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Tag: alcohol use disorder

  • Support groups for alcohol use disorder are more effective when they are attended in person

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    Much of life went virtual during the COVID-19 pandemic — work, school and even some doctor’s appointments. So did many support groups for people with alcohol use disorder.

    But people who attended Alcoholic Anonymous, SMART Recovery, Women for Sobriety and other mutual-help groups in person were “significantly” more likely to maintain sobriety than people who participated in these groups only online, a recent study shows.


    MORE: Nurse who beat hard-to-treat cancer says she stayed strong by thinking of herself as a ‘survivor’


    “Online meetings are convenient and widely available, so they could theoretically support many people who face barriers to in-person attendance, such as young people and rural populations,” Sarah Zemore, the study’s principal investigator, said in a statement. “Unfortunately, attending online meetings exclusively was associated with poorer outcomes.”

    The study, led by researchers at Stanford University and the Alcohol Research Group, used data from more than 1,000 adults who took part in a previous study conducted between 2015 and 2021. It found that people who only attended mutual-help groups online were about half as likely to report that they had maintained their sobriety. At a three-month follow-up, people who attended only online were three times more likely to report problems with alcohol.

    People who attended groups in person and online were as likely to maintain abstinence as people who only went to meetings in person.

    One of the reasons why people attending only online may have had worse outcomes may have been because they reported lower participation levels in the meetings, researchers said.

    Nearly 28 million people in the United States have alcohol use disorder. They have trouble stopping or controlling their consumption of alcohol despite adverse effects on relationships, careers and overall health.

    Two years ago, the World Health Organization declared that no level of drinking is safe – not even moderate drinking. In January, former U.S. Surgeon General Vivek Murthy issued an advisory about alcohol consumption increasing the risk for seven types of cancer. He called for warning labels on alcohol about its carcinogenic risk.

    Several medications are available to treat alcohol use disorder, including naltrexone, which helps decrease cravings and reduce the amount of alcohol consumed during drinking episodes. Therapy and group supports are also important parts of a full recovery program for alcohol use disorder.

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    Courtenay Harris Bond

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  • Study Shows Significant Brain Recovery Following Alcohol Abstinence | High Times

    Study Shows Significant Brain Recovery Following Alcohol Abstinence | High Times

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    A study, published in August in the journal Alcohol, focused on how long-term abstinence can undo the effects of cortical thinning in the brain among those with alcohol use disorder.

    “Several cross-sectional investigations reported widespread cortical thinning in those with alcohol use disorder (AUD). The few longitudinal studies investigating cortical thickness changes during abstinence are limited to the first month of sobriety. Consequently, cortical thickness changes during extended abstinence in those with AUD is unclear,” the researchers said.

    As they explained, cortical thickness “is genetically and phenotypically distinct from cortical volume and surface area,” and that it reflects “the number and density of cells in a cortical column…and/or neuronal cell body size, the number of spines and synapses and the extent of myelination.”

    “Cortical thickness may show a differential pattern of recovery with abstinence in alcohol use disorder (AUD) compared to volume and surface area measures in the same brain regions…The cerebral cortex is primarily composed of neuronal and glial cells [i.e., astrocytes, oligodendrocytes, and microglia…and the ratio of glial cells to neurons is approximately 0.7:1; accordingly, cortical thickness may serve as a macroscopic surrogate marker of the cytoarchitectural integrity of cells comprising the cortex,” they wrote in the the study’s introduction.

    The researchers also noted that “few studies have investigated cortical thickness changes with abstinence in [alcohol use disorder].”

    In their study, the researchers studies participants with alcohol use disorder at one week, one month and a little more than seven months of abstinence. 

    In this study, AUD participants were studied at approximately 1 week (n=68), 1 month (n=88) and 7.3 months (n=40) of abstinence. 

