More People May Have Alcohol Use Disorder Come May 2013
The American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) serves as the guide to diagnosis and treatment for mental disorders. Psychiatrists and psychologists nationwide (and even worldwide) use this book to help their patients. In May of 2013, the APA will release the fifth edition of the book (also known as the DSM-V). This edition will include many additions, deletions, and changes over the previous version.
One such change has to do with alcoholism, according to an article on CNN.com. In the DSM-IV, alcohol-related diagnoses were separated into two categories: alcohol abuse and alcohol dependence. The former related to binge drinkers and those who had temporary experimentation with alcohol abuse. In most cases, these individuals grew out of their alcohol abuse phase and either eliminated or controlled their usage.
This diagnosis was generally given to college binge drinkers and young teens that experimented with booze.
The second, alcohol dependence, was reserved for those individuals having a problem with alcohol. These users abuse alcohol on a chronic level and have an addiction and dependence to it. These are long-term drinkers.
This diagnosis was previously given to those classified as alcoholics.
With the new edition of the DSM-V, these two categories of alcohol-related diagnoses have been merged into a single diagnosis called alcohol use disorder. Teen drinkers and college binge drinkers could receive the same diagnosis as long-term, dependent problem drinkers (i.e. alcoholics). The psychiatric and medical communities are concerned about the amount of increased alcohol dependence diagnoses on individuals who may not be dependent.
As of now, the concern is not that the condensing of the two alcohol-related diagnoses is wrong; rather, the concern deals with how this will affect individuals who would likely grow out of their alcohol abuse. One study, led by researchers at the Virginia Commonwealth University, studied more than 7,000 fraternal and identical twins to see if the new diagnostic system would alter alcohol-related diagnoses.
The analyses of the study did not determine clearly whether the new criteria represented an improvement. According to researchers, “(I)t is not clear that the proposed diagnostic changes will result in a more accurate diagnosis…(A)t best, one group of low severity cases will be replaced by another; at worst a group of individuals who exhibit more severe problems will be excluded from the DSM-5 diagnosis, while less severely affected individuals will meet diagnostic criteria.”
The biggest concern deals with young drinkers like teen and college binge drinkers. Only five percent of these drinkers will become long-term alcoholics, but if the majority of them are diagnosed with alcohol use disorder, then that could follow them and impact the rest of their lives.
People who would normally not have to worry about the stigma of a diagnosis may have to in the future, and many of these individuals may not truly suffer from an alcohol-related disease. Their experimentation with alcohol may simply be a result of rebellion, peer pressure, or even simple curiosity. They may not have an addiction disease.
But if they are diagnosed with such, then they risk job and insurance opportunities, not to mention the risk of dealing with people’s judgments and misunderstandings. The new diagnosis in the DSM-V may be better. It may diagnose individuals more aptly. However, the studies and suspicions of the medical and psychiatric community do not look promising.
I guess we will just have to wait and see once the new DSM-V comes out in May and psychiatrists and psychologists begin using it. Until then, though, we must do more research and have a greater understanding of the medical diagnoses and distinctions…or lack thereof in the case of the latter.
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