“Am I an alcoholic?” – Screen yourself for AUD with this alcoholism test
Have you ever asked yourself the question, “Am I an alcoholic?”
Alcohol is commonly used to “break the ice” at parties, braais, and other social events. In South Africa, we have a prevalent drinking culture that can make indulging in alcohol feel like a “necessary” part of the celebration. If you’ve ever abstained from drinking alcohol at a social event, you’ve probably been asked WHY you’re not drinking, or perhaps even been pressured to participate. That’s how normalized drinking is in our culture.
While drinking too much alcohol at a party, a wedding, a birthday (or at any time, really) may be normalised in our society, it can be a sign of alcoholism (which is now clinically referred to as “alcohol use disorder” or “AUD”).
Read on to learn more about alcohol use disorder, the signs of alcoholism, and what qualifies as alcohol abuse vs. alcoholism or alcohol dependence. Plus, use our AUD self-screening questionnaire to test yourself for alcoholism and assess whether your drinking qualifies as mild, moderate, or severe alcohol use disorder.
What is alcoholism or alcohol use disorder?
Alcohol use disorder, or AUD, is the new preferred term for alcoholism and is broadly used to describe problem drinking that stems from alcohol abuse or alcohol dependence. But what exactly is alcoholism?
While both alcohol abuse and alcohol dependence are marked by the inability to stop or control alcohol use, they’re not the same at all.
What is alcohol abuse?
Alcohol abuse may cause significant problems in your life; at home, at work, and in most of life’s many arenas, but it doesn’t involve physical addiction.
What does that look like? Maybe you’re showing up late for work every other week because of your drinking, and people around you are noticing and getting upset. Perhaps you’re having trouble sleeping because of your drinking.
What is alcohol dependence?
Now, alcohol dependence is a different demon altogether.
While alcohol abuse is harmful in itself, alcohol dependence (colloquially still called “alcoholism”) refers to a physical addiction to alcohol.
The key difference here is that when someone who is dependent on alcohol stops drinking, their body senses it isn’t getting the substance anymore, and they experience physical alcohol withdrawal symptoms.
When does drinking become “alcoholism” or alcohol dependence?
The truth is, no set volume of alcohol or frequency of drinking definitively determines whether someone would be considered an “alcoholic” — nor what type of alcohol use disorder they have. Just as every person is unique, so AUD manifests differently in each person afflicted by it. For instance, a casual drinker who overindulges or “binge” drinks on weekends may still have AUD if their drinking habit causes problems in their life.
So, how can you determine whether a person is drinking too much and has AUD? Simple — like most disorders, there is a set of criteria we can use to establish the severity of the disorder.
Diagnosing alcohol use disorder
Under the fifth edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), alcohol abuse and alcohol dependence — which were formerly categorised as two separate diagnoses — are integrated into a single disorder, namely alcohol use disorder (AUD).
The DSM-5 defines alcohol use disorder as a “problematic pattern of alcohol use leading to clinically significant impairment or distress“. It outlines 11 diagnostic criteria for AUD, and anyone who meets any 2 or more of the 11 criteria during the same 12-month period would receive a diagnosis of AUD.
The severity of AUD — mild, moderate, or severe — is based on the number of diagnostic criteria the person meets in the preceding 12 months:
- Mild alcohol use disorder: A person is regarded as having “mild AUD” when they meet two to three criteria of alcohol use disorder. This may indicate alcohol abuse.
- Moderate alcohol use disorder: A person is regarded as having “moderate AUD” when they meet four to five criteria of alcohol use disorder. This may be manifest either as alcohol abuse or alcohol dependence.
- Severe alcohol use disorder: A person is regarded as having “severe AUD” when they meet six or more criteria of alcohol use disorder. This constitutes alcohol dependence.
You can find the diagnostic criteria for AUD below. If you scroll down, we’ve included a simple self-screening questionnaire to help gauge the severity of your drinking problem.