    “Forty-five never-smoking controls (CON) completed a baseline study, and 15 were reassessed after approximately 9.6 months. Participants completed magnetic resonance imaging studies at 1.5T and cortical thickness for 34 bilateral regions of interest (ROI) was quantitated with FreeSurfer. AUD demonstrated significant linear thickness increases in 25/34 ROI over 7.3 months of abstinence,” the researchers explained in their summary of the results,, noting that the “rate of change from 1 week to 1 month was greater than 1 month to 7.3 months in 19/34 ROIs.”

    “After 7.3 months of abstinence, AUD were statistically equivalent to CON on cortical thickness in 24/34 ROIs; the cortical thickness differences between AUD and CON in the banks superior temporal gyrus, post central, posterior cingulate, superior parietal, supramarginal and superior frontal cortices were driven by thinner cortices in AUD with proatherogenic conditions relative to CON. In actively smoking AUD, increasing pack-years was associated with decreasing thickness recovery primarily in the anterior frontal ROIs,” they continued. 

    “Widespread bilateral linear cortical thickness recovery over 7.3 months of abstinence was the central finding for this AUD cohort. Proatherogenic conditions were associated with decreased thickness recovery and thinner cortex after 7.3 months of abstinence in several ROIs; this suggests alterations in perfusion or vascular integrity may relate to structural recovery in AUD. These results support the adaptive and beneficial effects of sustained sobriety on brain structural recovery in those with AUD.”

    The findings were hailed as “groundbreaking” by PsyPost, saying that the study reveals “a remarkable potential for recovery.”

    “There is very limited information in the alcohol use disorder field regarding how human brain structure recovers over longer-term abstinence after treatment,” said Timothy C. Durazzo, a clinical neuropsychologist at the VA Palo Alto Health Care System and professor of psychiatry and behavioral sciences at Stanford University School of Medicine who was one of the authors of the study, as quoted by PsyPost. “Our study is the first to demonstrate significant recovery of cortical thickness in multiple regions in those seeking treatment for alcohol use disorder over approximately 6-7 months of abstinence after treatment.”

    Alcohol use disorder is defined as a “a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences,” according to the National Institute on Alcohol Abuse and Alcoholism, which said that 28.6 million adults aged 18 and older had alcohol use disorder in 2021.

    Genetics, exposure at an early age, mental health conditions and other traumas are all identified as factors that increase the risk of alcohol use disorder.

    “It encompasses the conditions that some people refer to as alcohol abuse, alcohol dependence, alcohol addiction, and the colloquial term, alcoholism. Considered a brain disorder, AUD can be mild, moderate, or severe. Lasting changes in the brain caused by alcohol misuse perpetuate AUD and make individuals vulnerable to relapse.The good news is that no matter how severe the problem may seem, evidence-based treatment with behavioral therapies, mutual-support groups, and/or medications can help people with AUD achieve and maintain recovery,” the Institute explained.

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    Thomas Edward

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  • It’s 5 a.m. Somewhere

    It’s 5 a.m. Somewhere

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    JFK Terminal 8—It is 9:22 a.m., and I am learning about consumer protections from a food-safety inspector who is on her second Bloody Mary. There is nothing quite like alcohol to facilitate an expansive conversation: I should encourage young people, she tells me, to consider careers in food safety. She’s on her way back from a work trip, and I learn that she always drinks Bloody Marys when she travels, which is often, but never drinks them at home. We move on to other topics: reincarnation, ExxonMobil, karma, the state of labor unions. The only thing that seemed to be off limits was her full name (her job, she said, prevents her from speaking to the media).

    We’re sitting in the New York Sports Bar across from Gate 10, which is next to Solstice Sunglasses and a vending machine selling ready-to-eat salads in plastic mason jars. In the corner, two blond women drank white wine. A passing traveler pops her head in: Does the bar serve French fries? The bartender says no, they don’t start serving French fries until 10:30. It is too early for French fries. But it is not too early for white wine.

