How Do I Know If I Have A Problem With My Drinking?

Illustration: Assa Ariyoshi
Many of us dread the doctor inquiring about our alcohol intake. “How much do you drink?” they’ll ask. At which point we’ll take a well-considered pause, make a “meh” face and say, “Hmm, not that much. Maybe a couple of glasses of wine a week?”
And sure, for many of us, that’s true (although for some reason we still feel like we’re lying) but for others, maybe it’s a little more than that. Maybe it’s even a lot more than that. However much you drink, though, there’s definitely a stigma around alcohol that we need to break down if we’re ever, as a country, going to have a healthy relationship with it.
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Someone who’s trying to help is Mark Holmes, a specialist alcohol nurse and online DrinkCoach for HAGA, an online coaching organisation that allows people who are concerned about their relationship with alcohol to figure it out, with a counsellor, over Skype. The average woman Mark sees? A 29-year-old, middle-class professional.
“I believe it’s the biggest stigma that we still have in this country,” says Mark. “If you say you have a bit of a coke problem or a bit of a cannabis problem, I think that’s more acceptable than alcohol. Alcohol [problems] are seen as weak.”
Recently, we’ve been presented with a whole bunch of studies that show that drinking is in decline. From reports that half of adults are shunning regular alcohol intake to those saying 16-24-year-olds are barely drinking at all, there is nevertheless a rise in alcohol consumption occurring among well-educated, well-off women.
This could mean women who are 40+, sure – the Big Little Lies housewives whose never-empty glasses of sauvignon blanc are bigger than soup bowls. But this could also mean the group of 28-year-olds sipping prosecco at brunch in Manchester’s Northern Quarter; it could mean the Vetements-wearing hipsters drinking kombucha and stevia cocktails in an east London warehouse; it could mean the Michael Kors and gin-in-a-tin-toting hen do on the 18:47 out of Paddington on a Friday night.
It could mean you.
But is it totally our fault? Or has advertising driven us to make false assumptions about our alcohol intake? Over the past few years, premium alcohol has cornered its market. “I think the drinks industry has realised that young people are drinking less, but they’re drinking more premium drinks,” Mark says, adding that he believes that drinks companies are now aiming for the higher profit margin that comes with people willing to pay more for a triple-distilled gin in a nice bottle.
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The problem, though, is that premium drinks have the same effect as non-premium. Just because we’re drinking a cocktail that cost £12, doesn’t mean we’re consuming any less alcohol than if we were necking several cheap cans of cider.
“I was talking to a lady the other night and she was saying that she’s drinking half a bottle of, as she put it, ‘nice quality wine’ a night,” says Mark. “But actually, when I equated it to other alcohol, she didn’t realise that she was drinking potentially the equivalent of a bottle and a half of vodka a week.”
Prosecco, he says, is a law unto itself. “Prosecco has come from nowhere in three or four years. The marketing’s been incredible.” It is now, as we all know, acceptable to have a glass at the hairdressers, or instead of tea when you're sat around the kitchen table at your mates' houses. Look past the bubbles, though, and Mark says you realise that it is aimed at one market. "And that market’s not men, is it? It’s aimed at women.”
Women are being falsely reassured by the expense of their alcohol. “I know people, I’ve seen their Instagram feed, who are obsessed with their health,” Mark says. “They clearly eat the right things and take protein shakes but when it comes down to alcohol they’re drinking things they don’t know what’s in it.” Because, thanks to the fact that there is no law about labelling the ingredients of an alcoholic drink, we’re unlikely to know anything about the quite probably astounding amounts of sugar in our premium cocktails.
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If we sit down and really think about it, we know that too much alcohol – no matter how expensive – is bad for us. But we don’t listen. As Mark puts it: “We almost stick our fingers in our ears when it comes to alcohol and say ‘blah blah blah’.” For those that do think they should get a little bit of help, the stigma surrounding that choice is huge. Going from posting beautiful cocktails on Instagram to an Alcoholics Anonymous meeting in the local community centre seems a step too far for many. AA is for a different kind of drinker, we tell ourselves, those who rely on cheap bottles of cider to get through the day.
Actually, Mark says, he sees “a whole breadth of people” across the services he works in. When it comes to Drink Coach, he says that the majority of people he sees aren't necessarily alcohol-dependent. They are perhaps just drinking "a little too much". They are people who wouldn't "dare" to go to an alcohol service. "The stigma of actually walking through those doors is quite dramatic. And it shouldn’t be, but we have to recognise that.”
Speaking to Mark, it seems the goal isn't necessarily to aim for a place of teetotalism. “Virtually everyone I see, their aim is to cut down,” Mark says. Some clients will decide to cut alcohol out altogether (those who work better with an all-or-nothing mindset), but others choose just to work on their relationship with alcohol. In fact, he says, by the end of the sessions some people will be drinking a similar amount to before but “they’ve learned to manage it in a different way so that they begin to learn to enjoy the drink a lot more.”
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So how do you know if you’re in need of a little advice? If you're worried, that's probably as good a sign as any.
“I really believe we need to nip things in the bud with early intervention,” says Mark, and there are plenty of things you can try. Drink Coach has an online screening test which, for once, doesn't feel patronising or judgemental.
Still unsure? Mark recommends keeping a drink diary. Just for yourself. Not for anyone else. Once you’re finished, look at why you drank all those times. “Is it a habit?" he asks. "Are you doing it for reward, because you deserve it? Are you doing it because you enjoy it? It can really give you an idea of what’s going on with your consumption.”
Most important, though, is just to talk. It's the only way we're going to break that stigma.
To find out more visit DrinkCoach
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