# "Doc, I'm NOT an alcoholic" **URL:** \ **Category:** Miscellaneous and Personal Stuff I Must Share\ **Created:** [May 4, 2006, 12:20am UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326 "2006-05-04T00:20:41Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Rick](https://avatars.discourse-cdn.com/v4/letter/r/9f8e36/32.png) [@Rick](https://boards.straightdope.com/u/Rick)\ **Post date:** [May 4, 2006, 1:09pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/21 "2006-05-04T13:09:05Z")
Doc I’m not an alcoholic, I’m a drunk. Alcoholics go to meetings. 😃 **dnooman, Dr\_Paprika**'s statement makes perfect sense. If I told you that this glass contained a deadly poison, and you went ahead and drank it, you would be an idiot. Both in the common usage of the word, and in medical parlance. If you know that you are going to lose 18 months of your freedom if you drink a beer, \*\* and you go ahead and drink one anyway\*\* the same commnets apply. ---
**Author:** ![Ensign\_Edison](https://avatars.discourse-cdn.com/v4/letter/e/7ab992/32.png) [@Ensign\_Edison](https://boards.straightdope.com/u/Ensign_Edison)\ **Post date:** [May 4, 2006, 1:12pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/22 "2006-05-04T13:12:33Z")
> [@Excalibre](#): > > I don’t think that’s what he meant. From a legal standpoint (since “felony” is an explicitly legal term) that’s not true - statutes like that are specific in describing which familiar relations count as “incest” and which don’t. Besides, your interpretation makes no sense in context. I just thought it was a dumb (and inaccurate, yes, sometimes comedians make things up) joke, and I misread the original context. ---
**Author:** ![eleanorigby](https://avatars.discourse-cdn.com/v4/letter/e/ee7513/32.png) [@eleanorigby](https://boards.straightdope.com/u/eleanorigby)\ **Post date:** [May 4, 2006, 1:16pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/23 "2006-05-04T13:16:30Z")
> [@Guinastasia](#): > > People don’t start out intending to get addicted. And the “big to do” is about supporting them in the rough spots. > > :dubious: Oh, lord–here we go. We all have “rough spots”. No alchoholics “rough spots” are any rougher than a sober person’s. An addict’s pain is not somehow worse or more difficult to deal with than everyone else’s. Elevating their pain to some deeper, more intense level is wrong. It’s their coping skills that are not sufficent. The pain is the same (although it does have a unique significance for every person who goes thru it. I am talking about any type of pain here, physical or emotional). ---
**Author:** ![eleanorigby](https://avatars.discourse-cdn.com/v4/letter/e/ee7513/32.png) [@eleanorigby](https://boards.straightdope.com/u/eleanorigby)\ **Post date:** [May 4, 2006, 2:08pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/24 "2006-05-04T14:08:05Z")
Gah. Realized I am pulling this thread OT and so will bow out. Sorry. I don’t know if the man in question is an alcoholic or not, but he sure sounds like one to me. ---
**Author:** ![Crotalus](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/crotalus/32/41_2.png) [@Crotalus](https://boards.straightdope.com/u/Crotalus)\ **Post date:** [May 4, 2006, 2:12pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/25 "2006-05-04T14:12:14Z")
> [@eleanorigby](#): > > Oh, lord–here we go. We all have “rough spots”. No alchoholics “rough spots” are any rougher than a sober person’s. An addict’s pain is not somehow worse or more difficult to deal with than everyone else’s. Elevating their pain to some deeper, more intense level is wrong. It’s their coping skills that are not sufficent. The pain is the same (although it does have a unique significance for every person who goes thru it. I am talking about any type of pain here, physical or emotional). The struggle that most addicts in 12-step programs have is learning to “deal with life on life’s terms”, not dealing with more difficult actual problems than non-addicts have. When someone has reached adulthood without the coping skills of a normal person, and has learned instead destructive and ineffective ways of coping, don’t you see it as a personal triumph, worthy of celebration, when such a person breaks the cycle and learns to cope? ---
