Straight, No Chaser: Self Assessment of Alcohol Dependency

The number one response to the post on acute alcohol poisoning was pretty simple: “How can I tell if I’m drinking too much over the long haul?” And so it’s back to back the Straight, No Chaser (literally) days. The problems with most intoxicating substances involve the same consideration. You had the most incredible time and got the most incredible high the first time, and you spend the rest of your life chasing the joy of that first buzz, which for most drugs you’ll never get again. The difference with alcohol abuse is that alcohol is legal and comparatively inexpensive, so you get to keep trying without much fuss (at least initially).
Let’s set the stage by standardizing some terms:


  • Alcohol intoxication: You’re drunk and under the influence of alcohol.
  • Alcohol abuse: Your drinking habits are unhealthy, resulting in bad consequences (e.g., at work, in your relationships, with the law).
  • Alcohol dependency: You’re physically and/or mentally addicted to alcohol.  You crave liquor and seemingly can’t do without it.  Dependency involves withdrawal symptoms when alcohol is not in your system.  These symptoms may include anxiety, nausea, sweating, jitteriness, shakes and even withdrawal seizures.

Alcoholism is a chronic disease. Unfortunately, some of us start with a predisposition based on genes and strong influences based on family and cultural considerations. It is so much more than either a lack of willpower or an inability to quit. This disease has a predictable course and defined effects on various parts of the body, leading to specific means of death if unaddressed. Because I’m Straight, No Chaser, I’m not going to deal with the subjective “I can handle my liquor” or “I can stop anytime I want.” I’m going to give you some medical data that defines when you’re doing damage to your body.  It’s actually pretty simple.
Are you this guy or gal? (Keep in mind a standard drink is defined as one 12 ounce can of beer, one glass of wine or one mixed drink.)


  • Women having more than three drinks at one time or more than seven drinks a week
  • Men having more than four drinks at one time or more than 14 drinks a week

If so, you’re causing damage.  We’ve discussed the damage in these additional Straight, No Chaser posts.

Now let’s discuss dependency. Consider the possibility that you may be dependent on alcohol if you have any of these problems over the course of a year:

  • While you’re drinking, you can’t quit or control how much you drink.
  • You have tried to quit drinking or to cut back the amount you drink, but can’t.
  • You need to drink more to get a previous effect. (This is called “tolerance.”)
  • You have withdrawal symptoms (discussed earlier) when you stop.
  • You spend a lot of your time either drinking, recovering from drinking or giving up other activities so you can drink.
  • You continue to drink even though it harms your relationships and causes physical problems.

So What?
Unfortunately, I’m pretty sure no one is giving up alcohol by reading this. Alcohol is part of the American social fabric. We live, celebrate and commemorate milestones with it. It’s glamorized throughout society. It’s constitutionally approved. I appreciate that. In moderation, it’s a good time. Just understand that it’s not a free ride. The danger is in the insidious nature of this disease, meaning issues may creep up on you before you ever know what’s hit you. Then we’re having a completely different conversation.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
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