When you hear the word “alcoholic,” what comes to mind?
Is it the belligerent drunk father sitting in a recliner pounding beers while terrorizing his wife and family?
Is it the stumbling homeless man who smells like ethanol begging for change on the corner and sipping something out of a brown paper bag?
Maybe you envision Meg Ryan’s character in When A Man Loves A Woman collapsed in the shower, drunk, leaving her children to find her.
We think we know what an alcoholic is (and isn’t). The truth, however, is more nuanced and complicated.
Do alcoholics drink every day?
Not all alcoholics drink every day. Many so-called high-functioning alcoholics fit the clinical diagnosis of an alcohol use disorder but still manage to carry out daily tasks such as maintaining hygiene, keeping a job, and paying bills. You don’t have to drink daily to have a drinking problem.
You might be struggling with alcohol use disorder (what we typically call alcoholism) if your alcohol consumption has negatively impacted your professional and personal life, but you continue to drink. You know it’s harming your life, but you can’t seem to reduce or stop drinking.
But what’s the technical definition?
American Addiction Centers defines alcohol use disorder in the following way:
“An alcohol use disorder is a treatable chronic medical disorder that causes long-term changes in the brain that make it difficult to control drinking without leading to clinically significant impairment or distress.”
You can meet this definition without drinking daily.
That’s because AUD ranges in severity. Sometimes that range makes people delay getting help.
They think, “Well, I don’t drink every day,” or “I still have my job and pay all my bills,” so they convince themselves that their drinking is still okay.
But that’s where many people go wrong.
Are you questioning your drinking?
Typically when someone asks if alcoholics drink every day, and they are referring to themselves, they are trying to gauge their drinking habits. (I have a quiz to help you with that.)
If this is you, chances are you engage in gray area drinking, an in-between kind of drinking that might not tick all the boxes of AUD, but you exist on the spectrum.
You might not experience the full range of clinical impairments, but you’re headed in that direction and know that alcohol negatively impacts your life.
You’re concerned but don’t want to quit drinking, so you want confirmation that you aren’t an alcoholic. That it’s not as bad as you fear it might be.
Or maybe I’ve just described a loved one in your life.
Whether or not you or a loved one suffers from AUD is something I can’t answer. But I can help you understand this topic more fully so that you can make an informed choice about what to do next.
What is alcoholism?
The term du jour is alcohol abuse disorder (AUD), but it’s the same. It’s meant to encompass both chronic alcohol abuse and dependence. There are 16 million Americans currently battling various stages of AUD; of course, it doesn’t happen overnight.
What are the stages of Alcohol Use Disorder?
How do we even get on this path?
Many of us start experimenting with alcohol and gradually push the limits of our drinking. Think back to your earlier days of partying. Despite the repercussions, we decide it’s worth the excitement to try again.
When you’re young, it’s presented as a rite of passage.
Somehow getting trashed and engaging in risky behavior while puking in your friend’s hat and dying the next day of a hangover is normal.
We push the boundaries more. Instead of partying on weekends, we add a Wednesday into the mix. Maybe we get a DUI or have a regrettable hookup. Maybe something worse happens.
Par for the course, right? We’ll grow out of our partying ways eventually.
But many of us don’t. We take the alcohol out of the party and into our everyday adult lives.
Early Signs of Alcoholism and Alcohol Abuse
Our little dance with addiction typically starts with occasional binge drinking.
It’s that experimental stage I just mentioned.
How far can we take it? What’s the most amount of drinking I can do and still drag myself to class or work the next morning?
From there, we progress into weekend drinkers. We go hard every weekend without fail. Drinking becomes the catalyst for getting together with friends.
“Hey, you guys wanna come over and have some drinks?”
The frequency of those invitations increases. You go from drinking as a social activity to drinking as a way to decompress and drinking as stress relief. This is where your relationship with drinking takes a darker turn.
The invitations become, “I’ve had a horrible day. Want to grab a drink at the bar after work?”
This was my MO during my problem-drinking days.
I worked a high-stress job that ramped up pre-existing mental health problems to unmanageable levels. Rather than get help or switch careers, I drank.
Not alone…at first.
My misery had company for a while. My coworkers and I had our go-to happy hour spot where we drank away the heaviness of our week. I was routinely the first to get there and the last to leave.
But that’s where it started.
What are the stages of alcohol use disorder?
Alcohol abuse doesn’t happen suddenly. It’s insidious that way. It is progressive. For anyone questioning their own drinking or feeling concerned about a loved one, it’s useful to understand the stages of alcoholism.
It’s important to clarify some basic terms we use when discussing drinking.
Talking about alcohol consumption in terms of “heavy” or “too much” is subjective. That is why we’ll use the agreed-upon definition when discussing health risks associated with alcohol consumption.
Binge drinking is defined as 4+ drinks for men and 3+ drinks for women on a single day or occasion.
Heavy drinking is considered 5 or more episodes of binge drinking in a given month. Once you engage in moderate to heavy drinking regularly, you’re at risk for alcohol dependence.
Your brain becomes accustomed to using alcohol to boost dopamine and deal with stress, boredom, and other unpleasant feelings. It produces less dopamine on its own and becomes dependent on the artificial boost of dopamine from alcohol.
As your brain adjusts to the constant presence of alcohol, it starts to close dopamine receptors, forcing you to drink more alcohol to get the same effect (more on that in a bit).
This is when alcohol starts changing you in fundamental ways.
You may not be physically reliant on alcohol, but you will notice a psychological dependence forming.
