Updated: Mar 29
If drinking problems exist on a continuum where does yours sit?
Before I quit drinking, my understanding of so-called ‘alcoholism’ was very limited. Booze dominated my life, and I didn’t seem able to escape it, but I certainly didn’t think I was an alcoholic. I drank more than the government guidelines, but I assumed everybody did. It was concern about my boyfriend’s drinking that drove me to start researching. Late-night Google spiraling led me to the idea of the almost alcoholic.
Clinical psychologist, Dr. Joe Nowinski, and Dr. Robert Doyle, a nationally recognized expert on alcoholism, came up with the term. It describes a type of drinker who falls into the huge grey area between normal and alcoholic drinking.
This kind of drinker experiences negative consequences because of their drinking, but would not yet meet the diagnostic threshold for what they call ‘true alcoholism’.
“Put simply, the “almost alcoholic” does not drink normally but also wouldn’t be labeled an “alcoholic.” Because this is a new concept to many people, they often don’t see the connection between their drinking and the various problems it is causing. Similarly, the doctors or other professionals they consult with may not connect the dots either.” — Doyle and Nowinski, Almost Alcoholic
So how can you tell whether you are almost alcoholic?
And more importantly, what should you do about it, if you suspect that you are?
1. You can hold your liquor
This is a point of pride for you. To be able to match your friends drink for drink, and not lose too much dignity along the way? Victory!
Being able to drink heavily feels like a super skill when you love the pub. Weaklings fall to the wayside, but you just keep on chugging. It’s admirable the way that you can keep going, and not get sloppy until much later than most people.
Except for the tiny little, unwelcome fact that increased tolerance is one of the earliest signs of a drinking problem.
It doesn’t ensure a drinking problem, but it’s one of the trademarks along the way.
Tolerance develops as a direct consequence of regular drinking. You get used to the buzz and need more to get the same effect.
Over time, this means you can soak your brain in way more pickle juice before you start to ferment.
2. You have a list of times you’re ashamed of, and in each one you were drunk.
Have you ever cheated or started a fight?
Stolen or said something unforgivable?
Alcohol feels so good as it loosens our inhibitions, but sometimes we go too far. The morning after we wish we’d never allowed ourselves to get so free in the first place.
If you are almost alcoholic, it won’t be immediately obvious that alcohol is causing your problems. But on closer inspection, do you notice that booze is always there, in the background, for those troubling events?
3. You occasionally worry about your drinking, but you can’t imagine life without alcohol.
The hallmark of the almost alcoholic is that they don’t necessarily worry about their drinking.
They are more concerned by the issues their drinking is creating.
The people that Nowinski and Doyle describe all showed up in a clinical setting to get support around something else.
After a period of counseling and discussion, the role of alcohol became apparent in their situation.
This is precisely what happened to me.
Because of stereotypes around what ‘true alcoholics’ look like many almost alcoholics will not recognize the part that booze is playing in their problems.
“the line separating normal social drinking from being almost alcoholic is not bright and sharp, but is more of a gray area that a person can venture into before they know what’s happened.” — Doyle and Nowinski, Almost Alcoholic
Drinking seems incidental and unrelated. Like a great solution to the stress that life problems are causing.
It’s the great quandary of every drinker. How to have all the fun and high jinks of booze, without the consequences?
4. Your hangovers are cause for concern.
Alcohol is a depressant, and sustained heavy use plays havoc with your mental health. Maybe you experience chronic hangxiety and have to send out reassurance-seeking texts before you can face the day.
Maybe you can’t drag yourself off the sofa to do all the important and life-affirming things you had planned.
Maybe the sickness, shakes and headaches feel as serious as an illness, but you never get any sympathy.
Whatever your hangovers look like, they have become severe enough that you dream of a life without them.
And yet you can’t imagine life without drinking.
Okay, this sounds like me or someone I love. What should I do?
Firstly, congratulate yourself for acknowledging that you, or your loved one, has a problem.
If you are reading this, then you have begun an important journey into learning more about how addiction works. This is a wonderful thing.
As Julie Silver, MD, states in the foreword to Almost Alcoholic:
“Diseases can develop slowly, producing milder symptoms for years before they become full-blown. If you recognize them early, before they become fully developed, and take relatively simple actions, you have a good chance of preventing them. In many instances there are steps you can try at home on your own; this is especially true with the mental and behavioral health disorders.”
If you begin to address the problem now, then you might happily avoid ever becoming a ‘true alcoholic’. Here’s Silver again:
“In short, recognizing the almost effect has two primary goals: (1) alleviate pain/ suffering now, and (2) prevent more serious problems later.”
Do some research and find out what’s available. Visit your GP and get some medical advice. Then start experimenting.
Maybe mindful drinking would work or Moderation Management. Almost Alcoholic, the book, offers solutions too. It helps readers identify and assess patterns of alcohol use, and to develop strategies and goals for changing the amount and frequency of their drinking.
And what if you’re still not sure you have a problem?
Once you understand that ‘alcoholism’ or Alcohol Use Disorder exists on a spectrum, it makes sense to reflect honestly about where your drinking fits.
In the huge grey area between the ‘normal drinker’ and the ‘true alcoholic’, where might you sit? More importantly, do you want to keep sitting there?
Because while the almost alcoholic’s problems are not as severe as the ‘true alcoholics’:
“they are nonetheless real and can have devastating effects on the lives of almost alcoholics and the people around them.” — Nowinski, Doyle, Almost Alcoholic
Speaking as someone who struggled in that grey hinterland of almost alcoholism for years, I can attest to the value of leaving it behind. There are so many ways to move on, and build a better life for yourself, without risky drinking at its center.
Once you have rid yourself of the conviction that drinking is the best thing in the universe, there is a whole world to discover. Hangover-free.
If you need help to stop drinking, you’re not alone.
There’s no shame in getting addicted to something deeply addictive.
If you’re ready to try something different, try my alcohol experiment. Do whatever it takes to stay sober for 30 days: go to your doctor, try Smart or AA or Hip Sobriety or Soberistas. Read beautiful hangover. Listen to Recovery Elevator and SHAIR podcasts. Read This Naked Mind. Try Moderation Management.