Anyone Can Be Diagnosed with a Substance Abuse Problem: The Problem with Current Drug and Alcohol Assessments and AA’s Assumptions Regarding Alcoholism

Throughout the last few years, I’ve thought quite a bit about my drinking and whether or not I ever had a problem with drinking in the first place. As some of you know from my previous blogs, I was coerced into AA by my parents and a family doctor after I was drinking on the night that I was sexually assaulted/almost murdered. The perpetrator had been planning to do this to me ever since he met me and used all kinds of techniques to groom me into trusting him. It worked, and not because I was drinking, but because he found a vulnerability of mine, which was that his step-mother was one of my professors in graduate school. However, I was scapegoated by my parents, my doctor, chemical dependency professionals, other family members, and people in AA who told me that the reason why I was raped was because I was drinking.

My parents and my family doctor, who they are friends with, found ammunition for this scapegoating when they discovered that I reported during the rape kit that I was drinking two bottles of wine a week or so on my rape kit. The truth is, though, that most of my college buddies and fellow grad students drank this much and did not have a problem with alcohol. However, my parents jumped on the idea that I must have a drinking problem and that this is what led me to be sexually assaulted. This is actually a common form of scapegoating towards women in my situation and especially in my family. I also think that they were trying to take the focus off of the sexual assault that I experienced because it was starting to bring up abuse from my childhood.

My parents convinced me to take an alcohol assessment. As I see it though, there was no hope for me to not score as having a substance abuse problem due to my parents’ abuse and manipulation of me over the years when it came to drinking. My family made drinking out to be horrible (even though they did it themselves), and always told us that if we drank we would likely become like our alcoholic grandfather, who was a scary and extremely abusive guy, and almost definitely a sociopath. Not only did he abuse his kids and grand kids in every way, but he also killed animals for sport. An example of this is that after he retired, he moved to Arizona. There he developed a hatred of rattlesnakes. One day my Step-Grandmother, his wife, opened the front door to find a rattlesnake on their welcome mat. Now, my Grandfather (Grandpa John) had at least one gun that he could have used to kill the rattlesnake, or of course he could have called some sort of animal control. But, he did neither of these. He actually took a rake and impaled and mutilated the snake, hitting it over and over again with the rake until it was in pieces and of course, dead. And, he took great pleasure in doing this and found and obviously felt glorious about it. He told what he did with laughter to anyone who would listen. This story became a hit in our dysfunctional family and everyone thought it was hilarious… today, though, I see it as pretty disturbing. And, he was an AA member during this time.

The fact that he was a member of AA and the influence of it on him I believe bled out to the rest of my family. Because of it, they learned through him another yet another way to abuse each other and the children in our family, which was to put each other down due to their drinking and to scare the children into “sobriety”. Many of the fear tactics that they used were also ones that I experienced when I went to AA years later. It was after Grandpa John went to AA that people started making a big deal about drinking and abuse in our family and fearing for their children when it came to drinking, although I’m pretty sure that people feared this before he even went to AA because of his behavior. Still, I’m convinced that a big part of the reason why my parents acted the way that they did in regards to drinking was due to the influence of AA on our family.

Because of this, though, and other episodes of his, my parents used this and other stories as ammunition to convince my twin and I not to drink, and that if we did we must have a drinking problem, regardless of what our drinking looked like. They were always shaming and blaming me for drinking, and this led to me feeling a lot of guilt surrounding it. I suspect that the reason why they did this was not out of protection, but because they want(ed) us to be the “perfect daughters”, and in their opinion drinking did not lead to this. This is made obvious by the fact that they have a strict set of “family values” that me and my sister were supposed to live up to, even as adults. One of these “values” was that we don’t drink. Even today my mom preaches to me about these “family values”. Also, my family was and still are heavily under the influence of AA because of my Grandfather’s participation in it. If any of you are reading this and thinking that my family sound like AA members, it is likely because of this influence.

I had other family members who also expressed concern if I drank at all. The truth is, though, that my family didn’t/don’t just do this to me. They are constantly calling each other out as having drinking problems and being alcoholic when they likely are not. And, they are more likely to point the finger at the women in our family than the men. All of this criticism got into my head, and because of this I feel like there was no way that I was going to be able to objectively take an alcohol assessment. Plus, I found that this same kind of behavior and abuse happened in AA. I really stood no chance at finding out for myself whether or not I had a problem with drinking.