**Author:** ![Dinsdale](https://avatars.discourse-cdn.com/v4/letter/d/97f17d/32.png) [@Dinsdale](https://boards.straightdope.com/u/Dinsdale)\ **Post date:** [May 4, 2006, 2:24pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/26 "2006-05-04T14:24:27Z")
I’m not a huge fan of the word “alcoholic,” as I consider it rather vague and of limited descriptive or prescriptive value. IME, the reasons people drink and their drinking behavior are extremely varied, as are their potential responses to their current or past drinking practices. Applying a single label of “alcoholism” - or “substance abuser” - does little for me other than appeasing my basic preference for categorization. The guy obviously is “not thinking right,” and I cannot imagine why someone would consider a drink (or a drunk) worth the potential risk of 18 months’ imprisonment. But calling the guy an alcoholic - or an idiot - doesn’t provide me much clarification of the reasons he made what strikes me as an extremely irrational choice. ---
**Author:** ![eleanorigby](https://avatars.discourse-cdn.com/v4/letter/e/ee7513/32.png) [@eleanorigby](https://boards.straightdope.com/u/eleanorigby)\ **Post date:** [May 4, 2006, 2:27pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/27 "2006-05-04T14:27:21Z")
Short answer is no. Longer answer is yes, for that person. I am assuming you mean emotional adulthood, since not all alcoholics start at a young age. There are alot of sober people who are also emotionally stunted and do not grow, until they face some kind of life crisis-but are they lauded and on talk shows? No. Not that I think talk shows are a goal–I’m just trying to make a point. What I find distasteful is a reverance for the reformed alcoholic or addict–you didn’t save the world or stop world hunger, you learned to stay sober and cope. This is laudable on a personal level, but IMO it should not be enshrined as an almost neccessary right of passage for all people. That was not posited in this thread(indeed, I would be shocked if **Qadgop** advocated such a thing), but I find the attitude prevalent in society as a whole. I don’t put reformed addicts on pedestals–why should I? If anything, I feel a twinge of pity for them–they have lost so much time and wasted so many relationships. There is no turning back that clock. I also find the whole “well, I was drinking at the time that I [insert horrible hurt/permanent damage or loss here], so you have to forgive me” a crock. Some people don’t disappear down a bottle when life gets rough-and yet their triumphs are not lauded as Self Growth and Great Achievements. Sorry, this is getting personal. Being a reformed alkie does not make you more interesting or more self actualized. It makes you a reformed alkie. ---
**Author:** ![Cheesesteak](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cheesesteak/32/3694_2.png) [@Cheesesteak](https://boards.straightdope.com/u/Cheesesteak)\ **Post date:** [May 4, 2006, 2:40pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/28 "2006-05-04T14:40:02Z")
Alcoholic or not, I can certainly see someone thinking they could get away with drinking, even though abstinence is a condition of parole. Hell, we’ve seen people drinking in violation of probation, photographing it, posting it on the internet with the judge’s name attached so it can be conveniently found on Google, and STILL thinking they’d get away with it. There is no lower bound on stupidity. ---
**Author:** ![lisacurl](https://avatars.discourse-cdn.com/v4/letter/l/41988e/32.png) [@lisacurl](https://boards.straightdope.com/u/lisacurl)\ **Post date:** [May 4, 2006, 2:40pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/29 "2006-05-04T14:40:12Z")
If a doctor can’t suggest to his patient – in the course of treatment, mind you – that he might be an alcoholic, when exactly would it be appropriate? :rolleyes: ---
**Author:** ![Dangerosa](https://avatars.discourse-cdn.com/v4/letter/d/22d042/32.png) [@Dangerosa](https://boards.straightdope.com/u/Dangerosa)\ **Post date:** [May 4, 2006, 2:41pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/30 "2006-05-04T14:41:55Z")
So what are the diagnostic criteria for an alcoholic…? The family believes my sister is an alcoholic, but she says (and due to HIPPA we can’t tell if its true or not) that despite TWO trips to rehab, she has not been diagnosed as an alcoholic. She is depressed and self-medicates. I’m not asking for medical advice, just wondering what the criteria actually are? (Has she actually visited Egypt?) ---
