Addiction

Patient Story: Addiction and Substance Use Disorder

Keith, a 45-year-old plumber, was referred for a psychiatric evaluation after his family met with him to express their concern about his heavy drinking. Since making the appointment 3 days earlier, Keith denied having a drink.

For 20 years after high school, Keith drank 3-5 beers per evening, five times per week. Over the last 7 years, Keith drank almost daily, with an average of 6 beers on weeknights and 12 beers on weekends and holidays, His wife repeatedly voiced her concern that he was “drinking too much.” Despite his efforts to limit his alcohol intake, Keith spent much of the weekend drinking, sometimes missing family get-togethers, and often passed out while watching TV in the evening. He remained productive at work and never called in sick. Keith was able to stop drinking twice for 1 month in the past 4 years. Both times, he said he had gone “cold turkey” in response to his wife’s concerns. He denied having had symptoms of alcohol withdrawal either time.

Keith had been married for 18 years and had one 17-year-old daughter. He was a high school graduate with 2 years of community college. He owned a successful plumbing company and had never seen a psychiatrist.

Keith was diagnosed with Alcohol use disorder. His lack of success in cutting down, overall time spent intoxicated or recovering from being intoxicated, missed family events, and frequent alcohol use despite problems all fit the criteria for the disorder.