By David Joel Miller.
Alcoholism is not the only problem alcohol causes.
Most of the time when people think of the problems that could be caused by alcohol they think of the “chronic” alcoholic. A lot of what people “know” about alcohol-related issues turns out to be untrue.
Most people who have the problem we used to call Alcoholism, and are now calling a moderate to severe alcohol use disorder, have full-time jobs. About 90% of those who are dependent on alcohol physically or mentally work full-time. They may have trouble keeping those jobs but they can go on getting and changing jobs for a long time.
Someone does not have to be an alcoholic or even have an Alcohol Use Disorder to experience an alcohol-related problem. If a surgeon shows up drunk to do your heart surgery, do you really care if this is the only time it happened? A pilot flying drunk even once is one time too many.
Because alcohol disinhibits and impairs coordination people do things when drunk they might not do when sober. They also fail to do things they should, like stop for an oncoming car. You will find a number of other posts at counselorssoapbox.com on the problems drugs, alcohol and mental illness cause. The “What is.” Series of posts includes a number of post on this topic and more will be publishing soon. If you want to see those other posts the best way is to subscribe or follow counselorssoapbox.com
Here is the short list of 5 problems that together make up the Alcohol-Related Disorders. This is based on the new DSM-5 but it parallels other classification systems and ways of thinking about Alcohol-Related problems.
Alcohol Use Disorder (F10.10 or 10.20.)
This used to get divided into Alcohol Abuse and Alcohol Dependence, then we started looking at the difference between physical dependence, psychological dependence, alcoholism and Chemical Dependency and the lines got blurry depending on who was describing the problem. Now we think if when you drink you have a problem, you have an alcohol use disorder, which can come in mild, moderate or severe. More on Alcohol Use Disorder in an upcoming post.
Alcohol Intoxication (F10.129, 10.229, or 10.929.)
This is not funny the way some entertainers portray it. When drunk, people can get distorted thinking. Being intoxicated increases the risk you will do something you would not do sober. Drunk people hurt themselves and others, both directly on purpose and in unintended ways. You only need to drive drunk once if you kill someone, and you have destroyed their life and yours. This, when you drink it is a problem, qualifies as an Alcohol Use Disorder.
It is also possible to drink enough to die if you run that blood alcohol level up high enough and fast enough.
Alcohol Withdrawal (F10.239 or F10.232.)
A well-kept secret is that you can die detoxing off alcohol, especially in combination with other drugs in your bloodstream. The experience of a hangover is so common that you will find lots of online hangover remedies. (Hint here, only not drinking and lots of time after drinking have been proven to treat hangovers.)
Alcohol withdrawal gets treated medically sometimes and in detox facilities a lot. Facilities that treat alcohol withdrawal are the busiest substance abuse treatment facilities there are.
Other Alcohol-Induced Disorders (lots of codes depending on what the alcohol induces.)
Sometimes things that look like a mental illness are caused by prolonged drinking. This can be lifetime prolonged or just a single run. Contrary to popular opinion it is not necessary to make people sober up and get thirty days or any other period of time sober before assessing or treating them for other problems. It just takes a lot more effort and skill on staff’s part.
Unspecified Alcohol-Related Disorder F10.99.)
This gets used when a clinician thinks that Alcohol may be the cause of or may have contributed to your problem but you do not have symptoms that match any of the other diagnoses close enough to get that other label. Yes, I know that these labels can be somewhat subjective. Despite the best efforts to create very precise categories for issues, there are some problems that just do not fit the existing categories. Still, Professionals need some sort of label for what they are treating and not every client fits these labels exactly.
Those are the five Alcohol-Related disorders. More on this and related topics coming up in the “What is” series of counselorssoapbox.com blog posts.
FYI. These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.
Staying connected with David Joel Miller
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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page or my Facebook author’s page, David Joel Miller. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.