305.00 Alcohol Abuse/Binge Drinking

The DSM-IV diagnosis of alcohol dependence:

...maladaptive alcohol use with clinically significant impairment as manifested by at least three of the following within any one-year period: tolerance; withdrawal; taken in greater amounts or over longer time course than intended; desire or unsuccessful attempts to cut down or control use; great deal of time spent obtaining, using, or recovering from use; social, occupational, or recreational activities given up or reduced; continued use despite knowledge of physical or psychological sequelae.

Applicable in my case: taken in greater amounts or over longer time course than intended; desire or unsuccessful attempts to cut down or control use; great deal of time spent obtaining, using, or recovering from use; continued use despite knowledge of physical or psychological sequelae.

I am not sure if alcohol dependence is the correct diagnosis for me, it may actually be alcohol abuse. The above criteria also can apply to alcohol abuse. I need a special category like Binge Drinking Disorder.

My drinking hasn't impacted my social life negatively - it has compensated for the lack of one.

I frequently decide that I would like to cut out binge drinking for a while, but then am unable. I do not drink every day. When I do drink, it is always a binge, unless I am in 'holiday' or 'travel modes'. I occasionally do manage to stop for a few weeks, and maybe once or twice a year for up to 10, but the most usual situation is that I regularly binge drink, and can't cut down when I try to.

I spend a lot of time planning for and recovering from alcohol use. For example, before I begin drinking, I like to have a hangover plan. This means that I have hangover food ready beforehand - often an individual size portion of pasta with tomato-based sauce which I can microwave. When I wake up hungover, it is important that I manage two things: 1. I get some caffeine into my system and 2. That I eat something substantial. These two things help prevent me from feeling too sick. I think the caffeine helps prevent or cure a headache. As the day goes on, I will have to monitor how I feel, and drink water and eat at appropriate intervals. As the day goes on I feel better, perhaps still a bit weak. If I had a life outside the house, I could probably manage activities when hungover, but most of the time I don't leave my room much on hangover days. If I were less depressed it might be possible to focus mentally and work on the computer, but most of the time I don't feel up to it on hangover days. It is hard enough to concentrate on non-hangover days. So, a couple of days a week are usually spent with me in my room unable to do as much as I do on non-hangover days.

Before I go to bed, I do usually manage to remember to drink a large glass of water, no matter how drunk I get.

I will occasionally be very sick the day after, but these occasions are rare - they may occur a couple of times a year. When these occur, I may not be able to keep food down, or even keep water down. I just stay in bed until I am able to keep something down.

I do experience frequent periods of blackout. Usually, I have a vague idea of what I have been doing and only some is foggy, but the issue is that even when extremely drunk, there is not really all that much variation in my activity. I don't become violent, I don't (usually) email people, I don't make phone calls. Occasionally I might sing in my room, or talk gibberish to GK for a while.

I may often decide I will try to stop at 10 drinks, but continue on until I have had 14, or until all alcohol in the house is gone.

I don't think tolerance is strictly applicable - in my case it seems to be a genetic thing that doesn't really change significantly, or if it does, it seems to be related to changes in weight and fitness. Some people apparently inherit genes that make them able to drink larger quantities. For many years, the amount of alcohol I have required during one binge drinking episode has remained 10-14 standard units. Any alterations are usually minor and not long- lasting, however, over the years, average number of binge drinking episodes per week has increased. At the time of writing, however, it is around 2 binge drinking episodes per week - at times it has been a bit higher.

I recognize that I am reliant on alcohol to help me get through a week, a day, and that I don't see any other way to 'have fun'. It is closer to an approximation of 'pleasure' than other activities. At present, I can't imagine ever giving up alcohol for good, only for certain periods in order to feel healthier, such that I will enjoy alcohol more after having a break from it.

Mainstream society, which currently is becoming more aware of alcohol and other dependencies, and may even recognize such dependencies as disease, still attaches a great deal of moral judgment to such dependencies. Those with alcohol or drug issues must bow their heads in public, take responsibility for their waywardness and how they have affected the lives of everyone around them, without anyone seeming to recognize that families are systems in which all members affect each other. The original issues which led to dependency might never be addressed, and yet those with addiction issues may themselves have suffered similar erratic surroundings to those they now inflict upon others.