Am I an alcoholic, or do I just drink too much?

Two or more of them in the same 12 months point to alcohol use disorder, and a clinical assessment is what turns that into a diagnosis. Count yours in the questionnaire below, or score the ten-question AUDIT out of 40. If you hold down a job and still wonder, start with what a functioning alcoholic is.

What is alcoholism or alcohol use disorder?

Alcohol use disorder is the medical name for alcoholism. In the words of the US National Institute on Alcohol Abuse and Alcoholism (NIAAA)⁹, it is “a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.” The diagnosis absorbed two older ones, alcohol abuse and alcohol dependence, which doctors used to give separately, as NIAAA explains³.

Alcohol abuse or alcohol dependence?

Most people still use the two old words, and they mean different things. Alcohol abuse is drinking that keeps causing trouble while the body does not yet need the drink: you come in late after a heavy night more than once, your partner starts counting the glasses, you drive home when you should not. There are no shakes the next morning, which is why people at this stage feel sure they are fine. Alcohol dependence is the form in which the body has adapted to alcohol and withdraws without it, with shakes, sweating, a racing heart, nausea and a night without sleep when the drinking stops. If you drink every day, do not stop suddenly on your own. Talk to us before you stop; whether you need a medical detox is decided after an assessment.

When does drinking become alcoholism?

No set amount or number of drinking days makes someone an alcoholic; a pattern of lost control and harm does. A person who drinks only on Friday and Saturday, but cannot stop once the first bottle is open, can meet the criteria. A person with one glass of wine at dinner every night may not. “Everyone I know drinks like this” is not the test either. The diagnostic criteria below are.

How is alcohol use disorder diagnosed?

Alcohol use disorder is diagnosed when someone meets at least 2 of the 11 criteria in the DSM-5, the diagnostic manual psychiatrists use, within the same 12 months, as NIAAA sets out³. Two or three criteria count as mild, four or five as moderate, and six or more as severe, which is what people often call extreme alcoholism. Severity changes the plan: at the mild end the drinking is easier to turn around, and at the severe end stopping suddenly on your own is risky.

What are the 11 diagnostic criteria?

• Drinking more, or for longer, than intended.
• Wanting or trying to cut down, without success.
• A lot of time spent drinking or recovering from it.
• Craving: a strong urge to drink.
• Failing at work, school or home because of drinking.
• Drinking despite problems with people close to you.
• Giving up important activities to drink.
• Drinking in situations where it is physically dangerous, such as driving.
• Drinking despite a physical or mental health problem it causes or worsens.
• Tolerance: needing more for the same effect.
• Withdrawal, or drinking (or taking a sedative) to avoid it.

These are the alcoholism symptoms a clinician checks; the signs a family notices first are in signs of alcoholism.

Am I an alcoholic? Take this alcoholism test

The quickest “am I an alcoholic” quiz is the 11 criteria turned into yes-or-no questions. Answer honestly for the last 12 months and count the yes answers.

Alcoholism screening questionnaire

In the past year, have you:

• ended up drinking more, or for longer, than you meant to, like “one after work” that finished at midnight?
• wanted to cut down or stop more than once, and not managed it?
• spent a lot of time drinking, or getting over it?
• wanted a drink so badly you could think of little else?
• found that drinking, or being sick from it, got in the way of home, family, work or study?
• kept drinking even though it caused trouble with family or friends?
• given up or cut back on things you used to enjoy, to make room for drinking?
• more than once got into a situation while drinking that raised your chance of getting hurt, such as driving?
• kept drinking even though it made you low or anxious, worsened a health problem, or came after a blackout?
• needed much more than before to feel the same effect?
• had withdrawal as it wore off: shakes, sweating, nausea, poor sleep, a racing heart, or a seizure?

How many AUD criteria do you meet?

