By: The Monument Team
We don’t use the word “alcoholic” at Monument because your drinking does not define you. And what many people don’t know is that dependence on alcohol is a medical condition that can be diagnosed by a doctor and treated with evidence-based tools. We know how scary the “do I have a drinking problem?” Google search can be, and are here to help you navigate this question without the infinite scrolling and misinformation.
The bottom line is: this is a medical condition, like any other health condition. Recognizing AUD as a medical issue and treating it that way is necessary to get the support you deserve, without any of the shame or stigma.
Let’s start with a helpful analogy
Here’s an analogy from Monument advisor Dr. Mark Willenbring, who has treated thousands of patients with Alcohol Use Disorder: Think of a water slide. What would happen if you set a marker about 15 feet down from the top? You’ve told yourself, I won’t go past that line. On your first go, you pass the mark. Okay, now the second time, you again pass the mark. See a pattern here? How often can you stop before the 15-foot line? What if that line marks three drinks?
Continuously passing that line of the drink limit you set for yourself is a sign of Alcohol Use Disorder, or AUD. Another key sign of AUD is anticipation. Are you exhilarated before going down the water slide? Do you consistently look forward to it? Is the anticipation often even better than the ride itself?
Alcohol Use Disorder (AUD) is characterized by drinking more than you want and for longer than you want, despite wanting to cut down.
It’s also characterized by having strong urges to drink during certain times of the day. And this is more common than you think. An estimated 15 million people in the United States alone live with AUD. The bottom line is: this is a medical condition, like any other health condition. Recognizing AUD as a medical issue and treating it that way is necessary to get the support you deserve, without any of the shame or stigma.
‘Wait, how is this a medical condition?’ Let’s break it down.
Alcohol Use Disorder limits your ability to control or quit alcohol consumption, despite the consequences experienced from drinking.
Statistically speaking, AUD is 50–60% genetically determined. Gene interactions are complex, so there are hundreds of genes that shape how someone ends up developing Alcohol Use Disorder, and to what degree. The range of severity comes down to how these genes are expressed.
The American Psychiatric Association put together a manual called the Diagnostic and Statistical Manual, Fifth Edition (DSM-5) to help define and diagnose the severity of conditions like AUD. Per the DSM-5, AUD is broken down into 11 points of criteria. The severity of AUD depends on the number of symptoms present. A mild AUD diagnosis means 2–3 symptoms are present, a moderate condition means 4–5 symptoms are present, and a severe condition means 6+ symptoms are present. Understanding where you fall on the AUD spectrum can be a helpful indicator of the level of care that makes sense for you, and if you’ll be able to moderate your drinking, or if you should stop drinking entirely.
To take the DSM-5 and learn about your treatment options, you can sign up for Monument for free.
‘Can I moderate my drinking, or should I aim for sobriety?’
The choice to moderate or quit drinking all together is a very personal decision, and one that might evolve over time. Some people prefer to start moderating with an end goal of sobriety, others quit drinking with aspirations for reintroducing controlled drinking down the road, others decide sobriety is their only option, and everything in between. So, what’s right for you?
Dr. Mark Willenbring explains that people who meet fewer than 5 criteria for AUD have a better chance of successfully moderating their drinking given their level of control. At Monument, we connect you to a specialized physician and therapist to set attainable goals based on your medical history, lifestyle, and preferences. Goal setting is an important step in defining what success looks like, and putting together an action plan to get there. To start reflecting on if moderation or sobriety is best for you, check out these questions from a licensed therapist.
How AUD varies by age & severity
AUD displays itself to varying degrees and during different stages of life. No one’s diagnosis looks identical to another. For example, some develop symptoms of AUD earlier in life, and others much later. Oftentimes, those who develop symptoms at a younger age aim to quit drinking in their twenties, and for those whose symptoms develop in their thirties and forties, AUD can easily go undetected. Stress hormones, which are common while navigating parenting, marriage, work, finances, and more, can be catalysts for the AUD genes to express themselves more strongly. Someone who falls in this category may be asking themselves, Do you see what I have going on? Who wouldn’t drink! And that’s fair! But that doesn’t mean it’s not a problem and one that deserves attention. There is no shame in acknowledging when your drinking has become unhealthy and getting support to make a change.
If you’re feeling like your drinking has gotten out of control, it’s always good to check in with yourself and a physician and therapist specialized in treating AUD. At Monument, you can do that completely anonymously, and entirely online.
How AUD co-exists with other medical conditions
It is incredibly common that people who are diagnosed with AUD experience other mental health conditions. According to Monument Advisor Laura Diamond, Counseling Supervisor of the dual-diagnosis inpatient detox and rehabilitation unit at The Addiction Institute of Mount Sinai West Hospital:
Alcohol use disorder is complex and is often accompanied by co-occurring disorders, such as anxiety or depression, and is intensified by trauma, stressors and societal impact. Each of these aspects cannot be treated solely by one treatment method, but the right combination of treatment tailored to your specific needs can alleviate and resolve multiple issues simultaneously.
Learning to manage negative or uncomfortable emotions is one of the fundamental components of this journey, and you don’t have to do it alone. One of the most useful steps to take during your recovery process is committing to a therapy program that is specifically tailored to you and your needs. Learn about specialized therapy with Monument here.
‘What if I’m not on the spectrum for AUD?’
It’s important to note that while the above criteria can serve as a helpful tool to evaluate your drinking behaviors, you do not have to check any boxes or identify with any labels to make a healthier choice for yourself and start online alcohol treatment. If your drinking feels out of control, you deserve support to make a change. At Monument, our goal is to get you from where you are to wherever you want to be, no matter the starting point.
‘What does medical treatment for a medical issue mean?’
Making the choice to change your drinking is a courageous decision, and you deserve to get results. That’s why we use evidence-based treatment methods that are proven to work. We connect our members to licensed physicians and therapists who are specialized in helping people change their drinking. They use tools like cognitive behavioral interventions and FDA-approved medication options to empower you to reach your goals. You can read more about our medical approach here.
You can also sign up for free to access additional resources like this one, free virtual therapist-moderated support groups, and an anonymous community forum.
Regardless of your path forward, know that:
1. You are not defined by your drinking habits
2. You can change your drinking habits
3. You don’t have to change your drinking alone (it’s hard!)
4. Making the choice to change your drinking is something to be proud of. And we’re proud of you.