July 30, 2021 • 15 mins
Alcohol use has soared because of the pandemic—especially among women. A listener wants to know if her nightly glass of wine is actually a problem; Dr. Saltz reveals how to tell, and how to cut back without going cold turkey.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:05):
Bees are challenging times, but you don't have to navigate
them alone. Welcome to how can I help? I'm doctor
Gale Saltz. I'm a clinical Associate Professor of Psychiatry at
the New York Presbyterian Hospital, a psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:27):
hopefully with understanding, insight and advice. There's a lot of
conflicting information out about alcohol and how good or bad
it is for you. Recently, the World Health Organization attempted
to suggest all women of childbearing age should avoid alcohol,
(00:48):
ostensibly to protect all potential fetuses from alcohol exposure. In
a day and age where women have the ability to
decide when to become pregnant, can know when they are pregnant,
and of course most women are not pregnant from ages
fifteen through fifty most of the time. This seems to
(01:11):
me to be, frankly, a very sexist approach to medical advising.
Drinking in mild to moderate amounts is by and large
not detrimental to your physical or mental health, but there
are important things to understand about alcohol. Alcohol is in
(01:31):
the class of drug known as depressives. Meaning it generally
depresses the central nervous system. It does this by increasing
the amount of the neurotransmitter GABBA in the brain, which
is an inhibitory neurotransmitter which inhibits the nervous system, and
(01:52):
by increasing the amounts of dopamine, the neurotransmitter of reward,
and serotonin. The neurotrans are associated with mood. Therefore, the
effect is alcohol produces happiness and euphoria, It decreases anxiety,
it increases sociability, but it also causes sedation, an impairment
(02:18):
of your cognitive functioning, your memory, your motor functioning, and
your sensory functioning. This effect is often why people like
to drink, but there can be problems. As a psychoactive drug,
alcohol is also addictive. This means that one must, over
(02:40):
time drink more of the alcohol to have the same
desired effect because you become tolerant of the drug. And
it also means that when you try to decrease or
stop the amount you drink, if you have done so
over a period of time, you will experience a very
(03:02):
unpleasant withdrawal, which includes symptoms like headaches, nausea, anxiety, agitation, tremors,
loss of appetite and insomnia. This is why that glass
of wine, which is initially just relaxing and enjoyable in
the evening, starts to fade out, such that over time
(03:25):
you start drinking two classes, and why if you skip
the night or try to skip the night, you find
you don't feel so great. There are numerous factors when
it comes to drinking alcohol in a way that doesn't
harm your health or create addiction. One is that men
(03:46):
and women metabolize alcohol at different rates, which means that
the recommendation for moderate drinking for women is one drink
a day, which is half that of men who and
moderately drink to drinks a day. A woman's blood alcohol
level is likely to be similar to a man's with
(04:08):
one drink to his two drinks. The same goes for
the unhealthy problem with binge drinking. The definition of binge
drinking is four or more drinks for women or five
or more drinks for men on the same occasion, meaning
at the same time or within a couple of hours.
(04:31):
Heavy drinking or heavy alcohol use is defined as binge
drinking on five or more days of the past month
for both men and women. These are general guidelines but
of course people come in different sizes, weights, family histories
(04:51):
that include addiction and addictions running families. They may be
on different medications that affect alcohol metabolis them or exacerbate
the effect of alcohol while it's being consumed, such that
alcohol consumption and movement into alcohol abuse or dependence or
(05:13):
addiction can vary from person to person, even if staying
within the numbers guidelines. The past year and a half
has been very stressful for so many people, evidenced by
anxiety rates going up to of the general population from
eleven of the population free pandemic according to the c
(05:36):
d C. In that setting, many people increase their alcohol
intake in an effort to distress, to find some way
to decrease their anxiety, and in feeling so limited in
what they could do to feel better, they had another
glass of wine and many are left wondering is this okay?
