Alcohol? Who Are They Kidding?

I always ask patients about alcohol.

They always minimize their use.

Mostly all of the patients who have psychopathology and make it in my door name “stress” as the causal factor in their illness.

They generally go on to describe the enormity of their stresses, as if they have more of them than anyone in the world.

The use of alcohol enjoys a rather amazing amount of social validation for relief of that stress.

Me, I never had a great desire for it.

My first consumption of wine came at some incredibly young age — ceremonial wine at my parents’ Passover Table, I felt it tired me out. It was as exhausting as if it were sapping my life force, for it put me to sleep quite quickly.

Yet today, when people ask me when I had my last drink, they are surprised when I say “at least 2- years ago.”

The current psychiatric Diagnostic and Statistical Manual gives a long list of criteria with severity of the illness determined by the number of criteria.

Nobody in my career has ever spontaneously walked into my office asking for help with this disorder, as they have with depression or anxiety. Even with symptoms on the list like physical cravings, or withdrawals (which can kill a human) people never spontaneously self-refer.

The American Society of Addiction Medicine has more detailed criteria. Still, I doubt anyone would self-refer.

It takes more than this to counteract dearly held values of our culture such as “men who hold their liquor” or “women who like to relax with a glass of white wine.”

I wish people could somehow present for treatment for this illness before it destroys their lives.

Treatments are not perfect.

I just wish more people knew they exist.