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A readers asks:  ‘I don’t drink in the mornings or have black outs, but my hangovers are getting worse and I drink 1-2 glasses most nights and at least a bottle on nights out.  How can I know if I have a drink problem?  Where can I get help?  What help is there if I don’t want to go to AA and don’t think my problem warrants rehab?!’

Mandy Saligari smallMandy Saligari, founder, clinical director and counsellor at leading London addiction treatment facility Charter in Harley Street has your answer

Drinking in the mornings and having blackouts are easily identifiable signs of an extreme alcohol abuse dependence or addiction. Blackouts for example are an early sign of Korsakoff’s Syndrome where permanent neurological damage is done so that a person experiences severe short term memory loss. Although many people report blackouts as an acceptable part of their drinking experience, take note.  On any journey there are points at which you can get off or take preventative measures and attending to the early warning signs is infinitely better than dealing with the damage.

At Charter we hear from many people who report a growing discomfort with their relationship with alcohol so that they are drinking more than planned, maybe behaving in ways that cause them to feel ashamed or embarrassed, or feeling so rough and hungover that it compromises their next day.

The first rule of diagnosis is to see where the drinking behaviour needs adjusting and to discover if you are actually in control.  Some report making assertions around their drinking consumption that they cannot keep, such as trying to drink less and not being able. This is different to those who are able not to drink on certain occasions, but get blathered on others.

So make a plan when you feel clear headed for your week’s drinking, and see if you can follow it through. Factor in how much you will drink at each occasion and when, as well as times when you will go out but not drink alcohol.  It is important that you include being sober at social occasions so that you can discover if you are using alcohol to compensate for feelings of inadequacy or shyness, social anxiety, or to achieve a sense of belonging.  Many people report fears of being boring or of feeling left out if they don’t drink, and even have friends who tell them this is the case!  Be aware of the price you may pay for these feelings if alcohol becomes a problem.  Brief therapy can work wonders with these symptoms to disentangle them from your use of alcohol and help you develop a more robust sense of valuable self.

Keep a diary through this process so that you find out the actual evidence of your drinking in black and white, not what you think.  Log the process, the craving, the ability to keep to the plan (or not), the emotions and the consequences. Be honest.  If your drinking is controlling you, you would be well advised to seek specialist help. Rehab, AA and therapy are perceived as support networks for those suffering from an extreme problem.  And its true.  But the same specialists treat extreme cases as well as those requiring early intervention. Extreme problems demand extreme measures – if you are alcoholic then it is likely you will need treatment and to remain abstinent for life, and AA can support you to achieve this.

However, simple problems demand simple measures so that if you attend to what is going on for you, you may not have to entirely give up drinking.  It may be a self-regulatory or emotional issue that needs attention, but that left to its own devices develops into full blown alcoholism. At Charter for example we can provide brief therapy to cut an addictive pattern off at the pass by helping a person to adjust their behaviour, their relationship with themselves, and attending to the emotional deficit exposed as a result.

Take the challenge, find out what’s going on and if you need help, confront the stigma and allow yourself the specialist input; prevention is so much better than cure.








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