(06:01):
Or do I have a problem now? Which is why
today I'm answering the question I received from a woman
about her drinking habits. According to a study published in
JAM and Network Open, as the COVID nineteen pandemic surged,
more people turned to alcohol to cope with unprecedented uncertainty
(06:22):
and stress. The studies, researchers found that alcohol consumption among
adults increased by fourteen from two thousand and nineteen to
two thousand and twenty. Women in particular exhibited a fort
increase in alcohol consumption over their two thousand and nineteen baseline.
(06:47):
How can I help with Dr Gaale Salts will be
back after this short break, so let's turn to our
question and see how can I help, Dear Doctor Saltz.
I like to have a glass of wine before dinner.
(07:08):
It makes me feel like my day is done and
I can unwind. I genuinely enjoy it. A friend of
mine was saying, if I have one every day, maybe
that's a problem. What do you think is a daily
glass of wine too much? By the textbook definitions, one
(07:29):
glass of wine a day is not too much. But
embedded in this question is could I be developing a
problem with alcohol if I drink daily? And the answer
requires a few other questions back to you. If you
have a parent, a grandparent, an ants, or uncle or
(07:49):
sibling that had in the past or has currently struggled
with alcohol abuse, then the odds of you having a
problem are increased. This, of course doesn't mean you will
have one. It means that addictions of all types run
in families, and it means that you might, depending on biological, genetic,
(08:14):
and environmental factors, develop a problem. It means you should
be a little more aware and assessing and willing to
be reactive than had you no family history at all. Now,
sometimes a family history exists and you don't know about
it because it wasn't labeled as such. And your grandfather
(08:38):
who merely liked his lunchtime martinis and dinner time martinis
and had a lot of angry outbursts, was in fact
a closeted abuser of alcohol and even closeted from himself.
So knowing something of the family's propensities toward drinking and
any social or work problems caused as a result, is
(09:00):
important for everyone to know. Another important question is why
you like your glass of wine. If it's you like
the taste, you associate it with relaxing and treating yourself nicely,
but you don't have the need. That is different from
(09:21):
spending parts of your day mentally waiting for your glass
of wine, feeling anxious before the glass and feeling better
after it. If you're not making sure you get the glass,
even if it's quite inconvenient to do so, like you
would be out and elsewhere before dinner, but you want
(09:42):
to make sure you get your glass, maybe even doing
out of your way things to make sure you get it,
like not driving your child to see their friends or
at their friend's house, because you want to make sure
you have your glass of wine, either moving your life around,
making sure you have it, feeling you need it. We're
(10:04):
using it to reduce feelings of stress or anxiety, otherwise
known as self medicating. Those are indicators that you are
at risk for alcohol abuse. These things allude to a
dependence on alcohol. Even if you say to yourself, well
I don't need it, I just like it, but you
(10:25):
do everything to make sure you get it. Most people
walking towards abuse tell themselves they don't need it and
could stop any time they wish, but in actuality, they
can't and they don't. Another problem signed would be that
(10:45):
your glass started out as a small, poor and now
it's grown to a heftier poor Glasses can be filled,
and then they can be filled with a capital F.
One can fit two glasses into the size of one
glass and thereby be increasing what you drink because you've
developed a tolerance and need more of the same drink
(11:09):
to achieve the same feeling and not experience any withdrawal.
I suggest if you're feeling concerned to do a few things.
One is to take a break for a week, give
yourself a one week wine and other alcohol holiday, and
reset your tolerance. If you cannot give yourself a one
(11:33):
week holiday, then actually you may have a problem. You
may either psychologically or physiologically be addicted. If you are,
you can decrease the amount you are drinking until you
can take a holiday. Cut your glass by one third
for one week, by one half for one week, and
(11:55):
then by two thirds for one week. Then have a
week off after which you can resume, but try starting
with half a pore. Another possibility is to move to
a lower alcohol pore for a week or two. A beer,
for example, has less alcohol, and many specific wines such
(12:16):
as Verde wines or proseccos, have a low alcohol level. Specifically,
you can look up the alcohol level of what you're
drinking and try to choose something that is significantly less
than what you've been drinking. Because it's not just how
much you drink it's the alcohol percentage of what you drink.
