Lauren submitted an online medical history form to come to the Coleman Network for Addiction Medicine seeking for a safe way to stop drinking alcohol. When I looked it over before reaching out to talk to her, I noticed that Lauren was 36, a data scientist, and married for 10 years with 2 children.
Neither of her parents had any history of Alcohol Use Disorder (AUD) or other Substance Use Disorders. Lauren wrote that she had never before sought treatment for alcohol use. She said that she was currently drinking approximately 2 bottles of wine daily–sometimes with additional cocktails–and had been doing this for almost a year.
When I called her, she sounded scared. Tearfully, she said that she’d recently found out that she would soon have to return to work in person. This was going to be a real challenge in light of her daily drinking habit.
Back to the Office After COVID-19 Quarantine
Lauren told me that liked to party in college and occasionally drank to excess, and that as she married, had kids, and got increasingly larger roles at work, a few drinks every night just became part of her routine.
She said, “I basically considered it as part of being an adult. My husband, Mike and I would have a couple of drinks after coming home and working out, or after the kids’ soccer games, or while we were making supper, helping with homework…it became part of our lives and it helped me unwind. It was a small treat after a hard day at the office.”
COVID-19 Normalized Heavy Day Drinking
On weekends, it was easier to drink 2 bottles of wine, since they often started earlier. They live in an outgoing, social cul-de-sac, so Lauren didn’t feel like her drinking was much different from that of her friends.
When COVID-19 arrived, Lauren’s life—like everyone else’s—was sharply disrupted. She ended up working from home while her husband, whose job was considered essential, went to the distribution center. This change also placed her squarely in charge of all school and social challenges faced by their 6- and 8-year old girls. Lauren started pouring a glass earlier in the day, eventually buying cases at a time. Boxed wine was always on her grocery list.
She and her friends laughed about the drinking, and she assumed they were drinking just like her. They shared memes with each other, normalizing and rationalizing their drinking to cope with stress.
“When you combine wine and dinner, the new word is winner.”
“Putting a drink today in every room of my house and calling it a pub crawl.”
“Mommy celebrates every moment with you, darling; that’s why she drinks so much.”
“I need a drink, just kidding, I need 10.”
“Once upon a time some kids did as they were told and mommy didn’t have to lose her sh*t and drink out of a box before lunchtime.”
“I could really use a hug from something alcohol-based right now.”
“S.L.I.F.= Sorry liver, it’s Friday.”
Impact of Alcohol Industry Growth During COVID-19
I wondered how this year had looked from the perspective of the spirits industry and asked a friend who has been a sales rep for every major alcohol brand over the past 3 decades. He asked to be anonymous.
I’ve never seen a year like 2020. When it comes to retail sales, typically 2 days before Christmas is the busiest day of the year–both dollar-wise and volume-wise. During the pandemic, many of the busiest retail outlets had their highest dollar volume day in history in late March 2020. But the pandemic continued, and when December 23rd came, it was again the busiest day ever, but it eclipsed the previous numbers by upwards of 30%.
For the retail industry, it was an absolute boom. Another interesting phenomena happened when the stimulus money was mailed out. Higher ticket items like bourbons in the $75 to $2000 range per bottle were being sold regularly. Sales of the larger bottles of liquor (handles) were up by double digits. The most amazing category was wine that was packaged in a box. The 3-liter category grew almost 80% during these pandemic times.
Signs Drinking is More Than Just a Habit
Lauren started losing her appetite. She attributed this to stress and not having enough time to focus on a healthy diet. She frequently felt ill after eating, but drinking settled that down, and it also relieved the slight tremors she started to have in the mornings.
Her husband convinced her to go to her primary care physician. Lauren told her doctor that she was drinking regularly but didn’t elaborate. Her doctor did some blood tests, and Lauren found out that her liver enzymes were elevated. Suddenly the “S.L.I.F.” meme didn’t seem very funny.
Alcohol Consumption and Liver Disease
A study done in 2018 showed the highest-ever increase in cirrhosis-related mortality—driven by alcohol-related disease— among people aged 25-34 between the years of 2009-2016.
This growth in liver related disease due to alcohol use is not surprising given that an earlier study in JAMA Psychiatry showed a significant increase in heavy drinking, especially by women from 2001-2002 to 2012-2013. We don’t yet have full data on what has transpired during Covid, as drinking rates have skyrocketed.
Increased Health Risk Among Women Drinkers
Women are at much higher risk than men for alcohol-related liver problems, since women weigh less than men on average and have less water in their bodies. Because alcohol is mostly in body water, when men and women of similar weights consume similar amounts of alcohol, the women’s blood alcohol concentration will likely be higher, increasing their risk of harm.
I checked in with April Ashworth, AGPCNP-BC, a nurse practitioner who works at Bon Secours Liver Institute in Richmond, Virginia.
“There has been a substantial increase in alcohol use, especially among people who usually have a few drinks in the evening and are now working from home. They tend to start earlier in the day and to drink more. ‘Day Drinking’ has become more normal. It is just plain more accessible. This is the clear trend I am seeing.”
This is consistent with a recent article shared on NPR. They interviewed liver specialist Dr. Jessica Mellinger at the University of Michigan, who said that she has seen a 30% increase in cases of alcoholic liver disease, including “milder fatty liver and permanent scarring of cirrhosis, as well as alcoholic hepatitis.
Accelerated Alcohol Detox at the Coleman Institute
Lauren signed on for a medical detox at the Coleman Network for Addiction Medicine. Although not everyone needs a medical detox, it is important to talk with your doctor before stopping abruptly, because of the risk of alcohol withdrawal seizures. I have heard from many people over the years who went to the emergency room in hopes of getting a safe detox, but simply received a small amount of anti-seizure medication and were sent home.
Particularly during COVID-19, hospitals have had to prioritize what they consider to be the most urgent cases. Doing a confidential, safe, outpatient detox at one of the medical offices in the Coleman Network for Addiction Medicine could be an option to help you reach your goals around sobriety.
If your drinking has increased during the pandemic, you are not alone. Schedule a call below if you have questions about how to get help. Take care, stay safe. Best wishes.
Joan R. Shepherd, FNP