Escaping the Addiction Downward Spiral
The main reason problem drinkers do not quit this self destructive behavior is that they do not recognize the serious of their situation. They may fully believe that alcohol is a beneficial force in their life because it helps them to cope with things – they may view this substance as their only real friend.
Even if they are willing to admit to the negative aspects of their drinking they are likely to downplay these. The ability of the individual to assess their own situation is further compromised by the increase in denial as people fall into addiction. The failure of people to see the dangers of heavy drinking can mean that they lose everything. It is only by facing reality that they can develop the will to escape the addiction downward spiral.
Problem Drinker Defined
The term _problem drinking_ can be confusing because it is used in different ways. Some experts use it to describe [pre-alcoholic drinking](http://www.aafp.org/afp/2002/0201/p441.html). It means that the individual is on the path to alcoholism, but they can still turn back. Some other experts use the term _problem drinking_ to include all types of unhealthy alcohol consumption patterns, including alcoholism. The term alcoholic contains a degree of stigmatism and this is why some people in recovery prefer to consider themselves as ex-problem drinkers.
Dangers of Problem Drinking
If people are consuming so much alcohol that it is interfering with their life it can lead to all sorts of serious problems. The dangers of problem drinking include:
* It can lead to the downwards spiral of alcoholism. When the individual becomes addicted they risk losing everything of value in life.
* Drinking excessively can cause a great deal of damage to the body. Even occasional binge drinking can put the individual in the [first stage of alcoholic liver disease](http://alcoholrehab.com/alcohol-rehab/fatty-liver-alcoholic-liver-disease/).
* Alcohol is a type of drug known as a [depressant](http://alcoholrehab.com/alcohol-rehab/central-nervous-system-depressants/). It can exacerbate symptoms of an existing depression and heavy drinkers can develop _alcohol induced depression_.
* It leads to a general deterioration of the mental state of the individual.
* It can interfere with a person’s ability to take care of their social and family responsibilities.
* Problem drinkers have a [very high rate of suicide](http://www.ncbi.nlm.nih.gov/pubmed/6648755) – 5080 times that of the general public. Alcohol increases the risk of suicide because of the detrimental effects of this substance on people’s life and the fact that it lowers inhibitions.
* Problem drinkers are more likely to engage in domestic violence. [As much as 87% of those who beat up their partners](http://www.ncbi.nlm.nih.gov/pubmed/6648755) will be under the influence of alcohol.
* If the individual abuses alcohol their friends and family will usually suffer.
* Problem drinking can rip apart communities and lead to social problems.
Problem Drinkers find it Difficult to Adequately Assess Their Situation
There are a number of reasons for why problem drinkers find it hard to adequately assess their own situation including:
* As the individual becomes more obsessed with alcohol they will begin to experience increasing [denial about their problem](http://alcoholism.about.com/cs/info2/a/aa050797.htm). This [subconscious defense mechanism](http://alcoholrehab.com/alcohol-rehab/addiction-and-denial/) protects the individual from uncomfortable realities.
* Problem drinkers also tend to use [cognitive dissonance](http://alcoholrehab.com/alcohol-rehab/cognitive-dissonance-in-addiction-and-recovery/) as a means to justify their irrational behavior. They may adapt new beliefs in order to explain their substance abuse – for example, the idea that alcohol makes people more creative.
* There are many problem drinkers who fall into the category of [high functioning addicts](http://alcoholrehab.com/alcohol-rehab/well-maintained-addiction/). So long as they continue to perform well it will be easy for them to ignore their drinking problem.
* Problem drinkers tend to spend their time with other heavy alcohol users. This means that within their group alcohol abuse will be considered perfectly normal.
* Most problem drinkers are said to have characteristics of the [addictive personality](http://alcoholrehab.com/alcohol-rehab/addictive-personality/). These character traits make it harder for the individual to realize that their drinking is out of control.
