Alcohol and the Recession
Published and reviewed January 2009
In the current economic situation, financial stress is likely to be endemic. The level of concern will vary, from putting off buying a car, to dreading a layoff. One thing to be on the alert for is substance use. Some who have been able to achieve sobriety may relapse under financial stress. Others who use alcohol or other mood-altering substances on a more casual basis may increase their use. It is important to realize that use of such substances does not solve any problem, and often creates others. Unfortunately, when substance abuse accompanies job loss, the misery can be compounded when there is less money available for treatment. Alcohol use is often accompanied by other mental health issues, such as depression and anxiety.
Alcohol has been with us for over 10,000 years. Fermentation of items such as grain and hops resulted in products known for their intoxicant effect. In a time when safe drinking water was problematic, alcohol-based beverages (for example, beer and wine) could be lifesaving, as the alcohol inhibited bacterial growth. Beer may have been a nutritional staple even before bread. If one does not think beer provides calories, one may quickly regret the weight gain associated with regular use. Alcohol has both cultural and religious underpinnings, with moderate use accepted in most countries. Although alcohol is forbidden by Islam, it is part of the Catholic mass.
Alcohol use has effects on our economy that are often not considered by the average citizen. The national economic burden from alcohol use is staggering. Losses include those related to productivity in general, collateral loses from inept or incompetent performance of duties, and health-treatment related costs. Chronic alcohol use can lead to early death from various cancers and liver impairment, as well as prolonged disability due to cognitive (i.e., alcohol-related dementia) and physical effects. Most people do not realize that alcohol is a toxin, having effects on many organ systems. Alcohol causes birth defects, suppresses bone marrow and eats away at the lining of the stomach, just to name a few. Although some will use alcohol as a sleep aid, this is problematic. While the alcohol may cause a quicker onset of sleep, it affects the structure of the sleep period, leading to a non-refreshing sleep. Chronic alcohol use so disrupts sleep patterns that once sober, a former alcohol dependent person can suffer sleep disturbances for extended periods, even a year or so. Alcohol use affects interpersonal relationships, social functioning, work productivity and health. It is a significant factor in property damage and road deaths (about 50%), arrests, homicides, emergency room visits, falls, suicides and fires.
Although many think of alcohol as a social lubricant (After all, don't people seem in a better mood after a few drinks?) it is actually a central nervous system depressant. Alcohol inhibits judgment and coordination and is often involved in violent behaviors.
With all that is problematic about alcohol, it has gotten some good press lately. "Moderate drinking" (definitions vary, but to be safe, for men this is no more than a can or two of beer, or one or two 5 ounce glasses of wine, or one to two ounces of alcohol daily, and half of these for women) has shown some beneficial effect in relation to cardiac disease, raising "good" cholesterol, gallstones, and type-2 diabetes. That said, anyone who does not drink alcohol should not start simply to try and garner a few possible health points. As one goes past so-called moderate drinking, the risks far outweigh any potential benefit.
So, how does one know that they are using too much alcohol? There are indicators that help is needed: missing work more than one or twice due to drinking the night before; blackouts; unexplained bruises, nerve injuries (from sleeping in unnatural positions) and injuries (alcohol is an anesthetic); feeling shaky after waking up and craving a drink to "calm the nerves"; drinking alone; hiding alcohol use from others; drinking at work; craving and "tasting" the alcohol when not drinking; being unable to "wind down" without alcohol use; neglecting social and family responsibilities to drink instead, including arguing with family and friends over how much alcohol you are using; continuing to drink in spite of alcohol related health issues; continuing to drink in spite of legal issues, such as a DWI. Waking up with "the shakes" is a sign of dependence, as is an alcohol cessation related seizure.
When cognizant of an alcohol use problem, many will try to lessen use or quit on their own. If one is not physically dependent, this is certainly a reasonable route to consider. But one must not remain in denial if the use continues to be problematic. There are opportunities to attend a 12-step program anonymously, even if only to "check it out". There are state-licensed programs available, as well as private practitioners, where an evaluation can be obtained without obligation. Opting for intervention early in the disease process holds the greatest potential for a successful outcome.
Michael McGrath, M.D.
Michael McGrath, M.D. is the chair of Behavioral Health at Unity Health System.
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