• 0 or 1 yes. Probably not alcohol use disorder. Something made you take this test, though, and noticing it early is worth a lot.
• 2 or 3. Points to mild alcohol use disorder. The drinking is easiest to turn around at this stage, and not everyone at this stage needs residential treatment; how to stop drinking sets out a plan of your own and when it is not enough.
• 4 or 5. Points to moderate. Cutting down alone gets hard at this level, and a plan with people behind it helps.
• 6 or more. Points to severe. Get assessed before you stop.

Whatever your count: if you ticked withdrawal, or you drink every day, do not stop suddenly on your own. Talk to us first; our medical team decides after an assessment whether you need a medical detox.

Only a clinical assessment can turn your count into a diagnosis. Recognise two or more? Send us the signs you ticked, with what you drink and when you last went a day without, and we will talk you through the next steps.

Your count shows how far the drinking has gone, not why it started. For many people it began as a way to feel at ease in a room full of people, or to get through the evenings after a divorce. Stop the drinking and leave that reason untreated, and the pull back to the bottle stays.

The AUDIT: a ten-question alcohol test with a score

The AUDIT, the Alcohol Use Disorders Identification Test, is the standard alcohol screening test. Its ten questions were developed across six countries for the World Health Organization, and each is scored 0 to 4, to a maximum of 40, as Saunders and colleagues reported in 1993¹. In their study, “92% had an AUDIT score of 8 or more” among people diagnosed with hazardous or harmful drinking. It has been tested in South Africa too, in a 2025 study of 1,885 people in the Eastern Cape by Stockton and colleagues⁷.

Pick the answer closest to the truth for the past year; the score for each answer is in brackets. Counts below are in UK units; one South African standard drink (12 g, by the SAMRC⁸) is about one and a half of them.

The three-question version. The first three questions alone make up the AUDIT-C, a quick check that picked up heavy drinking or alcohol abuse and dependence about as well as all ten (Bush et al., 1998⁶). In the Eastern Cape study, 4 or more for men and 3 or more for women was the line.

What does your AUDIT score mean?

Add up the ten answers. Under 8 is low risk, 8 to 15 is increasing risk, 16 to 19 is higher risk, and 20 or more points to possible dependence. The score is a guide to where your drinking sits, not a diagnosis.

The top band, 20 to 40, is the zone the WHO manual⁵ calls “Referral to Specialist for Diagnostic Evaluation and Treatment”. NICE guidance on alcohol-use disorders¹⁴ draws the same line: from a score of 20, it recommends considering assisted withdrawal, a medically managed detox. In the Eastern Cape study⁷, a positive screen started at 8 for men and 7 for women, and 9.5% of the 1,885 people tested had alcohol use disorder. Send us your score, and we will go through what it means for you.

What is a functioning alcoholic?

A functioning alcoholic, or high-functioning alcoholic, is someone whose drinking meets the criteria for alcohol use disorder while they still hold down a job, pay the bills and look fine to most people around them. It is an everyday phrase, not a diagnosis: the same 11 criteria apply whether or not you make it to work on time.

Dependence does not always look like falling apart. In a nationally representative US study of people with alcohol dependence, two of the five subtypes, about 19% each, had the latest onset, the lowest rates of periodic heavy drinking and higher psychosocial functioning (Moss et al., 2007¹¹). Doing your job well in spite of the hangovers, or drinking “only” once or twice a week, does not rule it out, because the questions are about control and harm, not attendance. Patterns that come up often:

• rules about drinking, such as “only after six” or “never on a school night”, that keep getting bent;
• a drink that has a job: switching off after work, getting to sleep, quieting worry;
• colleagues and friends who have no idea how much you drink, and one person at home who does;
• evenings that end in gaps you cannot remember, while the mornings still run to plan.

For many people the functioning part holds until something gives: a blackout at the wrong moment, a missed deadline, a partner who stops believing the explanations. If nobody around you would believe you have a drinking problem, the first conversation can stay between you and us: it is free and confidential, and nobody on the call will ask you to take on a label. Write to us on WhatsApp. You can also keep working remotely during treatment; you agree with your counsellor how much work fits around the programme.

Are you drinking too much?

