Monthly Archives: June 2019

Ending Excessive Alcohol Use – Do Some Methods Work Better for Women?

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Alcohol is the third leading cause of preventable death in America – right behind tobacco and poor diet and physical inactivity. The Center for Disease Control and Prevention (CDC) released data that reveals the grim truth about alcohol abuse in the United States. This dangerous activity is responsible for 88,000 deaths and almost $250 billion in economic burden every year! Of those deaths, it is estimated that 26,000 are women. Excessive alcohol use has two forms – binge drinking and heavy drinking. Binge drinking is defined as consuming 4 or more drinks in a 2-hour period for women and 5 or more drinks in the same time frame for men. Heavy drinking is drinking 15 or more drinks per week for men or 8 or more drinks per week for women. In 2015, nearly 30% of the adult population reported that they’d engaged in binge drinking in the prior 30 days. Seven percent reported heavy drinking. As we can see – excessive alcohol use is a real issue in the U.S. What is even more alarming is the fast rate at which women are engaging in risky drinking behaviors.

Prevention is necessary for combating the rising rates of alcohol abuse in general. There have been many prevention strategies proposed. There are several questions that remain, however. Should prevention methods differ between men and women? If so, which methods are best for women? To answer these questions it is necessary to know why women drink. The answer, though likely multifaceted and complicated, will guide public health professionals the most appropriate prevention techniques. 

Regulating Alcohol Outlet Density

The Community Preventative Services Task Force (CPSTF) recommends regulating – through licensing and zoning – the density and number of alcohol outlets as a method to reduce alcohol overconsumption. Places that have employed this method have fewer alcohol sales – which one could only assume means less usage. Several studies have found an association between alcohol outlet density and alcohol-related harm. Where the density was high, the level of consumption was high and more harm occurred. Whether or not this method would be effective in women has not yet been determined. We may see that the effect on lower alcohol outlet density may have equal effects among men and women because women drivers outnumber male drivers so getting to an alcohol outlet that is further away would still be possible for women. 

Increasing Alcohol Taxes

Another method of prevention recommended by the CPSTF is to increase the price per unit of alcohol by raising the alcohol tax. A similar method was adopted for tobacco sales which resulted in a dramatic reduction in sales.  A similar rationale applies to alcohol – if you make it more expensive, fewer people will buy it and fewer people will drink it. Several studies have shown that this is an effective method. The downfall here is that this method will do nothing to reduce alcohol consumption in wealthy populations which we know are responsible for the consumption of most alcohol. Whether or not it will work to reduce consumption in women would depend on the socioeconomic status (SES) of the women. Employing this method will almost certainly result in a reduction of use in women with a low to middle SES but probably won’t have much of an effect on those women who have a higher SES. 

Image result for alcohol use in women

Maintaining Limits on Hours of Sale

This method for alcohol consumption control may limit the times of day that alcohol can be sold or served. Recently, Fulton County, Georgia proposed and passed a bill that would allow drinks to be purchased in a restaurant earlier in the day on Sundays. This bill was commonly referred to as the “Brunch Bill” because it mostly affected brunch alcohol sales. This bill mostly increases alcohol consumption in women. If the permitted hours of alcohol sales were limited, we may see a reduction in how much women are consuming. 

Determining which methods will work best for women will require more research and surveillance to figure out what factors that influence drinking and abstinence are unique to women. This information can then be used to develop best practices that will ultimately lead to a reduction in excessive alcohol use in women. 

 

Raising awareness on the harms of alcohol for women

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Alcohol is know to have it’s dangers; from developmental delays if exposed too young, to lowered inhibitions often leading to risky behaviors, the harms it can cause are no secret, and often seen as worth it for the relaxation a small drink can bring. However, as research and technology move forward, new findings often come to light. Included in this are the recent publications that show how drinking can be much more dangerous for woman than men. Examples include higher prevalence of liver disease, increased dependency issues, and the critical issue of growing rates of breast cancer among women who drink regularly compared to those who don’t.

Beyond the extensive problems themselves these issues can bring,  there is an additional pressing matter in that  often these risks aren’t as well known as others. Without having all of the facts of the dangers of the substance, it’s not completely possible to make an informed decision regarding alcohol.  There are a variety of tactics that can be enacted to educate the population, and seeing how crucial these concerns are, it’s time to implement some of these changes.  

In a 2018 analysis, effectiveness of mass media campaigns targeting alcohol were assessed. Looking at 24 campaigns all placed throughout different areas in developed countries, testing for effectiveness was evaluated by how well consumers recalled information and if any steps or actions were taken that could be directly related to the issue of drinking. The campaigns mainly focused on distribution through materials and media in the form of TV and radio adverts. However, many also utilized billboards, social media ads, and ads along transportation modes and routes.

