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Ask Dr. Bob

QUESTION
Most of the information related to "binge drinking" that I've found relates to college students. How would you define this as a general alcoholism-related problem regardless of age? I began binge drinking in high school, as I've seen it defined. I didn't drink any other way. As an adult, I am able to have one or two "social" drinks without adverse effect. However, when the mood calls for a party, I drink one after the other without thought to limits. The limits I normally have regarding behavior are ignored, I have had blackouts, and there is a history of alcoholism in my family. Sometimes I crave a glass of wine and if I have some on hand will have a glass or two. The out of control episodes occur when I have someone else to follow along with me, not alone. This type of episode hardly ever happens anymore but used to happen three or four times per week when I was in my twenties. I believe I may be an alcoholic, but am unable to reconcile the problem and myself as the same thing. I don't want to stop drinking altogether, but I hate that I have no control in certain situations. What is going on?

ANSWER
You have done some serious thinking about your drinking patterns, which you worry about but do not seem to be able to control or change. This fact alone implies a drinking problem, likely alcoholism.

Binge drinking may occur at any age even though, as you mention, most studies have been done on college age persons. It is generally defined as 4 or more drinks per occasion for women and 5 or more per occasion for men. Some researchers would also add a time factor, eg: this pattern taking place 2 or more times in a 2 week period. (Please see "Ask Dr. Bob" answers for Dec. 2000, Sept. 2001 and Sept. 2003.)

Your pattern of not having control in certain situations but being able to drink socially at other times is interesting and, I suspect, one of the reasons you wonder if you are not alcoholic. This is not an uncommon occurrence, however, among alcoholic persons, many of whom will be able, with some effort, to control their drinking at certain times particularly when hoping to show someone else (or themselves) that they do not have a problem! The key feature here is the unpredictability of the loss of control, not knowing when it may happen, the blackouts and unacceptable behavior followed by remorse --and the repeated drinking in the same manner in spite of your attempts to change it! Of course, the family history of alcoholism is a key vulnerability.

So "what's going on"? I suspect you are alcoholic with a pattern of binge or episodic drinking, still able to maintain a bit of control over your drinking but on the path to progressively more severe consequences. You don't want to stop drinking, but you should. Get some good literature on alcoholism from a resource center, talk to someone in recovery, go to an "open Meeting" of AA, make an appointment to see an alcoholism professional, but do something now!

Thanks for being concerned enough to write. Good luck!

Dr. Bob



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Dr. Bob does not provide specific medical advice or a medical diagnosis for any particular condition described, nor verify the authenticity of any information described in the questions presented. Patients should always consult their physician to discuss any specific symptoms, conditions, or modes of therapy for any particular mental or physical difficulties, diseases or conditions.

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