Although the terms alcoholic and alcoholism are often used in discussions about heavy drinking, the science community has been moving away from these terms for years now.
There are two primary reasons to use more nuanced terms:
- Alcohol problems are not a “yes” or “no” issue. You don’t need to be at “rock-bottom” to experience alcohol problems and want to change. It’s important to remember that drinking problems can exist at any point on a scale between “none” and “severe.” Once someone recognizes drinking is causing problems in their lives, the decision to change may come easier.
- The term “Alcoholic” carries lots of cultural baggage and stigma. Historically substance misuse has been treated as a moral failing rather than a serious mental health condition. Thinking about yourself or a loved one as an “alcoholic” is a limiting and pejorative approach that often downplays the fact that unhealthy alcohol use and alcohol use disorder are health conditions that can be resolved.
So what words should you use?
The more appropriate and clinically accepted term is unhealthy alcohol use. Instead of asking whether they’re an alcoholic, people should ask themselves to what extent their drinking is causing problems.
What Is Unhealthy Alcohol Use?
“Unhealthy alcohol use” is a technical term that includes “at-risk alcohol use,” which, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), is more than 4 standard drinks per occasion or 14 drinks per week for men, and 3 drinks per occasion or 7 drinks per week for women. At higher levels of drinking and problems, unhealthy alcohol use can become an Alcohol Use Disorder (AUD). AUD is defined by the Diagnostic and Statistical Manual of Mental Disorders – 5thedition (DSM-5) and can range from mild to severe. More on the criteria for AUD can be found here.
And clinicians no longer talk about alcoholics or addicts. The appropriate words are “a person with an alcohol use disorder” or “a person with a drug use disorder.”
Please note that these are clinical standards. If your drinking does not meet these definitions, but you believe you have unhealthy habits, we urge you to consider changing your drinking.
Click here to learn how SMART Recovery can help with unhealthy alcohol use.
How to Learn if Your Drinking is Unhealthy
The fastest way to self-screen for the risk of drinking problems is to answer CheckUp & Choices’ free ten-question screening. The screening is called the AUDIT (The Alcohol Use Disorder Identification Test); it has been developed by the World Health Organization. The AUDIT can give you objective feedback about your risk for, or level of, alcohol problems, and the need for a more in-depth assessment.
Use this helpful CheckUp & Choices quiz to gauge your drinking and any problems.
How Your Score is Helpful
Measuring your drinking against a clinically valid standard like the AUDIT takes the guess work out of evaluating your drinking. For individuals who drink moderately, a low score can ease anxiety around drinking and improve confidence around what it means to enjoy alcohol in moderation. Conversely, higher AUDIT scores and the associated feedback can prompt a person to consider changing. In either case, it’s better to know your risk than to remain in the dark.
Concerned About Your Loved One? Recommend the Screening
Broaching the subject of drinking with a loved one can be a difficult conversation. Life is full of positive and negative memories, events, and traditions that can trigger someone in your life to drink more heavily. Because of this, it can be hard to know if someone is just drinking heavily at one or two events, or if he or she is engaging more generally in unhealthy drinking.
Suggesting that a friend or family member takes a screening can be a great way to begin the conversation. Just do it when he or she is sober. Mentioning that you and other friends or family members have taken it may also make it easier for the person you’re concerned about to take it. The screening is anonymous, confidential, and evidence-based, which further removes the judgement from any conversation that might occur.
Click here to take the CheckUp & Choices quiz.
About CheckUp & Choices
CheckUp & Choices is a confidential, self-guided, online program that is clinically proven to help SMART Recovery participants. The “CheckUp” includes a comprehensive alcohol self-assessment. The “Choices” programs include 12+ weeks of ongoing motivational exercises, drink, mood and urge trackers, guided emails and change plans. With Checkup & Choices, you are never labeled and you will be treated with respect and without judgment. Get started with CheckUp & Choices today.
About SMART Recovery
Founded in 1994, SMART (Self-Management and Recovery Training) uses science-based techniques that have proven to be effective in helping people recover from addiction problems involving any substance or behavior, including such things as alcohol, drugs, gambling, over-eating, shopping and internet use.
Each week, many thousands of people discuss recovery progress and challenges at more than 3,000 in-person meetings each week in 23 countries, daily online meetings and 24/7/365 internet message board forums and chat rooms.
Participants use SMART to assume responsibility for their own recovery and become empowered using its 4-Point Program®: building motivation; coping with urges; managing thoughts, feelings and behaviors; and living a balanced life.