By NIAAA’s measure, heavy drinking is five or more drinks on any day or 15 or more a week for men, and four or more on any day or eight or more a week for women, as set out on its drinking levels page¹². Binge drinking, on the same page, is that many drinks in about two hours: an ordinary Saturday at plenty of braais. Below those lines the risk is smaller, and still there: “There is no form of alcohol consumption that is risk-free,” says the WHO¹³.

Many people do not see a problem because they drink no more than they did five years ago. Age changes the sum: older people “may reach higher blood alcohol concentrations than younger people”, and mixing alcohol with sleeping tablets, anxiety medicines or opioid painkillers “can be deadly”, according to NIAAA’s page on aging and alcohol¹⁶. Ask the people closest to you what they think; if they have been worried, the last AUDIT question has already scored it.

Some people try a dry month to see where they stand, and for a daily drinker that is not safe. If you drink in the morning to feel steady, or a day without a drink brings shakes, sweats or a racing heart, do not stop suddenly on your own. Message us first and tell us what the days without a drink are like; we will talk through your situation and the next steps.

What are the health risks of alcohol use disorder?

Alcohol plays a causal role in “more than 200 diseases, injuries and other health conditions”, according to the WHO fact sheet (June 2024)¹³. It caused around 2.6 million deaths worldwide in 2019, 474,000 of them from heart and blood vessel disease, and the same fact sheet links it to cancers of the breast, liver, head and neck, oesophagus and bowel. The harms that show up most in a heavy drinker’s life:

• liver disease, from fatty liver to cirrhosis;
• depression and anxiety;
• injuries, from falls to car crashes;
• stroke, high blood pressure and an irregular heartbeat, which NIAAA lists among alcohol’s effects on the body¹⁵.

Drinking in pregnancy “increases the risk of having a child with fetal alcohol spectrum disorders”, the same WHO fact sheet¹³ says, and a parent’s drinking shapes how children grow up. Depression and anxiety cut both ways: drink makes them worse, and they are often why the drinking started.

What should you do if you have a drinking problem?

If you have a drinking problem, first find out whether stopping is safe for you, then treat the reason you drink, because that reason is what pulls people back after detox.

Find out whether stopping is safe

Withdrawal can bring anxiety, sweating, trembling, nausea and sleeplessness, and its severe form, delirium tremens, may be fatal⁴. A medical assessment shows what the alcohol has already done to your body and how risky stopping will be. With us, our GP, Dr John Wulz, examines you after you arrive; he has a background in mental health and emergency medicine. If you need a detox, our medical team runs it. The days after the last drink are described in alcohol withdrawal symptoms and timeline.

If someone has a seizure, becomes confused or cannot be woken, call local emergency services immediately. Do not wait for a WhatsApp reply.

Treat the reason you drink

Detox ends the drinking for now; what keeps it ended is work on why you drink. NICE guidance¹⁴ pairs acamprosate or naltrexone after withdrawal with “an individual psychological intervention”. More on the tablets is in medication for alcoholism. Dr Wulz also reviews any medication you already take.

At Renewed Life Center the drinking and what sits under it (anxiety, low mood, trauma, burnout) are treated together. Ruby Weber, the psychologist who heads psychology at the centre, has more than 20 years in the addictions field. Your own counsellor works with you one-to-one every week, 45 minutes at a time, alongside group work every weekday: CBT and DBT for thoughts and urges, schema therapy for the old patterns that keep sending you back to the bottle, EMDR and TRE for trauma, family therapy and relapse prevention. The first month makes you safe and steady. Most clients stay for a second month, which goes deeper into trauma, relationships and who you are without the drink. More on alcohol use disorder treatment and alcohol rehab in Cape Town.

Lean on the people around you

Telling the people close to you lets them help, and they usually know more than you think. Families join a support group by video every week, visits are possible from the first week, and relatives can have sessions of their own. The 12-step meetings in the evenings build a habit you can take home, and AA meetings in South Africa pick it up from there.

Change your environment

Cravings come from context as much as from willpower: the braai-and-brandy Saturday, the bottle in the kitchen, the drive home past the bottle store. Every discharge includes a written relapse-prevention plan built for your home. Sober living on the same property is there for anyone who wants a slower return, and we keep in touch with former clients.

