April is Alcohol Abuse Awareness month
- April 26, 2022
I hope everyone is having a lovely Passover/Easter/Ramadan season. It is a season of many gatherings which is wonderful especially coming out of the COVID pandemic. There are many thoughts swirling around my head but since April is Alcohol Abuse Awareness month, there is no better time to discuss the safe use of alcohol. First, we must understand that there is a stark difference between cultural attitudes towards how much alcohol is acceptable and the medical definition of what is a safe amount of alcohol for consumption. Whenever I discuss this topic with my patients, they look at me as if I have two heads because I talk about not having any more than two drinks on any given day. It is the norm to intake 3-6 servings of alcohol, more even, without a second thought. Depending on the social or cultural environment, it might even be encouraged. People are often surprised at why this is discouraged. After all, if they are not “getting drunk” and staying within their limits, then they are alright. Right? So, let us talk about why that is not the case.
THE BAD STUFF
Truth is, too much alcohol can have various adverse effects. Every morsel or drop we put into our bodies is processed and utilized. Much like any machine, if what we put in is useless or harmful, it will mess with the system. The glass of red wine at night stops being helpful to heart health after two drinks. Going back to my point earlier, you do not have to get drunk regularly to experience these adverse effects. You may experience a pleasant buzz after drinking and nothing more, yet the alcohol affects your body on a molecular level. Alcohol can have toxic effects to the muscles of the heart, weakening it. It can increase your triglycerides (a form of cholesterol you want to keep low), cause pancreatitis, dementia, and liver disease. It also increases the risk of certain cancers. The more you drink, the higher the risk you have of experiencing these adverse consequences. Moreover, if these habits are sustained, so is the damage that begins to stack up. People gathering and having a good time is great for our mental wellbeing. However, consuming more than two drinks at any given 24 hours is not particularly healthy for you physically or for your mental health.
Recently, I saw a research paper that suggested that even one drink/glass of wine everyday is too much. Mostly because it can have subtle negative effects to our cognitive function—it weakens the neural pathways and causes changes in mood and behavior. While I am not ready to say no more than one drink a day yet, you need to know that alcohol has a lot of negative effects. And again, it is not related to getting drunk. Many people tend to drink in the evening to relax after a rough day and to wind down. The way alcohol is processed, the body may initially relax but later anxiety and stress increase. It may help sleep at first but interferes later in the night causing it to be fragmented due to the byproducts of alcohol in our body. Not to mention the dehydration and gastrointestinal problems that accompany drinking.
THE HARD QUESTIONS
Young people often start drinking to fit in and be part of the crowd. They are trying to be social. High school and college gatherings tend to be spaces where getting drunk is almost a requirement. Many begin drinking much earlier in life depending on their cultural or social environment. While most people change their habits as they mature and don't drink as excessively, they may still partake a lot at gatherings. The problem is that some people have a genetic predisposition to addiction and they cannot stop or moderate themselves. To determine if a person has an alcohol or substance addiction, researchers have devised the CAGE questionnaire. It is a screening tool for us to use to make sure we discuss with a patient how much alcohol is safe and to encourage seeking help for those who might be in the category of being dependent on alcohol. These questions are:
- Do you feel that you should CUT down on the drinking?
- Do you get ANNOYED when others suggest that you should reduce your alcohol intake?
- Do you feel GUILTY about how much you are drinking?
- Do you feel like you need a good drink to start your day (EYE-OPENER)?
If you have said yes to any of these questions, consider examining your habits, making positive changes, and seeking help. Alcoholics Anonymous is the most famous organization to help with this problem but there are several other options. Please also discuss with your doctor so they can better direct you. Getting drunk or being impaired due to alcohol reduces your judgement. It can lead to big mistakes while driving or at work and it can also affect your everyday relationships and bonds. As mentioned earlier, alcohol consumption affects your mood, behavior, and thought process. It affects how we deal with our loved ones, especially our children. April is also Child Abuse Prevention month and I would be wrong if I did not point out how badly we can damage our children, directly and indirectly, with the abuse of alcohol.
If your find yourself relying on alcohol, take the time to dig deep and figure out the why. Stress and anxiety have a high correlation with alcohol use. If you ever come home and say to yourself “what a terrible day, I need a drink” please don't drink alcohol. Instead, try to go for a walk, do intentional deep breathing, or engage in any positive activity that gives you pleasure. Learn to set boundaries at work and at home. Disengage from social media periodically. Limit the constant bombardment of negativity that is fed into our lives from various sources. Take the time to process your day and emotions. Truly bring in the things that bring you genuine joy and not just temporary comfort. All facets of our lives are interconnected, and we cannot fix just one part without taking in the whole person. Finding the why of alcohol use or abuse it just the first step. Then begins the work to heal the root cause of the problem.
I highly recommend the practice of journaling to help process your emotions and thoughts. This can be the space to tease out all your thoughts, untangle the emotions from the truth, and see your situation for what it is. Getting your thoughts out is an excellent way to gain perspective. It can guide you to the core of what is bothering you which then helps you deal with the problem appropriately. This, of course, takes intentionally thinking through the events of your day to determine what was good, what upset you and why, what made you mad, sad, irritated, or happy. Was it reasonable to feel that way? How can you calm yourself down in the future? Can you forgive yourself or others for whatever negative thing that happened?
Finally, focus on what is good in your life. Practice gratitude. Focus in on things that you want to learn and nurture what gives you pleasure. Make the time to do good things for yourself and it will go a long way to help you manage your stress and anxiety. As with all things worth the effort, this takes practice and patience and giving yourself the grace to heal yourself.
Exercise—everyone's favorite! I would be remiss not to mention exercise as it is an excellent stress reliever with countless benefits. It is the cheapest mental health drug out there and everyone should exercise if possible and spend time outdoors in the sun for at least 20 minutes a day. You can read some of my earlier articles to get a more in-depth understanding of exercising and its benefits. Alongside that, getting adequate sleep and eating good nutrition also facilitate managing stress. It helps our body function the way it is meant to. Alcohol is not the only addiction that can happen due to unmanaged stress. Overeating unhealthy foods, smoking, drugs also fall into the same trap. Drinking excessive caffeine adds to your feelings of stress as well.
Finally, do not be ashamed to ask for help. There are different resources out there to help you beginning with your doctor, counsellor, pastor, religious leader, or just a friend. There are many resources out there that can help you, but you must seek it out. Don't rely on the belief that you will be the exception who avoids the pitfalls. It is possible for it to happen to the best of us. There are steps you can take that are essentially lifestyle-based that can guide you to a better, healthier you. We are all on this life's journey together and this office is ready and willing to come alongside you to help you in any way we can.
Geni Abraham, Board Certified, American Board of Internal Medicine. Our Internal Medicine Practice is an integrated medical practice with a focus on Lifestyle Medicine. We offer health coaching sessions to help you reach your personal goals. Dr. Geni Abraham, Medical Specialists of the Palm Beaches, Inc., 205 JFK Drive, Atlantis FL 33462. Phone: (561) 432-8935, Visit DrGeniAbraham.com and Follow us on Facebook: @DrGeniAbraham