Also, looking back I can see that the questions that my doctor posed to me, as well as questions on the alcohol assessments that I took, could practically diagnose anyone as an alcoholic. For example, one of the questions that my doctor told my mom to ask me and was also on the assessment was: “Have you ever tried to control your drinking?” The answer for me was yes, which according to the test and professionals meant that I could have an alcohol use problem. However, these questions are yes or no, meaning that they do not take context into account. If one were to take context into account on these questions, he or she might discover that there are many alternative explanations to “the person has a problem” that confound the test and diagnosis of alcohol use disorder.

I’ll provide you with an example of context within my own drinking. Whenever I stopped drinking, I always had a reason for it. The first time that I stopped drinking was during my junior year in high school. The reason why I did so was not because I drank frequently or that it was causing problems in my life. It was actually because my boyfriend at the time, who was extremely controlling, didn’t want me to drink. He told me that he thought that I had a problem with alcohol when I only drank a couple of times a year, so very infrequently. Yet this boyfriend seemed to want me to be the perfect woman/girl, much like my parents, and he thought that women should not drink. So, he convinced me that I had a problem when I likely did not just to control me and mold me into the “right kind of woman”. He tried to control me in many other ways, including attempting to convince me to walk with a ruler under my arms to straighten my posture, trying to convince me to go to Yoga to be more flexible, and even tried to convince me to get a boob job. Obviously, he had an agenda to shape me into the woman who he wanted me to be, rather than love me for who I was. Yet despite him saying that I must have a drinking problem because I drank at all (I wonder if he thinks this of all women who drink), I had no problem abstaining from alcohol.

He followed me to the town that I went to college in, and continued to be controlling in different ways. Eventually I broke up with him, and found a new group of friends who drank on the weekend. So, I started drinking on the weekends with them. But, whenever I needed to I could stop. One of these times was when I first started having symptoms of Hashimoto’s Thyroiditis. I naturally didn’t feel well so I didn’t drink for awhile. This pattern of on and off drinking happened throughout college, and was one of the things that chemical dependency counselors, my family, and people in AA used to convince me that I was an alcoholic. Really, though, I may have just been drinking responsibly and putting alcohol down when it was appropriate to do so.

I also would count my drinks to make sure that I wasn’t drinking too much and take other measures to make sure that I felt okay the next day. I would drink one glass of water to every drink that I had because I heard that it lessened headaches and hangover the day after. I also make sure to eat plenty of food before I drank. When I took alcohol assessments and talked to my parents, I felt then like I should answer yes to the question of “Have you ever tried to control your drinking”. Also, with the question “Have you tried to stop drinking unsuccessfully/multiple times” I felt too like I should answer yes to, because I always seemed to drink again after I stopped. What I didn’t think about was the fact that when I didn’t want to drink, I had no problems doing so and usually also had a reason for doing this. I also didn’t consider that counting my drinks might be a responsible way of taking care of myself rather than control due to addiction, and that stopping and starting drinking based off life circumstances could actually be normal drinking behavior.

I remember that I also answered yes to the question “Do you shake after drinking” and then later was convinced that I had alcohol withdrawals by counselors and members of AA. Now that I’ve had space from AA, though, I’ve realized that this likely was because I had issues with my blood sugar after a night of drinking. I’ve always shook when my blood sugar is off, which can happen if I consume too much sugar or not enough protein. And, alcohol is full of sugar. I’ve even passed out before due to blood sugar issues. But, on these assessments, in treatment, and in AA, I feel like it was pushed onto me that this must be due to alcohol, and that I was never really given the time or space to think through or explore alternatives to this either on my own or with counselors/sponsors. I feel like I was encouraged to look for ways that I had a drinking problem, rather than to look for ways that I might not or to look for alternatives to why I answered yes on these questions. Thus, the whole situation was very one-sided.

This one-sided view on encouraging the person to “discover” that he or she has a problem, then, likely leads to many misdiagnoses of substance use disorders, and also leads people who go to AA to believe that they have a problem with drugs and alcohol when they do not. I’ve talked to many people throughout the years who stopped drinking for periods of time due to actual reasons in their life who were convinced that because of they have tried to stop or stopped their drinking in the past, and then later resumed, that they must have a problem with alcohol. I beg to differ. Just because a person stops drinking and then later resumes does not mean that he or she has a problem with it. Take, for example, women who stop drinking during pregnancy in order to ensure that they and the baby are healthy. Do we say that they must have a problem with alcohol if they do this? The answer is an obvious no, but, after going to treatment and spending over a decade in AA, I would bet that there are some people and even professionals who might try to convince a woman in that position that she must have a “problem”. Really, this is part of the blame and shame that is present in AA and the treatment industry and in our country as a whole when it comes to alcohol and drug use. It seems that there are people out there that are paranoid or even obsessive about drugs and alcohol and look for evidence that people around them must have problems with it, including themselves. Also, many people use other’s drinking as a way to scapegoat them. This makes you wonder if the problem in our society really is drug and alcohol use, or if it is scapegoating and abuse, because if a person is convinced that they have a substance abuse problem, could they then act accordingly simply due to suggestion itself? And, how many people develop “substance abuse” problems because they fall into society’s and/or AA’s shame and blame regarding substance use?

