LiveSmart: Alcohol Use and the Tolerance Connection – How Much is Too Much?

[This piece was written by Rachel Handler, executive director of behavioral health services, St. Peter’s Health Partners.]

The fable of the boiling frog is a familiar one. It describes how, if you put a frog into a pan of boiling water, it will jump out immediately. However, if you put the frog into a pan of water that is the frog’s body temperature and slowly turn up the heat, the frog will stay in the water – even to the point of boiling alive. Why? Because the frog does not notice the gradual change in temperature.

For many, alcoholism and addiction work in a similar fashion. Alcoholism is a progressive disease and the abuse of alcohol can spiral into problem drinking and addiction.

A problem drinker may drink more or longer than intended. Individuals may experience tolerance changes (needing more alcohol to achieve desired effects); withdrawal symptoms (e.g., sweating, tremors, nausea, anxiety, cravings); or an inability to cut back or quit. Without help, these behaviors can escalate to dangerous, excessive use of alcohol.

Alcoholism has serious consequences. It can lead to failure to fulfill obligations at work, school or home; legal problems related to drinking; drinking in dangerous situations (drunken driving); and social, family or interpersonal problems. The National Institutes of Health (NIH) noted in a study that between 33 to 50 percent of people struggling with alcohol use disorder also struggle with depression.

Many problems go unrecognized by physicians because of the alcoholic’s ability to hide or deny the amount of drinking and problems it has caused, and the gradual onset of the disease. Family members may deny or minimize problems, unwittingly contributing to alcoholism.

The CAGE questionnaire is one of several self-screening tests used by professionals to evaluate alcoholism risk:

  • Have you felt you should Cut down on your drinking?
  • Have people Annoyed you by criticizing your drinking?
  • Have you felt bad or Guilty about your drinking?
  • Have you had to drink in the morning to steady your nerves or get rid of a hangover (Eyeopener)?

“Yes” answers to two or more questions indicates a high likelihood of alcoholism.

The good news is that treatment services are available – including detoxification, inpatient, outpatient and residential programs – depending on need. Services include assessment, individual and group counseling, relapse prevention planning, as well as medications that can be prescribed in concert with treatment services.

St. Peter’s Health Partners provides support and a safe place for individuals with a variety of addictions, providing access to outpatient, inpatient and detoxification treatment sites throughout the Capital Region.

If you or a loved one is struggling with addiction, please call the SPARC Admissions Department at 518-452-6700 or Samaritan Hospital Inpatient Rehabilitation on St. Mary’s Campus at 518-268-5807. Visit us at for more information.

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