Wobbly, But Still Standing Recognizing, Understanding, and Helping - PDF document

Wobbly, But Still Standing Recognizing, Understanding, and Helping the High-Functioning Alcoholic Caterpillar Confidential Green Caterpillar Confidential Green 1 1

Purpose • Alcohol and socializing have gone hand-in-hand for thousands of years • Alcohol is neither good nor bad − It is your relationship with alcohol and the impact it has on your functioning • Educate and increase self-awareness to promote wellness Caterpillar Confidential Green 2 Alcohol and socializing have gone hand in hand for thousands of years. In ancient Greece, for example, Socrates would offer wine to philosophers during gatherings. In colonial times, early settlers would gather in bars to share news with each other. In more recent history, consider the role of alcohol in Oktoberfest, where crowds drink beer and celebrate, and the part that alcohol played at Woodstock in 1969 and the lasting trend of alcohol consumption at outdoor concerts today. It’s commonplace to drink alcohol at work parties, sporting events, on holidays, and at special occasions, like weddings. Alcohol, by its very nature, is neither good nor bad. As such, the intent of the information being presented is not to pass judgment, but rather to increase self-awareness and promote wellness. The line between alcohol use and alcohol abuse can be blurry. Learning to recognize some of the signs that you are close to crossing that line is a proactive way to maintain control of your health. 2

Objectives • Create a common understanding of language • Define high-functioning alcoholism • Identify traits common to functional alcoholics • Recognize red flags • Understand codependency/family impact • Resources for alcoholics and family members Caterpillar Confidential Green 3 3

Common Language • Standard drink • Alcohol use • Alcohol abuse • Alcohol dependence • “Alcoholic” and “alcoholism” Caterpillar Confidential Green 4 To ensure that we are all on the same page, we are going to go over several terms that will be used throughout this presentation. 4

A Standard Drink • Standard drink − 5 ounces of table wine − 1.5 ounces of 80-proof liquor (e.g., vodka, bourbon, scotch) − 3.3 ounces of champagne − 12 ounces of regular beer • Common drink − The way most drinks are poured Image Source: National Institute on Alcohol Abuse and Alcoholism (www.niaaa.nih.gov) − Often contains more than one standard drink 5 Caterpillar Confidential Green 5 A standard drink is defined by the Centers for Disease Control and Prevention as is noted in the slide. (Review slide). The challenge comes with the measurement. Common drinks (the way most drinks are poured), especially in restaurants, bars and by friends, often contain more than one standard drink. You may have one common drink and not realize how much alcohol you are consuming, resulting in becoming more intoxicated than you planned. A margarita, for example, might actually contain the equivalent of 2-3 standard drinks, so drinking 2 common margaritas would be like drinking six standard drinks. To give you a clearer idea, one bottle of wine contains five standard drinks, a bottle of champagne contains 7.5 standard drinks, and a bottle of 80-proof alcohol contains about 17. The size of the glass, the type of alcohol, and the amount of alcohol all matter. 5

Use, Abuse, and Dependence Alcohol Use Low-risk or moderate drinking No notable impact on functioning Alcohol Abuse Repeated binge drinking Drinking interferes with daily and/or routine heavy social activities or fulfilling drinking responsibilities Alcohol Dependence Compulsive alcohol use Main motivation for many decisions revolves around alcohol; tolerance and withdrawal Caterpillar Confidential Green 6 Alcohol Use: Low-Risk Drinking For Women: 7 standard drinks in a week, with no more than three of those in one day. For Men: 14 standard drinks in a week, with no more than four of those in one day. Staying within these limits is known as Alcohol Use. Keeping drinking within these limits has the following benefits: - Allows a person’s liver to keep up with metabolizing the alcohol in each standard drink so that brain functioning isn’t compromised. It takes about one hour for the body to metabolize, or process, one standard drink. - Helps a person to avoid crossing the line to alcohol abuse. - Protects nutritional health. Give or take a little, a standard drink contains about 100 calories and little to no nutritional value. That being said, consider the implications for maintaining a healthy body weight. A person who has 3-4 standard drinks in one day is adding 300-400 calories to their daily intake. Splitting the difference, let’s do a little math: 350 calories per week x 52 weeks per year = 18,200 calories. 18,200 calories is roughly the equivalent of 5.2 pounds. 6