(12:36):
You go with a three to four percent alcohol spirit,
then it can be like cutting in half, you're eight
to ten p wine. The point really is can you
cut back and feel fine? Can you miss it and
feel fine? And perhaps even more importantly, are you using
it to treat your anxiety? In the latter case. If
(13:01):
this is the case, you are really angling to develop
a problem. Developing and practicing other means to manage stress
and anxiety like exercise, meditation, deep breathing therapy. Those are
healthy ways to manage anxiety and don't leave you essentially
(13:21):
using the drug of alcohol to manage it, which during
particularly stressful times, is likely to drive an abuse of
the alcohol. If upon consideration, this is what is happening,
as it has this past year for so many people
who have been struggling with anxiety, it's very important to
(13:44):
build in and up several other tools to deal with
your anxiety, and perhaps even talk to someone so that
alcohol doesn't come into the equation. Technically, one drink a
day for a woman is modern alcohol drinking and is
not considered unhealthy, but understanding what drives consumption, being able
(14:07):
to take a break and using it for enjoyment as
opposed to stress management. Tell you more about your drinking
in the long run. I hope that was helpful. Another
important concern regarding alcohol use that has been on the
rise in recent years has been shrinking. Often, someone who
(14:30):
drinks five or more drinks in a night and then
doesn't drink for days afterwards tells themselves they can't have
a problem because they don't drink every day, But ben
drinking can be every bit as unhealthy and even more
dangerous as daily consumption of alcohol. Getting blackout drunk, even
if it's only a few times a month, is a
(14:52):
type of alcohol abuse, and it harms both your brain
and your body. If you were, when you know, are
stuck in a cycle of alcohol abuse. Help is available
for both detoxing and recovering from an addiction reach out
because it is exceedingly hard and often impossible to stop
(15:15):
alcohol abuse without professional help. Do you have a problem
I can help with? If so, email me yet how
can I help? At Seneca women dot Com. All centers
remain anonymous and listen every Friday to how can I
help with me? Dr Gail's Salts
Bees are challenging times, but you don't have to navigate
them alone. Welcome to how can I help? I'm doctor
Gale Saltz. I'm a clinical Associate Professor of Psychiatry at
the New York Presbyterian Hospital, a psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:27):
hopefully with understanding, insight and advice. There's a lot of
conflicting information out about alcohol and how good or bad
it is for you. Recently, the World Health Organization attempted
to suggest all women of childbearing age should avoid alcohol,
(00:48):
ostensibly to protect all potential fetuses from alcohol exposure. In
a day and age where women have the ability to
decide when to become pregnant, can know when they are pregnant,
and of course most women are not pregnant from ages
fifteen through fifty most of the time. This seems to
(01:11):
me to be, frankly, a very sexist approach to medical advising.
Drinking in mild to moderate amounts is by and large
not detrimental to your physical or mental health, but there
are important things to understand about alcohol. Alcohol is in
(01:31):
the class of drug known as depressives. Meaning it generally
depresses the central nervous system. It does this by increasing
the amount of the neurotransmitter GABBA in the brain, which
is an inhibitory neurotransmitter which inhibits the nervous system, and
(01:52):
by increasing the amounts of dopamine, the neurotransmitter of reward,
and serotonin. The neurotrans are associated with mood. Therefore, the
effect is alcohol produces happiness and euphoria, It decreases anxiety,
it increases sociability, but it also causes sedation, an impairment
(02:18):
of your cognitive functioning, your memory, your motor functioning, and
your sensory functioning. This effect is often why people like
to drink, but there can be problems. As a psychoactive drug,
alcohol is also addictive. This means that one must, over
(02:40):
time drink more of the alcohol to have the same
desired effect because you become tolerant of the drug. And
it also means that when you try to decrease or
stop the amount you drink, if you have done so
over a period of time, you will experience a very
(03:02):
unpleasant withdrawal, which includes symptoms like headaches, nausea, anxiety, agitation, tremors,
loss of appetite and insomnia. This is why that glass
of wine, which is initially just relaxing and enjoyable in
the evening, starts to fade out, such that over time
(03:25):
you start drinking two classes, and why if you skip
the night or try to skip the night, you find
you don't feel so great. There are numerous factors when
it comes to drinking alcohol in a way that doesn't
harm your health or create addiction. One is that men
(03:46):
and women metabolize alcohol at different rates, which means that
the recommendation for moderate drinking for women is one drink
a day, which is half that of men who and
moderately drink to drinks a day. A woman's blood alcohol
level is likely to be similar to a man's with
(04:08):
one drink to his two drinks. The same goes for
the unhealthy problem with binge drinking. The definition of binge
drinking is four or more drinks for women or five
or more drinks for men on the same occasion, meaning
at the same time or within a couple of hours.