For more information, please visit www.smartrecovery.org.
Thank you for the info. Having moved recently in a small community, I found out several people are all labeling me an alcoholic. True, I am a heavy beer drinker, but I also treat these people with respect and being civil. I do not get weird and drunk in public ever. Sometimes my thinking does get skewed, But I don’t say anything about it to others. this is all about judgment and spreading gossip.
Helping someone with this issue is hard. And even more if you love him. I know that very well. We struggled with it for many years until I saw a recommendation for How To Help An Alcoholic You Love by Ellen Petersen.
Excellent approach, which turned out to be a godsend so I can easily say that it’s the best help so far and believe me I have read a lot of books in my life about alcoholism. Hope it will help others too
This guide changed my life, I’m surprised that I haven’t heard of it before. I’m so grateful that I stopped by here for a moment to read this article and your comment.
This is the definition of a COMPLETE GUIDE to helping an alcoholic! Perfect! Thanks for sharing
And yet there is still the problem of those with AUD in denial. They cannot objectively look at their drinking and/or use. Historically, those requiring intervention were automatically labeled with alcoholism and/or drug addiction. Whether it’s called alcoholism or AUD it’s still the same, and those individuals are the ones most in need of treatment.
none of this is cited. without citations, this is just an opinion. like so many other opinions given without credentials or citations, this opinion will stay just that. I hear “alcohol use disorder” and “substance use disorder” and “alcoholic” and “alcoholism” … and in my non-cited, un-credentialed opinion: how really cares?
just what we need in recovery … more noise.
Thank you for the comment, Owen. We suggest listen to the podcast, “Words Matter: Addiction Terminology, Accuracy, and Stigma” by Richard Saitz, M.D
I appreciate the link to this podcast. I’ll be listening tomorrow. Language is a powerful tool in how we perceive ourselves. I don’t need the shame associated with being labeled an alcoholic that our culture puts on us. Shame hasn’t got me anywhere but back again wanting to divorce myself from drinking.
Exactly! No matter what words you use, the alcoholic is in major trouble
Ok. I understand all of this. But say I’m in a social setting where people are drinking alcohol and I’m offered a drink… What’s a quick and easy way of saying “I’m an alcoholic” but without using the ‘A’ word? …”No thanks, I’ve often struggled with unhealthy alcohol use in the past” doesn’t exactly roll off the tongue. Perhaps “I have alcohol use disorder”? But then if I’m recovered, then do I still have the disorder? It’s a bit of a quagmire.
Seems like a lot of AA types commenting. As if this article is harmful when it’s helpful. Labeling yourself “I am an alcoholic” vs “I have a substance abuse issue / or an unhealthy alcohol use issue” IS helpful and scientifically proven. Please stop acting like these are semantics when they are not. The point of the article is that labeling yourself an “alcoholic” is exacerbating the issue. And please don’t twist this. It has nothing to do with “admitting you have a problem”. That’s not the point of the article either.
I have attended AA meetings from 1983 to 2010 and from 2017 to the present. I am delighted to see this term being used. It prevents me from feeling bad about myself and changes my outlook about when I stopped attending and decided to use alcohol again. I like how I think of myself. I see that using it inside meetings with young and older people who participate in the discussions in my area would be challenged \ by people who have been without a drink for many years and respect themselves for that choice. So using the term alcohol use disorder feels freeing to me and helps me understand how professionals have wanted to use a term that causes them to be less judgmental and have the ability to make us feel less ashamed. Change is a good thing for me.
I do need to limit my drinking a bit, but my concern is an overall addiction approach to several things: drinking and overeating. Is this material right for me?
I’m finishing a degree in addiction counseling, where you’d think we’d have more and better terminology, but I’m finding it to be woefully inadequate. “Substance Use Disorder” doesn’t quite cover the hell of severe physical dependence upon a chemical, although I appreciate that at least now it’s being considered on a spectrum. But it would be swell to have a succinct term for “so I drank so much and for so long that if I ever drink again the withdrawals will be way worse than last time, and last time they would have killed me if it weren’t for the nice folks in the ICU.”
Although to address the concern of a previous commenter — that most certainly shuts people down when they offer me a drink at parties XD
Thank you for the comment.
There is an article posts about Post-Acute Withdrawal Syndrome (PAWS) that you may find interesting. – https://smartwww.wpengine.com/am-i-going-crazy/.