Alcohol Use or Abuse? Four Questions to Ask

Author: IAFF Staff

May 14, 2018

According to the National Institute on Alcohol Abuse and Alcoholism, alcohol use leads to 88,000 deaths every year. Diverse health experts agree that alcohol is linked to a host of health problems, including cirrhosis, hypertension, pancreatitis and certain types of cancers, as well as some mental health disorders.

Chances are, you personally know someone whose life has been negatively affected by alcohol addiction.

In a recent poll of nearly 7,000 IAFF members, 27 percent reported abusing alcohol or drugs to cope with occupational stress and related emotional problems. While the majority of fire fighters use alcohol responsibly, it’s important to know the line between alcohol use and alcohol abuse.

The CAGE Questionnaire is simple four-question screening tool developed by the Bowles Center of Alcohol Studies at North Carolina University School of Medicine. The questionnaire is used internationally by primary care doctors and mental health clinicians to screen for alcohol abuse. While self-screening does not substitute the need for a diagnostic assessment with a licensed physician or mental health provider, asking yourself or friend these simple questions can help shed light on a problem.

1. Have you Ever Felt you Should Cut Down on your Drinking?

If alcohol use has begun to interfere with your daily functioning or routine, you may already know you have a problem, even if you have not acknowledged this to others. This awareness may lead to a persistent desire to cut down, stop or better control your drinking. Unfortunately, efforts to stop cold turkey or without professional help are often unsuccessful due to the complicated mix of physiological, genetic and psychosocial factors the lead an individual to alcohol in the first place.

2. Have People Annoyed you by Criticizing your Drinking?

Has your friend or spouse confronted you about your drinking? Individuals with alcohol use disorder often feel irritated or alienated when a loved one expresses concern. While concern from friends or family may help motivate an individual to seek help, it can also have the unintended consequence of pushing the individual further away. Her or she may cut off these relationships completely and sink further into isolation, thus fueling additional drinking. In other cases, an individual will actively seek relationships in other social circles, where their drinking is accepted or even celebrated.

Fire fighter struggling with alcohol abuse sitting down with his hand on his head

3. Have you ever Felt Bad or Guilty About your Drinking?

For some, drinking alcohol is accompanied by feelings of guilt, anxiety or depression. This can be understood for several reasons. If your drinking has become as or more important than your obligations to your family, friends or work, your conscience may be weighing on you. For others with underlying mood disorders, such as clinical depression or anxiety, any central nervous system depressant (such as alcohol) can exacerbate symptoms. Furthermore, if you are struggling with other co-occurring physical health problems that are made worse by alcohol, you may feel guilty or disappointed in yourself.

4. Have you Ever had an Eye Opener, or a Drink First Thing in the Morning to Steady your Nerves or Get Rid of a Hangover?

If you’ve consumed a large amount of alcohol the night before, it’s not uncommon to experience a hangover the next day, as the body attempts to process and breakdown the alcohol. Having a hangover certainly doesn’t mean you are an alcoholic, but how you respond may. Individuals with true physiological alcohol dependence will begin to experience withdrawal symptoms as soon as they stop drinking. Symptoms, such as sweating, vomiting, headaches, tremors and hypertension, are not only extremely uncomfortable, but can be life-threatening if not treated immediately.

Paradoxically, consuming more alcohol (whether it’s first thing in the morning or any time of day) will delay the onset of such symptoms, thus providing temporary relief.

For some, having a drink of alcohol is simple choice, but for others, the choice is not so simple. Scientists have found that those who suffer from alcoholism are deficient in certain types of genetically inherited enzymes that help the body efficiently process and remove alcoholic toxins from the body. If you are unable to metabolize alcohol efficiently, as little of one sip can lead to intense physiological cravings for more alcohol.

Do you Feel Stuck in a C.A.G.E.?

If you answered yes to any of the questions above, you may meet clinical criteria for alcohol use disorder. The bad news is that, for many, alcohol use disorder does not resolve on its own.

The good news is, evidenced-based treatment is available to help you stop the cycle and regain control over your drinking and your life. Getting help for alcohol abuse or addiction is usually a combination of community-based support groups, professional treatment, medication and – for some – detox. Treatment is always based on an individual’s clinical needs and co-occurring mental and physical health problems.

The IAFF Center of Excellence for Behavioral Health Treatment and Recovery is a comprehensive treatment center designed exclusively for IAFF members struggling with addiction, PTSD and other co-occurring mental health problems. Call the IAFF Center of Excellence today for a non-obligation, free and confidential screening for you or a loved one.

Medical Disclaimer: The IAFF Center of Excellence aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

We can help. Call 855-900-8437 or

Get Help Now