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Ask Brainiac M.D. -- Do I Have Alcoholism?

Well, I had thought I would write Brainiac M.D. about once every two weeks, and that it would be a mix of providing education, answering questions, inviting discussion etc.
Kicked Alcoholism's Butt

Well, I had thought I would write Brainiac M.D. about once every two weeks, and that it would be a mix of providing education, answering questions, inviting discussion etc.  But less than one week after the launch, and questions are already beginning to come in.  So, I've decided to write a bit more often, and get into whatever it is you guys want to know.  Here is the first question:


I read your blog article, Substance Abuse and Addiction Associated with Impaired Impulse Control. This was interesting to me. I do not ever think I need a drink or feel like I need to drink. Yet when I do, even if I say I will only have a couple I cannot stop once I start. I can stop if I really force myself but usually it is like well one more won't hurt, then have another. Do you think it is more impaired impulse control or addiction?


Addiction is defined as continuing to engage in a behavior despite negative consequences. So, you have to take a hard look back and ask yourself — has my drinking pattern led to negative consequences? If so, have I continued the same drinking pattern despite those consequences? If yes, you likely have some form of alcoholism. It comes in all sorts of varieties, binge drinking being one, but the common denominator is a drinking pattern that has not changed despite consequences.  Compare yourself to these Diagnostic Criteria for Substance Use Disorder, taken from the DSM-5, the diagnostic manual Psychiatrists and other mental health professionals use as our basis for categorizing illnesses.

You will come up either with no diagnosis, Alcohol Use Disorder mild, moderate or severe. It sounds like you might qualify — just because the blog touched you enough to make you email me. If so, then you know it is time to take a look at your drinking pattern and make a change — that could mean many things, but one thing you know it will mean for you is paying particular attention to your impulse control and accepting that your impulse control system is more sensitive than others —i.e. can't just drink one.

Wherever you see the word SUBSTANCE just replace it with ALCOHOL and see if or how many of these diagnostic criteria fit.  Circle the number if it is true, and then count up your circles when you're done.  The scale for determining no disorder, mild, moderate or severe disorder is at the bottom.  Go with your gut on the answers.  If you read the criteria and your gut tells you it's true, don't let your brain talk you out of it.  That way, you'll make an accurate, honest appraisal of what's going on.
If you find that you qualify for an alcohol use disorder, there are lots of ways to start making a change.  All of them include accepting that alcohol is a problem.  To be cliché, that literally is the first step.  The next step is to let your friends and family know that you are making a change around the way you use alcohol, so that they can support you.
Finally, consider getting a formal assessment and join forces with a professional to determine what will be your winning formula for kicking alcohol's butt.   Click here to find someone in your area with expertise in substance use disorders.
Hope this helps.

-Braniac, M.D.

Submit your questions to Brainiac, M.D. using the Ask the Doctor form at


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