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November 1982

The Diagnosis of Dysfunctional Drinking

Arch Intern Med. 1982;142(12):2081-2082. doi:10.1001/archinte.1982.00340250039007

An important cultural attitude shift toward excessive drinking is under way. We are witnessing frank admissions of politicians, sports figures, and media and entertainment personalities who, in earlier days, may have sedulously concealed their drinking problem. Although many people still deny their alcoholism, others are appearing in physician's offices willing to discuss the issue and hopeful that accurate information about their drinking practices can be obtained. Quite a few persons remain unaware that their current alcohol consumption level is hazardous.

The notion that someone has to "hit bottom" before he can be rehabilitated is obsolete. In no other condition does the health professional wait until the disorder is terminal before intervening. Instead, it is more reasonable to identify dysfunctional drinking patterns early and then attempt to motivate the patient to change his drinking style by showing objective evidence of impairment. Not everyone will be able or willing to alter his

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