If an accurate description of the situation this is ridiculous.
http://healthland.time.com/2012/05/14/dsm-5-could-mean-40-of-college-students-are-alcoholics/?iid=obnetwork#ixzz1vBGb1cjS
QuoteDSM 5 Could Mean 40% of College Students Are Alcoholics
Most college binge drinkers and drug users don't develop lifelong problems. But new mental-health guidelines will label too many of them addicts and alcoholics.
By Maia Szalavitz | @maiasz | May 14, 2012 | 37
Are you or have you ever been a college binge drinker? Welcome to alcoholism, a diagnosis your college self could qualify for under the changes proposed to the next edition of psychiatry's diagnostic manual, the DSM 5.
As the New York Times noted on Saturday in an article that rapidly became one of the most emailed, DSM 5 will have just one diagnosis for addiction problems, though it will be characterized as either mild, moderate or severe. Currently, alcohol and other drug problems come in two flavors. The first, "substance abuse" is a short-term, self-limiting problem: it encompasses most heavy drinking in college. The second "substance dependence," is what everyone else calls addiction or alcoholism and is typically chronic and marked by relapses.
Fortunately, the new diagnosis will get rid of the confusing term "dependence" (physically needing a drug to function isn't actually addiction) and the stigmatizing term "abuse." Unfortunately, however, it will also tremendously elevate the number of people considered alcoholics. One Australian study suggested that using DSM 5 definitions will increase the number of people diagnosed with alcoholism by a stunning 60%.
Ian Urbina writes:
"The chances of getting a diagnosis are going to be much greater, and this will artificially inflate the statistics considerably," said Thomas F. Babor, a psychiatric epidemiologist at the University of Connecticut who is an editor of the international journal Addiction. Many of those who get addiction diagnoses under the new guidelines would have only a mild problem, he said, and scarce resources for drug treatment in schools, prisons and health care settings would be misdirected.
"These sorts of diagnoses could be a real embarrassment," Dr. Babor added.
Proponents of the new system argue that it will allow substance problems that might develop into serious addictions to be nipped in the bud:
"We can treat them earlier," said Dr. Charles P. O'Brien, a professor of psychiatry at the University of Pennsylvania and the head of the group of researchers devising the manual's new addiction standards. "And we can stop them from getting to the point where they're going to need really expensive stuff like liver transplants."
Yet because it's impossible to determine which college bingers will moderate after graduation and who will go on to have lifetime problems, the distinction between abuse and dependence is difficult to pinpoint. The reality is that most college binge drinkers and drug users don't develop lifelong problems. But most addiction treatment programs encourage them to see themselves as having a chronic, relapsing disease that requires a lifetime of attendance at 12-step meetings to keep in check. Currently, about 31% of college students meet criteria for "alcohol abuse," while only 6% have the alcoholism-equivalent diagnosis of dependence.
Earlier editions of the DSM explicitly said there are alcohol and other drug problems that legitimately exist but do not reach the level of addiction; Alcoholics Anonymous itself differentiates between "problem drinkers" who can learn to moderate and alcoholics who can't. DSM 5 obliterates the distinction. If the change is finalized, anyone whose drinking or drug use creates any problems will essentially be an addict or alcoholic with a "mild" case of the disease and presumably, therefore, not someone who can learn control over his habits.
While researchers have been encouraging the widespread adoption of "brief interventions" and other techniques that don't require abstinence or a label— with great success— this change could swing the field in the opposite direction.
And that poses a huge problem, particularly for adolescents and young adults with mild problems who may be pushed to adopt an addict identity and to see themselves as having no way to control their drinking or drug use if they ever "relapse." Rather than empowering those who do have control to use it, these programs essentially tell kids that if they ever have just one drink or puff on a joint, they're lost.
(MORE: Does Teen Rehab Cure Addiction— Or Create It?)
While that strategy may help some people with addiction avoid relapse, research shows that it makes relapses worse if they do occur. And given that the overwhelming majority of teens who are treated will not remain abstinent for life, this strategy is counterproductive for most who will be exposed to it.
In my years of covering addiction, I've heard the story dozens of times: someone with a mild problem enters treatment, is convinced they have a more severe case and meets others who help him or her get worse. One teenage girl told me about meeting someone who turned her on to cocaine while in treatment for marijuana; another young man told me how treatment was the source of his perception that "who I was, was an alcoholic and drug addict."