**Author:** ![lieu](https://avatars.discourse-cdn.com/v4/letter/l/c2a13f/32.png) [@lieu](https://boards.straightdope.com/u/lieu)\ **Post date:** [May 4, 2006, 2:45pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/31 "2006-05-04T14:45:43Z")
> [@Dr\_Paprika](#): > > A dumbass who has a forbidden beer when aware of the tremendous consequences, gets caught, blames it on his friends is, in medical parlance, an “idiot”. Or perhaps “crazy”. True if (and it’s a big if) he’s accepted the court’s validity to disallow that freedom. I think he’d be an idiot to get drunk. But I also would have real reservations about obeying directives from the court that I felt were extreme or unwarranted. Maybe that what this fellow felt about drinking a beer. The action in and of itself isn’t unreasonable and maybe he just has a real problem with the court overflexing it’s muscle just because it has the ability to do so. He might simply be giving the finger to what he considers unjust. I sooo hope I never find myself in his shoes. ---
**Author:** ![Clothahump](https://avatars.discourse-cdn.com/v4/letter/c/51bf81/32.png) [@Clothahump](https://boards.straightdope.com/u/Clothahump)\ **Post date:** [May 4, 2006, 2:53pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/32 "2006-05-04T14:53:45Z")
> [@Dangerosa](#): > > So what are the diagnostic criteria for an alcoholic…? There’s a good discussion on [Wiki](http://en.wikipedia.org/wiki/Alcoholic) . Under the Diagnosis section, they have: > [@](#): > > In a 1992 JAMA article, the Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine published this definition for alcoholism: “Alcoholism is a primary chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, mostly denial. Each of these symptoms may be continuous or periodic.” > > The DSM IV diagnosis of alcohol dependence represents another approach to the definition of alcoholism, one more closely based on specifics than the 1992 JAMA article. In part this is to assist in the development of research protocols in which findings can be compared with one another, but the DSM definition is the one in general use from a diagnostic standpoint. That definition is: maladaptive alcohol use with clinically significant impairment as manifested by at least three of the following within any one-year period: tolerance; withdrawal; taken in greater amounts or over longer time course than intended; desire or unsuccessful attempts to cut down or control use; great deal of time spent obtaining, using, or recovering from use; social, occupational, or recreational activities given up or reduced; continued use despite knowledge of physical or psychological sequelae. ---
**Author:** ![PoorYorick](https://avatars.discourse-cdn.com/v4/letter/p/ecccb3/32.png) [@PoorYorick](https://boards.straightdope.com/u/PoorYorick)\ **Post date:** [May 4, 2006, 3:40pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/33 "2006-05-04T15:40:04Z")
Denial is a weird and powerful thing, and often crosses the line from “That’s a dumbass thing to do” to “That guy’s got a serious problem.” Without getting into the debate about the reality of alcoholism, here are some of the things I’ve done: [ul] [li]Took the garbage out at night so the neighbors wouldn’t see how many vodka bottles I was throwing away.[/li][li]Showed up drunk at a job interview.[/li][li]Drank a glass of vodka in the morning “to get jump started.”[/li][li]Bought my liquor at different stores so no single clerk would know how much I drank.[/li][li]Thought no one knew how much I drank, even though I was drunk about 80% of my waking hours.[/li][/ul] And if you had asked me if I had a problem, I’d have honestly, truly, sincerely told you “No.” I wouldn’t have been bullshitting you, I’d have been telling you the truth as I really saw it. That’s the difference between being a dumbass and having a serious mental problem. ---
**Author:** ![dnooman](https://avatars.discourse-cdn.com/v4/letter/d/839c29/32.png) [@dnooman](https://boards.straightdope.com/u/dnooman)\ **Post date:** [May 4, 2006, 4:07pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/34 "2006-05-04T16:07:09Z")
> [@Vlad/Igor](#): > > QtM will certainly be able to clarify this, but this sounds like the patient was looking for a source of narcotics, and gambled that by violating his parole, he might be able to get a steady source from the prison MD. When QtM said no, the patient realized he had lost his bet, and tipped his hand with the comment “I never should have had that beer.” That is an addictive type of behavior, and an idiotic decision to make. The patient was willing to give up his freedom and screw up his parole record for the chance at a long-term fix of narcotics. At the very least it was incredibly short-sighted. > > Vlad/Igor > [@QtM](#): > > While in prison before, he got quite a thorough evaluation for it; it’s run-of-the-mill musculo-skeletal non-malignant intermittent back pain like everyone gets, and he made it thru his last incarceration with some tylenol or ibuprofen, exercises, and occasional ice/heat. Doesn’t seem like it. ---