Diagnostic criteria
The diagnostic criteria of alcohol use disorder are as follows:
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- Alcohol is often taken in larger amounts or over a longer period than was intended.
- There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
- A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
- Craving, or a strong desire or urge to use alcohol.
- Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
- Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
- Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
- Recurrent alcohol use in situations in which it is physically hazardous.
- Alcohol use continues despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
- Tolerance, as defined by either of the following:
a) A need for markedly increased amounts of alcohol to achieve intoxication or the desired effect.
b) A markedly diminished effect with continued use of the same amount of alcohol. - Withdrawal, as manifested by either of the following:
a) The characteristic withdrawal syndrome for alcohol.
b) Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.
Screen yourself with this alcoholism test
Go through the self-screening questionnaire below to learn which type of alcohol use disorder you may have. If you answer “yes” two to three times, it indicates mild alcohol use disorder. Four to five times indicates moderate AUD, and six or more times indicates severe AUD.
This questionnaire is a self-screening tool, not a clinical assessment. It’s intended to help you reflect on your drinking patterns, not replace a conversation with a doctor or addiction counsellor. If you have concerns about your drinking, speak to a healthcare professional or contact us.
Alcoholism screening questionnaire
Answer YES or NO to the following questions, and track how many times you answered YES.
In the past year, have you:
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- Continued to drink even though it was making you feel depressed or adding to another health problem?
- Wanted to cut down or stop drinking, on more than one occasion, but couldn’t do it?
- Had to drink much more than you once did to get the effect you wanted?
- Given up (or cut back on) activities that were important or interesting to you, or gave you pleasure, to drink?
- Spent a lot of time drinking, or recovering from the after-effects of drinking?
- Wanted a drink so badly you couldn’t think of anything else?
- Found that drinking (or being sick from drinking) has interfered with your personal life, like taking care of your home or family, or caused problems for you at work or school?
- Continued to drink even though it was causing trouble with your friends or family?
- Gotten into situations that increased your chances of getting hurt while or after drinking, on more than one occasion?
- Ended up drinking more, or for longer, than you intended?
- Experienced withdrawal symptoms when the effects of alcohol were wearing off — such as shakiness, restlessness, nausea, sweating, difficulty sleeping, a racing heart, or a seizure?
How many AUD criteria do you meet?
How many times did you answer “yes” to the questions above?
- 0-1 times: Your drinking is unlikely to be causing significant harm. That said, if something prompted you to take this questionnaire, it’s worth paying attention to. Patterns can change, and the earlier a problem is recognised, the easier it is to address.
- 2-3 times: You likely have a mild alcohol use disorder. At this stage, change is most achievable. Speaking to your GP or an addiction counsellor is a practical starting point. An outpatient programme may be all that’s needed to bring your drinking under control.
- 4-5 times: You likely have a moderate case of AUD. At this level, self-directed change is harder, and the risk of relapse without support is much higher. Speak to an addiction counsellor or our admissions team. They’ll help you determine which level of support best fits your situation.
- 6+ times: You likely have severe alcohol use disorder. At this level, stopping without medical supervision carries a risk of serious withdrawal complications. Medical detox is the safest first step. Contact us to talk through your options.
Health risks associated with AUD
If you drink too much alcohol, it can lead to problems in your job, relationships, and other important aspects of your life — including your health.
Excessive drinking is associated with an increased risk for many health issues, including:
- Liver disease (hepatitis and cirrhosis)
- Dementia
- Cancer (especially of the breast, colon, liver, oesophagus, or throat)
- Heart failure
- Irregular heart rhythms
- Brain damage
- Stomach ulcers
- Stroke
- Sleep disorders
- Osteoporosis
- Malnutrition
- High blood pressure
- Concentration issues
- Weight gain
- Depression
- Anxiety
In pregnant women who drink alcohol, there is also a danger that the baby will develop physical and psychological problems such as fetal alcohol syndrome.
Are you drinking too much?
