Dr. Linda Helps - According to the DSM-IV (Diagnostic and Statistical Manual used by psychiatrists, psychologist, social workers, and counselors), alcohol abuse and dependence are the most prevalent mental disorders in the general population. Several other screening tools can be used to help you determine if someone you love has an alcohol problem.

After a long day at work, Jim eats dinner, turns on the television, goes to the refrigerator, grabs a beer, and sits in his favorite lounge chair. Relaxed, he drinks another, then another, until he finishes off the six-pack. He dozes off occasionally and eventually falls asleep in the chair. Around midnight he awakens and stumbles to his bedroom.

Jim never misses work unless he is violently ill. He is liked by his coworkers and gets along with most people. He has a few friends, but leads a rather lonely life. His sister feels he is an alcoholic and needs help. Jim says he can stop drinking anytime and does not have a problem. He only drinks at night and weekends to calm down and relax from a stressful day.

What do you think?

The terms “abuse” and “dependency” are somewhat confusing, but are defined in the DSM-IV as follows:

Alcohol abuse — A maladaptive pattern of alcohol use leading to significant distress or impairment as shown by one or more of the following in a 12-month period:

• You are unable to fulfill expectations at work, school, or home.
  
• You use alcohol in physically hazardous situations.
  
• You have legal problems related to alcohol use.
  
• You continue to use despite interpersonal and social problems.

Alcohol dependency — A maladaptive pattern of alcohol use that leads to impairment or distress shown by three or more of the following occurring in a 12-month period:

• You have developed alcohol tolerance. This means you either need more amounts of alcohol to get intoxicated or you experience less effect with the same amount of alcohol.
  
• You have alcohol withdrawal, characterized by withdrawal syndrome or you use another substance to relieve or avoid withdrawal symptoms.
  
• You take alcohol in larger amounts over time than initially intended.
  
• You persistently and unsuccessfully try to cut down on use.
  
• You spend much time in activities necessary to obtain, use, and recover from alcohol and its effects.
  
• You give up or reduce social, occupational, or recreational opportunities because of alcohol use.
  
• You continue alcohol use despite knowledge of persistent or recurrent physical and psychological problems.

When someone is alcohol dependent, he or she could be physiological dependent on the substance. This determination is part of the diagnosis.

In addition to looking at the standard criteria to determine alcohol use disorders, there are a number of tests that help assess psychological problems.

A therapist may use a structured interview called the Time-Line Follow-Back Interview, or these self-report screening measures:

• Adolescent Drinking Index
  
• Substance Abuse Subtle Screening Inventory
  
• CAGE Questionnaire
  
• Michigan Alcohol Screening Test

Biochemical methods for screening recent alcohol use include:

• Urinalyses
  
• Breathalyzer tests
  
• Blood alcohol tests

If someone you love has a drinking problem, encourage him or her to be evaluated by a qualified counselor or doctor. Help is available.

Dr. Mintle – author, professor, Approved Supervisor and Clinical member of the American Association for Marriage and Family Therapy – is a speaker and media personality, as well as a licensed clinical social worker with over twenty years in psychotherapy practice.

For more articles and information, visit Dr. Linda Mintle's Web site.