The results of the analysis showed that while individuals were not necessarily changing their drinking behaviors or attitudes after being exposed to the campaigns, they were recalling the information provided even after substantial amounts of time had passed since being exposed. The graph, summarizes the most notable results of the campaigns after each had aired. Awareness, understanding and recollection were present after in almost each campaign. While none of the studies focused on spreading awareness for the link between alcohol and breast cancer, or any other adverse effects for women, they are effectively showing that these media blitz  advertisements can still work towards making the population aware of certain health issues they may be facing. 

Beyond traditional media efforts that public health organizations can take, there are newer modes that I believe could help spread the issue surrounding this link. Information hidden under the disguise of an internet quiz, listicle, or even a meme. For example, everyone is familiar with Buzzfeed completely pointless and sometimes sponsored quizzes. Mattel sponsored one entitled “Which Barbie doll are you” and the quiz went on to be viewed over 1 million times with almost 200,000 shares on Facebook.

While the idea may be unheard of, if a health related organization put out content in a way that seems maybe less threatening and more Gen z friendly, for example a sponsored quiz or listicle “Are your drinking habits healthy” with a short series of questions that could indicate a need for further research on the users part. It’s private, not intimidating, and exposure could reach a lot of younger women who are coming of drinking age. These sponsored ‘articles’ could be just a small stepping stone towards legitimate information and could provide additional websites or sources to visit for additional information.  It might seem odd and unprofessional in a way but if the goal is to increase awareness around the link between alcohol and breast cancer, and it is, then this is simply another method to increase public awareness for all women in all age ranges. 

Public health organizations and officials who are trying to educate on the dangers of drinking for women should implement some traditional informational techniques, such as media targeted campaigns, while attempting strategies to connect with younger populations. These campaigns need to be targeted, they need to address the issues plainly, and these to be present widespread in spaces where women will access. Through this education, women well at least have the chance to be better informed and hopefully make better decisions regarding long term health. While there is a separate issue of actually mobilizing these populations to change their behaviors around some of the risk factors of alcohol, first and foremost should be the issue of spreading accurate information. 

 

Alcohol consumption causes breast cancer: Did you know?

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It is clear that many women still don’t know about the harm alcohol can cause, including breast cancer. How can we better disseminate these messages?

Unfortunately, there are several women and girls who are not aware of the consequences of alcohol. Through my current research using the YRBS 2017 survey, it appears that high school girls are starting to drink earlier than before, and Black and Hispanic girls are engaging in binge drinking more than their male counterparts.

During my time in middle and high school, health teachers only discussed that alcohol and sex is wrong and should be avoided completely, but they did not tell us what the side effects are of engaging in drinking. They basically only said that we would not be able to drive after drinking, and that our vision would be blurry. Nothing about cancer.

Many people, including myself get to college not knowing that alcohol causes more problems than just liver cancer. One drink and we’ll be fine right? But one drink can contain 4 shots of vodka. Don’t you think that affects your body, especially if you continue with that mindset? The answer is YES. And to my women friends, did you know that the more alcohol we drink, the more we increase our chances of developing breast cancer? Yeah, neither did I until a few weeks ago….and I’m 23. 

Here is an excerpt from breastcancer.org:

“Research consistently shows that drinking alcoholic beverages — beer, wine, and liquor — increases a woman’s risk of hormone-receptor-positive breast cancer. Alcohol can increase levels of estrogen and other hormones associated with hormone-receptor-positive breast cancer. Alcohol also may increase breast cancer risk by damaging DNA in cells.”

Did you know that before reading this blog? 

–Yeah, I didn’t think so. This goes to show that important information related to alcohol and cancer has not been given often to the general public. 

What we should do to disseminate this information better:

  1. Provide healthy drinking guidelines to high school and college students. 
    • Here’s an infographic on what excessive alcohol use is. I strongly believe pictures describe 1,000 words.
  2. Once in college, Resident Assistants (RAs) should be responsible for giving a safe drinking lecture and holding an exercise to demonstrate how much is okay to drink and what kind of diseases can come from drinking. Speaking from experience, college students learn more from people their own age– neither professors nor administrators. 
  3. I strongly believe in community programs. Macon, Georgia is a relatively large city and puts together something called “Open Streets” every year. During this program, the streets are blocked off in the city, and open for people to partake in exercise classes and ride their bikes all across town! Atlanta has a similar thing called Atlanta Streets Alive. These programs are super successful. So, maybe at these programs, alcohol lectures can be given! 
  4. Fliers!!! Fliers are so powerful! Pictures. Words. Colors. It’s eye-catching. One of the best ways I got information about events and programs in college was through fliers. Location is key! They need to be placed where young people go, such as the mall, the grocery store, the movies, etc. 
  5. Advertisements on social media. Recently, I have noticed advertisements about the JUUL on Snapchat. Every post I look at, there’s an advertisement about how the JUUL leads to certain health issues. I think social media is an easy and effective way to reach young people and the population that drinks the most. 

