Those of you not following All About Addiction on Facebook (you should) or paying attention to our updates on Twitter and such might not have known that I was recently informed that in order to become a psychologist in California (actually, to get registered as a Psychological Assistant, which allows someone to get experience towards becoming a fully licensed psychologist) I was going to have to submit to a 3-year probationary period of drug and alcohol testing. I was completely sober for almost 3 years between January 2002 and about September 2004 following an arrest and jail stint for drug possession and sales (see here for part of the story). In the summer of 2004 I decided to take on the classic “AA Experiment,” meaning that I wanted to see if having an alcoholic drink would bring me back to drug use as so many in my 12-step groups told me it would. I am happy to report, that 8 years later the answer is still no – I’ve been drug free since 2002 but have been drinking alcohol socially since 2004.
Aside from staying drug and crime free, I also received my PhD, published dozens of articles, set up All About Addiction, started writing for Psychology Today, and had my convictions set aside by my judge after completing 5 years of probation without a single dirty drug test or violation of any sort. But the California Board of Psychology wanted more, so they told me I had to test if I wanted to move forward. I was offended, consulted with many other professionals I know about what I should do, and threatened to request additional hearings before eventually succumbing. The bottom line is that the Board is almost all powerful and can ask me to do anything they want. Besides, I am a 9-felony ex-convict asking to become a psychologist – maybe I’ll never live down my past no matter what I do (for my take on stigma, read here). So I have a probation officer again and I have to stop drinking.
Last Wednesday I stopped drinking alcohol – having a final glass of wine with my wife who is being nice and joining me (for now) in not drinking. Ironically, I stopped last week because I thought my meeting with my probation representative was in two days – I was a week off. And apparently I was so concerned about not drinking any more that I only drank half of my glass (my wife didn’t actually touch hers). Still, I have been drinking a drink or two 3-4 times every week for a while now and had gotten used to my glass of wine as post-work stress relief. So I’m wondering what the experience will feel like having to give up my coping tool for at least 2 years.
I talk to addicts and alcoholics on a regular basis and my own social drinking has come up as an issue many times before. I always said it wasn’t a problem and many others have told me I’m wrong – that I am either in the midst of a relapse or that I was never really an addict. The latter point is moot and I can’t prove that at all, but I know that this little experience might be an interesting experiment (the reverse of the initial one if you will) to see if returning to drinking was indeed a cop-out.
Having this website and all, I decided I am going to write about it. I’ll be giving weekly (probably summaries) of my not-drinking experiences and how quitting drinking has affected me in my daily life. If something comes up in between updates I might write an impromptu post to talk about it. I’d love to hear your thoughts as comments here or on our Facebook page.
Week #1 – September 1th-15th (short week since I stopped on Tuesday)
As I mentioned, we never finished those last glasses of wine. Still, Thursday and Friday were stressful workdays (I am now up to about 65 hours of work per week) and I have to say that realizing I won’t be able to have my nightly alcohol serving was a bummer. I had that thought a few times throughout those workdays and on the way home. I know full and well that for me stress is a trigger for alcohol use. Thankfully, I was not actually tempted to open up anything and drink once I got home. This is still early on in the process, so obviously it does not mean that I won’t be tempted soon, but I was happy to find that resisting a drink was not a difficult task even when I would have usually had one.
Also, I realized that my weekly (or so) friendly get-togethers with a couple of guy friends are either going to have to change venues or I’m going to be the only guy not drinking at a Happy Hour. We’ll see. I’m sure they won’t mind but I’m not sure how I will feel. Lord knows some of my clients frequent bars without issue while others are triggered constantly… If I’m right about my lack of alcoholic drinking issues, it shouldn’t be a problem.
I can’t even count how many times I’ve talked about the difference between alcohol or drug users and alcoholics or addicts (see here, here, and here for some examples and keep reading). The quick summary: Many people use drugs and many abuse them at times, a small percentage meet criteria for addiction at some point in their life and an even smaller percentage is the type of addict we’ve been taught to think of – chronically relapsing and seemingly incapable of quitting no matter how crappy their life gets.
One of the main reasons we study drug and alcohol abuse is because of the hugehealth impact of this stuff – we spend billions and billions of dollars every year on health-care that is directly or indirectly related to the abuse of nicotine, alcohol, and pretty much every other drug on earth (marijuana can certainly help some conditions but heavy use of marijuana can bring its own consequences). One of the major players in these health problems is the effect of alcohol and drug use on stress in the body. Stress increases death rates in several ways including: Heart attacks, strokes, cancer, and more.
