we have a few MD's on SF that can chime in.

^^^^
I would not do ANY benzodiazepine script on an outpatient basis EVER. Benzos have a worse detox than alcohol. Tapering with a benzo along with B 12 injections and complete blood work should ONLY be done on an inpatient basis under medical supervision. Obviously AA should be a part of the treatment protocol as well as appropriate therapy.

The GOLD standard for alcohol dependence is a 90 day residential program. These are the current clinical guidelines. Most inpatient programs use AA extensively in their programs.

You might not, and perhaps for good reason, but plenty do. It's true, alcohol withdrawal can be lethal, but to suggest that use of benzodiazepines puts the patient at greater risk, specifically due to withdrawal from that agent, assumes a lot about the patient and the situation. There are many evidence-based protocols which have been successfully used on an outpatient basis to manage alcohol withdrawal. Some involve benzos. Some folks will require inpatient management, but not all, and detox itself does not require 90 days. It's worth saying for those who can't access, afford or spend the time a 90 day rehab stint takes. I wouldn't want anyone who wants to quit to think that he's out of luck because the gold standard isn't an option for him.

Benzo's are extremely addictive. More so than alcohol. Alcoholics generally have to work at drinking for years before actually becoming an alcoholic...….Benzo addiction takes only a few short months. Benzo addiction also advances in dosage requirements very quickly. I know of an alcoholic who was forced not to drink and switched to Benzo's......and within a year or so, it's a handful of them a day.

quote:

Benzo's are extremely addictive. More so than alcohol. Alcoholics generally have to work at drinking for years before actually becoming an alcoholic...….Benzo addiction takes only a few short months. Benzo addiction also advances in dosage requirements very quickly. I know of an alcoholic who was forced not to drink and switched to Benzo's......and within a year or so, it's a handful of them a day.

^^^^^^^^^^^^^^^
Yep. Check out Stevie Nicks horror story on Klonopin. Got off coke, psychiatrist put her on Klonopin, eight years of Hell followed.

quote:

Benzo's are extremely addictive. More so than alcohol. Alcoholics generally have to work at drinking for years before actually becoming an alcoholic...….Benzo addiction takes only a few short months. Benzo addiction also advances in dosage requirements very quickly. I know of an alcoholic who was forced not to drink and switched to Benzo's......and within a year or so, it's a handful of them a day.

Consult with a doctor. That's the best advice I can offer. This is my business; I'm pretty good at it.

Some things stand out when you read this thread. There are people who use the label as a weapon. Often When it doesn't apply, but it serves their purpose to call someone and alcoholic to demean them. Just for the record here, I'm not one, but I've had others call me that because I've been seen with a beer in my hand.

I haven't quit drinking, but I stopped last summer. I think that means I plan on drinking beer again. But when circumstances seem right. Just last Wednesday I was at a club meeting and a friend came over to sit with me and talk. The damn fool set his beer down, so I grabbed it and had a drink. Shocked him, but the old rule from back in my drinking years was that mine was the beer with more in it.

And there is still an open bottle of bourbon in the house. This one was opened back about 2000, give or take. Good stuff, too. Its lasted this long because I opened a bottle of A H Hirsch. Google it sometime. I bought mine back when it was $54 a bottle when purchased by the case, which I did. Its generally acclaimed to be the best ever distilled or bottled, easily outdistancing Pappy. Yeah, and I still have 3 unopened bottles. I guess I'd better start drinking it so there's none left when I croak.

The only beer I've had recently, like in months, was that swig from the buddy's beer. His fault, he set it down too close to me. I think we call that a stunt. I used to bring a six pack into the club meeting each month. I feel for my son, he got half of it for free.

There are wives in the club who label anyone drinking a beer as an alcoholic. I consider anyone using it as a label to be undependable. The best people I know and have for friends drink beer. I see nothing wrong with it at all.