    By the time security spit me out into JFK Terminal 8 at 7:02 a.m., the bars were already slinging drinks. At least four bars had patrons, including O’Neal’s Restaurant (a “cozy wood-paneled pub,” according to the JFK directory) and Bobby Van’s Grill (“elegant ambiance and upscale menu”). At JFK, alcohol service can begin at 6 a.m., the same time bars open at LAX. That’s hardly early for major airports. At MSP, outside Minneapolis, opening time was once also 6 a.m. but is now 4 a.m.; at Tokyo Narita Airport and London’s Heathrow, there are no restrictions. Early-morning drinking at airports is not just accepted but pervasive, Kenneth Sher, a University of Missouri expert on alcohol habits, told me. The internet has noticed, too. “What’s with all these people drinking pints in the airport at 6am?” wondered a Redditor in one of the many threads devoted to the topic.

    Outside the airport, this is not how drinking works—or at least, not how it works in public. Morning drinking, with few exceptions (brunch, tailgating), tends to be “a sign of pretty severe alcohol dependence,” Sher said. Legally, it is discouraged: Non-airport bars in New York State are not allowed to start serving alcohol until 8 a.m. (10 a.m. on Sundays), and most hold out until at least the early afternoon, if not happy hour, Andrew Rigie of the New York City Hospitality Alliance, told me. But in the airport, the normal rules of drinking do not apply. “I’m not judging,” the bartender at Bobby Van’s Grill said, pouring vodka into a flute of orange juice. “It’s 5 o’clock somewhere.”

    I’d woken up at 4 a.m. to get to the airport, and by the time I met the food inspector, five hours later, I would have believed it was any time you told me. I was hopped up on adrenaline—feeling glamorous and vaguely ill—even though I had accomplished nothing. Mostly, travel is standing in different types of lines. I waited for people to look at my ticket. I waited for different people to inspect my shoes. None of this especially made me want alcohol, even though the idea of drinking at the airport felt romantic, in a novelistic sort of way.

    At Bobby Van’s, perhaps the most dignified dining option in Terminal 8, I ate lukewarm potatoes next to a sad-eyed man drinking coffee and red wine. Mostly, the terminal was quiet. How Do I Live played, which seemed like a reasonable question. I watched a man in a zip-up cardigan eat eggs.

    What are any of us doing here, sipping early-morning drinks at the airport Bobby Van’s? I am here because I am trying to answer that question. Other people have other reasons. You can, by observation and experience, put together a basic taxonomy of airport-drinking types. There is the solo business traveler with time to kill and no particular interest in working. There is the festive couple for whom airport drinks signal the beginning of vacation, and their corollary, the festive group of friends. And then there is the anxious traveler, motivated less by excitement than by ambient terror of being in a pressurized metal tube at 36,000 feet.

    For a place where everyone is watching clocks, there is no real sense of time at an airport. “If you look out, all you see is the tarmac, a few airplanes,” says Michael Sayette, an alcohol researcher at the University of Pittsburgh. There are very few cues that you shouldn’t drink, and maybe it is actually happy hour for you. “You’ve got people coming in from all over the world who are on different times,” he points out. “It really is 5 p.m. where they woke up.” The airport perhaps is best understood as what French anthropologist Marc Augé has called a “non-place:” a blip in space and time. “A person entering the space of non-place is relieved of his usual determinants,” he wrote in his book on the subject. “He becomes no more than what he does or experiences in the role of passenger.” It is perversely freeing, if lightly dehumanizing, to be alone in the airport.

    Once you pass security—the transition, in the language of the business, between “landside” and “airside”—you assume another version of yourself. Landside, you are still anchored in your normal life, which is to say that you can come and go and hang out with your family and carry as many ounces of water as you want. Airside, you have assumed a new identity. You have become a traveler. You have no legible context and no obvious history. Are you a person who orders cocktails on a weekday morning? Who’s to say? You belong to the airport now.

