"I'LL JUST have one after work." Those words, often a prelude to drinking more than intended, could contribute to nearly one in 10 people being diagnosed with alcohol use disorder under proposed changes to the condition.
Australian drug researchers believe the number of people in the country who will fit the criteria for problematic alcohol use will rise by about 60 per cent - or half a million people - under new criteria in the Diagnostic and Statistical Manual of Mental Disorders.
The manual is being updated this year in an attempt to create more accurate psychiatric diagnoses. But critics have charged it will expand the criteria for many disorders, leading to more people being diagnosed.
A postdoctoral fellow at the National Drug and Alcohol Research Centre at the University of NSW, Louise Mewton, said alcohol use disorder could be diagnosed using two symptoms that were very common.
The first, tolerance, was meant to capture long-term drinkers who could consume a lot without showing effects, but this occurred naturally in younger people as their brains developed.
"Often tolerance can be reported when it's really a normal developmental process," Ms Mewton said.
The second, drinking more or for longer than intended, was meant to capture people who drank compulsively, but cast too wide a net, she said.
She said a recent study of Australians aged between 18 and 24 had found about 94 per cent reported drinking larger amounts or for longer than they intended. "A lot of people report that … but the reason they were doing it was because they were having fun," she said.
A research article she wrote, published in the journal Addiction, used data from nearly 8000 drinkers aged over 18, applying the new criteria to the answers they had given when the survey was conducted.
Under the current DSM-IV, about 2 per cent met the criteria for alcohol abuse and 4 per cent for dependence, however under the DSM-5 proposed single alcohol use disorder, nearly 10 per cent were affected.
Dr Mewton said under DSM-5 only two symptoms were needed to diagnose the disorder, creating the increase.
"They have a strong rationale for all their other changes but they haven't provided any basis for proposing the two-symptom threshold," she said.
She was worried the changes would erode the public's faith in recommendations around alcohol intake and disorders, and decrease already low levels of people seeking help.
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What does everyone think of this? I think there is a public perception that you are either a hardcore alcoholic or you aren't, that there is no in between on the spectrum of alcohol problems. I'd see this as obviously not true, and that these new guidelines will potentially diagnose people with low level alcohol problems who perhaps would have gone unnoticed prior. Substance abuse can come in many varieties and levels of seriousness; I think that while people will think this might be strange, I don't see that they are proposing low level problem drinkers be treated the same as heavy duty alcoholics. People love to drink but are loathe to admit they can't control themselves, and the reaction to the article is an example of that kind of stigma. Sure some people may technically fit the diagnostic criteria who aren't problem drinkers, but a doctor and/or person with common sense should be able to realize whether or not they actually do have an issue.
![:\](https://bluelight.org/xf/BL_Images/Orig_Emoji/wrygrin.gif "wry grin :\")
