Not Quite Alcoholic

Monday, April 09, 2012

Robert Doyle, MD, clinical instructor in psychiatry at Harvard Medical School and co-author with Joseph Novinski of Almost Alcoholic: Is My (or My Loved One's) Drinking a Problem? (The Almost Effect), talks about those people who fall somewhere between social drinkers and black-out drinkers.


Robert Doyle, MD

Comments [16]

Ben from Queens

I was disappointed the Dr. Doyle did not really address a very serious problem: the comorbidity of (near)alcoholism and mental illness.
An example would be those diagnosed with bipolar disorder who more often than not also abuse alchohol or drugs.
It is certain that much of this behavior began/continues in the desire to control, 'self-medicate', the symptoms of this illness.
My specific question is: is there any clinical evidence showing a higher vulnerability to alcohol among this population?
By this I mean both 'sensitivity' to alchohol (ie, a much smaller amount of alcohol intake has a much stronger effect on the individual), and
whether this population shows a higher incidence of serious, long-term alcoholism.

Apr. 10 2012 11:05 AM
Andrew Carothers MD from Englewood, New Jersey

9 April 2012
Rhetorically: Was Babe Ruth an alcoholic? Was Mickey Mantel an alcoholic? Was Winston Churchill an

Doctor Doyle need to travel more. Go to a pub in London for lunch. In France they make wine
for daily consumption. Italians drink vermouth with their breakfast coffee.
They're not drunks, they're just drinking!

Doctor Doyle will take us back to to 1918. A good Republican era.

Doctor Doyle. Take some Zanax. Leave us alone.
Andrew Carothers MD

Apr. 09 2012 11:57 PM
Eugenia Renskoff from Brooklyn, NY

Hi, I think that alcoholism is a very sad thing. It ruins lives and it is just the worst. Eugenia Renskoff

Apr. 09 2012 06:16 PM
Hannah Aron

This Almost Alcoholic doctor needs to get more subtle about his message, at least on the radio.

For example, I feel nervous if I don't have at least 1 ounce of chocolate a day. Does that mean I need to examine my relationship with cacoa? Is it destroying my relationship with others? Not at all.

While extremely helpful, this MD needs to get just a tad more French and a little bit less American prohibitionist with this message about drinking at least as communicated in shorthand on the radio.

The lady, for example, who said she needs that drink every day...what if it's only one drink? Two? Is that OK? Where do you draw the line of "need" and when is "need" really bad or just a fact of modern life.

And is popping Lexapro really any better than a glass or two a day of wine? Isn't the only difference, really, is that Lexapro etc. helps the MDs pay their bills, while wine or "self-medicating" pays them nothing.


Apr. 09 2012 12:05 PM
Dan from BK

As a 32 yo in New York, I've been a solid drinker since 16. Everything in this town is geared toward booze, sex and food.

If I'm otherwise healthy, how do I know it's bad if so many others are much worse than me?

Apr. 09 2012 11:57 AM
Amy from Manhattan

With people who drink more to get the same effect as they get older, is it a question of dependency (are they less & less able to abstain, or is it that they don't drink any more often but drink more when they do) or simply that they're drinking more in total & therefore it's affecting their physical health?

Apr. 09 2012 11:57 AM
Tara from Westport ct

Is this the same as Epsilon alcoholic? How about binge

I have always considered someone as
Having a drinking problem if their drinking damages
Their relationships or hurts those around the drinker -- not necessarily fall down,
Pass out, can't hold a job alcoholic.

Apr. 09 2012 11:55 AM
Diedrich Knickerbocker from Manhattan

Does the Doctor himself drink socially, or is he a teetotaler? Not a judgement, just curious.

Apr. 09 2012 11:55 AM
Jane from Brooklyn

what about a daily glass of wine with dinner?

Apr. 09 2012 11:54 AM
NYCarl from LES

I'm 36, and I have one or two drinks probably 4 nights a week, usually with dinner. I "party" probably once every 2 months, where I might have 4 or 5.

I don't drink alone, but my girlfriend and I are both social drinkers, who go out to dinner with friends a lot. We never drink enough to puke, pass out.

We do talk a lot about our drinking, and are both a little concerned that it may be bad for us. Honestly, I really love going out to dinner and having a cocktail or two. I don't know how to gauge how much is unhealthy though.

Apr. 09 2012 11:54 AM

I have a perosn in my life who has a glass of wine a night. one glass. however, he MUST have that one glass. thoughts?

Apr. 09 2012 11:52 AM

Approaching diagnosis as a spectrum (continuum) makes a lot of sense from a behavioral perspective. Can the Dr. Robert Doyle discuss how this could inform treatment?

J. Ryan Fuller
Clinical Psychologist

Apr. 09 2012 11:50 AM
David from Chelsea Manhattan

Does Dr. Doyle only deal with Alcoholism as a physiological disease or disorder? What about the 12 definition of Alcoholism?

Apr. 09 2012 11:50 AM
Larry from Brooklyn

The DSM does not require either withdrawal or tolerance as required to be diagnosed as being alcohol dependent ("alcoholic" is not a term used in the DSM). The current DSM does recognize a "spectrum" of abuse and dependent. Someone can be dependent and not have withdrawal or tolerance... I think the guest is using an old fashioned definition. By the way, the new DSM does not even have "dependence" and the idea that substance dependence is a "disease" is old fashioned indeed.

Apr. 09 2012 11:48 AM
John A.

Absolutely agree 16-26: a special age for alcholistic use.
BTW also a problem now: Marijuana everywhere inside and outside this group.

Apr. 09 2012 11:47 AM
john from office

Interesting, I have been there and just dont drink anymore.

Apr. 09 2012 11:46 AM

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