    So does everybody else there. There is a sense of solidarity: As fellow travelers, we are all indefinitely trapped in the same timeless, placeless boat. Why not drink? “It’s exciting for people to take an activity that is normally very, very regulated, time-wise, and then be embedded in a space where everything’s okay,” Edward Slingerland, the author of Drunk: How We Sipped, Danced, and Stumbled Our Way to Civilization, told me. Alcohol signals the transition from one set of rules to another. “We use this, on a small scale, at the end of the workday, to transition to leisure time at home,” he suggests. “Drinking in airports is just kind of a bigger version of that. It’s a way of transitioning from our normal everyday lives to whatever unusual thing we’re off to.”

    From the bartender at New York Sports Bar, I learn that women drink white wine and men order whiskey. I learn that back in Terminal 4, where she worked until recently, she’d go through five or six bottles of prosecco every morning shift. Luckily, for the travelers, JFK has no shortage of drinking opportunities, also including but not limited to Tigín Irish Pub, Soy & Sake Asian Eats, Blue Point Brewery, and Buffalo Wild Wings. And that’s not counting the multitude of private lounges, where elite passengers (or those with certain credit cards) are treated to an oasis of snacks and free-flowing booze. The American Express Centurion Lounge in Terminal 4, in fact, has three distinct bars, including a Prohibition-inspired speakeasy with drinks curated by a James Beard Award–winning mixologist.

    None of this is an accident. The modern airport produces a captive, thirsty audience. Airports were once permeable by design, says Janet Bednarek, a historian of airports at the University of Dayton. Bars and shops and restaurants were open to everyone, and “airports depended upon non-travelers to spend money,” she told me. Then 9/11 happened, airports locked down, security tightened, and once you were airside, you’d passed a point of no return. For airports, Bednarek said, that provedt to be a business opportunity rather than a problem: People were now getting to the airport hours early, and they had to do something to pass the time, whether it was shopping or eating or lounging at the bar. “Airports are looking for any way they can to generate revenue,” Henry Harteveldt, a travel-industry analyst, told me. Airports charge airlines huge fees, and still, pre-pandemic, retail concessions accounted for approximately 30 percent of airports’ total revenue, according to data from the Airports Council International.

    Here is the thing about the airport, though: Nobody has control. You cannot control the people sitting next to you, or their children, or the security line, or the prepackaged sandwich options at CIBO Express. And most of all, you cannot control when the plane comes, or whether it comes, or how long it is delayed. More than 20 percent of arrival flights in the U.S. in the first three months of this year were delayed, more than the same stretch in any year since 2014. And that’s not even considering the epic meltdowns that can leave travelers stranded for days. “In a way, alcohol may be crucial for air travel, because it allows you to relax into passive helplessness,” said Slingerland, who was in an airport when we spoke. “I’ve been on, like, 10 flights in the last week and a half, and every single one of them was delayed.” Alcohol, he explains, turns down your brain’s ability to focus, suppress distractions, delay gratification, and do all the things you need to do to succeed in your daily life as a functional adult. But you are not a functional adult in the airport. You are a giant suitcase-wielding baby.

    There is, perhaps, a darker read. “I think 80 percent of what you’re seeing is people who, in their normal lives, would never drink in the morning,” Slingerland said. But that leaves a good number of people whose regular behavior is presumably on display at 7 a.m. No one at JFK seemed all that bothered by the white wine and whiskey passengers were sipping so early in the day, but it’s hard to not see it as yet another sign of what everyone keeps saying: Americans drink too much.

    “Drinking is acceptable in all sorts of other places it didn’t used to be,” wrote The Atlantic’s Kate Julian in 2021. “Salons and boutiques dole out cheap cava in plastic cups. Movie theaters serve alcohol, Starbucks serves alcohol, zoos serve alcohol.” A study published last year traced one in five deaths of people ages 20 and 49 to booze. Another paper found that one in eight American adults drank in a way that met the criteria for alcohol use disorder, a figure that seems to have worsened during the pandemic. And drunken passengers cause problems. Although all-hours drinking is useful for airports, airlines have been less thrilled. “It’s completely unfair,” a Ryanair executive said in a statement arguing for stricter policies in 2017, “that airports can profit from the unlimited sale of alcohol to passengers and leave the airlines to deal with the safety consequences.”