 

Works cited:

https://www.breastcancer.org/risk/factors/alcohol

https://pubs.niaaa.nih.gov/publications/aa83/aa83.htm

Choosing Sobriety

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One of the problems of “sober culture” is that it is generally associated with teenagers, those with strong religious beliefs, and people in recovery. It has not typically represented the average woman and man who decide not to drink alcohol for any of the other countless reasons: they don’t like the taste, they worry about the potential health consequences, they don’t want the empty calories, they want to spend their money on other things that bring them joy. Yet, if an individual declares that they are choosing to remain sober, it evokes questions from their audience: “are they in rehab?”, “did they become religious?”, or, if the individual is a woman, the unavoidable “is she pregnant?” that leads to careful glances at the woman’s midsection for evidence of a bump.

But, in fact approximately 46% of people in the Americas are choosing to abstain from alcohol, more than half of whom are former drinkers. 

Maybe the problem in the United States, among many other countries, is the fact that drinking alcohol is the norm. Consider all the places and events where drinking is supported. Going on a trip? Have a drink at the terminal while waiting for your flight to board, and then select from a variety of wine, beer, and spirits while you are in the air. At a baseball game? Nothing is better than a cold beer to go along with your peanuts and cracker jacks. Attending a wedding? At best, there’s an open bar. At worst, it’s a dry wedding (but most likely you will find at least one person with a flask stowed away).

These are just a few examples of the ubiquitous nature of alcohol. So it makes sense that people who are deciding to abstain from alcohol have a hard time feeling supported. How can we, as a society, make sobriety not just a choice but the default?

Maybe the answer lies in the amazing efforts of the anti-smoking campaigns of the earlier part of this century. The Truth Campaign, for example, was notorious for showing the public what was on the other side of those glossy ads of sophisticated, handsome smokers. The “truth” was that the heads of the tobacco companies (mostly older, white men) were making billions of dollars by carefully tapping into consumers’ psyches to convince them that their cigarettes, though highly addictive and deadly, would make them cooler, sexier, smarter, or whatever adjective the target population coveted. 

Alcohol companies are not much different. Their main goal is to get as many customers as possible to buy and consume their products, regardless of how deadly they are. Take, for example the CEO of Anheuser-Busch, Carlos Brito, who has this to say:

“At the heart of our business, we strive to understand what unites people. From sports, to music, to dinner parties, or nights out with friends and family, it’s our goal to make those occasions even better with our extensive product portfolio.”

Clearly, the narrative he is trying to sell to keep his $1.49 Billion dollar company afloat is that “alcohol brings people together”.

Unfortunately, this is not always the case. Alcohol is the third leading cause of preventable deaths in the United States. Approximately 88,000 men and women die each year from alcohol related causes. And alcohol is the source of a myriad of other morbidities, including non-fatal accidents, chronic diseases, birth defects and social harms. None of which are listed alongside photos of people drinking Michelob Ultra at the lake.

We need to rebel against these companies that lie in order to sell their products and that analyze and target the weaknesses of the most vulnerable and susceptible Americans. It’s not enough to just report on another alcohol-related death because, as callous as it may sound, we have become desensitized to it in the media. We need to call out the alcohol industry by name. “Today, another young person died due to Bacardi, or Jim Beam, or Smirnoff.” Once we start to associate alcohol not only with “good times”, but with the truth, we may no longer question why people chose to be sober. 

College Drinking Culture: Men and Women Differ

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“Drink! Drink! Drink! Drink!”, a familiar chant during a typical Friday night on campus. Students are hanging upside down chugging down a keg, coolers filled with jungle juice and alcohol games in every room you turn in. Has college drinking gone too far? Is it time we change the culture? Depending on whom you talk to this topic  can become reasonably controversial.

