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There's a big difference between having a beer after a hard day at work and actual alcohol dependency. One is harmless (and possible harm-reducing), the other d

There's a big difference between having a beer after a hard day at work and actual alcohol dependency. One is harmless (and possible harm-reducing), the other destroys lives and relationships. We need to be able to differentiate between the two without conflating them.

hobs 8y ago
The GP clearly notes they are an alcoholic, so I wouldn't say the responder is conflating anything.
- barking 8y ago
  So what's an alcoholic? Seems to me that almost all drinkers are, seeing as how most of them find it nicer to keep drinking.
  - finaliteration 8y ago
    If we shouldn’t conflate having a single drink with alcohol-dependency then we also shouldn’t conflate the occasional drinker with those who are struggling with alcohol-dependency.
    - barking 8y ago
      When I started smoking I used to smoke other people's cigarettes. Then I started buying my own out of embarrassment. I wasn't a tobacco addict in my own mind at that stage, I just like smoking. It was only when I wanted to quit I found it really hard to stay off for long periods. Eventually I managed it. The level I smoked at was about 10-15 a day. I know a man who smokes 60 a day. He is probably more addicted than I was but it's a matter of degree rather than me being able to look down on him as an addict as compared to my moderate level of smoking.
  - francisofascii 8y ago
    It is best measured on continuum, rather than a binary.
  - DanBC 8y ago
    Harmful drinking covers a wide range of behaviors and levels of drinking. https://www.nice.org.uk/guidance/cg115 https://www.nice.org.uk/guidance/cg115 Someone can be doing harm to themself well before they reach dependent-drinking levels. > Harmful drinking is defined as a pattern of alcohol consumption causing health problems directly related to alcohol. This could include psychological problems such as depression, alcohol-related accidents or physical illness such as acute pancreatitis. In the longer term, harmful drinkers may go on to develop high blood pressure, cirrhosis, heart disease and some types of cancer, such as mouth, liver, bowel or breast cancer. Alcohol-dependency is marked by > craving, tolerance, a preoccupation with alcohol and continued drinking in spite of harmful consequences (for example, liver disease or depression caused by drinking). Alcohol dependence is also associated with increased criminal activity and domestic violence, and an increased rate of significant mental and physical disorders. Although alcohol dependence is defined in ICD-10 and DSM-IV in categorical terms for diagnostic and statistical purposes as being either present or absent, in reality dependence exists on a continuum of severity. However, it is helpful from a clinical perspective to subdivide dependence into categories of mild, moderate and severe. People with mild dependence (those scoring 15 or less on the Severity of Alcohol Dependence Questionnaire; SADQ) usually do not need assisted alcohol withdrawal. People with moderate dependence (with a SADQ score of between 15 and 30) usually need assisted alcohol withdrawal, which can typically be managed in a community setting unless there are other risks. People who are severely alcohol dependent (with a SADQ score of more than 30) will need assisted alcohol withdrawal, typically in an inpatient or residential setting. In this guideline these definitions of severity are used to guide selection of appropriate interventions.
finaliteration 8y ago
> There's a big difference between having a beer after a hard day at work and actual alcohol dependency. I’m not saying they’re the same thing and that having a beer ruins lives. I certainly have a glass of wine from time to time and don’t feel it’s having an impact on anyone around me. But, at least to me, “self-medicating” implies far more consumption than just one drink.
DanBC 8y ago
A beer a day is definitely not harm-reducing. One beer a day could be one 330 ml bottle of beer at 5%. That's 11 uk units a week, which is at the upper end of the maximum recommended level.
- freehunter 8y ago
  Define harm, and explain maximum recommended level for what. (This is rhetorical)

hobs 8y ago

The GP clearly notes they are an alcoholic, so I wouldn't say the responder is conflating anything.

barking 8y ago
So what's an alcoholic? Seems to me that almost all drinkers are, seeing as how most of them find it nicer to keep drinking.
- finaliteration 8y ago
  If we shouldn’t conflate having a single drink with alcohol-dependency then we also shouldn’t conflate the occasional drinker with those who are struggling with alcohol-dependency.
  - barking 8y ago
    When I started smoking I used to smoke other people's cigarettes. Then I started buying my own out of embarrassment. I wasn't a tobacco addict in my own mind at that stage, I just like smoking. It was only when I wanted to quit I found it really hard to stay off for long periods. Eventually I managed it. The level I smoked at was about 10-15 a day. I know a man who smokes 60 a day. He is probably more addicted than I was but it's a matter of degree rather than me being able to look down on him as an addict as compared to my moderate level of smoking.
- francisofascii 8y ago
  It is best measured on continuum, rather than a binary.
- DanBC 8y ago
  Harmful drinking covers a wide range of behaviors and levels of drinking. https://www.nice.org.uk/guidance/cg115 https://www.nice.org.uk/guidance/cg115 Someone can be doing harm to themself well before they reach dependent-drinking levels. > Harmful drinking is defined as a pattern of alcohol consumption causing health problems directly related to alcohol. This could include psychological problems such as depression, alcohol-related accidents or physical illness such as acute pancreatitis. In the longer term, harmful drinkers may go on to develop high blood pressure, cirrhosis, heart disease and some types of cancer, such as mouth, liver, bowel or breast cancer. Alcohol-dependency is marked by > craving, tolerance, a preoccupation with alcohol and continued drinking in spite of harmful consequences (for example, liver disease or depression caused by drinking). Alcohol dependence is also associated with increased criminal activity and domestic violence, and an increased rate of significant mental and physical disorders. Although alcohol dependence is defined in ICD-10 and DSM-IV in categorical terms for diagnostic and statistical purposes as being either present or absent, in reality dependence exists on a continuum of severity. However, it is helpful from a clinical perspective to subdivide dependence into categories of mild, moderate and severe. People with mild dependence (those scoring 15 or less on the Severity of Alcohol Dependence Questionnaire; SADQ) usually do not need assisted alcohol withdrawal. People with moderate dependence (with a SADQ score of between 15 and 30) usually need assisted alcohol withdrawal, which can typically be managed in a community setting unless there are other risks. People who are severely alcohol dependent (with a SADQ score of more than 30) will need assisted alcohol withdrawal, typically in an inpatient or residential setting. In this guideline these definitions of severity are used to guide selection of appropriate interventions.

finaliteration 8y ago

> There's a big difference between having a beer after a hard day at work and actual alcohol dependency. I’m not saying they’re the same thing and that having a beer ruins lives. I certainly have a glass of wine from time to time and don’t feel it’s having an impact on anyone around me. But, at least to me, “self-medicating” implies far more consumption than just one drink.

DanBC 8y ago

A beer a day is definitely not harm-reducing. One beer a day could be one 330 ml bottle of beer at 5%. That's 11 uk units a week, which is at the upper end of the maximum recommended level.

freehunter 8y ago
Define harm, and explain maximum recommended level for what. (This is rhetorical)