Dear Wisegal:
I have been in a relationship with a lovely woman for over a year. She is very concerned about my drinking, and has told me that unless I get help she would leave me. The thing is, I don’t think I have a problem, though I do have several drinks a day, and I guess on the weekends, I might binge drink with my buddies, especially during sports season. My girlfriend grew up in a family where alcohol was a problem with both parents, so I kind of understand her fears. But I really enjoy alcohol – it helps me deal with stress, and bond with my buddies. Any thoughts about how I can assure my girlfriend that I can handle my drinks?
Not An Alcoholic

Dear NAA,
You can google the internet and find self-administered quizzes that will tell you whether or not you fit the label “alcoholic”. By definition, the term refers to someone for whom drinking has become an activity that is way past excess, is compulsive and out of control, and has damaging consequences in multiple life areas (physical and mental health, work, family life/relationships).

Most adults can drink safely and without negative consequences, though alcohol-related medical (cirrhosis of the liver, pancreatitis, epilepsy, polyneuropathy, alcoholic dementia, heart disease, increased chance of cancer, nutritional deficiencies, sexual dysfunction) and emotional (depression, anxiety, marital conflict, domestic violence) disorders constitute a major public health problem as a whole and utilize a significant chunk of health care dollars in developed countries.

You need to look at the effects of alcohol on different areas of your life, and honestly assess how it affects them. Is your health affected by drinking? Do you avoid emotional issues by numbing out with alcohol? Are you able to stop at two or three drinks or do you drink until you get drunk or pass out? Can your partner approach you when you are drinking? Do people in your life (partner, friends, family, boss) express concern about your drinking? Have you been told that you are a different person when you drink? Does drinking interfere with you achieving your life goals? Have you incurred any DUI (drinking under the influence) charges or had your driving license suspended due to such charges?

You say that you can “handle” your drinks. Does this mean that you drink like most adults who don’t have a problem with alcohol (no more than two drinks a day)? Or does it mean that you can drink more than most and tolerate the effects better than them? In any case, this may be rather subjective on your part. The objective evaluation of “handle” lies in assessing your behavior and level of impairment at different BACs (Blood Alcohol Content).
For most adults, moderate alcohol use—up to two drinks per day for men and one drink per day for women and older people—causes few if any problems. (One drink equals one 12-ounce bottle of beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits) A 160 lb. man who has 3 drinks will have a BAC of 0.07%, which is just under the legal limit for the US and most of Canada (0.08%; 0.0%5 in Manitoba). At around 0.08%, your reflexes, peripheral vision, depth perception, distance acuity, reasoning and glare recovery are compromised. When your level surpasses 0.11%, your reaction time is considerably slowed and gross motor control is impaired, while after 0.20% you are at risk of severe motor impairment, loss of consciousness and memory blackout. (http://en.wikipedia.org/wiki/Blood_alcohol_content)
The level of impairment that results from increasingly high levels of blood alcohol can obviously result in serious and dangerous problems from motor vehicle accidents and other injuries resulting from falls and blackouts. Over the long term, as I’ve mentioned, the health problems resulting from alcohol effects are numerous, progressively approaching lethality as the damage increases.

Apart from these, alcohol can also lead to impairment in relationships – the ability to communicate, to participate, to be intimate are all skills that diminish with increasing alcohol consumption. Put another way, if your primary relationship is with alcohol, that leaves little room for a real relationship with a woman.

The risk factors associated with the development of alcoholism are heredity, environment, and behaviors. In other words, you are at risk for having problems with alcohol if you’ve

- inherited a genetic predisposition towards alcoholism,
-experienced or are experiencing a high level of stressors in your environment (that can be stress effects from relationships, traumatic events, loss, etc.), and
- have ineffective coping behaviors.

Most people do have a drink or two to relax, as well as to enjoy themselves. Social and regular use of alcohol does not constitute problems, and in fact may have some health benefits. Alcohol abuse happens when drinking becomes frequent and excessive, cause interpersonal difficulties, and lead to impaired judgment, which in the worst case scenario can lead to accidents (motor vehicle accidents or falls) and domestic violence. Alcohol abuse can be thought of as a problem of self-regulation that begins when alcohol becomes the main way that drinker copes with challenging life demands, whether it be at work, home, or in social circumstances. Over time, the drinker may regulate moods and difficult emotions in this way too.

Abuse can become dependence as the drinking gets out of control, tolerance develops (you need more and more to achieve the same effects) and attempts to stop leads to withdrawal symptoms. The compulsion to drink in order to avoid the unpleasant withdrawal symptoms makes it difficult to abstain.

I cannot say whether or not you have a problem with alcohol based on the information you have given me. But I know that your drinking is interfering with your relationship with your girlfriend. You may not see a problem, but if she does, then you owe it to her to hear her concerns. She grew up with parents who had problems with alcohol, and she is rightly reluctant to be involved with someone who appears to similarly choose alcohol over her. So do talk to her, listen to her fears, and assure her that you respect her feelings.
She may feel more assured if you were to talk to someone who has some expertise in the matter (your doctor, or a counselor) who could help you explore your drinking habits and its effects. You may also want to moderate your drinking, learn other ways to manage stress (such as exercise, yoga, meditation), and expand your “bonding” repertoire of behaviors with your buddies (for instance, playing sports or competitive games).

You say that alcohol helps you deal with stress; yet, it also causes stress in your relationship with your girlfriend. It helps you bond with your buddies; yet it seems to alienate you from her. There are benefits to drinking, and there are also costs. You alone can decide whether overall it is an asset or a liability to you.

Bottom line is this – would you rather cuddle up with a cold, hard bottle of liquor in bed, or would you rather cuddle up with a warm-blooded, soft and loving woman? If you pick the former, then you have a problem, and you should get help.