Young adults between the ages of 18–25 report high rates of alcohol consumption, including heavy episodic (binge) drinking, defined as consuming five or more drinks at a time (Kate, 2007). Compared to their peers not attending college, college students consume larger quantities of alcohol on drinking occasions (Kate, 2007), and as many as 43% of undergraduates report heavy episodic drinking at least once in the last two weeks (Kate., 2007). 90% of college schools provided counseling and treatment services for students, and nearly as many provided prevention services (e.g., alcohol education) for freshmen or other at-risk groups.

Three major findings emerged from a A meta-analytic review for Individual-level interventions to reduce college student drinking:

(a) individual-level alcohol interventions for college drinkers reduce alcohol use

(b) these interventions also reduce alcohol-related problems, and reductions in problems vary by sample and intervention characteristics

(c) the contrast between students who receive interventions and those in control conditions diminishes over time. 

Collegedrinkingprevention.gov provides comprehensive research-based information on issues related to alcohol abuse and binge drinking among college students. An alcohol prevention strategy they propose involves parents and it is called, “Fall Semester—A Time for Parents to Discuss the Risks of College Drinking”. As college students arrive on campus in the fall, it’s a time of new experiences, new friendships, and making memories that will shape their future; for many students, it is also a time of underage drinking.

Outlined is the prevention strategies parents are urged to help reduce unhealthy alcohol use by:

  • Talking with students about the dangers of harmful and underage college drinking—such as the penalties for underage drinking, and how alcohol use can lead to sexual and other violence, as well as academic failure and other adverse consequences.
  • Reaching out periodically and keeping the lines of communication open, while staying alert for possible alcohol-related problems.
  • Reminding students to feel free to reach out to them to share information about their daily activities, and to ask for help if needed.
  • Learning about the school’s alcohol prevention and emergency intervention efforts.
  • Making sure students know the signs of alcohol overdose or an alcohol-related problem, and how to help.

Now with all this said, would you think there needs to be different prevention strategies for women and men?

The short answer is yes. Gender differences in alcohol use and associated problems have been the focus of research and news stories to develop prevention strategies. Below are a few links of alcohol gender based differences: 

Why alcohol affects women more than men

Think Before you drink: Alcohol Affects Men and Women & Differently

Women appear to be more vulnerable than men to many adverse consequences of alcohol use. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) documents that women achieve higher concentrations of alcohol in the blood and become more impaired than men after drinking equivalent amounts of alcohol. Research from the NIAAA also suggests that women are more susceptible than men to alcohol-related organ damage and to trauma resulting from traffic crashes and interpersonal violence. 

In order to be an effective alcohol prevention strategy there must be a focus on the problems affecting that subgroup of the population, being men and women in this case. The World Health Organization (WHO) developed a framework called the strategic communications framework. The purpose of this Framework is to describe a strategic approach for effectively communicating information, advice and guidance across a broad range of health issues. In order to communicate effectively across the audiences (men/women), the prevention strategy has to be tailored to them. Everyone knows that men and women think different, act different and are different, after all men are from Mars and women are from Venus. 

Source:

Fact Sheet For New College Students And Parents. (n.d.). Retrieved from https://www.collegedrinkingprevention.gov/NIAAACollegeMaterials/FactSheets/colle

H. Wechsler, M. Seibring, I.C. Liu, M.Ahl Colleges respond to student binge drinking: Reducing student demand or limiting access
Journal of American College Health, 52 (2004), pp. 159-168

Kate B. Carey, Lori A.J. Scott-Sheldon, Michael P. Carey, Kelly S. DeMartini, Individual-level interventions to reduce college student drinking: A meta-analytic review, Addictive Behaviors,
https://doi.org/10.1016/j.addbeh.2007.05.004.

National Institute on Alcohol Abuse and Alcoholism,  No. 46. Are Women More Vulnerable to Alcohol’s Effects? https://pubs.niaaa.nih.gov/publications/aa46.htm

World Health Organization. WHO strategic communications framework. https://www.who.int/mediacentre/communication-framework.pdf

 

 

Sober Curious – The New Norm for Drinking Culture?

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What is Sober Curious?

Sober curious is a movement characterized by eliminating alcohol from the lifestyle for health and wellness reasons. It asks people to “imagine what it’s like to be hangover free,” and is meant as a way to encourage people to take a break from drinking. For some, this means participating in “Dry January” or “Sober September” to see if it is something that they can do. And if they do make it through, and notice the benefits, they may be more likely to make this change over the long-term.                                                     

The sober curious initiative is gaining popularity among Millennials, those aged 22 to 38. They are beginning to realize that going out and always feeling the need to drink is not necessarily fun or feasible. Many in the Millennial generation are trying out this movement in order to not feel the social pressure to drink, and they also want to drink less. Sober curiosity does not necessarily mean that one must abstain from drinking alcohol completely; it just means altering drinking habits to become less frequent. Instead of drinking being a weekly occurrence, it becomes something that happens only once a week or on special occasions, such as birthdays, holidays, or certain celebrations. For some, however, sober curious might mean completely abstaining from alcohol.

