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Thinking you might have a drinking problem is often the first step toward addressing it. What you do with that awareness matters.
What You'll Discover:
• How to assess whether your drinking is actually problematic.
• The criteria professionals use to evaluate alcohol problems.
• Why having concerns about your drinking is meaningful.
• What options exist if you decide to make changes.
• How medication can help you regain control.
• Why you don't need to hit rock bottom to get help.
• How to take the first step.
If you've found yourself thinking "I think I have a drinking problem," that thought itself is worth paying attention to. According to the National Institute on Alcohol Abuse and Alcoholism, approximately 29 million Americans had alcohol use disorder in 2022. Many more drink at levels that concern them without meeting criteria for a formal diagnosis.
The fact that you're questioning your drinking suggests something has shifted in your awareness. This article helps you evaluate your situation and understand your options.
How to Assess Whether Your Drinking Is Problematic
The first thing to know is that alcohol problems exist on a spectrum. You don't need to match the stereotype of someone who has lost everything to have a drinking problem worth addressing.
Questions to ask yourself:
• Do I often drink more than I intended?
• Have I tried to cut back without success?
• Do I spend significant time drinking, recovering from drinking, or thinking about drinking?
• Do I experience cravings or strong urges to drink?
• Has drinking affected my work, school, or family responsibilities?
• Have I continued drinking despite relationship problems it causes?
• Have I given up activities I used to enjoy because of drinking?
• Have I found myself in risky situations because of drinking?
• Do I continue drinking despite knowing it causes physical or mental health problems?
• Do I need more alcohol than I used to for the same effect?
• Do I feel withdrawal symptoms when I don't drink?
These questions come from the DSM-5 criteria used by healthcare professionals to diagnose alcohol use disorder. Meeting 2 to 3 criteria indicates mild AUD, 4 to 5 indicates moderate, and 6 or more indicates severe.
Something to consider is that you don't need to meet diagnostic criteria to benefit from changing your drinking. If alcohol is causing you concern, that's reason enough to explore your options.
Why Your Concerns Are Meaningful
If it seems like you might be overreacting, consider this: most people who drink problematically minimize or rationalize their consumption. The fact that you're questioning your drinking rather than dismissing concerns is actually significant.
Common thoughts that lead people to question their drinking:
• "I'm drinking more than I used to"
• "I look forward to drinking more than seems normal"
• "I can't seem to moderate once I start"
• "Other people have commented on my drinking"
• "I regret things I do while drinking"
• "I feel worse overall but keep drinking anyway"
• "I've tried to cut back and couldn't"
These thoughts often arise before external consequences force the issue. Paying attention to them now, before problems escalate, gives you more options.
So, could you be wrong about having a problem? The short answer is that it's possible, but if drinking is occupying this much of your mental space, something is worth examining regardless of diagnostic categories.
The Spectrum of Alcohol Problems
Alcohol use disorder isn't all-or-nothing. Understanding where you might fall on the spectrum helps determine appropriate responses.
Risky drinking:
• Exceeding recommended guidelines (more than 7 drinks/week for women, 14 for men)
• Occasional binge episodes
• No dependence or major consequences yet
• Still in early stages where change is relatively easy
Mild alcohol use disorder:
• Meeting 2 to 3 diagnostic criteria
• Some difficulty controlling drinking
• May have experienced minor consequences
• Physical dependence typically not present
Moderate alcohol use disorder:
• Meeting 4 to 5 criteria
• Clear pattern of problematic drinking
• Multiple areas of life affected
• May have some physical dependence
Severe alcohol use disorder:
• Meeting 6 or more criteria
• Significant life consequences
• Physical dependence often present
• May require more intensive treatment
Most people who think they have a drinking problem fall somewhere in the mild to moderate range. This is actually good news because intervention at these stages tends to be more effective and less disruptive than waiting until problems are severe.
For a more detailed framework, see our article on understanding alcohol use disorder.
You Don't Need to Hit Rock Bottom
A common misconception is that you need to experience severe consequences before addressing a drinking problem. This idea has caused tremendous harm by encouraging people to wait until things get worse.
Why earlier intervention is better:
• Less entrenched habits are easier to change
• Physical dependence is less likely
• Brain changes are more reversible
• Consequences haven't accumulated
• Treatment can be less intensive
• Recovery is typically faster and more complete
What "earlier" looks like:
• Noticing you drink more than you intend
• Feeling concerned about your relationship with alcohol
• Recognizing that drinking occupies too much mental space
• Experiencing minor consequences (poor sleep, low energy, regrettable behavior)
• Someone expressing concern about your drinking
If you're at this stage, you have the opportunity to make changes before drinking causes serious harm to your health, relationships, career, or finances.
All that said, it's never too late. People recover from severe alcohol problems every day. But why wait if you don't have to?
What Options Exist
If you conclude that you want to make changes, multiple paths forward exist.
Self-assessment and goal setting:
• Track your actual consumption for 2 to 4 weeks
• Set specific limits for drinking
• Try taking a break to see how it feels
• Identify your triggers and develop strategies
Medical evaluation:
• Talk to your doctor about your concerns
• Get blood work to check for any alcohol-related health effects
• Discuss medication options
Medication-assisted treatment:
• Naltrexone reduces cravings and makes drinking less rewarding
• Can be accessed via telehealth for privacy and convenience
• Doesn't require abstinence to be effective
• Significantly improves outcomes compared to willpower alone
Counseling or therapy:
• Work with a therapist specializing in alcohol issues
• Address underlying factors contributing to drinking
• Develop coping strategies and new habits
Coaching programs:
• Regular check-ins for accountability
• Practical guidance for changing drinking patterns
• Often combined with medication
Support groups:
• AA for those who connect with its approach
• SMART Recovery for those who prefer science-based methods
• Online communities for anonymous support
For that reason, many people combine approaches. Medication handles the biological aspect while counseling or coaching handles the behavioral and psychological aspects.
How Medication Can Help
Naltrexone is an FDA-approved medication that can make addressing a drinking problem significantly easier.
How it works:
The medication blocks opioid receptors in the brain. When you drink with naltrexone in your system, alcohol doesn't produce the same pleasurable "buzz." Over time, cravings decrease because the brain unlearns the association between alcohol and reward.
Why it helps when you think you have a problem:
• Reduces the intensity of cravings
• Makes it easier to stop after one or two drinks
• Takes willpower out of the equation
• Works whether your goal is moderation or abstinence
• Available via telehealth for complete privacy
Research shows that people taking naltrexone have significantly fewer drinking days and heavy drinking days compared to those using willpower alone.
Naltrexone is taken as a daily 50mg tablet. Side effects are generally mild and temporary (nausea, headache in the first few days for some people).
Our article on how naltrexone helps you regain control explains the medication in more detail.
Taking the First Step
If you think you have a drinking problem, the most important thing is taking some kind of action. The specific action matters less than breaking through the inertia of thinking about it without doing anything.
Low-barrier first steps:
• Take an online assessment to better understand your situation
• Track your drinking for a week to get objective data
• Tell one trusted person about your concerns
• Schedule a telehealth appointment to explore medication
• Try going 3 to 7 days without alcohol to see how it feels
You don't need to have your entire plan figured out. Taking one small step often reveals the next one.
If you want to explore whether medication could help you address your drinking, take the online Alcohol Use Assessment to see if naltrexone might be right for you.