You’ll start to feel more depressed or agitated if you go long periods without alcohol (for all the reasons listed above). Alcohol starts to shrink the areas of the brain responsible for impulse control and emotional regulation.
At this point, you may notice that alcohol changes your personality and ability to experience joy outside of drinking. You’ll start experiencing alcohol-induced mood swings and may even become aggressive while drinking.
You might also notice more reckless behaviors, like drunk driving or engaging in risky sexual activity.
Social Problems Caused By Drinking
Once you enter the at-risk stage or early alcohol use disorder, your personal relationships become more seriously effective. Common problems include:
- Losing relationships with others
- Erratic behavior
- No longer receiving social invitations
- Changing friends and social circles frequently
- Struggling to communicate with strangers
I spent years hopping from one social circle to the next. People got sick of my antics. Drunk me could suck the oxygen out of any room and frequently did.
Even when I tried to be a better friend or make myself available to others, I couldn’t connect. It felt like my brain was stuck in off-mode.
Despite my efforts, I couldn’t will myself the ability to be an engaged, present friend. I couldn’t shake the feeling that I just wanted to go drink somewhere.
It’s around this time that a lot of people start asking serious questions about their drinking. Maybe that’s where you are right now.
You might go back and forth with yourself over quitting.
Do you have a drinking problem or just need a break from alcohol?
Around this time, you may even experiment with short stints of sobriety, like one or two weeks, before drinking again.
Or maybe you try moderation with mixed results. Eventually, however, you wind up at a party or happy hour that gets out of hand and end up drinking heavily again.
This is where most people would benefit from early intervention but never get it.
If problem drinking continues unchecked, you may become physically dependent on alcohol to function. In the dependence stage, you lack control over your drinking. You want to stop or drink less, but you can’t.
This is also the stage where your tolerance increases. You continue drinking despite the damaging effects on your overall health, which you can feel at this point.
I used to wake up every morning feeling like my heart would explode out of my chest.
I tried to bury myself under blankets and pillows to calm down. I’d ask my husband to hold me while I took deep, ash-flavored breaths. (I’m still haunted by memories of next-day breath that no toothpaste could vanquish.)
I desperately needed to stop but would inevitably go back to drinking as soon as I came home from work.
When you can no longer physically or psychologically function without alcohol, you are officially in the mid-stage alcoholic territory.
I never wanted to end up in that place. The mere mention of the word “alcoholic” angered me. Once, during an attempt to see a therapist and get help, the topic of my drinking came up.
“I think there’s a problem here,” she said. “You need to go to AA.”
It was painfully obvious she was right, yet I’d never felt so offended. I told her what she could do with herself and never went back. (I was in denial.)
I ticked all the boxes, yet I could maintain a job, pay my bills on time, and enjoy an otherwise normal life, which made me believe that I was somehow above being labeled an alcoholic.
But I wasn’t.
Every medical assessment I took pointed toward a problem, but I was not receptive to the idea and refused help.
If you think you might have a drinking problem, you can also take the following Alcohol Use Disorder Identification Test (AUDIT).
These questions are similar to what a medical professional would ask you; however, it is not a substitute for medical advice or an official diagnosis. Use this quiz as a tool to examine your drinking patterns.
Final Thoughts: Do Alcoholics Drink Every Day?
Drinking every day is not the hallmark of alcoholism or AUD. You can suffer from AUD and still function and drink a few times per week.
The larger point is the way we stigmatize alcoholism more broadly.
Alcoholism is viewed as a personal failure and weakness. It’s an icky word, basically taboo, the kind of word we lower our voices to say.
In my mind, that word was for people who lost their homes and families to alcohol, those who woke up and drank first thing in the morning, and those with hidden bottles stashed around the office.
There was an ugliness to it I did not want.
Despite destroying relationships, burning professional bridges, and creating drama in my own family and marriage, I refused to entertain the idea that I, too, was an alcoholic.
It’s why I didn’t get help sooner.
In retrospect, it was also stupid to allow my ego and fixation with a label to keep me from getting the help I needed. Hopefully, you won’t make the same mistakes I did.
You don’t have to figure this out on your own.
Do you have to call yourself an alcoholic?
Hot point of contention in the recovery community. I’m not an expert, but my opinion is that you don’t. However, there is a caveat!
You have to admit you have a problem.
My hangup with identifying (or not) as an alcoholic was an excuse I used against myself to continue drinking.
It became an obstacle to my own healing. Rejecting that label meant I could not see alcohol as the real villain in my life.
I knew I drank to escape feeling stressed, miserable, and like my life had no joy or meaning. But I didn’t know that alcohol was reshaping my brain in ways that worsened those conditions.
Instead, I focused on the stigma of the label and the ultimately pointless debate over whether I had a “disease” for which there was no “cure.”
I had to shift my focus to sobriety and healing.
If calling yourself an alcoholic is the final step that brings you to sobriety, counseling, and healing (as it has for thousands of people), then that’s what you should do. Embrace it. There is nothing shameful in it.
If, for whatever reason, it prevents you from getting help and quitting alcohol, let it go.
What difference does it make if you get sober and turn your life around?
If you’re rejecting the label alcoholic because you want to leave yourself the option to drink again, that’s a problem. You haven’t accepted that you need to quit drinking yet and will likely stay on that relapse merry-go-round.
But if you reject calling yourself an alcoholic because it’s not serving you and you’re living your best, alcohol-free life without it, then I say do what works for you.
Whether or not you identify as an alcoholic is less important than whether you’re getting sober and getting your life back on track.
Know the warning signs of a drinking problem and get help. Everything else is secondary.