(04:31):
Heavy drinking or heavy alcohol use is defined as binge
drinking on five or more days of the past month
for both men and women. These are general guidelines but
of course people come in different sizes, weights, family histories
(04:51):
that include addiction and addictions running families. They may be
on different medications that affect alcohol metabolis them or exacerbate
the effect of alcohol while it's being consumed, such that
alcohol consumption and movement into alcohol abuse or dependence or
(05:13):
addiction can vary from person to person, even if staying
within the numbers guidelines. The past year and a half
has been very stressful for so many people, evidenced by
anxiety rates going up to of the general population from
eleven of the population free pandemic according to the c
(05:36):
d C. In that setting, many people increase their alcohol
intake in an effort to distress, to find some way
to decrease their anxiety, and in feeling so limited in
what they could do to feel better, they had another
glass of wine and many are left wondering is this okay?
(06:01):
Or do I have a problem now? Which is why
today I'm answering the question I received from a woman
about her drinking habits. According to a study published in
JAM and Network Open, as the COVID nineteen pandemic surged,
more people turned to alcohol to cope with unprecedented uncertainty
(06:22):
and stress. The studies, researchers found that alcohol consumption among
adults increased by fourteen from two thousand and nineteen to
two thousand and twenty. Women in particular exhibited a fort
increase in alcohol consumption over their two thousand and nineteen baseline.
(06:47):
How can I help with Dr Gaale Salts will be
back after this short break, so let's turn to our
question and see how can I help, Dear Doctor Saltz.
I like to have a glass of wine before dinner.
(07:08):
It makes me feel like my day is done and
I can unwind. I genuinely enjoy it. A friend of
mine was saying, if I have one every day, maybe
that's a problem. What do you think is a daily
glass of wine too much? By the textbook definitions, one
(07:29):
glass of wine a day is not too much. But
embedded in this question is could I be developing a
problem with alcohol if I drink daily? And the answer
requires a few other questions back to you. If you
have a parent, a grandparent, an ants, or uncle or
(07:49):
sibling that had in the past or has currently struggled
with alcohol abuse, then the odds of you having a
problem are increased. This, of course doesn't mean you will
have one. It means that addictions of all types run
in families, and it means that you might, depending on biological, genetic,
(08:14):
and environmental factors, develop a problem. It means you should
be a little more aware and assessing and willing to
be reactive than had you no family history at all. Now,
sometimes a family history exists and you don't know about
it because it wasn't labeled as such. And your grandfather
(08:38):
who merely liked his lunchtime martinis and dinner time martinis
and had a lot of angry outbursts, was in fact
a closeted abuser of alcohol and even closeted from himself.
