Which describes people who drink a lot but do not fit the definition of alcoholic. Generally speaking we have let the combination of puritanism (itself ironic considering colonial per capita alcohol intake), the self-help industry and the infantilization of society define away what it really means. Even with all that, the technically correct definition excludes most heavy drinkers even though DU and most other poutrage-driven fora assume anyone drinking more than a beer at a time is one.
Here's what the Mayo has to say:
Alcohol use disorder (which includes a level that's sometimes called alcoholism) is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking.
Unhealthy alcohol use includes any alcohol use that puts your health or safety at risk or causes other alcohol-related problems. It also includes binge drinking — a pattern of drinking where a male consumes five or more drinks within two hours or a female downs at least four drinks within two hours. Binge drinking causes significant health and safety risks.
If your pattern of drinking results in repeated significant distress and problems functioning in your daily life, you likely have alcohol use disorder. It can range from mild to severe. However, even a mild disorder can escalate and lead to serious problems, so early treatment is important.
Now I know a fair amount of heavy drinkers. I'm one. I can only speak to some of those descriptors for myself, but others more broadly. I can't think of a single one of my personal acquaintance who has problems controlling their drinking, or seem obssessed by it. We all stop before becoming slobbering buffoons. Maybe every one of them but me has shocking DTs when they stop but I have no problems at all taking time off from the beer if I want to, and my consumption level is decreasing rather than increasing (plus I don't seek any "effect" at all and don't feel one very much either. I would dearly love it if beer without alcohol tasted better than unwashed socks, and would drink naught else if any did). Again I can't speak to their function or distress in daily life very well (being male, certainly not the latter) but since my general group includes two doctors, one pilot, one high ranking state EPA official, a couple of senior managers in business, one lawyer and one UPS depot manager all of middle age and happily married, with well above average intellect and clean records to my knowledge, we are hardly dissolute wrecks struggling with the problems of abusing booze.
I'm not scared of labels. I'm fat not big-boned and I'm a cripple not differently-abled. But those are accurate descriptors I am not shirking. I don't think alcoholic is. If it were I'd have no problem applying it to myself. Unhealthy alcohol use acciording to the above? Damn right. My health other than obesity is untouched to date for anything alcohol is particularly known to cause (although in my case it was more about the cripple part. Hard to lose weight when you cannot exercise), but I'm not in denial enough to pretend that blood sugar, liver function et al are just words that don't apply to me so of course the health risk is there. Binge drinker? Christ yes. Starting a 3rd tall beer at most sports bars even over three hours makes anyone one of those (although the origin and shifting definition of the term is hardly an empirical and objective paragon to say the least). I used to gladly call myself a lush but that has absorbed connotations of uncontrolled frequent drunkenness too, so not applicable any more. The last time I was noticeably drunk ws 2010 when I was drinking a nice porter labeled at 5.6% ABV that was really 9.8%.
Functioning alcoholic has an oxymoronic quality when alcoholic is used correctly. It would only be possible briefly. If you cannot control your drinking, are obssessed by it, and refuse to stop even when it damages your life as the term dictates, "functioning" in all but biological terms is not likely to long continue. I've been a heavy drinker for well over 30 years, as have all but one of my group who's the baby at 38. You'd think it would have caught up with us by now.
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