Well, a recent study in Amsterdam looked at alcohol (yes, you read that right, the Dutch care about more than weed) consumption, alcohol addiction (alcoholism) diagnosis, and effects on the body’s stress system, also known as the HPA (Hypothalamic-Pituitary-Adrenal) Axis. If nothing else, the study helped confirm that an alcoholism diagnosis is not necessarily the same as an indication of heavy drinking and that excessive drinking is no bueno, regardless of whether it meets addiction criteria or not.
Alcohol drinking, alcoholism, and stress regulation
I’m not going to go into this in detail (look here and here for more) but just as our brains and bodies have systems for decision making, they also have complex stress management systems. The latter rely heavily on hormones, including Cortisol, to keep our bodies in the right states whether those be fight, flight, or reading a book before sleep (see figure on left for over-simplified cortisol levels throughout the day in a normal person). We’re supposed to have the most cortisol right upon waking with constant reductions throughout the day until we fall asleep, and back again. Individuals with mental health disorders like anxiety and depression have substantially different cortisol level patterns throughout the day and are less effective at regulating cortisol (in case you needed another reason why our biology affects our states of being and behavior).
The dutch study tested cortisol levels at 7 different times throughout the day after giving their subjects a 4 hour battery of tests. They also assessed their cardiac functioning by assessing different measures related to heart beat regulation that allows for adapting across challenging situations by affecting the sympathetic nervous system (excitatory processes) and parasympathetic nervous system (inhibitory processes).
They looked at these measures as a way of assessing the relative functioning of the HPA Axes’ of different groups. Specifically, they looked at:
Moderate drinkers (less than 3 drinks per day)
Heavy drinkers (more than 3 drinks per day)
Remitted alcoholics (met criteria for alcoholism previously but not in past 12 months)
One of the most interesting findings, as far as I’m concerned, was that among remitted alcoholics the average amount of drinking was around 1.3 drinks per day with a lot of variability, a little higher than that of moderate drinkers (0.8 drinks per day) but lower than that of heavy drinkers (4.0 drinks per day). I see this as a little more proof that people who met criteria for alcoholism at one point don’t necessarily abstain forever and don’t necessarily continue to have drinking problems (per Moderation Management, spontaneous remission, or some other means of stopping their alcoholic drinking).*
You can blame improper diagnostic criteria, a continuum of addiction severity, or anything else as far as I’m concerned but as I pointed out in my first paragraph, we’ve talked about this topic repeatedly and I see no end coming soon. The bottom line is that meeting criteria for alcoholism at one point in life tells me something, but far from everything, about a person’s drinking habits or drinking problems later in life.
But back to stress. As you might have already guessed, since it is heavy drinking that causes serious dysregulation of the body’s stress response, what the researchers found was that meeting criteria for alcoholism now, or in the past, didn’t have any major effect over their participants’ HPA functioning. Instead, all that mattered was how heavy their drinking was now. Heavy drinkers had higher waking cortisol levels, higher night-time cortisol, and increased sympathetic (excitatory) control. In short – heavy drinkers were less able to regulate their stress and excitation response, likely leading to increased stress on their bodies.
As a side note, this study also found that if anything, moderate drinking conferred health benefits when it came to stress over not-drinking at all – far from the first study to note this but another set of reinforcing evidence that drinking alcohol is not in itself bad for you while over-drinking is.
So – Drinking a lot of alcohol causes disruptions to your body’s stress regulation system that will likely increase the likelihood of heart problems, depression, anxiety, and more. Those disruptions are there whether you meet criteria for alcoholism or not.
Obviously, there are many alcoholics who drink a lot of alcohol, but there are also people who meet (now or in the past) criteria for alcoholism who are binge drinkers and therefore don’t drink daily and have lower “drink numbers.” As we mentioned before, addiction is not about quantity, in fact, the criteria for addiction barely mentions quantity – when it states that addicts consume “more than intended” or that tolerance creates a state where an person needs greater quantity to reach the same effect of the drug. Drinking or using a lot of drugs or alcohol does not an addict make.
*Note: Given the variability in the remitted-alcoholics groups their is little doubt that some of them had stopped drinking while others drank to excess. Additionally, it should be pointed out that alcohol abuse was not assessed in this sample, so it could still be a problem for at least some of those now-drinking past-alcoholics.