Clearly, treatment for young people already labels too many of them as addicts and alcoholics; the last thing we need is the DSM legitimizing this harmful practice. It should rename substance abuse "substance misuse," and label addiction, "addiction." From any perspective, it's absurd to potentially label the 40% of college students who get drunk at least once a month as having "mild" alcoholism.
(MORE: DSM-5 Debate: Committee Backs Off Some Changes, Re-Opens Comments)
Maia Szalavitz is a health writer at TIME.com. Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland's Facebook page and on Twitter at
The DSM lost credibility when they said that faggotry wasn't a disorder.
If it is impairing their ability to function/lead meaningful lives - sure why not?
How do you get the diagnosis in the first place? You spend your college money on going to your doctor with a non-problem? And even if you're that stupid aren't medical records sealed?
That's pretty alarming if true. I think this warrants a lot of research into how you can redefine DSM 5 to bring down the percentage of alcoholics in college to an acceptable level.
QuoteAlcoholics Anonymous itself differentiates between "problem drinkers" who can learn to moderate and alcoholics who can't.
Yepper.
QuoteDSM 5 obliterates the distinction.
Ruh-roh.
Jaron Trueheart
Just been talking about DSM 5 in the context of military neuroscience. Given that every issue invents new conditions to meet the drugs being researched (see the surge in ADHD for example) there are probably new alcoholism treatments on the horizon.
How would you "treat" student (or journalist) binge drinking anyhow? Other than the way the British government is already going about it, by making beer £4 a pint :bleeding:
In my book, an alcoholic is someone who is addicted to alcohol, period. If someone just drinks a lot without any sort of addiction, he is just a heavy drinker.
Back in 6th grade Health class we were shown a film that defined anyone who drinks alone as an alcoholic. It then sarcastically identified social drinkers, who do not think of themselves as alcoholics, but actually are. So the bottom line from the film is that anyone who drinks is an alcoholic. All of us knew that was complete BS.
The only redeeming feature of the film was when they got a fish drunk by pouring a little grain alcohol into the tank.
Quote from: derspiess on May 18, 2012, 11:02:08 AM
In my book, an alcoholic is someone who is addicted to alcohol, period. If someone just drinks a lot without any sort of addiction, he is just a heavy drinker.
How 1950s.
Quote from: CountDeMoney on May 18, 2012, 11:03:38 AM
Quote from: derspiess on May 18, 2012, 11:02:08 AM
In my book, an alcoholic is someone who is addicted to alcohol, period. If someone just drinks a lot without any sort of addiction, he is just a heavy drinker.
How 1950s.
Golden era. Pity I couldn't experience it.
Quote from: derspiess on May 18, 2012, 11:17:40 AM
Quote from: CountDeMoney on May 18, 2012, 11:03:38 AM
Quote from: derspiess on May 18, 2012, 11:02:08 AM
In my book, an alcoholic is someone who is addicted to alcohol, period. If someone just drinks a lot without any sort of addiction, he is just a heavy drinker.
How 1950s.
Golden era. Pity I couldn't experience it.
Yes, you would have been right at home in the Birmingham PD. :P
Quote from: CountDeMoney on May 18, 2012, 11:32:09 AM
Yes, you would have been right at home in the Birmingham PD. :P
:rolleyes: Why do you jerks always have to bring up race whenever I pine for the 50s?
Quote from: derspiess on May 18, 2012, 11:33:15 AM
Quote from: CountDeMoney on May 18, 2012, 11:32:09 AM
Yes, you would have been right at home in the Birmingham PD. :P
:rolleyes: Why do you jerks always have to bring up race whenever I pine for the 50s?
Because you would've gone insane trapped in
Leave It To Beaver.
I knew a real alcoholic once. The guy got a DUI riding a bike and another because he was sleeping in the back seat of another dude's car and had started the motor so he could run the heater. He literally started puking if he wasn't constantly drunk.
I had to fire him. That was my first ever experience firing someone actually. I was 18.
Quote from: CountDeMoney on May 18, 2012, 11:34:20 AM
Because you would've gone insane trapped in Leave It To Beaver.
You'd think that, but no.
Quote from: derspiess on May 18, 2012, 11:41:54 AM
Quote from: CountDeMoney on May 18, 2012, 11:34:20 AM
Because you would've gone insane trapped in Leave It To Beaver.
You'd think that, but no.
Mayberry would've been more fun.
Quote from: CountDeMoney on May 18, 2012, 11:43:01 AM
Quote from: derspiess on May 18, 2012, 11:41:54 AM
Quote from: CountDeMoney on May 18, 2012, 11:34:20 AM
Because you would've gone insane trapped in Leave It To Beaver.
