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How Do You Know if You Are an Alcoholic?

“Am I really an alcoholic?” is a question that haunts a lot of heavy drinkers. Before you make the decision to stop drinking, you may go through weeks, months or even years of self-questioning about your alcohol use. Although clinical screening tests might help you answer this question, the deciding factor in your recovery probably isn’t whether or not you’re an alcoholic, but whether you’re really ready to get sober.

Clinical Definition

Understanding the medical definition of terms like “alcoholism,” “alcohol dependence” and “alcohol abuse” may help you clarify whether you have a drinking problem. According to the University of Maryland Medical Center (UMMC):

  • Alcoholism is characterized by signs of physical dependence and upheaval in your personal life. In spite of the physical, emotional and financial problems caused by alcohol dependence, the alcoholic will keep drinking.
  • Alcohol abuse involves risk-taking behavior, problems with personal relationships and legal or financial difficulties. Unlike the alcoholic, the problem drinker is not yet physically dependent.
  • Alcohol dependence occurs when the body comes to rely on alcohol to function. When a dependent drinker can’t have alcohol, he or she may have tremors, seizures, nausea and other withdrawal symptoms.

Screening Tests

Psychologists and addiction experts have developed screening tests to help drinkers decide whether their drinking has become a problem. The journal Alcoholism: Clinical and Experimental Research lists several short tests that may be used to detect signs of alcoholism: CAGE, BMAPS, RAPS, AUDIT and TWEAK. These tests were developed to give clinicians a quick way to identify alcohol abuse, but will they work for you?

According to the traditions of Alcoholics Anonymous, a 12-step program that offers free recovery resources to alcoholics and problem drinkers all over the world, you don’t have to be an alcoholic to participate; you only have to have a desire to stop drinking. In the end, the most important question you can ask yourself may be: “Do I really want to stop?”

*The CAGE Test

The CAGE questionnaire, developed by J.A. Ewing and B.A. Rouse, is one of the most popular screening instruments for alcoholism. The test consists of four simple questions that form the first letters in the word “CAGE.” Answering “yes” to two or more questions may indicate that you have a drinking problem:

  1. Do people tell you that you should CUT down on drinking?
  2. Does it ANNOY you when people say negative things about your drinking?
  3. Do you ever feel GUILTY about your drinking?
  4. Do you need to take an early morning drink, or an EYE-OPENER, to stop shaking or soothe a hangover?

Personal Warning Signs

Denial is one of the primary symptoms of alcohol abuse and dependence. Because denial can have such a powerful influence on a problem drinker, you will probably overlook the clinical criteria for alcoholism until you’ve reached the point that you’re ready to get sober. Personal warning signs like these may tell you that you’re prepared to seek help:

  • You’re so used to feeling sick that you don’t remember how it felt to be healthy.
  • You’d rather spend time alone drinking than spend time with friends or family.
  • You’ve lost interest in activities that don’t involve drinking, like work or hobbies.
  • You’ve given up trying to get sober because your attempts have always failed in the past.
  • You want your suffering to end, but you don’t know how to make it stop.

Whether you choose a 12-step program, outpatient treatment or intensive residential care, confronting alcoholism may be the most important thing you ever do. Remember that alcohol withdrawal can be fatal — if you want to stop drinking and you’re physically dependent, medically supervised detoxification is the only safe way to start your recovery.