Alcohol as a cultural norm 

Alcohol is viewed in our society as something that must be present for a number of reasons. Need to have fun, relax, forget about what’s troubling you? The answer is always most frequently to grab a beer, take a shot, down a bottle of wine. Alcohol is ever present and is the main staple at parties, celebrations, and sporting events.

However, for those who do not drink or are wanting to limit their drinking, being in these social situations and surrounded by alcohol and people drinking can be daunting. For the sober person, it can be uncomfortable when they are bombarded with questions about their drinking habits. As someone who very seldom drinks, and spends most parties standing around with a cup of water, I can attest to the discomfort that these questions bring. As a younger adult, it was harder to socialize at parties when I didn’t drink, so I usually did not go. However, as I became older and felt more comfortable telling people “drinking just isn’t my thing,” being okay with being sober became easier. 

The social pressure to drink is real and can get people into trouble. People drink in order to socialize and fit in, and this is harmful because it can escalate into even worse habits. It can push someone to an alcohol use disorder and can be detrimental to their health.

Being sober is stigmatized by people who do drink, and therefore sober people are seeking out ways to socialize and have fun with other people who also want to be sober. For those who still like to be in a bar setting, a number of dry bars have been gaining popularity among the sober curious crowd. Bars such as The Sans Bar, cater to this crowd by serving non-alcoholic beverages. The drinks served at these bars are not just your ordinary O’Douls, they are very sophisticated drinks known as “mocktails.” They have all the complexities of a normal cocktail but without the alcohol. This is appealing to the sober curious individual because it is a safe space where they can go to socialize, be around other non-drinkers, and not feel pressure to partake in the drinking culture or be questioned about their choice to not drink.

 Mocktails – alcohol-free cocktails – that are served at dry bars.

Beer companies that market low-alcohol or alcohol-free options are also catering to the sober curious movement. Heineken has just come out with a new zero-alcohol beverage, Heineken 0.0. Because not drinking is stigmatized, it is important for some people who do not drink or are trying to cut back on drinking, to look as if they have a drink while in a bar. The Heineken 0.0 beer tastes very similar to the alcoholic beer and has kept the same packaging – the iconic green bottle – which allows non-drinkers to drink the beer while out at a bar and other people would have no idea that it was a non-alcoholic drink.

Heineken 0.0 – Zero alcohol beer.

What are some of the risks of chronic or excessive drinking?

According to the CDC, excessive alcohol consumption led to about 88,000 deaths and 2.5 million years of potential life lost in the United States from 2006 – 2010. Drinking alcohol can contribute to both short-term health risks – car crashes, suicide, risky sexual behaviors, alcohol poisoning – and long-term health risks – chronic diseases, depression, dementia, alcohol dependence.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) website note the damaging effects that alcohol – both chronic and occasional alcohol use – can have on the body. Alcohol can majorly impact the brain, heart, liver, pancreas, and the immune system. In addition, it is a carcinogen and can cause several types of cancers, such as liver, breast and esophageal cancer to name a few.

Effects of alcohol on the body – from Daily Mail

Agencies such as the NIAAA and CDC, which are tasked with conducting research and the dissemination of health information to the public sphere, can only do so much to change people’s views on the risks of alcohol consumption.

Is being sober curious worth it? What are the benefits of participating in the movement? 

A large number of people who are sober curious or participated in Sober September, Dry January or the like, have reported positive experiences from their time off from drinking, or just drinking more mindfully. They have reported feeling healthier, feeling more creative and productive, weight loss, and have had less trouble sleeping.  

In an article from NPR, Aaron White, a scientific advisor at the National Institute on Alcohol Abuse and Alcoholism said of sober curious people: “[…] at the end of that month — just after one month — people, by and large, lost some weight. They had improvements in insulin sensitivity, their blood pressure numbers improved and their livers looked a little healthier.” White goes on to say that while there were only modest improvements in the health of an individual who abstained from alcohol for that month, the results were still worth noting. Over the long term, the benefits of sober curiosity might outweigh the costs of drinking.

Will Sober Curious become culturally accepted?

