Maria submitted an online screening form to come to Coleman Addiction Medicine, looking for a safe way to stop drinking alcohol. When I reviewed it before calling her, I noticed that Maria was 34, a data professional, had been married for ten years, and had two children. There was no family history of either Alcohol Use Disorder (AUD) or other Substance Use Disorders.
Maria wrote that she had never before been in treatment for alcohol use. She wrote that she was currently drinking about two bottles of wine each day–sometimes with additional cocktails–and had been doing so for about 10 months.
When I spoke with her, she was scared. Tearfully, she shared that she had recently learned that she would soon have to go back to work in person. This was a real problem because of her daily drinking habit.
Back to the Office After COVID-19 Quarantine
Maria said that while she liked to party in college and occasionally drank too much, as she got married, had children, and got more responsibilities at her job, a few drinks every night just became part of her household routine.
“I basically viewed it as part of being a grown-up. My husband, Chris, and I would have a couple of drinks after we got home and exercised, or after the kids’ soccer practices, or while we were cooking dinner, helping with the kids with their homework…it helped me relax. It was a small luxury after a tough day at work.”
On weekends, it was easier to drink a couple of bottles of wine, since they got started earlier in the day. They live in a pretty social neighborhood so Maria didn’t feel like her drinking was out of line with her closest friends.
COVID-19 Normalized Heavy Day Drinking
When the pandemic arrived, Maria’s life—like everyone else’s—was turned upside down. She ended up working from home while her husband–whose job was considered essential—kept going into the office as usual. This disruption put her solely on point for all of the school and social challenges encountered by their 6- and 8-year old daughters. Maria started having a glass of wine earlier in the day, and eventually started buying wine by the case. Boxed wine became a fixture on her grocery list.
Her friends joked with her about their drinking, so she assumed they were drinking just like she was. They shared online memes back and forth, justifying and normalizing their drinking to cope with stress.
“Mommy celebrates every minute with you, darling; that’s why she drinks so much.”
“When you add wine to dinner, the new word is winner.”
“Placing a drink today in every room of my house and calling it a pub crawl.”
“Once upon a time some kids did what they were told and mommy didn’t have to lose her sh*t and drink out of a box before lunchtime.”
“I need a drink, just kidding, I need a dozen.”
“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 was curious how this year had been for the folks in the spirits industry, so I asked a friend who has worked in sales for every major alcohol brand over the past 30 years. He asked not to be named.
The past year has been unprecedented. In retail, 2 days before Christmas is usually the busiest day of the year—both in terms of volume and dollars. During COVID, many of the busiest retailers had their highest dollar volume day in history in late March 2020. But as the pandemic continued, when December 23rd came around, it was again the busiest day ever–but it crushed the previous numbers by over 30%.
For the retail alcohol industry, it was a total boom. Another interesting thing happened when the stimulus money was passed out. Higher priced items like bourbons in the $75 to $2000 range per bottle started to fly off the shelves more regularly. Sales of the bigger bottles of liquor (handles) increased by double digits. The most unbelievable category was wine boxed wines. The 3-liter category grew almost 80% during the COVID era.
Signs Drinking is More Than Just a Habit
Maria started losing her appetite. She figured this was due to the stress and lack of time to focus on cooking healthier meals. She sometimes felt sick after eating, but drinking made her feel better and it also stopped the occasional tremors she occasionally experienced in the morning. Her husband convinced her to check in with her doctor.
Maria told her physician that she was drinking pretty regularly but didn’t go into detail. When the results of her bloodwork came back, Maria learned that her liver enzymes were higher than normal. Suddenly the “S.L.I.F.” meme stopped feeling very funny.
Alcohol Consumption and Liver Disease
A study done in 2018 showed a record increase in cirrhosis-related mortality—driven by alcohol-related disease– among people aged 25-34 between the years of 2009-2016.
This increase in liver-related disease linked to alcohol use isn’t surprising in light of an earlier study in JAMA Psychiatry that showed a significant increase in heavy drinking, especially by women from 2001-2002 to 2012-2013. Although detailed data isn’t yet available for the COVID pandemic, it seems clear that consumption has really increased.
Increased Health Risk Among Women Drinkers
Women are at a substantially higher risk than men for alcohol-related liver problems, because women tend to weigh less than men and have less water in their bodies. Since alcohol is mostly in body water, when men and women of similar weights drink comparable amounts of alcohol, the women’s blood alcohol concentration will be higher, increasing their risk of harm.
I reached out to April Ashworth, AGPCNP-BC, a nurse practitioner who works at the Bon Secours Liver Institute in Virginia.
“There has been a significant increase in alcohol use, especially among people who used to just have a few drinks at night and are now working from home. They often start earlier in the day and drink more. “Day Drinking” has become more normal. It’s a clear trend that I see daily.”
This is consistent with a recent story 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
Maria signed up for a medical detox at Coleman Addiction Medicine. While not everyone needs a medical detox, it is really important to talk with your healthcare provider before stopping abruptly, since there is a risk of alcohol withdrawal seizures.
Over the years I have heard from many people who went to an emergency room in hopes of getting a safe detox, but ended up getting a small amount of anti-seizure medication and being sent home. Particularly during the pandemic, hospitals have had to triage and focus on only the most urgent cases. Doing a confidential, outpatient detox at Coleman Addiction Medicine in northern New Jersey gives you more than just a safe detox.
Our case managers and medical staff will ensure that you are connected with other resources like counseling and medication to help you reach your goals around sobriety. They have developed a network of trusted professionals throughout New York, New Jersey, Connecticut, and Pennsylvania who can support patients who live a bit too far away to come into our office regularly. We also offer several group meetings every week via Zoom that patients can attend for additional support.
If you’ve found yourself drinking more during the pandemic, you are not alone. Schedule a call below if you have questions about how to get help. And please stay safe.
Joan R. Shepherd, FNP