You'd think that, but no.
Mayberry would've been more fun.
Actually, living in all the sitcoms linked together would have been a hoot. If Mayberry gets boring, go hang out at the Munsters' house. Next day, stop by Donna Reed's house while the kids are at school. Late that night go sneak into Fred Rutherford's yard & leave some barrel hoops, etc.
It all ended with Dobbie Gillis. :(
Quote from: CountDeMoney on May 18, 2012, 11:53:10 AM
It all ended with Dobbie Gillis. :(
Hipster Gilligan ftw.
Quote from: derspiess on May 18, 2012, 11:02:08 AM
In my book, an alcoholic is someone who is addicted to alcohol, period. If someone just drinks a lot without any sort of addiction, he is just a heavy drinker.
Back in 6th grade Health class we were shown a film that defined anyone who drinks alone as an alcoholic. It then sarcastically identified social drinkers, who do not think of themselves as alcoholics, but actually are. So the bottom line from the film is that anyone who drinks is an alcoholic. All of us knew that was complete BS.
The only redeeming feature of the film was when they got a fish drunk by pouring a little grain alcohol into the tank.
Sort of like when folks claim anyone who smokes pot is a "drug addict". ;)
But yeah, I hear ya.
The problem is that of course there is a whole spectrum of behaviours from "never touch the struff" through "has the occasional glass of wine or puff off a joint to be sociable" right way through "lives under an overpass sucking Lysol through a sock/is 55 and stinks up his parent's basement with constant smoking while listening to the music popular when he was 18". Somewhere along the line is behaviour that is compulsive and destructive, but it is often hard to spot exactly where.
My take: if what you do is all about the high rather than all about other people - and getting the high actually damages your relations with other people - then, it's a problem.
Quote from: Malthus on May 18, 2012, 12:26:04 PM
Sort of like when folks claim anyone who smokes pot is a "drug addict". ;)
If someone can't enjoy himself/herself without his/her fix (pot, alcohol, harder drugs), than that person is a drug addict or an alcoholic.
Quote from: derspiess on May 18, 2012, 11:17:40 AM
Golden era. Pity I couldn't experience it.
It was a time when salaries and job security were high and living expenses were low. Couldn't last forever.
Quote from: Valmy on May 18, 2012, 12:46:25 PM
Quote from: derspiess on May 18, 2012, 11:17:40 AM
Golden era. Pity I couldn't experience it.
It was a time when salaries and job security were high and living expenses were low. Couldn't last forever.
I know :(
Quote from: derspiess on May 18, 2012, 11:33:15 AM
Quote from: CountDeMoney on May 18, 2012, 11:32:09 AM
Yes, you would have been right at home in the Birmingham PD. :P
:rolleyes: Why do you jerks always have to bring up race whenever I pine for the 50s?
We could raise taxes to 1950's levels if you like.
Quote from: Razgovory on May 18, 2012, 01:08:00 PM
We could raise taxes to 1950's levels if you like.
I bet you'd like that.
Quote from: derspiess on May 18, 2012, 01:18:33 PM
Quote from: Razgovory on May 18, 2012, 01:08:00 PM
We could raise taxes to 1950's levels if you like.
I bet you'd like that.
Well, what part of the 1950's did you like?
Why do quite a few Americans have a problem with drinkers; after all much of the British empire was won by half-cut people. :bowler:
I want 70's fashion and interior design to return.
Ewwwwww
Quote from: MadImmortalMan on May 18, 2012, 11:37:17 AM
I knew a real alcoholic once.
Me, too. I called him "Dad". :P
I've known quite a few people who self-identify as alcoholics who most likely were just problem drinkers when they were young. They have been clean and sober for decades, still go to AA meetings, and never crave the drink. But in their mind they are still alcoholics. *shrugs* If it helps them cope....
Quote from: Ed Anger on May 18, 2012, 08:44:45 PM
I want 70's fashion and interior design to return.
I'm with you.
Quote from: Ed Anger on May 18, 2012, 08:44:45 PM
I want 70's fashion and interior design to return.
I'd just be happy with my toys again. You can keep the lava lamps.
I want my Six Million Dollar Man, Star Trek and Space:1999 action sets back. :mad:
Actually this whole story looks like the case of a shoddy journalist. Look at this sentence:
QuoteIf the change is finalized, anyone whose drinking or drug use creates any problems will essentially be an addict or alcoholic with a "mild" case of the disease and presumably, therefore, not someone who can learn control over his habits.
