"I Don't Wanna Go to Rehab...I Say No, No, No!"

By Dirk Hanson 04/08/11

Only 1.2% of heavy drinkers say they would benefit from treatment. Are they in denial, or is the definition of alcohol dependence due for a revision?

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I'm fine. Really.
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Let’s face it: Most people who drink and drug in an addictive manner can take a very long time to figure out they've got a problem—a very long time to get their minds right, if they ever do. Obits of those who don’t can be found anywhere.  We’ve all shuddered whe we've heard that ancient Henny Youngman cliche about denial not being a river in Egypt. But as it happens, denial is a deeply engrained feature of the way addiction plays out for many people. So deeply engrained, according to a fascinating new study from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), that a recent national survey found only a meager 1.2 % of those who meet the accepted diagnostic criteria for alcohol dependence believed they would benefit from treatment. According to SAMHSA, there are an estimated 7.4 million American adults between 21 and 64 who meet the criteria for alcohol dependence listed in the American Psychiatric Association’s bible of mental disorders, the DSM-IV. And also according to SAMHSA, almost none of them believe they would benefit from treatment. The study “provides striking evidence that millions of Americans are in serious denial regarding problem drinking,” said SAMHSA administrator Pamela S. Hyde. That much is undeniably true. But might it not also mean that the diagnosis of alcohol dependence as codified by the DSM-IV is perhaps overdue for another edit?

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Dirk Hanson, MA, is a freelance science writer and the author of The Chemical Carousel: What Science Tells Us About Beating Addiction. He is also the author of The New Alchemists: Silicon Valley and the Microelectronics Revolution. He has worked as a business and science reporter for numerous magazines and trade publications including Wired, Scientific American, The Dana Foundation and more. He currently edits the Addiction Inbox blog. Email: [email protected]