The DSM-V, the diagnostic manual used by mental health professionals in America, refers to alcohol addiction as an alcohol use disorder. However, Alcoholics Anonymous leaves it up to the individual to identify themselves as an alcoholic or not. Additionally, an “acceptable” amount of alcohol consumption seems to differ by country, religion, family, age, and one’s overall social environment. Consider an Islamic family that drinks zero alcohol versus an American college student who regularly goes out to bars. If someone in a devout Islamic family drinks any alcohol at all, it is unacceptable. However, an American college student can drink heavily several times per week without anyone batting an eye. With so many different standards and criteria for what is acceptable, it leaves many people wondering “How do I know if I’m an alcoholic?”
Let’s take a deeper look at some of the criteria that a couple of organizations have outlined:
Alcohol Addiction According to the DSM-V
The current version of the Diagnostic and Statistic Manual of Mental Disorders lists 12 criteria used to diagnose an alcohol use disorder (AUD). Only 2 of these criteria need to be met in order to be diagnosed with a mild AUD, 4-5 for a mild AUD, and 6 or more for a severe AUD. These criteria include:
- Had times when you ended up drinking more, or longer, than you intended?
- More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
- Spent a lot of time drinking? Or being sick or getting over other aftereffects?
- Wanted a drink so badly you couldn’t think of anything else?
- Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
- Continued to drink even though it was causing trouble with your family or friends?
- Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
- More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
- Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
- Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
- Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure? Or sensed things that were not there?
However, just a few years ago, the medical community used significantly different criteria to diagnose alcohol addiction. In the DSM-IV, alcohol-related mental health disorders were broken down into 2 categories: alcohol abuse and alcohol dependence. There were 4 criteria for alcohol abuse but only one had to be met to be diagnosed with alcohol abuse. Three out of seven different criteria listed in the DSM-IV needed to be met to diagnose alcohol dependence.
An Alcoholic According to AA
Alcoholics Anonymous does not serve as a medical organization, but a support system for individuals that struggle with alcohol addiction. Thus, it does not set out to diagnose the condition. However, the one requirement to join AA is a desire to stop drinking. Some might be confused because AA is known for the phrase “My name is [insert name] and I am an alcoholic.” In reality, it is not required for members to identify as an alcoholic. Still, one could infer that an individual who seeks help with their desire to stop drinking may have been struggling to do so on their own. This does align with the 2nd criteria listed in the DMS-V for an AUD.
Additionally, the first step of AA states “We admitted we were powerless over alcohol—that our lives had become unmanageable.” Most would argue that someone who often drinks more than they intend or has tried to stop drinking, but didn’t, is powerless over alcohol. Also, most would agree that someone’s life is unmanageable if they are frequently hungover, experiencing withdrawal symptoms when they stop drinking or experiencing relationship and work issues due to their alcohol consumption.
Are you an Alcoholic?
Although over time and across different sources it has not always been clear how to know if someone is an alcoholic, there does also seem to be many consistencies. In the end, if you feel like you or a family member is struggling with alcohol, there is never shame in getting help.