Navigating Alcohol Misuse and Recovery
Each year in the United States, close to 30 million adults and approximately 800,000 adolescents live with alcohol use disorder and its subsequent mental and physical effects on their health. In the wake of the COVID-19 pandemic, those numbers have risen due to pandemic-related stressors that can lead to alcohol misuse.
“Alcohol consumption among adults increased by 14% from 2019 to 2020,” says Jonathan Avery, M.D., vice chair for Addiction Psychiatry at Weill Cornell Medicine and the program director for Addiction Psychiatry Fellowship. “Women, in particular, exhibited a 41% increase in alcohol consumption over a 2019 baseline.”
There’s no specific amount of alcohol you have to consume to be diagnosed with alcohol use disorder. Rather, doctors look at certain behavioral criteria, including if you are:
- Drinking more than intended
- Drinking that interferes with daily life activities, or that causes you to miss out on events you enjoy or spending time with people you love
- Often drinking to the point of being physically ill afterward
- Finding yourself in unsafe or illegal situations during or after drinking (such as drinking and driving)
- Having your thoughts consumed by alcohol
- Trying to abstain from alcohol but being unable to do so
Regardless of if you’re living with a fully developed addiction or are on the fringe of one beginning stress left unchecked can lead to people turning to alcohol to help them cope.
“I think self-medication and the self-medication hypothesis of addiction helps us understand that a lot of the reason that alcohol use becomes problematic is to help relieve stress,” says Dr. Avery. “And as a society, we've been under a ton of stress these last couple years.”
Mixing Alcohol and Medication
One notable danger of alcohol misuse is the effects of consuming alcohol and taking certain medications together. You’ve probably noticed warnings on the labels of your medication telling you not to mix those meds with alcohol. Even some herbal supplements or at-home remedies can interact poorly with alcohol. Heed those warnings: The effects can range from mild to life-threatening.
Side effects of mixing alcohol with these medications include:
- Drowsiness, lightheadedness or dizziness
- Decreased breathing, pulse or blood pressure
- Significant impairment of judgment
- Loss of coordination
- Increased fall risk, particularly for older adults
- Organ damage (particularly the liver)
- Loss of consciousness, coma or death
Women are at greater risk of experiencing these side effects than men because their blood processes alcohol differently. Older individuals, for similar reasons, are at higher risk for side effects due to their bodies breaking the alcohol down more slowly than younger people. Additionally, many health issues also become more common with age, which increases the chances that individuals are taking medication that will react poorly with alcohol.
It can be tricky to avoid combining alcohol and medication. Some medications, such as popular liquid cough and cold medicines, contain up to 10% alcohol. The last thing you want to do in that case is add more. Even medications you think should be fine to take alongside alcohol could potentially have serious interactions.
You don’t even have to consume the medication and the alcohol at the same time for the interactions to occur since side effects linger. Check all labels carefully for warnings, and when in doubt, ask a pharmacist or your primary care doctor.
Resources for Recovery
Working toward or through recovery from alcohol addiction is different for everyone. No one’s experience will exactly mirror that of another person struggling with addiction.
“I think we used to think that recovery from alcohol use or sobriety was abstinence,” says Dr. Avery. “And still, a lot of people when they say sobriety or resolution of an alcohol use disorder, they're often saying that they don't drink at all anymore. But we now are a little more flexible in our definition of what healthy alcohol use looks like these days.”
When it comes to socializing, the pressure to drink alongside your peers is very real. Fortunately, there are alternatives that can help curb both the external and internal pressure.
“There are good alternatives these days in terms of drinks that are increasingly tasty,” says Dr. Avery. “There are those non-alcoholic beers, non-alcoholic cocktails or even just getting a seltzer and having something to hold in your hand can be enough for a lot of folks.”
Resources available to help people on their recovery journey are beginning to more accurately reflect the needs of individuals as well.
“I think all providers here—from your primary care physician to your psychiatrist—are willing and able to address problematic alcohol and other substance use,” says Dr. Avery. “For those needing more intensive care though, we certainly have outpatient options that are utilizing technology, as well as inpatient substance use treatment for those who are really struggling. The Midtown Center for Treatment and Research is an outpatient program that evaluates and treats chemically dependent individuals and their significant others.”
Other treatment and recovery resources include:
- Alcoholics Anonymous (AA) is perhaps the most well-known option, and is an in-person program that involves a 12-step program and a sponsor
- Zoom programs are available online and while many of these programs are similar to AA, they are available virtually, broadening their accessibility
- Peer-based groups like SMART Recovery and others are free, mutual-support groups focused on recovery from addictive behaviors
“There are also better medications to treat alcohol use disorder now,” says Dr. Avery. “There are medications that help you drink less and medications that help cement abstinence. And these medications you can get from your internal medicine doctor.”
Whatever the path to a healthy relationship with alcohol looks like for you, Weill Cornell Medicine can help. Ask your primary care provider what resources may be right for you.
Your doctor is a great resource when you’re in recovery. Don’t have a doctor? Find one today.