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Alcoholism ... start the conversation
Prairie Doc
Matthew Stanley, D.O.
Matthew Stanley, D.O.

Alcoholism, and addiction overall, isn’t a character flaw, or a weakness of self-control. It’s a disease. And, if you are like most of us, you’ve probably been affected by it. Maybe you struggle with alcohol consumption yourself or have a friend or family member who does. I rarely talk with anyone who doesn’t have a personal story about how addiction has affected their life.

In fact, about 14 million adults have an alcohol use disorder and there are about 95,000 alcohol related deaths every year in this country.

Unfortunately, we don’t think of it like any other medical illness, so we don’t usually talk to our primary care doctor about it. But that is one of the best places to start the conversation, during your yearly checkup, when you’re talking about health goals it is okay to say, “I think I have a drinking problem.”  

Some of the warning signs to look for in yourself or a loved one include sacrificing family bonds for your addiction such as missing a child’s ball game, concert, or graduation. Things that you were once passionate about fall by the wayside. You’re fatigued and foggy; barely able to get up in the morning. You have cravings for the substance. You’re counting down the time until you can get off work and have a drink. You are in danger of losing your job or important relationships, or you’ve gotten in trouble with the law. You tell yourself and others that you could easily quit and will; but you never do.

By starting the conversation, you will have a clearer path toward the help you need. Your doctor can guide you to outpatient counseling or support groups, or perhaps treatment at a facility. 

There is overlap between behavioral health and addiction in terms of risk factors. Much like behavioral health, addiction has an approximate 60 percent genetic hereditability. Mental health conditions and a history of trauma put you at greater risk of addiction. And like so many health conditions the earlier you start the worse the disease. Those who begin drinking before age 15 have a five times greater risk of developing an alcohol use disorder.

I’ve spent my career talking about and treating addiction. I see that the conversation is changing, and I’m heartened by it. There is a rising social consciousness about addiction. More and more we’re willing to have candid and productive conversations about it. 

The next time your doctor asks you about alcohol consumption, take that as a prompt to have an honest conversation. 


Richard P. Holm, MD passed away in March 2020 after a battle with pancreatic cancer. He is founder of The Prairie Doc®. For free and easy access to the entire Prairie Doc® ® library, visit www.prairiedoc.org and follow Prairie Doc® on Facebook. Matthew Stanley, D.O., a psychiatrist in Sioux Falls, South Dakota is a contributing Prairie Doc® columnist.