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Alcohol Use Disorder

Question: My wife has increased the amount of wine she is drinking in the evening. It started being more during Covid, which I understood. She said, ‘after the world reopens, I’ll cut back.’ That hasn’t happened. Should I be worried?

Signed – Loving but Concerned

Dear Loving but Concerned,

Your question is a good one and frequently asked in various ways. How do we tell when a person has crossed that invisible line from social drinking into alcohol dependence? The first thing that stands out is your wife’s statement that she intended to cut back when she realized the amount was creeping upwards. This tells me that you are not the only one with a concern. Your wife was concerned also.

Wanting to cut down or making unsuccessful attempts to cut back is a hallmark sign of Alcohol Use Disorder. Many alcoholics are very successful in other parts of their lives. In fact, most alcoholics are FUNCTIONING, meaning that they are working, they are an integral part of their family, they have money in the bank, and make important responsible decisions every day. This has left many problem drinkers asking themselves why they can manage so many other things in their lives yet are unable to manage their alcohol consumption in the same manner.

For those that suffer from Alcohol Use Disorder, once they ingest alcohol all bets are off as to how much they will consume. This is called loss of control. A person does not have to drink daily or at any specified frequency to meet the medical criteria for Alcohol Use Disorder. However, if once they start drinking, they are unable to stop at just those 2 glasses of wine they promised their husband -or themselves- there is big reason for concern. Another area to pay attention to is whether your wife is using alcohol to reduce anxiety or other uncomfortable feelings. Sometimes the dependency on alcohol is as much emotional as it is physical. Is there something that the person is avoiding by drinking? The term often used to describe this is self-medicating. According to JAMA Network Open, the overall frequency of alcohol consumption during the pandemic increased about 15%. The very real and negative feelings that many experienced during the pandemic is an example of using alcohol to quell emotional discomfort. When someone says that they need to drink in order to relax, have fun or sleep, it is a clue that they are misusing alcohol.

The best indicator and the one most often used at our facility to determine whether or not someone has Alcohol Use Disorder is whether the individual continues to drink DESPITE negative consequences related to the drinking. Sometimes the consequences are grave in nature, such as an auto accident while driving under the influence. However sometimes those consequences can be more subtle, such as being more argumentative while drinking causing conflict in relationships.

Obviously, there is no singular way to determine if your wife has crossed into alcohol dependence. Information is power and I congratulate you on presenting your question. I hope you will create the opportunity with your wife to have an open and honest conversation about your concerns. This is best done of course when she has not been drinking. Also, a calm and non-judgmental approach will work best. Denial however is also a symptom of alcohol use disorder, so if she becomes too defensive and is unable to hear your concerns, please reach out for help to us or other treatment provider, your doctor, or 12 step groups in the area such as Al-Anon or Alcoholics Anonymous.