Did you start drinking in the “gray area” during the pandemic? How to know

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Many people increased their alcohol consumption during the pandemic, with some having their drinking behaviors in what is sometimes referred to as the “gray area”. JGalione / Getty Images
  • Alcohol use in the “gray area” is the area between healthy levels of alcohol consumption and a diagnosed alcohol use disorder.
  • Alcohol consumption in the gray area is not an official medical diagnosis. But experts say any level of alcohol consumption that negatively impacts your personal or professional life, your own health or that of others around you is cause for concern.
  • A number of recent surveys have found that people living in the United States say they started drinking more during the COVID-19 pandemic.

Many people in the United States may drink more alcohol to cope with the stress and disruption of the COVID-19 pandemic, several surveys suggest.

Some may even have slipped into the “gray area” of alcohol use – that area between healthy levels of alcohol use and a diagnosed alcohol use disorder.

Alcohol consumption in the “gray zone” is not an official medical diagnosis. But experts say any level of alcohol consumption that negatively impacts your personal or professional life, your own health or that of others around you is cause for concern.

Data from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) show that American adults bought more alcohol during most months of 2020 than the previous 3 years.

Several surveys suggest that some people also drink more frequently.

A recent investigation last spring, the Harris Poll, sponsored by Alkermes, an Ireland-based biopharmaceutical company, found that 17% of people aged 21 and over reported “heavy drinking” in the past month.

Of those who met the criteria for alcohol abuse, 13 percent said they were undergoing treatment.

Alkermes sells Vivitrol (naltrexone), a medicine used to treat alcohol dependence.

The NIAAA defines binge drinking for men as more than four drinks per day, or more than 14 drinks per week.

For women, this is defined as more than three drinks per day, or more than seven drinks per week.

The Harris-Alkermes survey used a slightly different definition of heavy drinking: two days of heavy drinking (four or more drinks for women and five or more drinks for men) in a single week at least twice. during the previous 30 days.

Another investigation, by nonprofit RAND Corp., since the spring of last year, the frequency of alcohol use by U.S. adults 18 and older has increased 14% from before the pandemic .

In particular, women increased their heavy drinking days by 41 percent.

What’s more to study from April to September 2020 found that dangerous alcohol consumption during the pandemic was more common for people in the United States with stay-at-home restrictions than those who did not.

The researchers also found that alcohol consumption was higher among young people, men and people who had lost their jobs due to the pandemic.

Ken Leonard, PhD, Director of the Clinical and Research Institute on Addictions of the University of Buffalo, said these surveys had to be taken with caution as changes in alcohol consumption varied across the country.

“COVID hasn’t really hit everyone the same,” he said. “Overall, there has probably been some increase in alcohol consumption, and [this was] probably among those most at risk for binge drinking.

A number of factors may have affected people’s drinking habits during the pandemic.

For example, stay-at-home orders have changed the routines of many people, as well as their access to alcohol.

Those who work from home may have found it easier to drink alcohol while working online. But even then, they might not have increased their total alcohol intake.

Likewise, students who take online courses from their parents’ homes may have had less access to alcohol than at school. Or if they weren’t supervised, they might have had better access.

However, not all states have imposed stay-at-home orders, so people’s lives have been disrupted to varying degrees. Likewise, economic disruption varied from state to state.

Stress is another reason many people increase their alcohol consumption. But even that factor varied.

“What was really remarkable about the pandemic was that some people ended up having multiple stressors at the same time,” said Leonard, whether it was a dying family member from COVID-19, job loss or being confined to home. with limited support.

However, for some people, working from home was less stressful because they didn’t have to commute long hours or could exercise regularly and get enough sleep.

Stress, however, is not the only reason people drink more.

“Boredom is a big factor,” said Robert Leeman, PhD, associate professor in the health and behavior education department at University of Florida.

“People don’t think about it, because it’s not as important as stressors, in terms of increasing alcohol consumption, but it is important,” he said.

While alcohol consumption in the “gray area” may reflect what some people think of their own drinking, Leonard said that term does not match how psychologists talk about alcohol use. .

“We are thinking of [alcohol consumption] as being on a continuum, ”he said,“ where there is a safe level, there is a dangerous level, and then there is a seriously problematic level. And that’s really problematic when you get into the categories of alcohol use disorder.

The appearance of these levels varies from person to person, depending on their life and social networks.

But there are several warning signs when alcohol consumption may have slipped into the dangerous level.

Leonard said it wasn’t just about drinking more alcohol than you expected. It can also include drinking at times you did not anticipate or in situations where you did not drink normally.

“This stuff happens occasionally,” Leonard said. “But if they start to occur regularly, it is a sign that you are not in full control of your alcohol consumption, that you are responding to social pressures or that you are responding to an increasing tolerance to alcohol. . “

Leeman said another warning sign is when alcohol consumption regularly impairs a person’s work performance, personal relationships or a person’s ability to take care of their family or household.

Excessive alcohol consumption can also impact a person’s health – and the health of those around them – in other ways.

Alcohol consumption is linked to over 200 illnesses and injuries, according to the World Health Organization.

This includes liver problems, heart disease, and some cancers, as well as domestic violence, suicide, and traffic accidents.

Dr Christian Hopfer, medical director and attending psychiatrist at UCHealth Center for Dependence, Addictions and Rehabilitation (CeDAR) in Colorado, said there are a range of treatment options for people concerned about their drinking.

“There isn’t a right path for everyone,” he said, “but a lot of people can do better if they ask for help. “

Options include outpatient visits, inpatient treatment programs, peer support groups such as Alcoholics Anonymous, and prescription medication.

Medicines such as naltrexone, acamprosate, and disulfiram can be used alone or with counseling or support groups.

“A lot of people can be successful by meeting with a counselor, taking training, or working with their family doctor,” Hopfer said. “[The treatment that works best] is a function of how much alcohol people drink and how difficult it is for them to reduce their consumption.

For some people, reducing their alcohol intake might be a reasonable approach, such as going from five drinks a day to two drinks a day.

That said, if you drink 15 glasses a day, cutting back to 10 glasses a day still leaves you at a dangerous level.

“A lot of people are trying to cut down on their alcohol intake,” Hopfer said. “It’s usually only after it hasn’t worked that they consider quitting, which is difficult and requires a lot more support.”

While many treatment issues and support groups focus on people who have been diagnosed with an alcohol use disorder, there are also options for people with unsafe drinking.

Leeman said there are apps that help people track their drinking, including those that connect to a breathalyzer. But he said you can even text each other every time you have a drink.

These methods can help people identify their drinking habits: how much they drink, when, and in what situations.

“For people who are in this dangerous drinking zone, they may just need an assessment that shows them that, compared to other people, they are drinking a little more,” Leonard said. “That might be all they need to motivate them to cut back on alcohol.”

The NIAAAs Redesigning the Beverage Website has a self-report tool that allows people to rate their alcohol consumption, as well as information and tools to help people change.

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