The Spectrum of Alcohol Use Disorders
Perhaps you’ve heard the notion that alcohol and substance use disorders (SUD’s) are not defined by a specific set of traits, but rather, exist on a spectrum. This novel ideology is helping create a more successful future of treating SUD’s.
For decades, society has formed and abided by a stereotypical archetype of what it means to be an ‘alcoholic’. And, up until recently, a somewhat unanimous belief has been shared amongst the sober community; “AA is the only way”.
Now, thanks in part to social media and the constant flow of information and connectedness we are privy to, sobriety is changing.
We’re learning that Alcoholics Anonymous, while still a crucial and important support system for many, is not ‘the only way’ to commit to a sober lifestyle. In fact, many have been finding unique and individual ways to make sobriety work for them on a long-term basis, and on their own terms.
For some, online communities have been a saving grace for those new to recovery. Instagram, Facebook, and TikTok have become flooded with groups, sober motivation, and used as an outlet to share recovery stories and invaluable information.
Others have built strong support systems through family & friends, therapy, and lifestyle changes that have contributed to the maintenance of their sobriety.
Sobriety has not been redefined, per say, but it has evolved, and continues to do so. Through these changes, we’ve opened up the topic of sobriety on a broader level.
This includes re-evaluating what it means to be an alcoholic…
You don’t have to diagnose yourself/be diagnosed as an alcoholic before you decide to quit drinking
Alcohol abuse should only be depicted using terms like ‘mild, moderate, or severe’ in a medical setting. Mild alcohol abuse warrants a need for sobriety just as much as severe alcohol abuse. Both can kill you with the same speed and callous.
Deciding to go alcohol free because you have an unhealthy relationship with alcohol and want better for yourself is okay. Again, the severity does not matter.
What is considered a societal norm does not necessarily mean it’s correct or morally right. Society decided ethanol should be packaged and sold for entertainment purposes, and (like the Easter Bunny) society decided what an alcoholic should look like.
How do I know if my Drinking Habits are a Drinking Problem?
Simply put, the first step in addressing an issue is by first acknowledging whether one exists.
Unfortunately, no one can decide whether you have a problem but you. However, your loved ones, friends, parents, and those you associate with are warranted to their own opinions. That is, you may not believe you have a problem, while others may feel the opposite.
But, the same can be said on the opposite side of the coin. You may feel that you have an issue with alcohol, while others disagree. You might confide in a friend or loved one to establish whether this is true, only to be met with constant reassurances that you are the furthest thing from an ‘alcoholic’.
If alcohol is consistently making you feel bad; anxious, depressed, ridden with guilt and shame – then it’s likely an issue for you.
If it’s disrupting your health, relationships, or job – then it’s likely an issue for you.
But, what if you feel that while alcohol certainly disrupts areas of your life some of the time, it’s not all bad? What if it helps manage your stress, makes socializing easier, and you can’t imagine giving it up for the rest of your life?
Well…everyone throughout eternity who has ever committed to sobriety felt the same way about alcohol – regardless of where they were at mentally, physically, and emotionally when they quit.
Hence, alcohol use (and abuse) exists on a spectrum.
Disordered Drinking is Not One Size Fits All
Here are some examples of what disordered drinking might look like. These may sound stereotypical, but that's okay. The bottom line is that alcohol abuse is not uniform, black and white, or singularly defined. Nor does anyone have to conform to the label of ‘alcoholic’ that we all-too-often associate with an individual who has lost everything: their health, their job, their home, their family, etc.
Red is a daily drinker and has been for as long as he can remember. He started using alcohol in his early teen years and has always considered it a part of his life, and even his identity. Red has never acknowledged whether he has a drinking problem but knows that it creates a variety of problems in his life. Regardless, he remains an advocate for alcohol, and surrounds himself with people who share in his perspective. He couldn’t imagine his life without alcohol and believes that not being able to drink would make him unhappy. Red understands that some folks can’t handle their liquor, but he isn’t one of them. He works hard, pays his bills on time, and is there for others when they need him. Red is so committed to his roles in life, he often forgets to consider his own health and happiness. As someone who was raised to tough things out and to never complain, he rarely gives his feelings much attention.
Orange does not have a drinking problem and he can prove it. He has a great job, tons of friends, and treats his body like a temple. He has a gym membership that is actually used, and he follows a healthy diet. His Instagram feed further proves his effortlessly perfect existence. When it comes to the weekends he likes to let loose. It usually begins with post-work drinks on Friday, weekend shenanigans with occasional drug-use, and ends with ‘Sunday Funday’. Often, he does regrettable and embarrassing things when he goes out, but so do his friends. Therefore, they’ve formed a collective agreement to never openly address any of the unclassy moments that happen during the weekend. When Orange reflects on things, he realizes that these unmentionable moments and binge drinking over the weekend constantly contradict with his morals, values, and who he wants to be as an individual. Secretly, he wishes that he could have just as much fun without alcohol ever being a factor, but he feels like he’s boring without it, and life is too.
Yellow rarely drinks, and when she does it isn’t much. At least, that’s how she had always been up until the past few years. Yellow is a wife and a mom and it’s no secret that she nails both roles. Her husband likes to drink and she often jokes that he ‘drinks enough for the both of us’. When Yellow and her husband decided to start a family, she focused all her energy on raising her little ones. But once her kids started getting older, she regained a sense of independence that she didn’t realize she had been sorely missing. Life also threw some curveballs in the meantime, and she started noticing her stress level was often through the roof. So, she started having a nightly glass of wine with dinner, and sometimes one or two after the kids went to bed. Her husband was elated that she was finally letting loose, and they grew to enjoy their evenings out without the kids, and their nights spent having a few drinks together at home. She reassured herself as often as she was reassured by others – ‘this is my time’. But, deep down, Yellow knew that she was slowly losing control over her drinking – as her tolerance and intake kept creeping up, and she became unwittingly reacquainted with regular hangovers.