**Author:** ![gotpasswords](https://avatars.discourse-cdn.com/v4/letter/g/c57346/32.png) [@gotpasswords](https://boards.straightdope.com/u/gotpasswords)\ **Post date:** [May 4, 2006, 4:28pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/35 "2006-05-04T16:28:12Z")
> [@Dangerosa](#): > > So what are the diagnostic criteria for an alcoholic…? As it was explained to me by someone with a Master’s degree in nursing (their specialty was critical care) they couldn’t legally say someone was an alcoholic as that would be considered as making a diagnosis. In California, even if a nurse has been in practice longer than an R2 (second-year resident) has been alive, they still can’t diagnose. So, their work-around would be to chart it as “apparent chronic etohism” - ETOH being shorthand for ethanol. ---
**Author:** ![hlanelee](https://avatars.discourse-cdn.com/v4/letter/h/3bc359/32.png) [@hlanelee](https://boards.straightdope.com/u/hlanelee)\ **Post date:** [May 4, 2006, 4:39pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/36 "2006-05-04T16:39:46Z")
On New Year’s day, a long time ago, after showing my ass the night before, Dad looked at me and said, “Drinking will get you killed!” That was the end of the discussion. Two days later he proved it could happen to anyone, I had to go ID him in the morgue. He had gone south in the north bound lane of A1A. Five years later I woke up in jail one Sunday morning. The night before I had rear-ended a carload of people. I had an epiphany, what happened to Dad will happen to me if I do not stop. So ended my denial in April 1987. I have been sober ever since. ---
**Author:** ![Accidental\_Yuppie](https://avatars.discourse-cdn.com/v4/letter/a/e56c9b/32.png) [@Accidental\_Yuppie](https://boards.straightdope.com/u/Accidental_Yuppie)\ **Post date:** [May 4, 2006, 11:18pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/37 "2006-05-04T23:18:58Z")
> [@Cheesesteak](#): > > Alcoholic or not, I can certainly see someone thinking they could get away with drinking, even though abstinence is a condition of parole. Hell, we’ve seen people drinking in violation of probation, photographing it, posting it on the internet with the judge’s name attached so it can be conveniently found on Google, and STILL thinking they’d get away with it. > > There is no lower bound on stupidity. I once knew a guy who worked for Amtrack and got in trouble for coming to work intoxicated a few times ( He would stay out drinking until 5 or 6 AM then come in to work at 8). He was told he could keep his job only if he went in rehab and joined AA …he would be subject to random testing. So one night after this happens he’s out drinking in a bar and a film crew comes in to film some random drinkers for a national beer commercial. He came home all happy and excited about the possibility of being on TV. When we reminded him of his little “problem” at work and mentioned that maybe it wouldn’t be a good idea to film this commercial, he got all defensive and went on a rant about how no one could tell him what to do, no one was the boss of him…etc etc etc. So I think alot of this kind of stuff stems from the same pervasive “No one can tell me what to do” attitude problems that contribute to unemployment and incarceration. ---
**Author:** ![Excalibre](https://avatars.discourse-cdn.com/v4/letter/e/898d66/32.png) [@Excalibre](https://boards.straightdope.com/u/Excalibre)\ **Post date:** [May 4, 2006, 11:30pm UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/38 "2006-05-04T23:30:01Z")
> [@Accidental Yuppie](#): > > So I think alot of this kind of stuff stems from the same pervasive “No one can tell me what to do” attitude problems that contribute to unemployment and incarceration. Amazing how confused some people’s thinking can be - in the case you describe, quite obviously they _could_ tell him what to do, but he wouldn’t acknowledge it. In kids that’s oppositional-defiant disorder - does that diagnosis exist in adults? Or is it just called “being a dumbfuck” in that case? ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [May 5, 2006, 12:31am UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/39 "2006-05-05T00:31:10Z")
