are you an alcoholic?

Until I dated a girl who had a nightly glass of wine (or two), I hadn't really thought about this question at any length. In my mind, alcoholism was closely correlated with common/routine bouts of drunkenness. With my friend, it became apparent that addiction could manifest itself more benignly-- as dependence that did not necessarily impede performance, at least dramatically.

This article, from Melinda Beck in the WSJ, explores the same questions...

More than 30% of Americans engage in risky drinking at some point in their lives, according to the National Institute on Alcohol Abuse and Alcoholism. But there's no consensus on exactly what an "alcoholic" is. Even Alcoholics Anonymous relies on alcoholics to diagnose themselves.

Researchers have made up dozens of screening tests over the years. According to one developed for Johns Hopkins University Hospital years ago that still pops up on the Web, I'm "definitely an alcoholic" because I answered yes to at least three of 20 questions: I "crave a drink at a definite time of day" (evenings, mostly) and drink alone (sometimes) and drink to "escape from worries or troubles" (doesn't everyone who drinks?).

But Alcoholscreening.org says I'm "below the range usually associated with harmful drinking or alcoholism" since I have only a glass or two of wine when I drink.

The authoritative American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, or DSM-IV, separates alcohol abuse from alcohol dependence, based partly on the problems the drinking causes. You qualify for a diagnosis of "abuse" if you've done any one of these in the past year: drunk alcohol in hazardous situations, like driving; kept drinking despite social or interpersonal problems; had legal problems related to alcohol or failed to fulfill major obligations at work, school or home because of drinking.

You've moved on to "dependence" if you've done any three of these seven: drunk more or longer than you intended; been unable to cut down or stop; needed more alcohol to get the same effect; had withdrawal symptoms without it; spent more time drinking or recovering; neglected other activities or continued to drink despite psychological or physical problems.

Experts long believed that abuse progressed to dependence, which almost inevitably became chronic and relapsing -- but that was based on observing severely addicted people in treatment programs. Several large new surveys have shown that drinking patterns in the general population are much more varied, with milder forms of dependence. Some 43% of daily heavy drinkers don't fit into either DSM-IV category, according to one big national sample, even though they are setting themselves up for serious health and addiction problems....