I’m not sure why I continue to find the interviews with the new Miss USA, Tara Conner, a little distasteful, but I think I’m closing in.

You may recall after some hard partying she nearly lost her crown; then agreed to a month-long rehab stint after a talk with the Donald, who co-owns the pageant. I completely believe her when she says she’s come clean. I am moved by her honest account of dealing with her demons. And I know she means it when she says she’s in a much better place.

I suppose what’s bothersome is this new, conspicuous characterization of the 21-year old Kentucky beauty. It sounds so steeped in traditional recovery dogma and it feels to me like the queen has been made a bit of a pawn.

“I didn’t think I had any kind of issue going into rehab,” she was quoted as saying recently, “but I’ve realized I do have an issue. I suffer from the disease of alcoholism and addiction.”  

So of course the headlines scream “I am an alcoholic!”

In fact, I had a tough time with this one when I wrote my book. Was I an alcoholic? A problem drinker? Alcohol dependent? Excessive drinker? Which was it?

As I said, in the end it really didn’t matter that much - I just wanted to fix it. But for a number of reasons, I simply couldn’t bring myself to stand in front of a room full of strangers and pin that tag on my shirt. For one thing, I wasn’t sure if it was medically and therapeutically valid. And emotionally, the thought of branding myself scared the hell out of me. Or perhaps I simply wasn’t as brave as others who have done so. I admire their courage.

But a new study, as reported in Science Daily, may support the position that many drinkers have been misclassified - and I assume, directed to improper treatment. The research reveals that binge drinking is the most prevalent form of excessive drinking and many alcohol related problems may be a result of drinking among people who are not, in fact, alcoholics. They point to a study in the February 2007 issue of Alcoholism: Clinical and Experimental Research in which 16.5% of 4,751 New Mexico adults were considered excessive drinkers, but only 1.8 percent of them met the criteria for alcohol dependence.

According to the National Institute on Alcohol Abuse an Alcoholism, alcoholism is defined by an individual’s continued drinking despite repeated alcohol-related problems. Specifically, it is measured by symptoms which include craving, impaired control, physical dependence and tolerance. More formal diagnostic criteria have been developed, as well.

In response to the recent study, Tim Naimai, a physician with the alcohol team at the Centers for Disease Control & Prevention, says we must recognize and address excessive drinking, in addition to alcoholism, if we are to prevent most alcohol related problems, including alcoholism.

“Focusing exclusively on alcoholism will identify only a small percentage of those at risk of causing or incurring alcohol-related harms, precludes the possibility of prevention, and is very costly, at least on a per-person basis,” says Naimai.

And then there’s treatment. How helpful, say, is a 12-step program to an individual whose binge drinking is tied to episodes of spousal abuse? Anger management classes, perhaps. But AA? Maybe, maybe not. Or a person who binge drinks to blunt depressive symptoms - perhaps they would be better served with a program of pharmacology, counseling and improved diet than forced to an in-patient facility away from their home and support network.

In the end, if Miss America is satisfied with her treatment and is empowered to lead a healthier, more productive life while setting a good example for others, it’s all worked out for the best. I mean that. I am in no position to judge whether or not she was a binge drinker or a true alcoholic.

And me, three years later, I freely admit that I am, in fact an alcoholic, not a binge drinker. I do (did) meet the criteria. Among other things, I drank to excess every night, had developed a tolerance for alcohol, and was powerless to control the craving.

I had a lot to lose before I got help - not a crown, certainly - but equally important to me: my family, my health, my career, my self respect. Thankfully, I wasn’t forced into rehab as many people are. I found something that worked well for me and my drinking is now in check.

I absolutely encourage others to attend fellowship based meetings or consider rehab if they’re willing and comitted to doing so. Both have been immensely helpful to millions of people.

Whatever the path, it’s important we expand our thinking about alcoholism and how we define it. How we define ourselves.

And I think it’s great to see new research is helping us do just that.

committed

This entry was posted on Saturday, February 10th, 2007 at 1:50 pm and is filed under Medications and research. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.