I believe that the Sober curious initiative can grow and become culturally accepted. At this moment in time, being completely sober or a light drinker is still seen by many people who drink regularly as strange. Especially when so many social activities and work functions rely on the presence of alcohol to make the atmosphere feel “normal.” I believe that as a society, we need to work on de-stigmatizing the sober culture.

The sober curious movement will also allow those who do not want to drink to essentially “opt out” of the social pressures of drinking. So many people who do not want to drink do so in order to fit in. What the sober curious initiative offers is unique in that it is catering to a marginal group of people who feel as if they need to hide the fact that they do not drink alcohol. The dry bars create a social network where an individual can feel comfortable about not drinking while being surrounded by like-minded individuals who also abstain from alcohol for various reasons. If more people are aware that this option exists, it may become just as culturally acceptable as drinking has become, and the social pressures associated with drinking will disappear.

With the growing wellness and self-care craze that has currently taken off on social media, I think that the Sober Curious initiative has a place right alongside quinoa superfood salads and goat yoga. If enough people get on board, especially the wellness influencers on social media, the stigma surrounding being sober will be a thing of the past! 

Somebody get me a (zero-proof) drink!

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If I’m being completely honest, I hate how central alcohol is to the social lives and activities for adults. Even though I don’t particularly enjoy alcohol, and I feel no motivation or pressure to drink if someone is trying to persuade me to do it, I still find myself in situations where I’m definitely at a disadvantage if I don’t want to drink alcohol. I’m mostly past the days where my friend group legitimately wants to stay out until 4am, in loud clubs, and be blackout drunk, where I would have to choose between FOMO or being exhausted and miserable, but I’m still in situations very regularly where everyone wants to drink.

We’ve moved into lower key fun activities– like hanging at chill (quiet) bars with food and games, or going out for fancy craft cocktails and overpriced appetizers. This is definitely less unpleasant than clubbing and doing shots, but I have always wished there were equally exciting, ‘craft’ non-alcoholic drinks at these places. My only options are regular soda, and water -__-. Well look no further, Brianna– sober curiosity has started a movement of exactly that.

  • As a brief note, I have an issue with the above linked article, and the linguistic concept of being ‘sober curious’. It appropriates and trivializes meaningful language and concepts from the LGBTQ+ community. Check out this article on appropriation of queer culture. Commandeering our vocabulary (like “‘coming out’ as sober”) for the trendiness of it feels thoughtless and inconsiderate of the daily struggles that queer people face for their identities. 

HOWEVER–I am very happy about some of the results of this movement! More and more establishments are offering exciting and unique drinks, just without the alcohol. This gives abstainers the option all the fun of going out for fancy cocktails without the liver damage! The social exclusion of ‘not drinking’ could be substantially diminished if you are drinking something just as (or more) exciting as your friends. The opportunities for creativity going into these spirit-free drinks holds significant potential for making them cool. If the popularity of craft, non-alcoholic, drinks spreads, more establishments will add them to their menus, and customer demand for uniqueness will increase. This could lead alcohol companies to join that market and put more time and effort into manufacturing the types of non-alcoholic ingredients and drinks people are demanding.

I can say without hesitation that if my local liquor store started selling stuff like fresh mint leaves, rosewater, lavender infused soymilk, and whatever other wild things they come up with… I would buy it over alcohol. Alcohol tastes bad and it’s expensive :(. I often look at a drink menu and wish I could order the drink without the alcohol– I mean look at this stuff! Somebody please make me a drink out of chocolate mousse and raspberry puree! 

This sober curious initiative could make sobriety much gentler on people’s social lives. Actually be excited to get drinks at the bar? I’m in, and already making plans to try all these drinks.

 

Read This Before You Order Your Next Drink

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Six weeks ago, I had one of the worst days of my life. I had just gotten back from a fantastic anniversary trip with my husband the day before. My parents had been strangely insistent that I call them the day after we got back. It’s not unusual for me to call them after a trip to let them know we made it back safe and share some of the high points with them. But this time they seemed a lot more persistent than normal. When I did call on that pretty spring Sunday, my mom cut me off in the middle of me enthusiastically describing a park we had visited on our trip. “We have to tell you something,” She said, “I have breast cancer”, and just like that, every ounce of oxygen left my body. It took me weeks to start to begin to wrap my head around it. In those weeks, I did the one thing everyone tells you not to do. I looked my mom’s cancer up on the internet. I dug through articles, papers, statistics, and survival rates. Looking for an answer to the question we’ll likely never be able to answer, why my mom?

