THE MYTH OF THE 'FINE LINE' BETWEEN HEALTHY AND UNHEALTHY DRINKING

By: Joseph Nowinski

This is a question that I'm often asked: "Where is the fine line that separates normal drinking from problem drinking?"

People ask this question for a good reason: They want to know if their own drinking qualifies a "normal" or "abnormal." This thinking also reflects the way we've traditionally come to think about drinking, which has been in black-and-white terms. Ever since medical professionals came up with a set of symptoms that they labeled alcohol dependence, or, more simply, "alcoholism," it has been popular to see the "drinking world" in terms of two categories: Either you are an alcoholic, or you are not. The implication here is that if you do not qualify for a diagnosis of alcohol dependence, you are "okay."

Although the intention of creating an official diagnosis of alcoholism was to allow a group of men and women who satisfied that diagnosis to get help, it has also led to a dangerous oversimplification of the real "drinking world." It has also given rise to a problematic concept called denial. People are said to be "in denial" when someone else -- a spouse, a doctor, a therapist -- says they are an alcoholic and they argue that they are not. It has also given rise to the mistaken belief that before an alcoholic can recover they must, first, accept denial and admit their alcoholism and, second, to accept that they have to abstain from drinking for the rest of their lives. In reality, I personally know many people who are in recovery who have not had a drink in many years, who have admitted that they were never really sure they were alcoholics but decided that abstinence was a better way of life for them. This give rise to the question: "Is there really a fine line that people cross into alcoholism?"

The Real Drinking World

Dr. Rob Doyle and I have recently proposed a way of viewing "the drinking world" that we believe to be more accurate than the black-and-white thinking that is represented by he above diagram. Specifically, we believe that the real drinking world looks something like this:

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