Alcohol use was already changing before the pandemic, but lockdowns and behavior changes drove up drinking in the first two years of the pandemic.
Many people drank to cope with the accumulated pressures – the uncertainty, loss of connection to others, fear of death, and the political and racial tensions that reached an apex in the summer of 2021, said Dr. Victor Karpyak, a psychiatrist who studies the genetics of alcoholism at the Mayo Clinic in Rochester, Minnesota.
Using alcohol to cope with stress actually makes the situation worse, said George Koob, who directs the National Institute on Alcohol Abuse and Alcoholism.
“When the alcohol wears off, the demons return with a vengeance,” he said.
Is any amount of alcohol safe? It depends on your taste for risk.
In the U.S., 5% of adults meet criteria for alcohol addiction.
But while the stereotype is that only those who have an addiction problem will face health consequences, the overall public health effect of drinking is driven by the 60% of adults who drink less heavily, said Dr. Brian Lee, a liver specialist at the Keck School of Medicine of the University of Southern California.
Prohibition is not the answer, Lee said, but “even cutting down can be helpful. It’s not all or nothing.”
Here’s what to know about alcohol use disorder, treatment and how to recognize signs.
What is alcohol use disorder, or AUD?
Alcohol use disorder, or AUD, “is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational or health consequences,” according to the National Institute on Alcohol Abuse and Alcoholism.
How much alcohol is considered one drink or serving?
Treatment for alcohol use disorder
Studies show that alcohol use disorder can improve with treatment and both medication and non-drug approaches have been shown to be effective.
Three medications have been approved by the Food and Drug Administration to help people stop or reduce drinking and avoid relapse:
- Naltrexone, which blocks receptors in the brain involved in alcohol cravings, is delivered as a daily pill or monthly injection. People with a family history of alcohol use disorder may see particular benefit, but it is not appropriate for those with a liver condition or who are taking opioid medications for pain.
- Acamprosate helps alleviate some of the negative symptoms that can come with prolonged abstinence and comes as a pill taken three times per day.
- Disulfiram causes some of the unpleasant symptoms found in people at low genetic risk for heavy drinking, including nausea and skin flushing.
Talk therapy, including cognitive behavioral therapy, has been shown effective for helping people control problem drinking. Programs like Alcoholics Anonymous are also extremely useful for some people.
Residential programs can be helpful in some cases, but many people won’t need such intensive treatment and experts typically recommended people with alcohol use disorder seek the least intensive type of care first.
The National Institute on Alcohol and Alcoholism offers a “treatment navigator” to help people find appropriate care.
How to spot a drinking problem
Someone is diagnosed with alcohol use disorder when they answer “yes” to two or more of the following questions from the National Institute on Alcohol and Alcoholism.
The more yeses, the more urgent the need for care. In the past year have you:
- Had times when you ended up drinking more, or longer, than you intended?
- More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
- Spent a lot of time drinking? Or being sick or getting over the after-effects?
- Experienced craving — a strong need, or urge, to drink?
- Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
- Continued to drink even though it was causing trouble with your family or friends?
- Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
- More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
- Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout (i.e., forgetting, after drinking, where you were or what you did while drinking)?
- Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
- Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, dysphoria, depression, restlessness, nausea or sweating? Or sensed things that were not there?
Source: National Institute on Alcohol and Alcoholism
Contact Karen Weintraub at email@example.com.
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