Imagine my shock one day in class to learn that after all my weeks of research, I came across something new. Alcohol has been linked to breast cancer. In all of my hours of research, I had read nothing suggesting that alcohol could be a risk factor for breast cancer. Now, my mother has never been much of a drinker not even in her younger, more explorative years, so it’s likely not the cause for my mom’s cancer. But I’ve always enjoyed a nice beer or 2 and, like millions of college-aged women, had enjoyed more than a few too many at one time or another. Maybe it’s because now that I have a history of breast cancer from not only my mother, but my paternal grandmother who had been diagnosed at just 37 years old and I have been forced to acknowledge my very real risk of developing breast cancer one day myself. But this hit me particularly hard.

An entire month every year is dedicated to breast cancer awareness. Famous athletes wear pink, millions of people march and run thousands of miles every year to raise money for breast cancer research. Breast cancer is the second most common type of cancer among women and the second leading cause of cancer death among women. It’s estimated that over 200,000 women in the U.S. will be diagnosed with breast cancer just this year. Yet despite all the information about breast cancer awareness and prevention screening, in a recent survey in the UK only 20% of the 205 women undergoing cancer treatment who participated knew that alcohol was a risk factor for breast cancer. Things aren’t looking much better in another survey conducted in the US which found 70% of Americans also did not know that drinking alcohol was a risk factor for breast cancer.

This begs me to ask this question, if all the pink ribbons, charity walks, billboards, bus signs, and tv commercials aren’t teaching us about the risk alcohol poses to women, what else can we do? A valuable, and perhaps obvious, the first step could be to increase and improve education. A woman’s physician is her best weapon in this never-ending battle against cancer. They could provide women with more comprehensive education about the risks of breast cancer at their yearly checkups. Breast cancer screenings and visits for breast cancer symptoms also provide some of the most teachable moments. Women are likely more open to this information when the threat seems so near. It wouldn’t take much, just 5 minutes at the beginning of their visit highlighting the biggest risk-factor and prevention methods.

Starting education even earlier seems like the best way to prevent more cases of breast cancer. We all remember those horrifically uncomfortable sex education classes, even if we wished we didn’t. What if we started educating girls on the risk of drinking alcohol for breast cancer when they are the most likely to start experimenting with alcohol? Maybe they wouldn’t listen. Maybe they’d just roll their eyes and turn away. But maybe it would plant a seed. Maybe if they’re presented with the evidence often enough, they’ll think twice before having their next drink. Maybe a few with family histories of breast cancer like me would decide it wasn’t worth it. I’m not 14 or 21 anymore, and I can’t speak for everyone, but even a craft beer enthusiast like me is opting for water or tea a lot more than I used to,  before I knew.

Caution for women of childbearing age

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Over the last 3 weeks, I have been amazed at how much I have learned about alcohol from a biological, social, and environmental standpoint. As a current dietetic intern studying nutrition, I have been very fascinated by the effects of alcohol in the body from a biological standpoint. In class, we discussed how alcohol can have detrimental effects on reproductive and maternal health, rates of infectious diseases, the incidence of non-communicable diseases, and mental health. Moreover, I was saddened to learn about the negative effects alcohol can have on infants and how drinking while pregnant can cause fetal alcohol spectrum disorder (FASD) in children. FASD is a devastating condition that can lead to poor cognition and delayed development in children. However, what is, even more, devastating is that this disorder could be prevented if the mother would have abstained from alcohol during pregnancy. 

  1. Image of children with FASD

 

Sadly, there is new research coming out every day that shows how destructive alcohol consumption can be in the body even if it is “controlled” especially in women. One example of this is a study published in June 2019 that showed how alcohol can stunt the growth of the early embryo and the stem cells that become the placenta. Researchers wrote, “After the rats were exposed to alcohol, the placenta was poorly formed and was not able to give the fetus all the nutrients it needed to grow. This effect was more severe in female fetuses than in male fetuses.” Furthermore, researchers were able to show that alcohol consumption prior to a few days before conception can have detrimental effects on the development of the fetus in rats.

Researchers were not able to fully understand the mechanism behind why female fetuses were more vulnerable than male fetuses calling for more research to be done. While it may take years to fully understand the mechanism behind this study, I believe it further solidifies the growing opinion around how toxic alcohol can be especially in women of childbearing age.

This led me to think about the following questions:

What if a mother drinks before she knows she is pregnant? 

If more childbearing age women knew that alcohol could potentially harm their fetus especially female fetuses would it decrease consumption of alcohol?

Should there be more policy around the alcohol industry targeting women of childbearing age since there is a greater health risk involved?

This article sparked many questions that I think our society should think about on a deeper level. 