Hmm, the DSM classifies people whose actions cause problems for them in daily living as having a disease or disorder? What a surprise!
And where's the mention of the actual criteria in the article?
Quote from: merithyn on May 18, 2012, 09:37:51 PM
I've known quite a few people who self-identify as alcoholics who most likely were just problem drinkers when they were young. They have been clean and sober for decades, still go to AA meetings, and never crave the drink. But in their mind they are still alcoholics. *shrugs* If it helps them cope....
Where ex-alcoholics are concerned, I'm not sure it's useful or accurate to surmise you know their situations better than they do...
Quote from: Pitiful Pathos on May 19, 2012, 11:20:48 AM
Where ex-alcoholics are concerned, I'm not sure it's useful or accurate to surmise you know their situations better than they do...
Why is alcoholism different than any other type of self-perception that we disagree with?
Because the effects and details of one's alcohol addiction are really only know to that person him/herself, particularly in the case of ex-alcoholics. Unless you are my spouse or otherwise really unusually intimate with me, I have far more information available to me about my alcohol consumption and its effects on my life than you could ever hope to. Contrast that with a self-perception, of, say, "I'm a good basketball player on our company team." That is much more easily measurable to you when we play basketball together.
Quote from: Pitiful Pathos on May 19, 2012, 11:35:49 AM
Because the effects and details of one's alcohol addiction are really only know to that person him/herself, particularly in the case of ex-alcoholics. Unless you are my spouse or otherwise really unusually intimate with me, I have far more information available to me about my alcohol consumption and its effects on my life than you could ever hope to. Contrast that with a self-perception, of, say, "I'm a good basketball player on our company team." That is much more easily measurable to you when we play basketball together.
Yet we constantly second-guess judgements that the principle naturally has more information on, like "I'm a thoughtful person," or "I'm very smart."
Quote from: Admiral Yi on May 19, 2012, 11:39:35 AM
Quote from: Pitiful Pathos on May 19, 2012, 11:35:49 AM
Because the effects and details of one's alcohol addiction are really only know to that person him/herself, particularly in the case of ex-alcoholics. Unless you are my spouse or otherwise really unusually intimate with me, I have far more information available to me about my alcohol consumption and its effects on my life than you could ever hope to. Contrast that with a self-perception, of, say, "I'm a good basketball player on our company team." That is much more easily measurable to you when we play basketball together.
Yet we constantly second-guess judgements that the principle naturally has more information on, like "I'm a thoughtful person," or "I'm very smart."
Again, your examples are much more easily measurable to the outside observer. "I'm an alcoholic" is basically an admission that alcohol is ruining one's life, and thus not as clear to most of one's acquaintances. You don't know the amount of alcohol the subject drinks, all the different behaviours he engages in when drunk, what his alcoholism has cost him in the past, whether he had promised to stop drinking before, the kind of self-loathing he feels the morning after, etc. You just see him drinking (or not drinking) a few drinks at the bar when he is with you. But when someone says "I'm very smart", that is an example that is much more easily measured to outside observers.
All those things you mention are observable as well.
Quote from: garbon on May 17, 2012, 10:03:02 PM
If it is impairing their ability to function/lead meaningful lives - sure why not?
The impairment is not a requirement for diagnosing alcoholism - hence the expression "functioning alcoholic". I think most people who drink regularly to feel better are alcoholics - I am and most of my friends are.
Quote from: derspiess on May 18, 2012, 11:02:08 AM
In my book, an alcoholic is someone who is addicted to alcohol, period. If someone just drinks a lot without any sort of addiction, he is just a heavy drinker.
Yeah but addiction is a broad concept. Most heavy drinkers are definitely addicted psychologically - that does not mean that if they go cold turkey they get delirious or die, but it means they will get more stressed, cranky and have hard time relaxing, at least for a while.
Quote from: viper37 on May 18, 2012, 12:42:44 PM
Quote from: Malthus on May 18, 2012, 12:26:04 PM
Sort of like when folks claim anyone who smokes pot is a "drug addict". ;)
If someone can't enjoy himself/herself without his/her fix (pot, alcohol, harder drugs), than that person is a drug addict or an alcoholic.
This is not a very useful definition, really (especially when we are talking, like you, about stuff that is actually health damaging) because it cuts both ways as insufficient and does not really accomplish anything.
