Alcohol: When is it a problem?

Patterns of alcohol use can change over the course of a lifetime or even over a semester. Deciding if your patterns of use are problematic can sometimes feel difficult. One way to conceptualize alcohol use is to think of it as behavior falling on a continuum.

Where would you place yourself on the continuum? If you have trouble placing yourself, consider asking a trusted friend to locate where they feel your use lies. 

Continuum of Use:

• Abstinence: Complete non-use of alcohol. 
• Non-problem use: Using in moderation; appropriate behavior when drinking. 
• Critical incident: An isolated event; a single episode of a problem or harm; may be an indication of substance misuse. 
• Substance abuse: Pattern of negative consequences (three or more incidents in six months); using despite knowledge that use causes or contributes to problems; moderation is still possible. 
• Dependency: Tolerance; periodic loss of control over the quantity of alcohol you're consuming and your behavior; important activities reduced or given up because of use; use criticized by family members or friends; moderation is difficult or impossible without treatment. 

Reflecting on Your Drinking 

Another way to help determine whether your use is problematic is to consider what consequences you’ve experienced due to alcohol use. Have you experienced any of the following in the past six months?

• Felt guilty about how often or how much you drink 
• Did or said something you later regretted or that caused you to feel shame or embarrassment 
• Missed a class, got behind in schoolwork, or otherwise felt unable to do your schoolwork 
• Spent more money on alcohol than you wanted to 
• Noticed your relationships have been negatively affected due to alcohol-related reasons 
• Had difficulty fulfilling school, work, or social responsibilities 
• Felt nauseous, got sick or vomited, had a headache or hangover the next day 
• Had difficulty remembering all or part of the time in which you were intoxicated 
• Found you no longer felt drunk or as drunk after consuming your typical amount of alcohol 
• Needed medical attention or treatment for alcohol-related reasons 

Options for Treatment

Much like the continuum of use, there’s a continuum of treatment options for substance abuse and dependency. There are many who use multiple forms of treatment to address their substance use concerns. Some of the treatment options may include: 

• Screening and Early or Brief Intervention Services: Screening and assessment for risk of dependence; increased awareness of relationship with substances; referral assistance to treatment and specialty care. 
• Behavioral Treatments: Longer-term care for behavior and motivation change, counseling and psychological services and support, and can include specialized medical professionals focused on alcohol, tobacco, and other drugs. 
• Medically Assisted Treatment: Medications to help minimize use and cravings, manage withdrawal symptoms, and prevent relapse. 
• Mutual Support Groups: Can include twelve-step programs such as Alcoholics Anonymous (AA) and other support programs such as Adult Children of Alcoholics (ACA). 
• Inpatient Treatment: patients are admitted to a controlled environment, typically to a hospital, to monitor symptoms and co-occurring conditions; may be involuntary in emergency situations. 
• Intensive Outpatient Programming (IOP) or Partial Hospitalization (PHP): typically, less restrictive than inpatient and treatment occurs in a hospital setting multiple days a week for multiple hours per treatment day; IOP can be three to five days a week and PHP can be five to six days a week. 
• Residential Treatment: Longer-term live-in centers that includes a structured day, access to behavioral and medically assisted treatment, and community-centered rehabilitation. Can be voluntary. 

Note: For some of these treatment options, insurance may cover part, or all the cost of treatment and some facilities offer payment assistance. 

If you’re concerned about the consequences of your use, there are many resources available to you. FindTreatment.gov can help you find support anywhere in the United States. You can also make an appointment with a medical professional or primary care provider to help you find resources in your country. Additionally, many mutual support groups don’t require insurance to be accessed, such as Alcoholics Anonymous (AA) or Adult Children of Alcoholics and are available in many countries. AA's website contains a map to search for meetings in your country.