Recognizing A Drinking Problem

August 22, 2016 Jack Lianjie Du, MD


St. Joseph’s Behavioral Health Services Program Creates Customized Treatment Plans for Patients

Few experiences are as devastating as those of patients who turn up in an ER, having injured themselves and/or other people due to being drunk.

But for such patients at St. Joseph Hospital, Orange, this is could be where their healing and road to recovery begins.

That’s because when ER doctors at St. Joseph suspect a patient has a problem with alcohol, they can refer him or her to Behavioral Health Services (BHS), a department at the hospital staffed by experts who are trained to help people with addictions, primarily to alcohol.

Some patients will deny having a problem, thinking Hey, my drinking isn’t so bad, or I don’t have a problem with drinking—I can control it. They may be right, which is why addiction experts use established tests to determine whether or not an individual needs help.

How to tell

“There’s a tool called CAGE,” says Lianjie (Jack) Du, MD, staff physician in BHS at St. Joseph. It’s a questionnaire with only four questions:

  • Have you ever tried to cut down your drinking?
  • Have you ever felt angry when people have commented on your drinking?
  • Have you ever felt guilty about your drinking?
  • Have you had an early morning drink to calm yourself down?

“If you have one answer that is yes, you have a 75 percent chance of being an alcoholic,” says Dr. Du. “If you have to two yes answers, then you have 85 percent chance. If you answer yes to three of them—then for sure you’ve got a drinking problem.”

Answering yes to the fourth question indicates advanced alcoholism. “That’s severe addiction,” says Dr. Du. “People don’t casually drink in morning.”

The test on National Council on Alcoholism and Drug Addiction’s website ( features more detailed questions, such as “Do you sometimes feel uncomfortable when alcohol is not available?” and “Do you drink heavily when you are disappointed, under pressure or have had a quarrel with someone?”

How bad is it?

Alcoholism can look like simply partying too much at first, then progress over time to where the drinker’s health, work life and relationships are damaged.

“There are many ways to decide if the pattern is in the early, middle or late stage,” says Dr. Du. “If it’s early, the person may not experience problems yet—you’re working, you’re [maintaining] an intimate relationship, it’s just that once in a while you drink too much.”

People who get help at this stage are lucky, he says. “This is the best time to change the drinking habit,” he says. “You can see a professional, check into a rehab or go to a meeting of Alcoholics Anonymous.

“The middle stage is the so-called functioning alcoholic,” says Dr. Du. This person is still working, does not have liver or heart problems, and is maintaining relationships – though their partner may have “complaints and comments about your drinking,” says Dr. Du.

The late-stage drinker is consuming alcohol every day, has poor concentration, insomnia and often slurred speech, says Dr. Du. Without alcohol, such people suffer tremors, sweating and heart palpitations. “This is called withdrawal,” he says. At this stage, the patient should see a doctor for medical treatment—suddenly stopping drinking altogether could cause death, he says.

St. Joseph Hospital’s team of Behavioral Health Services nurses, doctors and psychiatrists evaluate patients and create a tailored outpatient program of treatment for physical and emotional problems, including depression, anxiety and schizophrenia. In-patient services can be arranged, too. “We work with several rehabs—Twin Town and Cornerstone—as well as local professionals,” says Dr. Du.

Consequences of alcoholism

Getting help is critical, and the sooner the better. About 88,000 deaths are attributed to excessive alcohol use every year, according to the National Council on Alcoholism and Drug Addiction. It’s the third leading lifestyle-related cause of death in the nation.

But Dr. Du is upbeat about the future of patients who seek help, and says many find support at Alcoholics Anonymous meetings, located throughout Orange County (“Alcohol dependency is a treatable disease,” he says, adding: “I have seen many people maintain sobriety for many years.”

(This article originally appeared in OC Catholic in July, 2016) 

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.


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