Assessing your drinking habits
This quiz is stressing me out. It's a basic screening test designed by researchers at Johns Hopkins Hospital to tell me if I'm, you know, a little too fond of drinking. I was doing well, marking unhesitant no's to a series of seemingly loaded questions. But now I've hit a streak. Do I drink alone? Now and then, sure. Do I drink to relieve stress? Sometimes. Have I ever experienced loss of memory because of drinking? Yes. I went to college. I've had hazy nights. Hasn't everyone?
Apparently not. The test does not approve of my behavior. My three affirmative answers, it tells me, are a definite problem. My first reaction: Are they kidding? Consider that question about drinking alone. Surely there's a difference between guzzling Congress vodka in the men's room and sipping a scotch while reading a novel. Yet both count the same. Was this test written by the Women's Christian Temperance Union?
As I'd find out researching this article, pretty much. Addiction specialists deal with people so far out of control that drinking is their highest priority – even though it can lead to divorce, jail time, liver failure, bankruptcy, and worse. As a result, some docs see even casual drinking the way most of us regard huffing paint.
But what about me and you and most everyone we know – people who drink regularly, who have a respect for the good stuff, and don't usually think twice? Forty percent of Americans drink occasionally. Are we all incipient drunks?
I'll admit that I haven't always been a shining example of moderation. As an undergrad I partied more than I studied. Then I went to grad school and trained to be a journalist, which is basically code for professional drinking man. Then I moved to New York City, where there are 11,316 bars. For a good two years after my arrival I was still stuck firmly in college mode.
Things have changed since then. I've shed most youthful exuberances and replaced them with healthy habits I can't quite believe I have, like running. But in no way are my drinking days behind me. I've developed an aesthetic appreciation, I like to think, for the finer things. I don't chug sixers; I savor Belgian ales. Two or three nights a week I'll have a drink or two, sometimes a third, generally beer or a little scotch. Sometimes drinking is even part of my job. I've written three stories for this magazine that involved systematically ranking American and international microbrews.
So do a few weekday nightcaps, some boozy weekend socializing, and the occasional stiff drink after a hellish commute really mean I have a problem? Here's to confidently answering no.
There's some comfort in the knowledge that, compared to the rest of the developed world, we Yanks are relative lightweights. The average American tosses down the equivalent of about 8.5 liters of pure alcohol each year, in the form of beer, wine, or spirits. The Germans, French, Czechs, Irish, and Hungarians put away considerably more. In the U.S. we explain a nightly glass or two of wine by citing studies that say it prevents heart disease. We are, after all, a society that once banned alcohol entirely.
Still, approximately 7.9 million Americans suffer from alcohol dependency, a physical addiction that becomes ingrained in the neural pathways of the brain. How does one get to that point? New research suggests that the single biggest risk factor is DNA. "If there's a first-degree relative with something you would call alcoholism, you should be extremely careful," says Dr. Drew Pinsky. (You know him from the syndicated radio call-in show Loveline, but he's also a respected addiction specialist.) Another warning sign: You can drink all your friends under the table. An unusually high resistance to the motor-impairing effects of alcohol indicates that your brain welcomes booze a little too warmly.
These facts make me feel better. As much as I like to drink, I'm certainly not the guy who can pound back shots all night, and I have no family history that I know of. Another comforting fact: According to a study led by a researcher from the University of California-San Diego, only around three percent of people who abuse alcohol actually cross the line into full-blown alcoholism.
So what about those scary drinking questionnaires? Dr. Gregory Collins, head of the Alcohol and Drug Recovery Center at the Cleveland Clinic, says they're meant to be taken with a professional to help you interpret them. "There are a lot of gray areas," he says. It's also worth noting that "alcohol problem" literally means that alcohol is causing you problems, and you keep drinking anyway. If that's not the case, then it's probably all right to score a couple of "yes" answers on some quiz you're taking out of curiosity. But are you taking the quiz because your life's gone awry and you think it might be the drinking? Take a hard look at your answers.
As Jim Harrison once wrote in this magazine, proper use of alcohol is "celebratory rather than sedating, a nod to the realities of existence rather than an erasure." In other words, drink because you appreciate how it tastes, the way it enhances food, and the traditions behind it. Don't drink to get drunk. The key is to find your own balance point between the risks and pleasures.
And as long as it's not causing problems, whether they be medical, legal, financial, or personal, even addiction docs will forgive you. "You can binge every once in a while," says Pinsky, whose recommended five-drinks-per-week limit places him firmly on the hard-ass end of the spectrum of doctors I talked to. "And if you enjoy life more, what the hell are we worrying about?"
There's a tendency in this country to stigmatize excessive drinking as a moral failure. Worse, there's a common perception that the only answer to any drinking problem is to go to AA, apologize to everybody in your life you insulted on a bender, and never touch the stuff again. But unless you've developed a real alcohol dependence, the solution is less draconian. "Just quit the daily use," Pinsky says. "It's the stringing it together that's the problem. Just put some limits around it." If you're worried, take two weeks off.
Once you learn to recognize and obey the limits, keeping yourself in check is less a matter of counting drinks – something we Americans seem obsessed with – than paying attention to the circumstances surrounding your drinking. You had four glasses of wine last night? Okay: Were you laughing with friends or were you lying in bed listening to Joy Division? Context means a lot.
Which brings us to my weekend plans. The day after I file this story I'm getting on a plane to go to an old friend's wedding, where chances are I'll tear through Dr. Drew's five-drink-a-week allowance before sundown – because some occasions call for celebration, and life happens. The key is to respect the contents of the bottle, and myself.