In AA, too, all of these criteria, especially ones pertaining to whether you try to control your drinking, lead members to believe that they have a problem with drinking. Also, because the focus is on why you are an alcoholic and need AA rather than why you may not be, it is easy to even convince yourself and/or be convinced that you have a problem with substances even if you don’t. And, people in AA are discouraged to really explore their drinking in a way that includes challenging whether or not they have a problem. If a person does do this, he or she is generally told that he/she is glorifying drinking or that he or she is not accepting that they have a disease and that of course, this will lead the person to drink and to die. This discourages people from exploring their drinking and the time period that they drank in a balanced way. And, there are also sayings and beliefs in AA that if you come to AA, that you must have a problem. People even say this aloud in meetings, and pretty much everyone acts on this belief, whether they realize it or not. Plus, people believe that their sobriety depends on working with newcomers, and this leads to zealousness can easily lead to a blind spot when it comes to how they see and treat newcomers.

But, when you think about it, it doesn’t make sense that everyone who comes to AA has a problem. People come to AA for all kinds of reasons, and just going to AA does not mean that the person automatically has a problem with alcohol. Yet he or she is treated like he/she must. Thus, many people end up in AA for years who likely don’t even have a problem with alcohol. I wonder and bet that I am one of those people.

The same is true for the treatment industry. I believe that almost anyone could be assessed as alcohol/drug dependent, even if most definitely he or she is not one. It seems to me that many professionals, particularly chemical dependency professionals, have a bias surrounding this issue. They tend to see problems where there are none, but really think that they are helping people to see that they have a problem with drugs and alcohol. Because of this, I believe that there are likely many people in this country who believe that they have problems with substances who likely do not. I believe that this is also due to the lack of critical thinking by professionals and patients as to why a patient acts as they do, and the bias that is present in drug and alcohol screenings. It seems as though everyone in our society, even professionals, are quick to jump to the “you must have a disease” conclusion when it comes to drug and alcohol use.

This brings to question the validity of drug and alcohol research throughout the years, as much of the research is done based off of participants–“addicts and alcoholics”– who were assessed with the one sided and overly simplified drug and alcohol assessments that I have described. Again, these usually are pretty simple instruments that do not leave much for mitigating circumstances. Also, the bias in AA to convince everyone that walks into the door that he or she is alcoholic also results in bias in research that is done on AA. For example, research on the success rate in AA implicitly assumes that everyone there has an alcohol problem. But, could that 5-10% success rate, which says that only 5-10% of people maintain long term sobriety through AA, partially be low because some percentage of people discover that they really don’t have an alcohol problem and start drinking normally again? The research done on AA and other treatment programs do not generally take this possible confound into account and treat the populations as all having problems with drugs and alcohol.

If you’ve been diagnosed with alcoholism or addiction, or have been convinced by AA members or even friends and family that you have a problem with alcohol/drugs, I encourage you to try to consider alternatives to these conclusions. Try to find out for yourself whether or not you have a problem with drugs or alcohol by independently exploring your life. If you do feel that you have a substance use problem, exploring your use in this way will likely only concrete your belief that you have one. But if you don’t, this exploration might set you free.

Thanks for reading! Feel free to comment below.

2 thoughts on “Anyone Can Be Diagnosed with a Substance Abuse Problem: The Problem with Current Drug and Alcohol Assessments and AA’s Assumptions Regarding Alcoholism

  1. When you read the self-questionaire pamphlet, the questions about drinking are coached so that ANY kind of drinking is a problem. You might have one drink once a week & that’s a problem. If one person complains about how you act when you’re drinking, that’s a problem. (you laugh too loud for them, that’s a problem).

    My son’s father, who has been a member of AA for over 10 years & with whom I discuss these matters seriously, says it’s how you feel & what you think about your own drinking & drug use that matters. The hell with what AA thinks or what anyone else thinks. But not many members of AA will say anything like that.

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    1. I’m really glad that he is level headed about this topic. I do remember that there were some in AA who were able to hold on to balanced ideas and thinking, but they seemed to mostly be men. I think that more pressure is put onto women in AA to conform. And yes, I think that it is easy to peg pretty much anyone as a problem drinker these days. People are so judgmental of each other and this is bleeding into the field of medicine/treatment/counseling.

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