If you’ve ever been called an alcoholic, you know that the term can sting, even when it’s being used in a clinical sense. Addiction professionals have recognized that calling someone an alcoholic is likely to do more harm than good, and they’ve begun making moves to eliminate the word from the terminology used in psychological treatment settings.
The appropriate term for some who has issues with alcohol use (including both abuse and dependence) is now alcohol use disorder. This term is thought to remove some of the stigma of the terms “alcoholic” and “alcoholism” while placing emphasis on the fact that alcohol use disorder is a treatable medical problem – not a choice someone is making based on their morals or character.
What’s the DSM?
The Diagnostic and Statistical Manual of Mental Disorders, or the DSM, is published by the American Psychiatric Association, and is updated from time to time to keep up with the latest research in psychology and psychiatry. The latest version, the DSM-5, was published in 2013, and changed the way that mental health professionals talk about alcohol issues.
There are eleven criteria for alcohol use disorder:
Alcohol is often taken in larger amounts or over a longer period than was intended.
There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
Craving, or a strong desire or urge to use alcohol.
Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
Recurrent alcohol use in situations in which it is physically hazardous.
Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
Tolerance, as defined by either of the following: a) A need for markedly increased amounts of alcohol to achieve intoxication or desired effect; b) A markedly diminished effect with continued use of the same amount of alcohol.
Withdrawal, as manifested by either of the following: a) The characteristic withdrawal syndrome for alcohol (refer to criteria A and B of the criteria set for alcohol withdrawal); b) Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.
In order for a patient to be diagnosed with alcohol use disorder, they must meet at least two of these criteria during the same 12 month period. After a patient is assessed and diagnosed with alcohol use disorder, their level of the disorder will be classified as mild, moderate, or severe. Their treatment plan will reflect the severity of the issue.
Why is the terminology changing?
Let’s take a look at two of the reasons the therapeutic community for people who struggle with addiction are changing the way we talk about alcoholism.
Reason #1: Alcohol issues aren’t black and white.
The old way of thinking about alcohol addiction touted the notion that it was necessary to hit rock bottom in order to begin to work toward positive change. While this certainly can be a turning point for some, it’s not necessary to lose everything in order to make changes that positively affect your life when it comes to alcohol use. Alcohol issues exist on a continuum, just like any other mental health issue. The continuum ranges from no alcohol issue to an extremely severe alcohol issue, and many people fall somewhere on that spectrum.
For some people, drinking problems come and go. Abusing or becoming dependent on alcohol may be an issue that occurs when they go through a stressful time in life, or when certain biological factors come into play. Alcohol issues can also be heavily determined by environment. For example, a person who works in an industry where evening socializing is required may be far more likely to develop a drinking problem than someone who does not work in such an industry.
For some people, asking for help with a mental health disorder (alcohol use disorder) can feel easier than asking for help with an addiction. While this issue is simple semantics for many, it can make a world of difference for someone who is struggling with their self-esteem in the midst of a drinking problem.
Reason #2: The stigma of the “alcoholic” label is tough to overcome.
Many people believe that alcoholics can never truly get well, but this isn’t the case. In many families, when someone is labeled an alcoholic, they’re written off as unwell, or unstable. This may be different as the terminology changes. Much like someone who has depression can get help and get better, someone who has alcohol use disorder can seek treatment and overcome the chemical imbalance in their brain that is causing a problem.
It’s important to note that some people who deal with alcohol use disorder feel empowered by using the term alcoholic, and there’s nothing wrong with them continuing to do so. If someone has embraced the term and finds it motivating to continue living a healthy lifestyle, they should hold onto that motivation, even if the scientific and psychiatric communities are changing the way they talk about drinking problems.
Is Alcohol Causing Problems In Your Life? We’re Here For You.
If drinking is causing problems in your life, you’re not alone. At Cardinal Recovery, we’re here to help. We understand what you’re going through, and we know that recovery is possible for you. If you’re ready to make the changes necessary to live a sober lifestyle, reach out to us today to learn more about how we can help you take the steps necessary to get your life back.