Drinking alcohol in the “gray area” is not a medical diagnosis, but experts say it can still be a problem. What is it and what are the signs?

Angela Teuscher, 50, was looking forward to a few glasses of wine in the evening.

It was her reward for finishing a stressful day as a single mom who worked full time, the Portland, Oregon resident said. She deserved it.

Over the years, however, those few evening drinks turned into another glass of wine at 8 a.m. the next morning.

“The scary thing about this way of drinking is that there is no day or time to say, ‘This is a problem,'” she said. “It was a slow progression from what was just okay to suddenly what wasn’t.”

Teuscher has now been sober for nine years, but she wished she could recognize the signs of her unhealthy relationship with alcohol years before it got out of hand.

Health experts call this pattern of consumption the “gray zone,” and while it’s not a medical diagnosis, they say it remains problematic and can get worse over time.

As the coronavirus pandemic continues to add stress to daily life, Teuscher and health experts are warning others to take a critical look at their own drinking habits.

What is the “gray area” drinking?

Alcohol use in the “gray area” is a term used to describe a mild alcohol use disorder, said Dr Jessica Gregg, chief medical officer of De Paul Treatment Centers in Portland and assistant associate professor of medicine. at Oregon Health and Science University.

“Someone is not that far into his drinking that his body is addicted… he is not on the extreme extreme of the spectrum, but he drinks in a way that makes his life worse rather than better. “she said.

On the alcohol consumption disorder identification test (AUDIT) – a 10-question survey developed by the World Health Organization to assess alcohol consumption – a score of 8 indicates harmful alcohol consumption. A “gray zone” drinker can get a 3.

Gregg said that alcohol consumption in the “gray area” is not quantified by the number of drinks a person has had, but rather by their relationship to alcohol.

For example, a person who drinks a glass of wine every night may not be a “gray zone” drinker, but a person who drinks half the wine may still have difficulty drinking from the “gray zone”. grey “.

“If someone only drinks three nights a week, but thinks about that night every day…” she said.

Teuscher recalled that one of the first red flags in his drinking “gray zone” was seeing a man lining up at the grocery store with a six pack of beers and thinking it was “far away.” to be sufficient ”so that one person can drink. She also noticed that she drank more than anyone in her group of friends.

“My friend drank half a glass of wine and stopped, and that was a weird thought to me, like, ‘Who would leave half a glass of wine? It’s just a waste, ”she said. “Those little things now in hindsight made sense to me, but back then it was just living in my head, but I didn’t think it was a really incorrect thought.”

Although alcohol consumption in the “gray zone” has been around for over a decade, the concept sparked renewed interest as alcohol consumption skyrocketed during the coronavirus pandemic.

A YouGov survey in April found that 37% of U.S. adults have reported increased alcohol consumption since the start of the pandemic, according to the report commissioned by Field Trip Health, a provider of psychedelic therapies.

Another study from the RAND Corporation published in October 2020 found that women had increased their binge drinking days by 41% compared to before the pandemic.

“This notion of ‘gray area’ is a challenge,” said Alberto Augusten, chief pharmacist and toxicologist at Memorial Regional Hospital in Miami. “The COVID pandemic has made things more difficult. “

Signs of a mild alcohol use disorder or “gray area” of alcohol use

One sign that someone may have a hard time drinking in the “gray area” is if they know alcohol is damaging their life and want to stop drinking, health experts say, but he is unable to follow through.

They often silently worry about their habit even if it doesn’t affect their social interactions or daily activities, Augusten said. In fact, friends and family usually don’t notice that someone may be struggling with a mild alcohol use disorder.

“A lot of these people get this tug of saying ‘I want to quit’, and a lot of them may stop for a while and then have to increase their use,” he said.

Those who may have alcohol use problems in the “gray area” don’t normally hit bottom like others with severe alcohol use disorder, Gregg said, but they constantly challenge. question their spending habits.

It can be difficult to organize these feelings into possible signs of a “gray area” of alcohol use. Doctors typically use a simple questionnaire – called a CAGE – to assess problematic alcohol use, said Dr. KV Narayanan Menon, medical director of liver transplantation at the Cleveland Clinic.

CAGE is made up of four questions:

  • Have you ever thought that you need to cut down on your alcohol intake (Cut Down)?

  • Have people annoyed you by criticizing your drinking (annoyed)?

  • Have you ever felt bad or guilty about drinking (guilty)?

  • Have you ever had a drink in the morning to calm your nerves or to get rid of a hangover (Eye-opener)?

Answering yes to at least two questions is considered clinically meaningful, according to Johns Hopkins Medicine. But not all alcohol consumption in the “gray area” can be captured in a simple survey, according to health experts.

“If that bothers you… just say ‘Maybe I should explore this more,’ whether it’s with your primary care doctor or just Google it,” said Gregg.

How to get help

Even though drinking in the “gray area” is not an official diagnosis, Gregg recommends talking to a health care professional about drinking habits.

“Take it out of the shadows and say ‘This is something I want you to be aware of,’” she said. “Asking a doctor to say ‘I’m a little worried’ is an effective intervention. “

The doctor can do a formal assessment of alcohol and drug use and refer you to a counselor. But if seeking professional help seems too intimidating, says Teuscher, a good first step is to contact a trusted friend or family member.

She also suggests taking a critical look at alcohol and replacing it with other activities: what void does alcohol fill and what can be used instead?

“People shouldn’t lose everything or even have these consequences if they don’t have to,” Teuscher said. “If you have these thoughts, investigate and talk to someone before it gets worse.”

Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.

Patient health and safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial contributions.

This article originally appeared on USA TODAY: Drinking alcohol: what is the “gray area” and why can it be a problem?


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