ask dr. read      Idaho Statesman columns      new articles      biography      formal resume      philosophy      services offered      contact dr. read      psychology links      other links      forms      pictures		Late Discussion is the Norm by James M. Read, Ph.D. You'd think that someone who was having the "shakes," experiencing blackouts, drinking in the morning, having trouble on the job, and getting arrested might discuss a potential drinking problem with a doctor or psychologist or some kind of counselor. Wrong. Even when you throw in binge drinking, protests from family members and friends, and problems driving -- still discussion of the problem with a professional is not likely to occur. Score one more for the incredible strength of denial. And fear, avoidance, rationalization, self-deception etc., etc. Published last year, a study by K.K. Bucholtz and colleagues at the Washington University School of Medicine shed some light on an interesting question. When do people who clearly have a drinking problem first discuss it with a health professional of some kind? The answer is disappointing, but not unexpected, and once again underscores the need for more efforts to successfully intervene earlier when less damage has been done, and treatment outcomes may be better. No surprise. It isn't until very late in the course of the disease that most people will finally discuss their concerns about drinking with a clinician. Bucholtz found that subjects in his large study had talked about the problem only after unmistakable symptoms of social impairment, pathological use, and tolerance/withdrawal had appeared. Here's the rank order of occurrence in time of 11 common symptoms of alcoholism that Bucholtz et. al found in their sample of white males. (1) Binge drinking, (2) Outsiders objecting to the drinking, (3) Shakes, (4) Blackouts, (5) Morning drinking, (6) Driving problems, (7) Arrest, (8) Job problems, (9) Discussion of drinking, (10) Memory trouble, (11) Need to control drinking, (12) Inability to stop drinking, (13) Alcoholics Anonymous attendance. Obviously we should do what we can to make it easier to talk about a potential drinking problem. And get help earlier. Some progress is being made in that direction, but more is needed. James M. Read, Ph.D. Clinical Psychologist  Originally published in The Idaho Stateman newspaper (Boise, Idaho) June 17, 1993 For more information, or to contact the author (that's me!), write to James M. Read, Ph.D., jread@jread.com