Defining Alcoholism Video Transcript

Participants

David R. Marks MD, Richard Nelson Rosenthal MD, Carol Weiss MD, Michael Eckstein MD

Summary

Alcoholism is a widespread disease. Unfortunately, many sufferers are not aware that they are have a problem. What are the symptoms of alcoholism? And when should you worry? Our panel of experts will discuss the causes and warning signs of alcoholism and how to recognize them in yourself.

Webcast Transcript

DAVID MARKS, MD: I'm Dr. David Marks.

Many alcoholics don't even know they have a problem. So what are the symptoms of alcoholism? And when should you start worrying that you might have a problem? Joining us to answer these questions is Dr. Carol Weiss. She's an Addiction Psychiatrist and Clinical Assistant Professor of Psychiatry and Public Health at Cornell University Medical College, New York Presbyterian Hospital. Welcome.

And Dr. Richard Rosenthal, he's Chief of the Division of Substance abuse at Beth Israel Hospital in New York. Welcome.

So Carol, what's the difference between somebody who's an alcoholic and someone who just likes a drink or two?

CAROL WEISS, MD: Well, let's use the term "problem drinker" instead of alcoholic. An alcoholic is someone who has a problem with their drinking. Either they worry that they may have a problem, or someone else is worried that they have a problem. Just that is the beginnings of wondering whether or not you have a problem with drinking. There are some specific criterion that we use to determine whether or not somebody's a problem drinker. Have they tried to cut down and have been unable to cut down? Do they get annoyed and irritable when they drink? Do they feel guilty about their drinking?

And the most sever symptom is do they have to have a drink when they wake up in the morning?

That's sometimes called the CAGE questions: Cutting down; Annoyed; Guilty; Eye-opener. That's the sort of easy definition of alcoholism.

DAVID MARKS, MD: But someone who likes to take a drink at dinner, a glass of wine, that's not a problem, is it?

CAROL WEISS, MD: It's not a problem, if it's not a problem. If it doesn't disturb their social functioning, if it doesn't disturb their occupational functioning, if it doesn't disturb their health, it's not a problem.

DAVID MARKS, MD: Okay. Rick, Carol mentioned CAGE questions very briefly. Tell me about them.

RICHARD ROSENTHAL, MD: What they are is a sort of set of pocket tools that--that most clinicians should know if they don't know it. What you can use them for is a--is a sort of a rapid screening of a person to see if there's really a problem around drinking. So if the idea is Cutting Down, that's the first CAGE question.

What that really goes to is something that we addiction psychiatrists and other people in the addiction field have recognized is probably the most important factor around addiction. We used to think is was sort of the heroin model, okay. Where you still have to become physiologically dependent on the drug and then show withdrawal syndrome when you stopped it. We've evolved from that.

And so if you have tried to cut down, made unsuccessful attempts to cut down, that means that there's an issue about you drinking more than you had intended. Okay?

And so that becomes a very powerful and important symptom.

DAVID MARKS, MD: That's the "C."

The second one is Annoyance. Let me go a little bit further than what Carol said. It's a little bit more than not only annoyance when you drink, but annoyance that other people may have pointed out to you that they think that you drink too much. So it's annoyance at having that being brought up to in any kind of a way.

The third one is Guilt, which is saying, I think maybe I shouldn't be doing this. If you're beginning to have thoughts or feelings that there's some wrongness about your alcohol drinking behavior, whatever that might be. That's a positive sign.

And the last, as Carol said, Eye-opener use of alcohol.