Few would argue that alcohol use disorders do not cause terrible damage, both to drinkers' bodies and to their social world. The physical damage associated with alcohol abuse and addiction is discussed in your text. However, at what point do we say that a person has an alcohol use disorder? The end-stage alcohol can be easy to recognize. However, the high-functioning individual with Alcohol Use Disorder (DSM 5) is not always as easily identified.

Imagine, if you will, two different individuals. One is the vice president of a major corporation, in his or her early 60s, earning a salary well into the six-figure range, and married with two children who have completed college and have started their own lives. This individual belongs to a country club, owns a rather large recreational boat, and since the house mortgage is paid off, is well-off and comfortable. This person also consumes 3-4 glasses of an expensive brand of liquor each evening after dinner and is in good health.

In contrast to this scenario, is a second hypothetical person who drinks beer. This person goes to a favorite bar 3-4 nights a week and also has a sizable supply of beer bottles in the refrigerator at home. This person earns about $20,000 a year, and his or her spouse has to work to supplement the family income. They have two children, one of whom has been arrested for "underage consumption" of alcohol on four different occasions in the past, and once for driving under the influence of alcohol. Our hypothetical worker is also about 60 years of age and consumes 4-6 twelve-ounce bottles of beer in 6 hours after work. This person has also been diagnosed with steatosis of the liver, probably induced by drinking, according to the physician who made the diagnosis and has been arrested for driving under the influence of alcohol on two separate occasions (but not in the last decade).

Questions:

1. Would you suggest that one or the other did not have a drinking problem? Why or why not?
2. What information do you believe is needed to diagnose an individual with an alcohol use disorder? Does economic status alter the individual's diagnosis? Should economic status influence the diagnosis? Why or why not?