So knowing something of the family's propensities toward drinking and
any social or work problems caused as a result, is
(09:00):
important for everyone to know. Another important question is why
you like your glass of wine. If it's you like
the taste, you associate it with relaxing and treating yourself nicely,
but you don't have the need. That is different from
(09:21):
spending parts of your day mentally waiting for your glass
of wine, feeling anxious before the glass and feeling better
after it. If you're not making sure you get the glass,
even if it's quite inconvenient to do so, like you
would be out and elsewhere before dinner, but you want
(09:42):
to make sure you get your glass, maybe even doing
out of your way things to make sure you get it,
like not driving your child to see their friends or
at their friend's house, because you want to make sure
you have your glass of wine, either moving your life around,
making sure you have it, feeling you need it. We're
(10:04):
using it to reduce feelings of stress or anxiety, otherwise
known as self medicating. Those are indicators that you are
at risk for alcohol abuse. These things allude to a
dependence on alcohol. Even if you say to yourself, well
I don't need it, I just like it, but you
(10:25):
do everything to make sure you get it. Most people
walking towards abuse tell themselves they don't need it and
could stop any time they wish, but in actuality, they
can't and they don't. Another problem signed would be that
(10:45):
your glass started out as a small, poor and now
it's grown to a heftier poor Glasses can be filled,
and then they can be filled with a capital F.
One can fit two glasses into the size of one
glass and thereby be increasing what you drink because you've
developed a tolerance and need more of the same drink
(11:09):
to achieve the same feeling and not experience any withdrawal.
I suggest if you're feeling concerned to do a few things.
One is to take a break for a week, give
yourself a one week wine and other alcohol holiday, and
reset your tolerance. If you cannot give yourself a one
(11:33):
week holiday, then actually you may have a problem. You
may either psychologically or physiologically be addicted. If you are,
you can decrease the amount you are drinking until you
can take a holiday. Cut your glass by one third
for one week, by one half for one week, and
(11:55):
then by two thirds for one week. Then have a
week off after which you can resume, but try starting
with half a pore. Another possibility is to move to
a lower alcohol pore for a week or two. A beer,
for example, has less alcohol, and many specific wines such
(12:16):
as Verde wines or proseccos, have a low alcohol level. Specifically,
you can look up the alcohol level of what you're
drinking and try to choose something that is significantly less
than what you've been drinking. Because it's not just how
much you drink it's the alcohol percentage of what you drink.
(12:36):
You go with a three to four percent alcohol spirit,
then it can be like cutting in half, you're eight
to ten p wine. The point really is can you
cut back and feel fine? Can you miss it and
feel fine? And perhaps even more importantly, are you using
it to treat your anxiety? In the latter case. If
(13:01):
this is the case, you are really angling to develop
a problem. Developing and practicing other means to manage stress
and anxiety like exercise, meditation, deep breathing therapy. Those are
healthy ways to manage anxiety and don't leave you essentially
(13:21):
using the drug of alcohol to manage it, which during
particularly stressful times, is likely to drive an abuse of
the alcohol. If upon consideration, this is what is happening,
as it has this past year for so many people
who have been struggling with anxiety, it's very important to
(13:44):
build in and up several other tools to deal with
your anxiety, and perhaps even talk to someone so that
alcohol doesn't come into the equation. Technically, one drink a
day for a woman is modern alcohol drinking and is
not considered unhealthy, but understanding what drives consumption, being able
(14:07):
to take a break and using it for enjoyment as
opposed to stress management. Tell you more about your drinking
in the long run. I hope that was helpful. Another
important concern regarding alcohol use that has been on the
rise in recent years has been shrinking. Often, someone who
(14:30):
drinks five or more drinks in a night and then
doesn't drink for days afterwards tells themselves they can't have
a problem because they don't drink every day, But ben
drinking can be every bit as unhealthy and even more
dangerous as daily consumption of alcohol. Getting blackout drunk, even
if it's only a few times a month, is a
(14:52):
type of alcohol abuse, and it harms both your brain
and your body. If you were, when you know, are
stuck in a cycle of alcohol abuse. Help is available
for both detoxing and recovering from an addiction reach out
because it is exceedingly hard and often impossible to stop
(15:15):
alcohol abuse without professional help. Do you have a problem
I can help with? If so, email me yet how
can I help? At Seneca women dot Com. All centers
remain anonymous and listen every Friday to how can I
help with me? Dr Gail's Salts
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