Dr. Bob's Psychopharmacology Tips

Tests for alcoholism

From: HSPeyserMD@aol.com
Date: Fri, 6 Jun 1997 22:32:05 -0400 (EDT)
Subject: Tests for alcoholism

I quite agree that the concept of "loss of control" tends to be subjective and the physiological factors of tolerance and withdrawal are more objective.

But it is clear that a heavy, regular drinker who has tolerance but is told by his doctor he has a bad liver (or his wife will leave him or he will lose his job or whatever) and stops and suffers withdrawal -- but stays stopped -- clearly does not suffer from a dependence disorder. And a binge drinker who has blackouts and DWIs, but in between bouts loses his tolerance -- but continues from time to time to drink with deleterious effects -- suffers from a dependence disorder.

The best test for alcoholism is not for him or her to remain abstinent for a month -- he or she may be able to do that -- but to drink 3 oz. of booze every day, no more, no less, for 30 days. That is an agony for an addict. And that's what loss of control means. And that is fairly objective, no? It's the best we can do at this time, anyway.

Date: Sat, 07 Jun 1997 16:41:03
From: "Richard David Brand, MD" <rdb@icu.com>
Subject: Tests for alcoholism

I have heard that before, only it was two oz. daily for two months. Is this a real test? I mean, if you and patients disagree about whether they are in denial vs. you are overly concerned, do you actually suggest they try this?

From: HSPeyserMD@aol.com
Date: Sun, 8 Jun 1997 14:16:25 -0400 (EDT)
Subject: Tests for alcoholism

I do use the test with possible alcoholics. Drink a certain, regular amount of booze (two shots, one glass of wine, one beer, whatever is equal) every day, exactly that amount (it doesn't matter if it is 2 or 3 oz.), no more, no less. That is an agony for the alcoholic ("I can resist anything but temptation," quoth Oscar Wilde). The test was orignated by Marty Mann and was called the Marty Mann test. It touches on the essence of loss of control. Compulsive total abstinence is easier -- which is why the abstinence model is advocated by ASAM and AAAP and the field in general for the most part.

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