Summary: You can tell if someone is an alcoholic who needs treatment or just a heavy drinker by determining whether their drinking has a direct and negative impact on their ability to engage in typical daily activities in a healthy and productive manner.
Key Points:
- Words matter when talking about alcohol addiction, but behavior matters more.
- If someone’s drinking disrupts their daily life in a negative way, it doesn’t matter whether they’re labeled an alcoholic, a heavy drinker, or something else: they probably need help.
- A diagnosis for alcohol use disorder (AUD) from a qualified medical professional is important in that it can facilitate a referral for evidence-based clinical treatment.
Alcoholic, Heavy Drinker, Binge Drinker, Person with Alcohol Use Disorder (AUD): The Label Isn’t Important, Getting Help Is
In 2026, we do our best to avoid the old words that carry stigma: alcoholic, addict, drunk, druggie, and junkie. Those words matter when we face the public and talk about treatment for the disordered use of alcohol or drugs.
But here’s something important to know:
When drinking disrupts the healthy daily life of an individual, that person can benefit from treatment for drinking.
In the grand scheme of things, the labels – even the stigmatizing ones – don’t matter unless they keep someone from getting help. And people who need help may be daily drinkers, heavy daily drinkers, or weekend binge drinkers. Whatever their pattern, amount, or frequency of use, this rephrasing of the sentence above applies:
If drinking has an obvious and observable negative impact on their life, their ability to maintain a healthy lifestyle, and their ability to meet their school, work, and family commitments and responsibilities, then they can benefit from getting treatment.
In the next section, we’ll share an official alcohol consumption assessment tool created by the World Health Organization (WHO) to identify problem drinking. First, though, we’ll review common behavioral signs you can watch for in a friend or loved that indicate they may have a problem and need treatment.
Five Signs Someone Is An Alcoholic Who Needs Treatment
1. Lying About Drinking, Hiding Drinking
- In most cases, a person with a drinking problem knows it and doesn’t want to admit it. Therefore, they keep it from people, especially people close to them who point out they may have a problem. To keep the topic from coming up, they may lie about how much they drink and how often they drink. For instance, rather than saying, “I got a drink with friends,” they may say, “I had to stay late at work to get something important done.” They may also hide alcohol in unexpected places: in the bedside table, under the car seat, under the bed, in the garage or gardening shed – anywhere but the liquor cabinet of refrigerator where they belong.
- Lying about drinking and hiding drinking are classic warning signs that someone drinks too much, knows it, and does not want to do anything to change. When you see these signs, there’s a very good chance that person actually needs to make real changes in their relationship to alcohol.
2. Sudden Change in School or Work Achievement
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- If a person who typically gets good grades goes from As and Bs to Ds and Fs in the space of one semester – or even over a school year – that could indicate their drinking is a real problem, and they need treatment. And if a person with a steady job suddenly starts showing up late, showing up hung over, or not showing up at all, that’s also an indication they may be an alcoholic who needs treatment, rather than just a heavy drinker.
3. Risky Behavior
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- Two things associated with alcohol consumption impact cognitive function: intoxication and chronic, long-term exposure to alcohol. It’s easy to see how intoxication increases risky behavior. Intoxicants impair the rational decision-making processes and can lead to choices such as drunk driving or irresponsible sexual activity. Over the long-term, chronic alcohol exposure impairs the rational decision making process, which can lead to poor decisions that place overall health and wellness at risk.
4. New and Uncharacteristic Anger, Irritability, and/or Mood Swings
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- If a person shows a dramatic change in their emotions, that’s typically a sign something is going on with them. When a person begins acting irritable and angry all the time, or shows moods you’ve never seen before – anxiety, sadness, fear – these may be signs of two things related to alcohol. First, they may be intoxicated, which means they don’t have full control over their emotions or behavior – that’s why they may lash out in anger. Second, they may be showing an early sign of withdrawal: anger, irritability, sadness, and anxiety are all early symptoms of alcohol withdrawal. Both are signs a person may be an alcoholic who needs treatment.
5. Retreating From/Cutting off Contact With Family and Friends
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- An alcoholic who needs treatment may not want the people who know them best to see them up close. Families and long-time friends can often – not always, but most of the time – take one look at someone they care about and tell something’s off, something’s wrong, and when something’s not quite right. That’s one major reason a person who’s drinking too much may withdraw from family and friends: those are the people who can see it plain as day with just a glance. They may not want to hear advice about getting help. They may be ashamed and embarrassed about needing help. In either case, when a person who drinks a lot suddenly goes absent from all family and social functions, that’s a serious warning sign that they may be an alcoholic who needs treatment, rather than someone who’s a heavy drinker and just drinks too much.
Those five items are called red flags. Any one of them alone can be a warning sign that someone drinks too much and needs treatment for alcohol addiction. If someone you know and love shows those red flags, it may be time to consider helping them find a way to help themselves by seeking professional treatment and support.
World Health Organization (WHO): The AUDIT for Alcohol Use
Based on a long-range, worldwide study on problem alcohol use, the WHO created the alcohol use disorders identification test (AUDIT), an alcohol use screening tool designed to identify alcohol use on a continuum from needs education about alcohol to needs intervention, evaluation, and treatment.
Here are the questions on the AUDIT:
- How often do you have a drink?
- How many drinks do you have when you drink alcohol?
- How often do you have 6 or more drinks (for men) or 4 or more drinks (for women and men over age 65) on a single occasion?
- Have you or someone else been injured because of your drinking?
- Has a relative, friend, or health professional been concerned about your drinking?
- How often during the last year:
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- …you were not able to stop drinking?
- …you failed to do what was normally expected from you because of drinking?
- …you needed a first drink to start your day after heavy drinking
- …you had a feeling of guilt or remorse after drinking?
- …you been don’t remember the night before after you drank?
Although the AUDIT was designed for use in a primary care setting, anyone can use the AUDIT to assess their alcohol consumption to determine whether or not their drinking puts them at risk of addiction or additional health problems:
Read About and Take the AUDIT
Each question has a possible numeric answer that ranges from 1-4 (follow link for details). Summing the scores for reach question yields a final numeric value between 0 and 40. Here’s how the scores break down:
- 0-7:
- Risk Level 1: individual can benefit from increased education about the effects of alcohol consumption.
- 8-15:
- Risk Level 2: individual can benefit from targeted advice about alcohol consumption
- 16-19:
- Risk Level 3: individual can benefit from targeted advice about alcohol consumption, brief counseling on alcohol consumption, and continued monitoring for behavioral change
- 20-40:
- Risk Level 4: individual requires referral for full diagnostic assessment and evaluation for treatment for alcohol use disorder
The AUDIT was created over 25 years ago, but a recent study confirms its currently a relevant, viable, and accurate assessment for alcohol consumption. That means it’s a reliable way to tell if someone is an alcoholic who needs treatment, or just a heavy drinker. And as a reminder, a simple way to understand the answer to that question is this:
If the level of alcohol an individual consumes interferes with their ability to make healthy choices and meet typical daily responsibilities, then their alcohol consumption may be a real problem, and they may benefit from professional treatment and support.