    Alcohol in the airport, I had thought, isn’t like alcohol in the world outside. But perhaps airport drinking isn’t different at all. It still facilitates transition from one state to another—only literally. It still provides the illusion of easing the low-grade misery of life. And it still fosters camaraderie. I thought about the food-safety inspector, whom I’d talked with for most of an hour and surely will never see again. Our conversation had been lovely, I thought. Why don’t I talk to people more? This is the weird duality of alcohol: It can simultaneously blunt and enhance the world. In the airport, you desperately need both.

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    Rachel Sugar

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  • Getting Sober: Finding Your Way

    Getting Sober: Finding Your Way

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    Brooke Aymes started drinking as a way to deal with the negative emotions that arose after the death of her cousin from suicide. Then it became a social activity — “a way to fit in and to feel good about myself,” she says.

    Social drinking led to sneaking water bottles filled with alcohol into high school. Eventually Aymes found that she couldn’t pull herself away from the bottle.

    Nearly 15 million people use alcohol to the point where it has harmful effects on their life and they can’t stop drinking. Those with alcohol use disorder have many treatments to choose from, including 12-step programs like Alcoholics Anonymous (AA), inpatient rehabilitation centers, and medication.

    Some methods work better for certain people than for others.

    At her parents’ urging, Aymes went to detoxes, rehabilitation programs, outpatient facilities, and 12-step programs. “None of those things worked until I was able to have the desire to not want to drink, and to have the willingness to follow through with doing work on myself.” she says.

    Aymes eventually used techniques she’d learned from the programs she’d done to find her way to recovery on her own. Today, she is a licensed drug and alcohol counselor in Oaklyn, NJ.

    “I do not believe recovery is one-size-fits-all,” she says. “There are a lot of roads to get there.”

    12-Step Programs

    AA is one of the best-known and most established alcohol recovery programs. Many other programs follow its 12-step method, which relies on 12 principles, the first three of which are admitting your powerlessness over alcohol, believing that a higher power can stop your drinking, and turning over your will to that higher power.

    It’s a system that centers on spiritual belief, which made Fay Zenoff uncomfortable because she hadn’t been brought up with religion. For her, alcohol had become a way to deal with the “tremendous grief and loss” from the death of her older brother and her parents’ divorce.

    By high school, Zenoff was a blackout drinker. But it was only at age 40, after two children and a divorce, that she realized that she couldn’t keep up the façade anymore that she was OK.

    Zenoff says that when she first walked into a 12-step program, she cried. “I didn’t see reflections of myself there.” But after 6 months of “white-knuckling it” on her own, she went back.

    She realized she had more in common with the people in the program than she’d thought. “They were talking about solutions, and they had stories that were similar to my lived experience,” she says. “I actually felt hope for the first time.”

    Zenoff learned the coping skills and resiliency she needed to break the behaviors that were controlling her life. She has been in recovery for almost 15 years, which she says is a continuing process. Now she’s a recovery strategist who helps others learn how to thrive after leaving rehab.

    A 12-step program also helped Ty Reed stop drinking, but only after he had hit bottom. Once a successful mortgage salesman, Reed had been living “a double life.” After work, he’d go out drinking late into the night. Eventually, he also got hooked on crack and meth.

    By 2014, Reed was homeless. He was in and out of jail and mental institutions. He even tried to take his own life. He credits the sense of community in his 12-step program with helping him stop using alcohol and drugs as well as keeping him from slipping back into a relapse.

    Getting a job was also instrumental to his recovery. “It gave me structure,” he says. “Having responsibility and an obligation to show up somewhere, and learning to be dependable again were critical.” The company he has since founded, Recovery Career Services, helps other people in recovery rebuild their careers.

    Therapy and Support

    Ashley Loeb Blassingame’s “drinking career” started early. At 7, she would steal beers from her family’s fridge and drink them alone in her closet. By high school, she was filling water bottles with wine or vodka and downing them before school. She also used drugs and got into trouble with the law.