We all know that drinking alcohol changes the way people think and can make them act strangely right? We also know that alcohol is involved in more than 50% of violent crimes and about 75% of partner violence. The question is, why the connection?
A recent paper I published suggests that drugs and alcohol can not themselves be thought to cause violence. Still, the relationship exists, so what gives?
The thought altering effects of consuming alcohol, and most drugs, can be said to affect something called executive functioning (EF). What exactly makes up this type of functioning is a source of some debate, but let’s just say that it refers to attention, strategic planning, reasoning, thought flexibility, and the ability to process information in working memory (an important type of memory used in learning).
You can probably already tell that this type of brain function is extremely important and that different people possess different levels of it. I can also tell you that alcohol consumption has been shown to reduce overall executive functioning. If you drink alcohol, or have ever seen someone drink, this probably doesn’t come as a huge surprise.
The thing is that alcohol consumption messes up everyone’s EF, though obviously, the more you drink, the more affected you become. Still, given the fact that more than 50% of Americans report at least one binge drinking episode a year and less than 7% are involved in violent crime, something else must be at play, right?
Aggressive personality and irritability
As I mentioned earlier, I published a paper showing that aggressive personality, which I measured using 5 different tests, contributes far more to violent behavior than drug use alone. Still, a recent study found that irritability alone could account for some aggressive behavior. Still, the more interesting finding had to do with alcohol-related EF problems and irritability together. The experiment was pretty interesting, so let’s go over it for a bit.
Researchers at the University of Kentucky took more than 300 students and gave them a whole bunch of tests assessing their EF and their overall level of irritability. Afterward, half of the students were given alcohol to drink (about 3-4 drinks per person) and the other half was given a similar number of drinks that contained no alcohol but were sprayed before being handed to smell the same. The students were then asked to play a game that pitted them against another person. The secret was that there was no game and no other person, the winner and loser in each round was pre-determined. Every time the student “won” they got to give the other player a shock, but every time they lost, they themselves got shocked. As the game went on, the shocks the participants got increased in intensity. The researchers wanted to see how the students would react and how large the shocks they would give back would be.
The results showed that the more mistakes people made in their initial EF testing (and therefore the less overall EF capability they showed) the more aggressive they were. This makes sense, as people who are less able to plan, think ahead, and control their behavior would be more likely to engage in things that would hurt them, or misjudge events and think react inappropriately. Irritability was also shown to affect aggression, but this time only for men and intoxicated women.
The effect of alcohol abuse on aggression and violence
When the whole thing was put together the researchers found that for drunk men only, reduced EF and increased irritability worked together to generate even more aggression that was shown for all the other participants. For the simplest example think back to anyone you know who is pretty quick to react anyway and is a little too easily pissed-off. Chances are they become a pretty mean drunk who likes to get in fights.
Obviously this makes sense if you know someone like that, but in terms of helping us make decisions about who should be considered dangerous and who shouldn’t, especially when consuming alcohol, this research helps further explain why we see such a strong connection between alcohol abuse and violence or aggression.
The way I see it there’s a relatively small number of people (mostly men) who is normally pretty aggressive, irritable, and lacking in judgment and self-control, who often get violent when they drink alcohol. For them, many alcohol drinking episodes end badly, and since they’re the most visible of the aggressive drinkers, their behavior produces an association between alcohol consumption per se and violence. For the rest of us, alcohol consumption rarely leads to violence, but violence rarely occurs without drinking alcohol either, so we hardly ever enter the equation at all. That’s why the pattern holds.
Godlaski, A. J., Giancola, P. R. (2009). Executive function, Irritability, and Alcohol-Related Aggression. Psychology of Addictive Behavior, 23, 391-404.
Jaffe, A. et al., (2009). Drug Use, Personality and Partner Violence: A Model of Separate, Additive, Contributions in an Active Drug User Sample. The Open Addiction Journal, 2.
What influences college students’ decisions about whether to drink and how much?
Do friends peer pressure them?
Do they do it because they are bored?
Do they drink to relieve depression or anxiety?
Researchers recently tried to answer these questions by surveying college students…
65% of the participants reported having at least one drink in the past three months. It was astonishing that the typical number of drinks in a week was 10.5 and on a weekend was 7.3 average drinks. These numbers included drinkers and nondrinkers and was the average (meaning around half the people had more drinks as those had less). This indicates that college drinking is far more extreme than drinking happening outside of the college setting.