Trust me, dude’s a full-blown alcoholic and addict. He’s had numerous psychiatric and psychological evaluations over the years that find no Axis One diagnoses, addiction as his major Axis Two diagnosis, more DUIs than I can count on one hand, and a long string of forged prescription arrests. As for his chronic pain claims, well besides thorough (and not cheap) medical evaluation, we’ve also had lovely video montages of him in the past, sashaying thru the hallways and playing on the rec field without a lick of trouble, yet when he walks into the Health Unit he’s suddenly doubled over in pain. When he leaves the Health Unit, his painful gait diminishes in direct proportion to his distance from the Unit. Noone’s cracked his denial yet. He won’t even Talk the Talk, which most inmates with addiction problems will do, just to try to get out sooner, or at least get to a minimum security institution sooner. His addiction doesn’t excuse his behavior. It makes it understandable, but it shouldn’t mitigate his consequences: Return to prison, etc. About the only way to face up to a problem is to suffer the consequences. He’s got a lot invested in protecting his addiction. It’s the only way he knows anymore to feel good, or even less bad. Forced abstinence may eventually show him that he can feel ok without a drug or a drink, but if/when he takes that first one again, he’s back sliding down that razor blade of relapse. At least it ain’t me doing that stuff anymore. 🙂 ---
**Author:** ![ouryL](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ouryl/32/6067_2.png) [@ouryL](https://boards.straightdope.com/u/ouryL)\ **Post date:** [May 5, 2006, 12:36am UTC](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326/40 "2006-05-05T00:36:44Z")
> [@Qadgop the Mercotan](#): > > About 70% of my patient population has a history of substance abuse. I’m used to it, I deal with it. Being in recovery myself helps a lot. One thing that helps me stay clean and sober day after day is the frequent raw denial I see in my patients. > > For your consideration, a patient encounter: > > Mr. Kztrimbel is back in prison, after serving about 6 years, and being out for nearly a year. He didn’t reoffend, he just violated his parole, so he’ll do another 18 months at least in prison. He’s seeing me to complain about not getting his oxycontin. He has back pain. He’s complained of it over a decade. While in prison before, he got quite a thorough evaluation for it; it’s run-of-the-mill musculo-skeletal non-malignant intermittent back pain like everyone gets, and he made it thru his last incarceration with some tylenol or ibuprofen, exercises, and occasional ice/heat. > > Upon discharge, he found a physician who believed his story of intractable pain, and gave him his oxys. > > He’s got a long history of drug and alcohol abuse. Suffice it to say that drugs and alcohol are the underlying reason he got a prison sentence in the first place. He’s had some halfway decent rehab while in prison in the past. Apparently he just went thru the motions. > > I evaluate him, realize that nothing has changed with his back, and I tell him he won’t be getting narcotics for his symptoms, it’s not medically necessary and certainly not appropriate. Needless to say, he’s not happy. Mr. Kztrimbel says “I knew it, I knew it, I knew that if I came back in, you’d never give me my drugs! I NEVER should have had that beer!” > > “You mean you got revoked for drinking alcohol? Complete abstinence was a condition of your parole, you knew that any alcohol consumption meant that you would get returned to prison, and you drank anyway?” I queried. > > “Yup, doc. That’s right. I never should have let my friends talk me into a beer” > > “Mr. Kztrimbel, are you an alcoholic?” > > “No, doc. I am not.” > > “Mr. Kztrimbel, you knew that if you took a drink, you’d return to prison for a year and a half, you would not be given narcotics for your back, and you took that drink anyway. Now to me, that’s something an alcoholic would do, because they can’t control their drinking. We expect that behavior from alcoholics who aren’t in recovery. It’s understandable. _But for a non-alcoholic to do something like that, they’d have to be either crazy or an idiot_.” > > “Doc, I’m _NOT_ an alcoholic.” > > “I see. Welcome back to prison, Mr. Kztrimbel. Let’s review your back exercises, and I’ll order some ibuprofen for your pain.” House would have called him “a drunk”. [Previous page](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326.md?page=1) [Next page](https://boards.straightdope.com/t/doc-im-not-an-alcoholic/355326.md?page=3)