Thursday, August 6, 2020


Here we go again, as the Coronavirus picks up speed all over the country and the world, even in places where quick shutdowns had flattened the curve early in the crisis.  And as time has provided more insights, as of now it appears that surfaces are less dangerous to us than close or prolonged contact with others who, often unbeknownst to themselves, are spreading the disease, not only through coughs and sneezes, but through speaking and exhaling. 

Turns out that face coverings are the most potent form of prevention of contagion, and that universal use of masks or shields might well make it possible to reopen much of the economy.  But we see, not only on news broadcasts but when we simply take a walk to get some exercise, many instances of individuals and groups who are congregating, playing casual team sports, having parties and nights on the town.  These people are, at those moments, in a state of denial.  Like the rest of us, they’ve had enough of putting much of their lives on hold, and they have pent-up demand for fun and human interaction.  Putting dangers out of their minds, they are offloading inhibitions and caution in order to feel good. 

Let’s see, what is the most common tool for discarding inhibitions and acting on impulse without thinking through consequences?  Could it be….. alcohol? 

Indeed, when we see people engaging in behavior that looks as if they are on a mission to spread disease, whether at house or pool parties or in and around bars, drinking tends to be the common denominator.  That’s not to say that nondrinkers are devoid of denial – I’ve heard a few long-sober people refer to COVID as little more than another flu bug – or that drinking is the only enabler of risky behavior (e.g.,some passionately religious gatherings).  But it seems pretty clear that if alcohol were subtracted from the picture, COVID rates and outbreaks would be significantly reduced.  And I don’t hear this mentioned much, at a time when, from what I read, beer, wine, and liquor sales have boomed. 

Although in some cases, increased drinking during the restricted COVID lifestyle has been fertile ground for the progression of alcohol use disorder, I’m not referring here mainly to those who are addicted, but to “social” drinkers.  Everyone’s chances of accidents, injuries, physical altercations, and acting on dangerous impulse are augmented when they drink. 

Drinking, of course, is embedded in our society (though something like 14% of American adults don’t drink at all).1  People find the effects rewarding, at least when they begin – alcohol temporarily reduces experience of many kinds of pain and discomfort, and since that includes social anxiety it is often used as a “social lubricant.”  In the longer run, of course, over-use tends to exacerbate the problems that drinking appeared, at first, to dissolve.

No one is saying that non-alcoholics shouldn’t drink at all.  Wait, I take that back, as some recent uber-studies have reached the conclusion that zero drinking is the best recommendation for people who prefer to live longer and healthier lives. 2, 3 On the other hand, another large-scale study4 suggested that “moderate” drinkers were overrepresented among those who lived past age 90 (most likely because they were moderate in their approach to a variety of health-related behaviors).

The American landscape has long been littered with the debris of human residue of alcohol over-use (illness, injury, death, lost careers and families, etc.).  COVID19 now invites us to add to that wreckage in a big way.  That’s an invitation worth rejecting.

Wednesday, April 22, 2020

Relapse Risk vs Healthy Coping during COVID19

It’s hard to think of a time when day-to-day life has been as disrupted as it has during the COVID19 crisis that persist and may continue to persist for some time.  At first, we were all pressed into rising to the occasion; then the isolation at home, ongoing worry and uncertainty, became our new-yet-temporary normal.  I was encouraging people to maintain their daily routines, but even I am beginning to lose sight of just what my routine is or was (despite my ongoing clinical work, which has of course shifted to “tele-health”). 

Many of us are drawn to the constant flow of news, which is more or less all COVID, all the time, while realizing that immersion in this news can fuel anxiety to the point of feeling overwhelmed and rudderless.  The isolation also tends to bring an increase in boredom, and restlessness.  Naturally, we seek to escape from all that, and to find a source of cheer.  We turn to streaming services (Netflix is apparently on fire), perhaps music, ideally forms of exercise that can be done in isolation, even reading (so 20th century), but many people are also turning to alcohol.  According to one survey, drinking is up by 55%.  The World Health Organization suggests that some people even have the (completely incorrect) belief that consuming alcohol can kill the virus!  In actuality, heavy drinking has an adverse effect on the immune system, and might make you more susceptible.

For those in recovery, of course, this situation can present risk.  People involved in 12-step and other mutual support groups have quickly migrated to online meetings, which is certainly the best option under the circumstances, and the process has even allowed them to connect with peers in far-flung locations.  

Beyond that, it’s important for all of us, whether or not we have histories of addiction, to maintain a schedule and enforce daily structure even though nothing forces us to do so, connect with others the best way we can (in some ways, a phone call can be more relaxing than a video call), and have a menu of healthy distracting/rewarding/relaxing activities.  

And most of us mental health/addictions professionals are now available online, providing confidential services.  Somehow, it may not feel like a time to initiate seeking help, but it’s actually a good time -- a way to connect, to disclose thoughts and feelings that you might not disclose to friends or family, and to brainstorm on ways to cope.  (For those who are experiencing withdrawal symptoms, detox programs are still open.)  

Although this stressful period won’t end quickly, and there may be a “new normal,” this, too, shall pass.