Green is a blast to have around and she knows it. She’s optimistic, strong-willed, and has a solid handle on her roles in life. She loves her wine and can be counted on as your local wine-pairing expert. Green knows that everyone has vices, and alcohol is hers. But she certainly does not have a problem. If anything, she can tell you at least ten other people off the top of her head who are ‘worse than her’ when it comes to drinking. She drinks moderately most days, and a bit more on weekends. Green is outwardly happy and thriving: with a beautiful house, car, clothes – everything one could ask for. Still, she struggles with depression and feelings of unfulfillment. She loves her home, family, and friends but has always wanted more for herself. She’s tried giving up alcohol in the past, but it never stuck. She doesn’t have any ill effects from her drinking (other than the occasional hangover and a bit of weight gain), so she doesn’t see the point in cutting back. Regardless, Green wonders if she would feel better if alcohol didn’t play such an integral role in her life. She feels constant guilt over having so much in life, and still feeling miserable.
Blue doesn’t drink often - maybe once a month or a few times a year. When she does drink, she has no control and often finds herself in dangerous situations or doing things that she later regrets – like damaging important relationships. Additionally, she feels the aftershock of drinking for weeks to months later, paired with intrusive thoughts about the seemingly insignificant, but somehow overbearing traumas that were born from situations where she overdrank. She’s thought about going alcohol free and is even quite educated on the topic of sobriety. But, Blue is still young and feels like being sober will alienate her from her friends. She also worries about dating and starting a relationship with someone while being sober. She feels stuck between a rock and a hard place as she is faced with deciding between what society expects from her versus what she really wants for herself.
Purple is the type of person who keeps her head down and doesn’t like to make waves. She lives a quiet life with a solid routine, and it works for her. What doesn’t seem to work is her compulsion to drink. Like Red, Purple started drinking at a young age – as it was the acceptable and expected thing to do. From the first time she ever drank, she knew that alcohol was concurrently the best and worst thing to have ever happened to her. She had very little control over her intake, and instead of cutting it out of her life, decided to invest insurmountable efforts to make alcohol fit into it. Purple realized the shame and guilt overdrinking caused, so she set some ground rules. She only drank in the secrecy of her home, and she wouldn’t drink around those who she knew disapproved, and she would only drink a certain type and amount of alcohol. If she did get out of hand in a social situation, she would ensure that there were other like-minded individuals present so that she wouldn’t get targeted as the ‘lush’. Purple knows she has a problem and wishes she could keep alcohol in her life minus all of the negative aspects of it – including the scary health problems she’s beginning to suffer from, and can no longer chalk up to other causes than alcohol. Purple feels stuck; like a hamster on a wheel that she can’t seem to free herself from. She’s scared of what’s on the other side, and traps herself with all or nothing thinking (i.e. “I can’t imagine never drinking again”). She is highly concerned with what everyone else thinks of her but doesn’t give much attention to how poorly she feels about herself.
Everyone knows Black has issues with drugs and alcohol, including Black. It’s no secret, and at his level of functioning, he probably couldn’t hide it if he tried. Black has been dealt a hard hand in life, and it’s outwardly obvious why he struggles. In fact, most people who know him have written him off as he is not easy to be around on a good day. Black waxes and wanes between acknowledging his addictions and ignoring them. But, for several reasons, Black’s efforts are often interrupted by his desire to return to old habits. Black struggles with his mental health, his past, and has a hard time acknowledging the role he plays in his own hardships. He wants more out of life but can’t seem to get there. He feels resentment and jealousy towards everyone he sees ‘living their best life’ through the lens of social media and his own pre-conceived notions.
Pink drinks to cope…but has good reasons. He suffers from depression and anxiety that disrupt his everyday life. He uses alcohol to help him sleep at night – when his intrusive thoughts and anxiety tend to peak. He drinks in social situations to help combat social anxiety and make himself a more likable person. He’s become a self-proclaimed master at balancing alcohol and drug use with everyday life. For instance, Pink realizes that while alcohol calms his stress and anxiety in the moment, it often leaves him more anxious the next day. To counter these effects, he started using marijuana the morning after a night of heavy drinking to ‘balance himself out’. After many years and attempts at using conventional anti-depressants, Pink has decided that alcohol is his medicine, and it’s one that is far less problematic than an anti-depressant. Ironically, his mental health continues to deteriorate over time, getting worse as his tolerance increases. Pink chalks it up to getting older – as ‘all mental health issues get worse as we get older’. At times, Pink wonders whether cutting out all stimulating drugs and addictive substances would help improve his mental health. But, he’s too afraid to find out, primarily because of what he’d have to face if that turned out to be true.
Shifting Outdated Perspectives
Maybe one or a few of these scenarios resonated with you, or maybe none did at all. Perhaps some of the behaviours spoke to you, but not the drug or alcohol use. We cope in a variety of ways – some negative and some positive.
It’s up to the individual to decide whether their coping mechanisms - especially those involving substance use, is impeding on their life, their prosperity, their relationships, and their general happiness.
And, it’s up to us as a society to work towards providing an honest depiction of the dangers that coincide with a past, present, and future fueled by constant forms of dopamine supplementation – with alcohol leading the way.
Finally, it’s up to us, collectively, to stop ignoring the deep-rooted ideologies that have brought us to this point in time. We have become instant gratification junkies in many ways, but it is has not been done so by nature alone.
I hope these words and examples have given you a new perspective on addiction (or have reinforced what you already knew). If you're struggling, don't hesitate to reach out to me.