How do you take the first step?

One conversation is enough to start: free, confidential, 20 to 40 minutes by WhatsApp, video or phone, with a reply the same day. Most often you talk to John Roberts, Senior Recovery Specialist and Operations Manager, who has 39 years in recovery himself. Bring your score; he will ask what you drink, how often and when you last went without.

Renewed Life Center is in Lakeside, a residential suburb of Cape Town close to Muizenberg beach, with the mountain ridge right behind the house. Drug and alcohol tests on arrival and at random during the stay keep the house safe. If you are coming from abroad, we meet you at Cape Town airport and take you back when you leave, and if you are still drinking when you travel, we can arrange for someone to travel with you, from home or from the airport. UK and US passport holders can visit South Africa as tourists for 90 days without a visa, but a stay for treatment can need a different visa: check before you book, and we help with the documents.

Nobody arrives with the right words. “I took a test on your site and I do not like my score” is enough of a first message.

Ready to talk it through with someone? Ask about an assessment.Ready to talk it through with someone? Call +27 79 880 0045, free and confidential.

How common is alcohol abuse in South Africa?

Only 32.5% of South Africans aged 15 and over drink, according to the WHO’s 2024 global status report on alcohol¹⁰, but those who do drink heavily. Adults average 8.8 litres of pure alcohol a year, and among drinkers the figure is 27.2 litres. That is why a weekend that would worry a doctor can pass for normal here.

What if you are worried about someone else’s drinking?

If you are worried about someone else’s drinking, fill in the test from what you have seen and expect the real score to be higher, because people hide the parts that worry others most: the bottles in the recycling that do not match what you saw, the “quick drink” after work that comes home at ten. More of what families notice first is in signs of alcoholism.

A relative can talk to our team before the person has agreed to come, and you need no proof to start. Message us before you talk to them, so the conversation has a plan behind it: tell us what you are seeing. More in how to talk to a loved one about rehab.

Questions people ask

Is there an “am I an alcoholic” quiz or test?

Yes, and you have two on this page: the 11-question screening questionnaire, which counts your yes answers against the DSM-5 criteria, and the ten-question AUDIT, which gives a score out of 40. Both take under ten minutes. Neither is a diagnosis; that takes a clinician’s assessment.

I drink every night. Am I an alcoholic?

Not automatically. Drinking every night does not meet the criteria by itself; what counts is how much control you have over it and whether it is causing harm. Count your answers in the questionnaire above. If you have had shakes or bad sleep on a night off, do not stop suddenly on your own: message us first. If it is your partner, read when your husband drinks every night.

Can you be an alcoholic if you only drink at weekends?

Yes. The diagnosis depends on loss of control and harm, not on which days you drink. Weekend binges that you cannot stop once started score on several AUDIT questions. If a binge has ever ended in a blackout or vomiting in your sleep, learn the signs of alcohol poisoning.

What causes alcoholism?

There is rarely a single cause. NIAAA names the main risks: drinking from an early age, a family history of alcohol problems, and mental health conditions or a history of trauma, including childhood trauma. That is why one team at Renewed Life Center treats the drinking together with the anxiety, depression or trauma underneath it.

Is a high AUDIT score the same as a diagnosis?

No. The AUDIT is a screen that flags risky drinking. A diagnosis comes from a clinician, who checks the 11 criteria above and also looks at physical risk, mood and anything else going on. Before admission with us, our team’s assessment takes 45 to 90 minutes, and a doctor examines you after you arrive.

Can I stop drinking on my own?

Not if you drink every day, or if you have had shakes when stopping before. Do not stop suddenly on your own: contact our team first to discuss your situation, and our medical team decides after an assessment whether you need a medical detox. Our guide on how to stop drinking safely sets out who should not try it alone.

Will anyone find out that I asked?

Not from us. The first conversation is free and confidential, and there is no obligation to go further. Tell us as much or as little as you want.