So what exactly constitutes excessive drinking? Here’s what the National Institute on Alcohol Abuse and Alcoholism (NIAAA) says:
- Binge drinking – 4+ drinks in a single day for women, or five+ drinks for men.
- Heavy drinking – 8+ drinks in a week for women, or 15+ drinks for men.
If you suspect you have alcohol use disorder, you can do a few things to test the waters:
- Take a break from drinking for a month. If you find it hard to stop, you may have a problem.
- Ask the people you frequently spend time with what they think. If they’re affected by your alcohol use or think your drinking is causing issues, you likely have a drinking problem.
- Talk to a healthcare professional and get evaluated for alcohol use disorder.
Some people don’t realise they have a problem because they haven’t increased their alcohol intake. Or they have, but still consider themselves to be perfectly functional. However, once they try to stop drinking, they often find themselves struggling and feeling ill.
It’s important to remember that the body’s ability to metabolise alcohol declines with age. This means that as you get older, alcohol can more easily impair your day-to-day functions. Certain medications can also cause dangerous interactions with alcohol, which can lead to potentially life-altering health incidents such as strokes or seizures.
And if you’re a parent, the benefits of sober parenting speak for themselves once you understand how having an alcoholic parent impacts children.
What to do if you have a drinking problem
If you even mildly suspect that you or a loved one has AUD, the best thing to do is seek help.
Seek medical advice
Consult your doctor. If you go to your doctor, ask them to look for signs that alcohol is affecting your health, such as higher blood pressure or higher liver enzymes. When you can physically see the effects of alcohol abuse, it can make it easier to acknowledge the seriousness of the issue.
If it is discovered that you do suffer from alcohol dependence, you’ll need medical guidance to help you stop drinking.
Get help for alcohol use disorder
If you’re physically addicted to alcohol, you’ll need help coping with the withdrawal symptoms. These can include anxiety, sweating, trembling, nausea, insomnia, cramps, and — in severe cases — psychosis, and even life-threatening seizures. Some rehab centres, including Houghton House, offer medically-supervised detox to get you through the alcohol withdrawal process safely with 24/7 clinical care, emotional support, and specialised alcohol withdrawal medication to ease your discomfort.
In the long term, therapy (such as cognitive behavioural therapy or CBT), a recovery sponsor, and group support — like 12-step programs — can help you change your behaviour and keep you away from the bottle.
Lean on your support system
Being honest with the people close to you about your drinking makes it easier for them to help. Friends and family who know what’s happening can offer practical support, check in on you, and hold you accountable without having to guess at what’s wrong.
Not everyone has that support readily available, and for some people, relationships have already been strained by the drinking. If that’s your situation, a counsellor can help you approach those conversations, and groups like Al-Anon offer support specifically for the families of people with alcohol problems.
Houghton House’s family support programme is also open to anyone with a loved one affected by alcohol, whether or not they’re currently in treatment.
Change your environment
Another way to stop drinking is to change your environment, alter your routines, and stay away from the settings and social activities you associate with drinking.
Removing alcohol from your home, building different winding-down routines, and giving those weekend braai-and-brandy evenings a miss in the early stages are all practical ways to reduce the cues or triggers that make drinking feel automatic. Cravings are often less about willpower than context, and removing yourself from familiar drinking environments takes away a significant part of the pressure.
The harder part is keeping those changes in place. Going back to the same settings and social rituals before you’ve built a stable foundation in sobriety is one of the most reliable routes to relapse. The environment hasn’t changed, and old patterns tend to reassert themselves once you’re back in them.
If your home environment makes sobriety very difficult to maintain, you might consider a halfway house. Halfway houses offer an alcohol-free communal living environment that can help you find your footing in recovery.
Take the first step
Contact Houghton House rehabilitation centres in Johannesburg for guidance on this subject. We offer free, no-obligation evaluations for alcohol use disorders, as well as personalised alcohol addiction treatment programmes that are fully covered by most medical aid schemes.
