Wondering if you or a loved one have been drinking too much, or if you’re in the early stages of a drug problem?
The pandemic, with its added stress and isolation, has led to alarming increases in the use of many substances.
Deaths from drug overdoses soared more than 30% in the most recent 12-month period, according to the U.S. Centers for Disease Control and Prevention, rising to 95,000.
In Michigan, rates rose 18%, amounting to 2,800 deaths.
People are also drinking more.
Some studies show that heavy drinking, defined as 15 or more drinks per week for men or eight for women, is up anywhere from 30% to 50%.
Health Beat asked Cara Poland, MD, who specializes in addiction medicine at Spectrum Health, to explain what this means for treatment options.
How has COVID-19 changed the way people use substances?
While it’s true that isolation helps prevent the spread of COVID-19, it also hurts people’s mental health. “And it certainly affected those with substance use disorder,” Dr. Poland said.
Stress also leads to increased use as people look for ways to cope.
“We know that drinking rates rose the most among people with children age 7 and under, due to challenges with school and child care,” she said.
I notice you use the term “substance use disorder.” How is that a different approach?
Dr. Poland said doctors are trying harder to talk about diseases–without labeling the people who have them. “Words like ‘diabetic’ and ‘alcoholic’ can be seen as judgmental, even pejorative,” she said. Using the term “substance use disorder,” introduced 10 years ago, is helpful.
“Words matter,” she said. “It’s all about creating safe places for our community, individual patients and their support system.”
How can someone tell if their use of alcohol or drugs is potentially dangerous?
Substance use disorder covers a spectrum, classed from mild to moderate to severe, she said. There are online resources, like this quiz, to help people gauge their relationship to alcohol. The CDC recommends no more than one to two drinks a day for men, one drink for women.
There is no guidance yet for marijuana or other drugs, she said. “So alcohol is a little unique–at lower doses, some studies indicate some health benefits,” she said. “But at higher levels, there are risks.”
Because it can be confusing, it’s helpful to talk to a professional, Dr. Poland said.
What would you say to people who may be afraid to tell providers they’re concerned about their use of alcohol or drugs?
There are many types of treatment, Dr. Poland said. Lots of people find help from organizations like Alcoholics Anonymous and Narcotics Anonymous. There’s also medication. “And research shows that people who get medication to support their treatment do better than those who don’t,” she said.
She likes to compare it to people diagnosed with high cholesterol. “Many people say they’d prefer to use lifestyle changes instead of a drug,” she said. “If they say that about their risky drinking habits, I’ll say, ‘Let’s try that.'”
But if six months go by and they haven’t been able to cut back on their own, it’s time to change tactics. “We don’t say, ‘You’re a bad person,’ or, ‘You’ve failed,’ because they tried to cut back and couldn’t. We say, ‘OK, that didn’t work. Let’s try something else.'”
Are those early attempts at cutting back typically successful?
After even a brief intervention with a health care provider, “about 50% of people with risky drinking behaviors can cut back to healthy limits,” she said.
And if they can’t?
After six months, if a person hasn’t had a change or if the problem has escalated, it’s time to switch tactics. “We use medications that can help stabilize the brain to reduce cravings,” Dr. Poland said.
When are residential programs, such as a 28-day rehab, required?
“People need the appropriate level of care for where their disease is at that moment,” Dr. Poland said.
Some people may need to go to a detox center or an inpatient treatment center, which gives them time to work the substances out of their system. “And they can be medically supported,” she said.
Why are teens so vulnerable?
“Adolescents are always at risk,” she said. “And there’s a good reason the drinking age is 21.” The longer kids delay their first exposure to a substance, their chance of developing a substance use problem drops precipitously.
Dr. Poland wishes more parents understood just how precious that time delay is. “Many think it’s up to them to teach their kids how to drink safely. About 80% of adolescents got their first drink from a parent or guardian.”
What do you wish everyone knew about substance use problems?
“Treatment is real,” Dr. Poland said. “Medication works. Spectrum Health is here to help you.”