Further Reading

What about alcoholism assessment at recovery centers, and do I have a drinking problem?

Dear Stanton,

I recently went through an alcohol "assessment" at a recovery center because of a dwi I recently received. My question concerns some of the questions that were on their form I filled out to determine my status as a "abuser". Some of the questions were nonsensical like "do you ever just sit about and daydream?"

My "counselors'" assessment of me was that I am an abuser. Based on these kinds of questions it seems to me that everyone could be called an abuser! Am I just getting snared by a system that is set up to make money ? Is there no standardized definition of these ideas or can treatment centers define their own bizarre criteria so they can make bucks of the effluence of the legal system?


Dear ----:

While these treatment centers claim they are dealing with a medical disease, they're approach violates all the laws of medical assessment. Here are the questions one could ask:

  1. What was your score in terms of alcoholism? Which questions indicated you were alcoholic? What are the cut-off points they use for diagnosis? What are the possible outcomes of their assessments: that is, are people either alcoholic or not? Is there any other drinking problem category beside "alcoholic"?
  2. What was the source of their instrument (scale) for measuring your alcoholism? Could you read any literature indicating whether this scale is valid? Where else is this scale used?
  3. What percentage of the people who enter the treatment center are scored as alcoholics? Where did your score fall relative to the standard intake assessment scores they receive?
  4. Could you go elsewhere for a second opinion, for example, to a university which specializes in alcoholism scale measurements?
  5. Could you speak to previous participants in their program to learn about their experiences in the program, to see whether your condition was as severe as their problems, to find out whether they saw any downside to the program?

Obviously, as you discern, in most treatment programs, assessment is the first step to the full treatment program, and not an independent process.

But now, if you were assessed for an alcohol problem, and you're not sure of the result, let's think about your drinking. Let's avoid an alcoholism scale, and reflect on its character.

  1. Are you concerned about your own drinking? Is someone you care about concerned with your drinking? Do you want to drink less?
  2. How much do you drink on an average drinking occasion? How many days a week/month do you drink 6 drinks or more?
  3. On this DUI occasion, were you substantially above .10 BAL? How often do you achieve this level of intoxication per week/month?
  4. Have you been apprehended for DUI before? Have you driven DUI before in the past month/year? What other interactions with the police/legal system have you had in the past three years due to your drinking?
  5. Can you identify other drinking problems (with family members, friends, coworkers; at work or reaching work; health, digestive, sleep problems, etc.) you've had in the past 3 years?

You know, it's not nice to drive while drunk, and its very unpleasant to be apprehended by the police. In fact, its a bummer to have to go through an alcoholism assessment. But you have managed to get yourself into such a position. I know real alcoholics who never had to do that. It's hard to criticize these dopey treatment centers when you're having drinking problems yourself.

How old are you? How is your health? How do you feel about yourself in general? Are you in control of your life? What are you doing for entertainment? Do you respect the people you associate with? Are you making good use of your time and life?

Do you have as much education as you want? Have you reached a good level of work output? Do you have goals you haven't even tried to achieve? Do you have a stable social life? Do you live in an intimate setting with people you care for?

Let's deal with real things and stay out of trouble.

Stanton