* Many problem drinkers suffer from [terminal uniqueness](http://alcoholrehab.com/alcohol-rehab/terminal-uniqueness/). They can accept that alcohol abuse is dangerous for some most people yet feel convinced that they are the exception to the rule.
* Many of those who abuse alcohol just do not know the facts about problem drinking. Their lack of knowledge means that they just slip towards alcoholism and self destruction.
* Most drinkers will inaccurately assess the amount they are drinking. The difference between the amount they think they drink and the amount they actually drink can be huge.
* It is common for problem drinkers to experience blackouts where they can’t remember a period of time while intoxicated. This can mean that they are unaware of just how badly alcohol is impacting their behavior.
* There are many alcoholics who have a dual diagnosis – this means that they have another mental health problem alongside their addiction. This dual diagnosis can interfere with the ability of the person to gain insight into their situation.
* Heavy drinkers fall passionately in love with alcohol. They become so obsessed that they are unable to see the faults in their lover.
Difference between Alcohol Abuse and Addiction
Problem drinkers can be said to fall into two categories; alcohol abusers and alcoholics. Those who abuse alcohol may later become alcoholics, but it is not necessarily the case. There are many individuals who go through a period of heavy drinking in their life but later snap out of it. For example, some people party hard at college but once they join the workforce they reduce their alcohol intake. The [American Psychiatric Association](http://www.psych.org/) has developed criteria for assessing whether somebody is abusing alcohol or if they have become alcoholic (dependent). The criteria for alcohol abuse are:
* The individual has become involved in hazardous situations while under the influence of alcohol, and this has happened more than once. Probably the most common example of this is driving while over the limit.
* Alcohol abuse is repeatedly interfering with the person’s ability to take care of their obligations at work, home, or school.
* The individual has been having interpersonal or social problems as a result of alcohol but they continue to engage in this behavior.
* They have experienced legal problems as a result of their drinking.
If the individual has experienced one or more of the above symptoms in a twelve period they will be classified as abusing alcohol.
The criteria for alcoholism (alcohol dependence) include the following:
* The individual is unable to cut down or control their alcohol intake.
* They have developed a tolerance for alcohol. This means that they need to drink more to get the same effect.
* If they try to stop or significantly cut down their consumption they experience withdrawal symptoms.
* Alcohol is causing physical and psychological problems yet the individual continues to drink.
* The individual regularly drinks more or drinks over a longer period of time than they intended to.
* They are devoting increasing amounts of time to obtaining, drinking, and getting over the effects of alcohol.
* Social, occupational, and recreational activities are neglected in favor of alcohol.
If the individual experiences three or more of the above symptoms in a 12 month period they would be considered to be alcohol dependent.
How to Accurately Assess a Drinking Problem
It can be difficult for an individual to accurately assess their own drinking problem. They will tend to downplay any problems and focus instead on their justifications for using alcohol. The individual may be adamant that they have earned the right to drink heavily and resent any attempts to question their behavior. Denial and cognitive dissonance means that the individual just does not see their drinking behavior in the same way as other people might do. In many instances the individual will need assistance if they are going to be able to see the reality of their situation.
An addition therapist is highly skilled at guiding problem drinkers so that they gain insight into their self destructive behavior. In most instances the therapist will not directly confront the individual. Instead they encourage the client to come to their own conclusions. Once the individual is able to accept that their drinking is actually detrimental to their life they will become far more willing to do something about it.
Another way that heavy drinkers can get a better understanding of their situation is by using a drink diary. This is where they accurately record the amount they drink and the effect it has on them. It is much harder to ignore things when they are written down in black and white. A drink diary can be hugely effective because it forces the individual to face reality.
Alcohol assessment tools use a serious of questions to determine if the individual has a problem. These can be effective but only if the individual is prepared and willing to answer the questions honestly. A good example of this is the [addiction severity index](http://alcoholrehab.com/alcohol-rehab/addiction-severity-index-asi/) which uses questions to determine the individuals relationship with alcohol. The higher people score on the addiction severity index the more serious their problem with alcohol.
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