Do I Have a Drinking Problem?

The standard tools that flag high-risk imbibing don’t always send the right people for help

David H. Freedman
Elemental
Published in
10 min readAug 8, 2019

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Illustration: Sammy Stein

JJoe drank regularly, but never seemed to run into trouble. He became sarcastic sometimes when he went to bars with friends, they said, but otherwise, they didn’t notice anything amiss. There were no ugly confrontations, no violence, no illness, no run-ins with the law. He didn’t think he had a problem.

Friends often told Frank, on the other hand, that he became sloppy and boisterous when he drank. He’d end up with crippling hangovers, and several times he drank until he vomited and passed out. There were embarrassing incidents some evenings with co-workers. He sometimes argued about his drinking with his longtime partner, and one night of particularly heavy drinking at a party so upset her that the resulting clash precipitated the permanent breakup of the relationship.

Frank was setting off several of the standard alarms for problem drinking, alarms that weren’t being raised for Joe. But it was Joe who eventually realized he was an alcoholic, and who now credits his 12-step program with helping him to remain sober for years. Frank, on the other hand, has remained a moderate drinker for years, and he, his friends, his new partner, his colleagues, and even his physician, and a family counselor all agree alcohol hasn’t proved to be a long-term problem for him. In spite of his occasional overindulgence and the resulting questionable behavior, his drinking generally appears well-controlled and of little ongoing harm. (Both Frank and Joe asked that their real names not be used.)

Most people are familiar with the questionnaires and lists of warning signs designed by government health organizations and others to provide drinkers with a heads-up on a developing problem. By all accounts, these long-trusted self-evaluation tools can be an essential aid to those who want to get a sense of whether they may be running into serious trouble with alcohol — or are simply among that majority of drinkers who, even if they regularly indulge and occasionally skate into drunken territory, don’t seem to be slipping into dependence or destructive behavior.

Many experts, though, have their doubts about these tools. “These are valid and reliable…

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David H. Freedman
Elemental

David is a Boston-based science writer. The most recent of his five books is WRONG, about the problems with medical research and other expertise.