I’m scheduled to appear on MPR News with Angela Davis this Friday, January 17th, at 11 a.m. I’ll be representing Allina Health in a live discussion about the sober curious movement (and here, here and here).
I’m occasionally asked if I have a personal history of addiction. I don’t but stopped drinking by my mid-30s before sober curious was a thing (I’m currently a week short of 50, so I’ve been “dry” for at least 15 years).
Some sober curious factoids appear below.
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“Would I be happier without booze? More productive? Would I feel more confident? What would it be like to never have to face another deadline half hungover? Would I be thinner if I didn’t drink? Look younger? Would I have less sex? More sex? Would the sex be better? Would I have anything to talk about at parties? Where would the glamour go? Would people think I was boring? Exactly how boring would I/life become? … I have termed this questioning as getting Sober Curious”
- Low-risk use: Consumption of alcohol or other drugs below the amount identified as hazardous, and use in circumstances not defined as hazardous
- Hazardous use: Use that increases the risk for health consequences
- Harmful use: Use with health consequences in the absence of addiction
- Addiction: As per criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
According to the USDA, “If alcohol is consumed, it should be in moderation—up to one drink per day for women and up to two drinks per day for men—and only by adults of legal drinking age.” I think that recommendation is okay for women, however, the number should be one drink per day for men. Of note, “The level of consumption that minimises health loss is zero”
- One U.S. Standard Drink contains 14 grams of alcohol. Examples include a 12-ounce can of beer, 5-ounce glass of table wine and 1.5 ounces of a distilled spirit like vodka
- Alcohol provides 7 calories per gram. In contrast, carbohydrates (fiber, starch, sugar) and protein provide 4 calories, and fat 9
- One 12-ounce bottle of beer provides 145 calories: 98 from alcohol and the rest from carbohydrates and protein
Drinking frequency (e.g., days per week) and intensity (e.g., drinks per day) has a “very small positive and marginally statistically significant effect” on body weight in men. There appears to be no relationship between alcohol consumption and body weight in women
Multiple studies have demonstrated that consuming alcohol in the evening “enhance[s] sleep onset but decrease[s] sleep continuity during the second half of the sleep period”
“The available scientific research indicates that higher amounts of alcohol intake have an immediate short-term negative impact on the arousal and orgasm phases of the human sexual response cycle”
“Hangover symptoms are not just physical; they are cognitive as well. People with hangovers show delayed reaction times and difficulties with attention, concentration, and visual-spatial perception.” Veisalgia—the medical term for hangover—can be traced back to kvies (Norwegian), the “uneasiness following debauchery.” “Hangover is common and underdiagnosed and can have serious physical, psychiatric, and occupational consequences”
The Saint Cloud Times recently featured CentraCare Health’s correctional care (“jail medicine”) program. This unique public-private partnership is designed to identify and treat mental illness and addiction while inmates are in custody. We then link them to a special clinic following release to the community for ongoing management. (I serve as the medical director for the program.)
We launched in the Benton County Jail on October 1st, 2017, and in the Stearns County Jail on January 1st, 2o18. As outlined in the article, the early signals are promising: fewer ambulance trips between the jail and hospital, fewer detox admissions and decreased total cost of care.
As far as we know, we’re the only Minnesota counties starting inmates on Suboxone, the medication to treat opioid addiction, while in custody. And, one needs to look far and wide to find other examples nationally.
Our ever-growing provider team includes:
- Zach Dorholt, psychotherapist
- Bri Eriksson, nurse practitioner
- Lori Korte, psychotherapist
- Julie Moriak, pharmacist
- Cat Standfuss, psychotherapist
Providers see inmates in jail and following release to the community. This continuity of care is unprecedented. Health authorities (a statutory term) have historically focused on inmates’ immediate medical needs in jail without regard for the bigger picture. This penny-wise but pound-foolish approach doesn’t resolve some big reasons—mental illness and addiction— for criminal recidivism. Thus the revolving door.
Special thanks to my partners in crime (sorry! couldn’t stop myself):
Many thanks to Joe Clubb, John Sutherland and Tim Burke at Allina Health for putting this important issue on the proverbial radar. §
Treatment Basics, an excellent educational DVD, is now available from Hazelden Publishing. I was fortunate to be included in the project.
I was fortunate to be included in both projects. Many thanks to Wes Thomsen and his team for the ongoing collaboration. What’s in the hopper for 2019? §