3 main influential factors for someone’s decisions in college drinking and to what extent:
You can tell a lot about a person by watching their friends, so watch who you surround yourself with. Those who think favorably of drinking tend to think they can drink more before reaching intoxication and also tend to hang out with others who do the same. However, these people are the ones that need the most intervention yet are the most difficult to change.
Those who socialize with a wide variety of people typically are lighter drinkers and tend to respond better to treatment immediately as well as have fewer problems further down the line. The heavier drinkers benefit more from motivational interventions focusing on their attitudes toward drinking.
Regardless of stereotypes, ethnicity, weight and gender did have an effect on any of these findings. It was peoples’ closest friends that were the most significant factor in influencing all aspects of college drinking.
Examining the Unique Influence of Interpersonal and Intrapersonal Drinking Perceptions on Alcohol Consumption among College Students. Journal of Studies on Alcohol and Drugs. Volume 70, 2, March 2009
We all know that college students often party and sleep more than they actually study. But do heavy alcohol use and poor sleep patterns cause poor grades?
A recently published study found that just altering bed times by 2 hours can throw off your sleepiness during the day. Most students in the study did show a 2-4 hour difference in daily bed times between weekdays and the weekend, and most went to bed after midnight.
The average number of drinks for participants came in around 6 drinks a night (equal for men and women).
The big question is: can these heavy drinkers in college still perform well academically? (See here for influential factors in college drinking)
No matter what the cause, insufficient sleep causes poor academic consequences. Interestingly, those students who reported much more sleep also had lower GPAs (oversleep was mostly assumed, by the researchers, to be caused by drinking and staying up too late, though it could have been due to other issues such as depression).
Overall, those that drank more often went to sleep later and also had bigger gaps between weekday and weekend bedtimes, all of which correlated very highly with a lower GPA.
Singleton, Wolfson (2009). Alcohol Consumption, Sleep And Academic Performance Among College Students. Journal of Studies on Alcohol and Drugs. 70, 355-363)
If you asked college students in America what goes on at a Fraternity or Sorority party they would tell you that drinking alcohol is a major component. The movie Animal House made heavy college drinking a well known fact decades ago, and research backs it up.
Studies have consistently shown that the highest rates of heavy alcohol use and alcohol disorders occur in the college-age population. But who’s to blame? Although heavy alcohol use has been documented within Greek organizations, the question of whether the Greek environment fosters substance use or whether heavy substance users chose to be in Greek environments has not been researched until now.
In order to find out whether the Frats/Sororities were the main influence for heavy alcohol use or if individuals joining the Greek organizations were simply heavier alcohol abusers researchers recently collected data from 3,720 pre-college students who were then followed for the 4 years of college they enrolled in (talk about a lot of work).
Of the almost 4000 participants there were students who joined the Greek environment and those who didn’t. Also, there were students who were late joiners and students who joined but withdrew before they graduated. After looking at all the different categories, one thing was apparent:
Students, who at any given period were part of a fraternity or a sorority, drank more alcohol and had more negative, alcohol-related consequences while being a member of a Greek organization. Also, once they deactivated, those participants drank less and had less drinking-related consequences.
The real issue as to why this is so important has to do with the consequences of alcohol use. Problems like drinking and driving (and possible DUI arrests), alcohol abuse, alcohol poisoning, and violence are a serious problem among college students. Apparently, Greek Environments make these consequences more likely.
It’s important to note: If the only finding her was that participants in the Greek system drank more alcohol or were more likely to drink alcohol at all that would be one thing (this findings was also true here by the way), but the fact that they were also more likely to have negative consequences associated with their drinking suggests that interventions might be useful within this college-environment.
Something to think about next time you’re bored on a Thursday night…
Park, Aesoon, Sher, J., Kenneth, S., & Krull, L., Jennifer (2008) Risky Drinking in College Changes as Fraternity/Sorority Affiliation Changes: A Person – Environment Perspective. Psychology of Addictive Behaviors, Vol. 22, No. 2, 219-229.
There has been some research suggesting that training people to better estimate their Blood Alcohol Content (BAC), can help reduce accidents and improve risk-taking while drinking among college students (see here and here respectively).
I’m including a recent piece from one of our readers, telling us about her first over-21 drinking experience in Las-Vegas. I think this story exemplifies that young adults may often consume more alcohol than they are aware of while underestimating its effects Read the rest of this entry »