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British singer-songwriter Adele says she has quit drinking, describing herself as a “borderline alcoholic” when she was in her 20s.
She joins a growing number of people who are trying to quit or reduce their drinking.
But what does “borderline alcoholic” mean and is it a real thing?
It’s not all-or-nothing any more
In the early days of alcohol treatment, people used to think of problems with alcohol as all-or-nothing. They used to believe there was something different about people who had problems with alcohol and those who didn’t. That’s how the idea of the “addictive personality” came about.
But now we think of drinking on a continuum. It goes from not drinking at all to dependent drinking. And people can move up and down that continuum at different points in their lives. The old saying “once an alcoholic, always an alcoholic” doesn’t apply any more.
How much is it okay to drink?
The Australian national alcohol guidelines say healthy men and women should drink no more than 10 standard drinks a week and no more than four a day. So that’s about two to three drinks three to four times a week. Most Australians drink within these guidelines.
If you drink over those guidelines you are more likely to experience a number of long- and short-term problems including alcohol dependence, cancers, diabetes, and heart disease. The risk of problems increases the more you drink and the more frequently you drink.
About 25% of Australians drink at risky levels and around 6% drink at such high levels that they would probably be dependent. Daily drinking is associated with dependence.
So when is someone an alcoholic or a borderline alcoholic?
The term “alcoholic” is rarely used by health professionals any more. It can make people believe there is nothing they can do about the problems they might be experiencing. Historically, that’s what the early treatment providers believed in the 1930s and that myth has continued. But some people find identifying as an “alcoholic” helpful to maintain their goal of quitting drinking.
Health professionals have never used the term “borderline alcoholic.” But in describing herself that way Adele is really saying alcohol is having too much of a negative impact on her life, and like many others has decided to do something positive about it by taking a break.
Which terms do we use now?
Now, we tend to talk about “dependence” on a continuum from mild to moderate to severe. We also talk about the range of problems other than dependence that people can experience, which also lie on a continuum.
The threshold for whether someone is a problem or dependent drinker is not just how much they drink (although that is important), but also how severe the alcohol-related problems are.
Problems with alcohol don’t always correlate with consumption. Some people can drink a moderate amount and have a lot of problems and others can drink a lot and appear not to have many negative consequences.
I’m worried about my drinking. What next?
If you are wondering if you are drinking too much you can check online with a free and anonymous assessment.
Signs you may have a problem with alcohol include:
- having trouble stopping once you start drinking
- wanting or trying to cut back but slipping up frequently
- spending a lot of time drinking or recovering from drinking
- having cravings to drink alcohol, such as if you come home from work and reach straight for a drink
- dropping the ball at work, study, or home because you’ve been drinking, such as not being able to do your work because you’re hungover
- continuing to drink alcohol even though you know it’s causing problems with your health, friends, work, or relationships
- giving up or reducing social and work activities to drink instead
- drinking when it’s not safe, such as before driving or swimming.
If you find you aren’t getting the same effects from alcohol as you used to or you need more and more alcohol to get the same effect, you have probably developed a dependence.
Sometimes people who are very dependent can experience withdrawal symptoms when they stop – strong cravings, nausea, sweating, agitation, and anxiety.
The more of these signs you have, the more likely you are to be dependent on alcohol.
If you have any of these signs, taking a break from alcohol for a few months or longer can help. If you find that’s too hard, you can try sticking within the Australian alcohol guidelines by reducing the number of drinks per occasion and increasing your drink-free days.
Sometimes when people experience some of these problems they need a bit of help to keep them on track. You can talk to your GP who can refer you to a psychologist or treatment service. Or you can try self-help options such as the Hello Sunday Morning’s Daybreak app (a community of people supporting each other to change their relationship with alcohol). If your problems are more severe, you can try something like SMART Recovery (evidence-based group support for alcohol and other drug problems). – The Conversation|Rappler.com
Nicole Lee is Professor at the National Drug Research Institute (Melbourne), Curtin University.