May 12th, 2009

Chris Keeley


Program Tries to Identify Problem Drinkers Before Problems Start

Most people who drink alcohol are not alcoholics and never will be. But the National Institute on Alcohol Abuse and Alcoholism knows all too well that millions of Americans drink in amounts or patterns that put them at risk of developing a dependence on alcohol and having to face the attendant medical, legal and social problems.

Based on a 2001-02 nationwide survey of 43,000 adults conducted by the National Institutes of Health, the alcohol institute estimates that 30 percent of people 18 and older drink at levels that raise their risk of alcoholism. And since helping those people identify themselves before they get into trouble with alcohol is easier than treating alcoholism, the institute has begun a groundbreaking preventive program called Rethinking Drinking.

The program includes a 16-page booklet for the public (“Rethinking Drinking: Alcohol and Your Health”), a product set for clinicians with a 34-page booklet (“Helping Patients Who Drink Too Much: A Clinician’s Guide”) and an interactive Web site for people who drink,, complete with quizzes, calculators and other tools.

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Chris Keeley

high functioning

High Functioning, but Still Alcoholics

Sarah Allen Benton is hardly your stereotypical alcoholic. She has a master of science degree from Northeastern University and is a licensed mental health counselor at Emmanuel College in Boston. In recovery from alcoholism for the last five years, she has written an enlightening new book about people like herself, “Understanding the High-Functioning Alcoholic” (Praeger Publishers).

As Ms. Benton describes them, high-functioning alcoholics are able to maintain respectable, even high-profile lives, usually with a home, family, job and friends. That balancing act continues until something dreadful happens that reveals the truth — to themselves or to others — and forces the person to enter a treatment program or lose everything that means anything.

A Hidden Problem

Typical high-functioning alcoholics, or H.F.A.’s as Ms. Benton calls them, are in denial about their abuse of alcohol. Coworkers, relatives and friends often enable the abusive behavior to continue by refusing to acknowledge and confront it.

“The story of the H.F.A. is seldom told,” Ms. Benton writes, “for it is not one of obvious tragedy, but that of silent suffering.”

Based on surveys and professional experience, she estimates that as many as half of all alcoholics are high-functioning types. The abuse can go on for decades until and unless some alcohol-related crisis occurs, like being arrested for drunken driving, exposed for having made unwanted sexual advances or being asked for a divorce when their spouses can no longer tolerate the abusive drinking.

Or, like Ms. Benton, they may seek help after recognizing that no matter what they try, they are unable to drink normally and fear that sooner or later their luck will run out.

Many well-known people have publicly acknowledged their battles with alcohol and entered recovery before their lives were destroyed. Among those listed by Ms. Benton are Betty Ford, the astronaut Buzz Aldrin, the actresses Elizabeth Taylor and Mary Tyler Moore, the actor Robin Williams, the singers Keith Urban and Eric Clapton, the football legend Joe Namath and former President George W. Bush.

But there are millions of others — including dentists and doctors, professors and teachers, lawyers and judges, journalists and authors, firemen and C.E.O.’s of major companies — who work for years while abusing alcohol, sometimes putting their lives, and the lives of others, at great risk. Surgeons have been known to operate with shaking hands, yet colleagues who knew or suspected that alcohol abuse was the cause failed to confront the doctor. Employees who suspect a problem often cover up for their bosses.

Ms. Benton emphasized that people in positions of power are often the hardest to detect and help because they tend not to be closely supervised at work, they are assumed to be able to deal successfully with the pressures of their jobs, their high pay enables them to escape the financial consequences of excessive drinking, and they see drinking as their reward for hard work.

As the writer Pete Hamill said in his memoir, “A Drinking Life,” “If I was able to function, to get the work done, there was no reason to worry about drinking. It was part of living, one of the rewards.”

In some cases, the culture of the workplace fosters high-functioning alcoholism. Abusive drinking was once commonplace among journalists, who had “liquid lunches” and frequently met for drinks after work. When work and social lives blend, excessive drinking may be considered part of the job.Collapse )