Quote from: Admiral Yi on May 19, 2012, 11:26:35 AM
Quote from: Pitiful Pathos on May 19, 2012, 11:20:48 AM
Where ex-alcoholics are concerned, I'm not sure it's useful or accurate to surmise you know their situations better than they do...
Why is alcoholism different than any other type of self-perception that we disagree with?
I don't think it is. This is why mental health is such a screwy field.
Also, would someone explain the definition of mental disorder to Marty.
Quote from: Admiral Yi on May 19, 2012, 12:00:14 PM
All those things you mention are observable as well.
I agree with Yi. People self-diagnose various mental stuff about themselves all the time, especially in this day and age of wikipedia. I can't see why when someone self-diagnoses as a sex addict or someone with a ADHD for example we should treat such claims differently than when someone self-diagnoses as an alcoholic.
QuoteAll those things you mention are observable as well.
To whom? God? I think you're still missing the point.
"I am very smart" is much more easily disproved if the subject spews forth moronic statements.
Contrast that with a person who says "I'm am an alcoholic, and actively engaged in alcoholism when I was young" (as per the example Meri gave). So, you have heard the person has not drunk for many years. Based on that data alone, are you really able to conclude you know more about the effects of alcohol on his life and his past than he does?
Most forms of intelligence can't be judged by casual conversation either.
You're right, smart is a bad counter-example.
Quote from: Martinus on May 19, 2012, 12:06:44 PM
Quote from: garbon on May 17, 2012, 10:03:02 PM
If it is impairing their ability to function/lead meaningful lives - sure why not?
The impairment is not a requirement for diagnosing alcoholism - hence the expression "functioning alcoholic". I think most people who drink regularly to feel better are alcoholics - I am and most of my friends are.
But that's the point of a lot of things that the DSM categorizes. I'm not sure why a psychiatrist would be that interested in a functioning alcoholic. Also I think your definition of alcoholic trivializes the issue.
From wiki:
QuoteThe current version of the DSM characterizes a mental disorder as "a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual [which] is associated with present distress...or disability...or with a significant increased risk of suffering."
Quote from: Brazen on May 18, 2012, 04:27:46 AM
Just been talking about DSM 5 in the context of military neuroscience. Given that every issue invents new conditions to meet the drugs being researched (see the surge in ADHD for example) there are probably new alcoholism treatments on the horizon.
No, there aren't any significant new alcoholism treatments on the horizon. ADHD is not an invented issue any more than schizophrenia or a broken leg.
Quote
How would you "treat" student (or journalist) binge drinking anyhow? Other than the way the British government is already going about it, by making beer £4 a pint :bleeding:
The technical term is "brief intervention." The physician states unequivocally that the patient has a problem with alcohol and emphasizes that this determination stems from the consequences of alcohol in that patient's life, not from the quantity of alcohol consumed. The physician emphasizes the effects of drinking on family, friends, and occupation, as well as any physical manifestation. Something as simple as that has been shown in studies to have a significant benefit in patient outcome. It doesn't cost much, either.
Not everything that happens in medicine revolves around pharmaceutical company conspiracy theories. :rolleyes:
Quote from: garbon on May 19, 2012, 01:08:09 PM
QuoteThe current version of the DSM characterizes a mental disorder as "a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual [which] is associated with present distress...or disability...or with a significant increased risk of suffering."
Thank you.
Quote from: Pitiful Pathos on May 19, 2012, 12:31:25 PM
To whom? God? I think you're still missing the point.
"I am very smart" is much more easily disproved if the subject spews forth moronic statements.
Contrast that with a person who says "I'm am an alcoholic, and actively engaged in alcoholism when I was young" (as per the example Meri gave). So, you have heard the person has not drunk for many years. Based on that data alone, are you really able to conclude you know more about the effects of alcohol on his life and his past than he does?
There was more data there, but apparently you missed it. "They never crave the drink" is an important part of it, imo. If you never crave alcohol, it seems odd to self-identify as an alcoholic. What made my dad an alcoholic, from my perspective, was that he always craved a drink. Always. Sober for five years and in AA? Still craved it. Dying from diabetes and congestive heart-failure? Still craved it. That, to me, is an addict.
You may also have missed the part where I said that I didn't really care how they self-identified. If thinking of themselves in that way and addressing their issues as an alcoholic helps them, good for them. I may not think they're really an alcoholic, but how does that factor into it at all? They're figuring out a way to cope with their lives that works. Giving it a name doesn't seem to matter, does it?