One day while on Twitter, I came across a classmates tweet on the CDC recommendations for women of childbearing age. 

According to the CDC, women should avoid alcohol if they are sexually active and not using birth control. What was interesting was how much backlash this recommendation receive from the public. Many major news outlets like Elle magazine expressed outrage over the new recommendations. Did the CDC go too far in telling women that they should not drink if they are sexually active and not using birth control?

In my opinion, the CDC is right. Women of childbearing age are more susceptible to some of the most devastating effects of alcohol. I think this policy helps to protect this population even though it may sound like your grandma preaching to you about your habits.  Furthermore, I think Dr. Anne Schuchat, CDC Principal Deputy Director, said it best, “Alcohol can permanently harm a developing baby before a woman knows she is pregnant. About half of all pregnancies in the United States are unplanned, and even if planned, most women won’t know they are pregnant for the first month or so, when they might still be drinking. The risk is real. Why take the chance?”

References

 

  1. https://scienceoveracuppa.com/2014/07/06/sometimes-you-can-tell-a-book-by-its-cover-shared-developments-of-the-brain-and-face/
  2. https://dev.biologists.org/content/146/11/dev172205
  3. https://www.huffpost.com/entry/cdc-alcohol-young-women-pregnancy-warning_n_56b22f03e4b04f9b57d805bc?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAABu_Fe4255l68fYf5D0k9N_bUtYMK2-kn12RKDNpi4iAuKq5B8qGXzHC1WiWo3YiDfyJqLYK-ZOE7sohkWeu_Y4IYm0zno6gzRNBuuccBi1bccbIFefokFOOatqwrogHeBAwPYWATqYS-Cz3ntfVLAFEbJgoBkzAexUosPL9KIb_

 

 

Sober Curious- Not Just For Health Tourists

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People start and (sometimes) stop drinking at all different phases of life for all different reasons. The expectation, however, is that everyone’s drinking. The internet, the bartender and the billboards all tell us that’s what you do. Period.

In the era of health experiments like detoxes, yoga retreats and juicing, we take a touristic approach to health experiences. Sober curious is something I perceive to be similar in this way, which means it can be marketed in the same way. The buzz word was coined by Ruby Warrington, author of “Sober Curious: The Blissful Sleep, Greater Focus, Limitless Presence, and Deep Connection Awaiting Us All on the Other Side of Alcohol.”

Additionally, bars for the sober curious are popping up everywhere, such as Sans Bar in Austin, TX and Ambrosia Elixirs in Williamsburg, NY. 

According to a British study from 2016, those who participated in Dry January experienced varying health benefits, including “increased drink refusal self-efficacy” and, of course, no hangovers. The significance of the short breaks in drinking influencing health in this way speaks to the idea that people can experiment with sobriety the way they can experiment with the Keto/dairy free/gluten-free/vegan/vegetarian/Paleo/Whole30 diet. Grocery and supplement stores have entire departments dedicated to diet categories, and alcohol stores and departments can easily be merchandised in this way for zero percent products. The increase in non-alcoholic beers and mocktails makes it easy to see how this would be possible.

By marketing sobriety as a healthy experience, we open peoples’ perceptions of sobriety, and the conversation around sobriety becomes more open as a result. In my experience with intentional sobriety, people almost always have needed an explanation for the absence of a drink in my hand. I’ve even been seriously confronted about pregnancy before. I have yet to become pregnant, but that seems to check out more easily in a crowd than the long-winded, baggage-ridden idea that I’m not a great drinker and have damaged a lot of relationships with my drinking, not to mention a murky family history with addiction. No, no, no, you get back to your game of pool, though, I promise it’s not a big deal!

 

Click the image to see the SoberGirlSociety Instagram profile!

I’ve never participated personally in a sobriety challenge like Dry January, only the challenge of getting truly sober. It was genuinely difficult surrounded by friends who never took a break from daily drinking after college ended and were relying heavily on it to manage their vulnerability and mental health issues. I have a personal notion that my not drinking made people uncomfortable, knowing that they, too, probably should have taken a step back from the bar. This illuminates the ambivalence we’ve discussed in class and the idea that there is such a thing as responsible drinking for some of us. People say that the binge drinking criteria seems too low- “five drinks in a night?! That’s a Tuesday at home!” I think the ugly reality may just be that many young adults don’t have the best drinking habits, but no one wants to admit that.

Sober curiosity is an easy movement to promote and absolutely has a place in the era of wellness exploration. Dry bars and social circles based on sobriety (that don’t meet each other in recovery meetings, per se) are carving out their places in this world of heavy drinking.