One of the first obstacles to helping alcoholics is helping them admit the problem.

Most people’s alcohol problem progresses because they refuse to accept there is a problem in the first place. And whether you’re a therapist, a family member, a friend, or the patient yourself, denial is one of the most frustrating things.

Too often, when you confront someone about an alcohol problem, the first instinct is to be defensive. We seldom look at ourselves and admit we have a problem that is too much for us to handle.

Honesty is one of the first things an alcoholic usually foregoes. It begins from little lies to themselves like, “I can quit anytime I want…I don’t drink as much as that guy….” Later, as the habit progresses, they begin to hide it from those around them. They can pretend to not drink as much as they do, not drink when around certain people or hide their drinking altogether.

In these situations, the act of denial itself is the signal that the person knows something is wrong. After all, if you didn’t have a problem, why the need to lie about it?

If you find yourself or someone you care about in this position, remember that acceptance is the first step and the first person you need to bravely admit to is yourself. If it is someone you know, let them feel that you are not judging or labeling them. Confront them with compassion. Denial is a frustrating hurdle to get over but it is the dam that needs to break in order to let the water flow.

Many people with alcohol problems will often deny it or even refuse to consider there is a problem. If you have a feeling you or someone in your family is developing a problem, here are a few signs you can look for if intervention needs to be in order:

• Irritability when alcohol isn’t available
• Keeping alcohol in unlikely places at home, at work or in the car
• Drink heavy amounts of alcohol alone or in secret
• Making a ritual of having drinks before, with or after dinner and becoming annoyed when this ritual is disturbed or questioned
• Losing interest in social and recreational activities that used to be enjoyable
• Feeling a need or compulsion to drink
• Gulping drinks, ordering doubles, becoming intoxicated intentionally to feel good or drinking to feel “normal”
• Being unable to limit the amount of alcohol you drink
• “Blacking out” during periods of drinking
• Having legal problems or problems with relationships, employment or finances
• Building a tolerance to alcohol so that you need an increasing number of drinks to feel alcohol’s effects
• Experiencing physical withdrawal symptoms — such as nausea, sweating and shaking — if you don’t drink

Alcohol Use Disorders Identification Test (AUDIT) is a test developed by the World Health Organization to help doctors assess persons with hazardous and harmful patterns of alcohol consumption and the extent of treatment these patients will have to undergo. It is a simple method of screening for excessive drinking and to assist in brief assessment. It can help in identifying excessive drinking as the cause of the presenting illness. It also provides a framework for intervention to help hazardous and harmful drinkers reduce or cease alcohol consumption and thereby avoid the harmful consequences of their drinking.

The WHO believes the majority of excessive drinkers are undiagnosed and often carry symptoms or problems that would not normally be linked to their drinking. The AUDIT is designed o help the practitioner identify whether the person has hazardous (or risky) drinking, harmful drinking, or alcohol dependence.

Here’s the test:

If you score between 8-10 or more, it may be worth consulting your doctor or an alcohol advice and information service to talk about your drinking.

1. How often do you have a drink containing alcohol?

1. Never (0)
2. Monthly or Less (1)
3. 2-4 times a month (2)
4. 2-3 times a week (3)
5. 4 or more times a week (4)

2. How many drinks containing alcohol do you have on a typical day when you are drinking?

1. 1 or 2 (0)
2. 3 or 4 (1)
3. 5 or 6 (2)
4. 7-9 (3)
5. 10 or more (4)

3. How often do you have 6 or more drinks on an occasion when you are drinking?

1. Never (0)
2. Less than monthly (1)
3. Monthly (2)
4. Weekly (3)
5. Daily or almost daily (4)

4. How often during the past year have you found that you were not able to stop drinking once you had started?

1. Never (0)
2. Less than monthly (1)
3. Monthly (2)
4. Weekly (3)
5. Daily or almost daily (4)

5. How often during the past year have you failed to do what was normally expected of you because of drinking?

1. Never (0)
2. Less than monthly (1)
3. Monthly (2)
4. Weekly (3)
5. Daily or almost daily (4)

6. How often during the past year have you needed a first drink in the morning to get yourself going after a heavy drinking session?

1. Never (0)
2. Less than monthly (1)
3. Monthly (2)
4. Weekly (3)
5. Daily or almost daily (4)

7. How often during the past year have you had a feeling of guilt or remorse after drinking?

1. Never (0)
2. Less than monthly (1)
3. Monthly (2)
4. Weekly (3)
5. Daily or almost daily (4)

8. How often during the past year have you been unable to remember what happened the night before because you had been drinking?

1. Never (0)
2. Less than monthly (1)
3. Monthly (2)
4. Weekly (3)
5. Daily or almost daily (4)

9. Have you or has someone else been injured as a result of your drinking?

1. No (0)
2. Yes, but not in the past year (2)
3. Yes, during the past year (4)

10. Has a relative, friend, or a doctor or other health care worker been concerned about your drinking or suggested you cut down?

1. No (0)
2. Yes, but not in the past year (2)
3. Yes, during the past year (4)