S M A R T H E A LT H By DARYL SHORTER, MD
Navigating Substance Abuse Pandemic stress has sparked a worrying increase in alcohol and drug use. To say the last couple of years have been a lot is an understatement. During times of stress, health behaviors are often negatively impacted. Eating nutritious meals, getting regular exercise, and maintaining good sleep habits can be particularly challenging in moments such as these. Disrupted patterns of behavior can also extend to changes in one’s relationship to alcohol or drugs, creating new problems or worsening old ones. As one might expect, the COVID pandemic has had a big impact on alcohol and substance use. In one preliminary study, while 13 percent of participants reported drinking less during the pandemic, 60 percent reported an increase in drinking. Perhaps just as concerning, roughly one-third of participants reported binge drinking, which is defined as having 4 (for females) or 5 (for males) or more drinks in one sitting at least once over the past 30 days. While consuming that amount of alcohol might seem innocuous, binge drinking has been associated with an increased risk of driving while intoxicated, or the development of alcohol-use disorder and other psychiatric conditions. Just as alcohol use has increased, the negative consequences of drug use have also skyrocketed. Most alarming is the substantial increase in accidental drug-overdose deaths last year, which reached an all-time high of more than 93,000 in 2020. While opioidrelated overdose deaths represent a majority of these unfortunate cases, the impact of other substances like alcohol—or psychostimulants such as cocaine and methamphetamine—cannot be understated. There are many reasons why the COVID pandemic led to an increase in alcohol and drug use. The restricted access to group-activity spaces left many people without easy ways to entertain themselves. Boredom represents a risk for some, since alcohol and drugs can serve as an easy distraction. For some, increased isolation and loneliness likely contributed to negative moods that individuals try to “medicate” with substances. 28 DECEMBER 2021 | OutSmartMagazine.com
Others may have experienced significant stress related to job loss, personal or familial illness, or relationship challenges. These factors all contribute to the increased use of substances as a means of coping. LGBTQ individuals are particularly vulnerable to developing substance-use disorders. According to the Substance Abuse and Mental Health Services Administration, LGBTQ folks have higher rates of tobacco, alcohol, and drug use in comparison to their cis-het counterparts. There are a number of factors that contribute to this elevated risk. Homophobic cultural attitudes are often internalized by LGBTQ individuals, resulting in lower self-esteem. Also, in an effort to cope with being shamed regarding identity or health status, alcohol and drug use may be increased. Further, the use of substances among LGBTQ individuals can increase comfort with sexual activities that society has deemed “unnatural” or “sinful.” These psychological underpinnings can complicate LGBTQ people’s relationship with alcohol and drugs. Not all factors are rooted in emotional or
psychological distress, however. Increased alcohol and drug use is observed in many cultural groups where stigma, discrimination, and oppression are part of the fabric of everyday existence. When evaluating whether or not alcohol or drug use has become problematic, these three questions are helpful:
• In the past year, have you consumed
more than 4 drinks (for women) or 5 drinks (for men)? (Unfortunately, this question does not acknowledge transgender or nonbinary identities, and is based on the National Institute on Drug Abuse (NIDA) Quick Screen.)
• Have I made certain rules for myself
about alcohol or drug use such as only drinking on weekends, but find that I have difficulty following them?
• Has my alcohol or drug use resulted in
relationship problems, impacted my ability to work, or contributed to health challenges?