    Therapy helped her understand the reasons for her drinking. “I was using it to medicate feelings of discomfort. I was using it to medicate anxiety,” she says. Two types were helpful: Cognitive behavioral therapy (CBT), which addresses the harmful thoughts and beliefs that trigger the urge to drink, and another kind called eye movement desensitization and reprocessing (EMDR).

    Therapy, plus support from her peers, has kept her sober for 15 years. Now, Loeb Blassingame is a certified alcohol and drug counselor and co-founder of Lionrock, an online substance abuse counseling program.

    Inpatient Programs

    For some people with alcohol use disorder, trying to recover at home or in an outpatient program may not be enough. Inpatient programs offer a higher level of care, including detox to ease the withdrawal process.

    Patrick Venzke ended up in an inpatient facility in Jacksonville, FL, a decision that he says probably saved his life. The German-born former NFL player had been investing his football earnings to buy and flip luxury houses when the 2008 housing crisis hit and his life crashed down around him. “I was living the American dream, and within 3 years we were on food stamps and had to file for bankruptcy,” he says.

    “I used alcohol like a tool, like a painkiller, just to get through one more day,” he says. By 2014, he was drinking two to three bottles of wine a day.

    The inpatient program helped him get sober. Then the NFL Alumni Association got him into the Desert Hope Treatment Center in Las Vegas, where he now continues his recovery while working as a patient liaison.

    Venzke is 5½ months into his program, but he realizes that recovery is a long journey. “It’s not like I’m healed,” he says. “It’s a lifelong process for me.”

    Sober Living Homes

    For Joe Marks, drinking had become so ingrained that 90 days in a treatment facility barely made a dent. “Two weeks later, I was going to pick up a pack of cigarettes, and what do I have in my hands? Two half-gallons of booze. It started all over again,” he says.

    More than 35 years of drinking had brought him to the brink of death. He would drink to the point where he passed out, only to wake up and start drinking again. “Alcohol had hijacked my brain,” he says. “I needed to get off alcohol for a long enough time to let those pathways find the right way to go.”

    His rehab counselor suggested that he move into a sober living housing community in Hickory, NC. “There was enough stability, and it put structure into my life,” he says.

    It took a couple of years, and making connections with like-minded people, to help him get sober. “I discovered a new life,” he says. “They took me by the hand and walked with me when I couldn’t walk on my own.”

    Today, Marks has found a renewed sense of purpose in helping others. As an ambassador for the Talk It Out initiative, speaking to young people about the dangers of underage drinking is a big part of his recovery.

    Do It Yourself

    Some people prefer to stop drinking in their own way, like actress, filmmaker, and podcast host Raeden Greer. Tired of the negative consequences (including a DUI and two arrests) from her drinking, she got sober by managing her anxiety and by substituting new rituals for the ones that used to involve alcohol.

    “Five o’clock is still going to roll around, regardless of whether you’re drinking or not. So what are you going to do now at 5, because you’ve got to do something different,” she says. When 5 o’clock does roll around, she drinks sparkling water with fruit juice or herbal tea. And she’s replaced the time she used to spend drinking with more positive pursuits focused on self-care.

    Greer takes recovery one day at a time, and tries not to put too much pressure on herself to never drink again. “The longer I go, the more I feel like I probably won’t ever do it again. But if I do at some point, I don’t want to create an environment for myself where I feel ashamed and … like a failure that I didn’t live up to this huge expectation that I put on myself,” she says.

    Find What Works for You

    Recovery from alcohol use happens for each person in their own way. Don’t beat yourself up if you don’t succeed the first time. See it as a step in the right direction.

    “It is very common for people to try recovery multiple times before it takes hold,” Reed says. “It’s tough not to be discouraged, but every time we fail, it’s actually an opportunity for growth.”

    If you or someone you love has trouble with alcohol use, call the Substance Abuse and Mental Health Services (SAMHSA) National Helpline at 800-662-HELP (800-662-4357).

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