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Brent Scobie Brent Scobie
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What role does alcohol play in your life?

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There has been tremendous news coverage over the past year about the opioid epidemic and its impact on many regions of the country, including Maine. As we read and listen to scary stories of diversion and abuse of narcotic medications and heroin, let us not lose sight of an equally dangerous drug in our communities and one that is far more pervasive relative to its abuse – Alcohol. One out of every eight Americans struggle with an alcohol use disorder, and far more experience negative health consequences from overuse. 

A 2017 study published in the Journal of Addiction Medicine found substantial increases among Americans in their high risk drinking in the decade following 2002-03. The prevalence of alcohol use disorders rose by nearly 50 percent during that same period, especially for certain subgroups such as women, adults between the ages of 45-64 years old, and those over 65.

Given the pervasiveness by which alcohol is advertised, glamorized and consumed in our country, the line that separates “normal” alcohol use from high-risk or problem drinking is unclear to many. The media has typically portrayed the stereotypical “alcoholic” as one who constantly has a bottle in their hand, appears disheveled, unshaven, unkempt and non-functional.  The reality, however, is that alcohol use problems are far more complex and varied than this—in fact, the majority of individuals with a drinking problem are invisible to you and me.

Alcohol drinking behaviors exist on a continuum with non-drinkers on one end, and those with the need to constantly have alcohol in their system on the other; the stereotypical “alcoholic.” Between those two extremes however are multiple other categories of drinking behavior, some of which can become quickly yet subtly problematic. 

Those who choose drink on a social basis, to have a glass of wine at mealtime, or during a special occasion, we typically refer to them as social drinkers. Alcohol in this context is an augment to the event, but it is not the event. While regular socially appropriate drinking will slow metabolism, cause weight gain, impact healthy sleep and affect mood, one drink per day for women and two drinks per day for men is considered healthy or moderate according to dietary guidelines.

Recreational drinking reflects consumption of alcohol for a purpose. In this case, alcohol is often a large part of the event if not the sole purpose. It’s drinking for the purpose of achieving an alcohol effect. It is not uncommon for people to toggle between social and recreational drinking throughout the year, for example on New Year’s Eve or the holidays they may consume more, to the point of mild to moderate intoxication. For those who recreate with caution, there are largely no significant consequences other than perhaps an upset stomach or headache the next day.

Binge drinking is considered the next evolution of recreational drinking and is classified as higher risk. Binge drinking is defined as consuming five or more drinks in one sitting by a man, or four or more drinks by a woman. Binge drinking is recreational drinking but often more intense with larger amounts of alcohol consumed. Yet some binge drinkers do not drink just to recreate, they drink for other purposes. They drink to help relax, to sleep and to alleviate boredom, depression or anxiety.

Early signs that you may be drinking too much include:

  •         You set personal limits for yourself but have difficulty sticking to them.
  •         You become distracted during the daytime in anticipation of being able to drink in the evening.
  •         You frequently tell yourself, “I need a drink.”
  •         You have tried to lose weight without luck.
  •         You don’t feel as if you are functioning physically or cognitively as you used to.
  •         Your friends or family comment on your drinking.
  •         A majority of your plans involve alcohol.
  •         When you’re under pressure or feeling blue, you reach for alcohol.
  •         You worry about your own drinking.
  •         Your doctor tells you are drinking too much or your physical health is deteriorating-high blood pressure, abnormal liver functions, weight gain, and depressed mood.

When it comes to drinking, knowledge does not necessarily lead to control, but awareness does. If you are a regular drinker, pay attention to the above signs and seek a consultation with an expert. Get feedback from family and even consider a brief experiment. Stop drinking for a short period, maybe a couple weeks to a month. Do you feel differently? Do you have more energy? Are you more efficient at work? Have you lost a few pounds? Has your mood changed? Are you less irritable?

If the answer to any of these questions is “yes,” perhaps you have just given yourself some much-needed insight. And with insight comes transformation.

(Brent Scobie, PhD, LCSW is Acadia Hospital Associate Vice President for Clinician Services and Quality. He also provides clinical oversight for Restorative Health.)

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