Alcohol Abuse A person is considered to be abusing alcohol when their pattern of drinking has an effect on their daily activities. If a person drinks too much at one time or the person drinks several times throughout the week and finds it difficult to take care of personal responsibilities, they may want to consider their alcohol use. Common signs of alcohol abuse include: • Turning to alcohol to drink, relax, manage stress or attempt to feel “normal” • Blacking out temporarily • Experiencing short-term memory loss • Avoiding responsibilities to drink • Increased social isolation from friends, family members, and/or colleagues • Choosing to drink alone and hiding alcohol use • Experiencing hangovers or feeling hungover when not drinking • Decreased performance at school/work Alcohol Use Disorder (Alcohol Dependence) Not everyone who drinks too much is going to develop an alcohol use disorder. The CDC reports “about 90 percent of people who drink excessively would not be expected to meet the clinical diagnostic criteria for having a severe alcohol use disorder.” As the National Institute on Alcohol Abuse and Alcoholism reports, problem drinking, or alcohol abuse, that becomes severe is given the medical diagnosis of “alcohol use disorder,” when a person has developed a chronic relapsing brain disease that is characterized by compulsive alcohol use. Other symptoms of alcohol use disorder are a loss of control over alcohol intake and when a person experiences a negative emotional state when not using alcohol. As someone begins to go from abusing alcohol regularly to becoming dependent on it, their main motivation for many of their decisions is to get alcohol and drink it just to consume more. This behavior is also known as alcohol addiction. The signs of alcohol dependence include: • Having a high tolerance for alcohol (needing to drink more to feel high) • Feeling like alcohol is needed to get through the day • Feeling unable to stop drinking despite repeated attempts • Rationalizing drinking behavior • Regularly engaging in binge drinking or heavy drinking (as defined above) 6

• Drinking more alcohol than intended • Experiencing withdrawal symptoms if alcohol isn’t used • Drinking alcohol just to avoid withdrawal symptoms (such as fatigue, anxiety, nausea, headache, tremors, insomnia, depression, irritability) • Drinking despite the negative consequences that can result, such as losing a job/relationship • Drinking in high-risk situations, such as when operating a car 6

The Terms “Alcoholism” and “Alcoholic” • Commonly used to describe a condition in which a person has a severe addiction to alcohol that impairs his/her functioning • Used within this presentation because they are widely understood by and related to by the general population • Non-clinical terms − Clinical professionals in the medical and psychiatric communities use the diagnosis of alcohol use disorder − Alcohol use disorder, once diagnosed, is then qualified using mild, moderate, or severe specifiers, depending upon the provider’s assessment Caterpillar Confidential Green 7 It should be noted that “alcoholic” and “alcoholism” are non-clinical terms by professional standards. Rather, these terms are commonly used in society to describe alcohol use disorder, a condition in which a person regularly uses alcohol to the point of impaired function. These terms are, however, used within this presentation because they are relatable and widely understood by the general population. Alcohol use disorder is the clinical diagnostic term utilized by the Diagnostic Statistical Manual, 5 th Edition (2013), or DSM-V, to describe the spectrum of alcohol misuse. Serving largely as an umbrella term, medical and psychiatric providers specify the severity of the diagnosis based on the amount and frequency of alcohol use and the degree to which said use has a negative impact on a person’s life. Alcohol use disorder, once diagnosed, is then qualified using mild, moderate, or severe specifiers, depending upon the provider’s assessment and the patient’s self-report. Alcohol use disorder (which includes a level that's sometimes called alcoholism) is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms. 7

Identifying the Problem Definitions, Criteria, Stereotypes Caterpillar Confidential Green Caterpillar Confidential Green 8 8