Few things are more American than drinking. Supermarkets now not only sell wine, but offer wine bars welcoming customers to shop and sip. Barbers now serve brews, nail salons market themselves as ‘tips and sips’. Chipotle sells margaritas; cinemas serve handcrafted cocktails; our zoos even have beer and wine for purchase.
And while our salons and entertainment venues shuttered during the COVID-19 pandemic, liquor stores were essential business and remained open. In fact, alcohol consumption rose among adults over age 30 by 14 percent during the pandemic alone, with a 41 percent increase in women heavily drinking, according to a September 2020 RAND Corporation study.
America has a drinking problem. Do you?
The 2020-2025 Dietary Guidelines for Americans suggests adults using alcohol to not drink daily, and when drinking, to do so in moderation by limiting intake to 2 or fewer drinks a day for men or 1 or fewer drinks a day for women. A drink is defined as a 12-ounce (oz) beer or a 5-oz glass of wine. However, emerging research suggests that even drinking within the recommended limits may increase the overall risk of adverse health effects. So how much is too much?
“If your relationship with alcohol impacts your relationship with people and results in problems functioning in your daily life, then there is a problem,” says Dr. Richard Capiola, a Psychiatrist practicing in Naples.
Unhealthy drinking can be mild, moderate or severe and can lead to Alcohol Use Disorder, which is diagnosed if you have two or more of the below symptoms:
• Difficulty limiting the amount of alcohol you drink
• Unsuccessful attempts to cut down on drinking
• Failing to fulfill tasks at work, school, or home because of repeated alcohol use
• Spending a lot of time thinking about drinking, getting drunk, or recovering from drinking
• Repeated use of alcohol in situations where it’s not safe, such as driving
• Tolerance to alcohol, leading to drinking more and/or drinks with higher alcohol content
If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms you have, the more urgent the need for change.
While drinking is acceptable in American culture, diagnosis and treatment for alcohol use can seem stigmatized. Well-known 12-step programs or inpatient rehabilitation still exist, but many new therapies have emerged, thanks to significant advances in the field. Simply knowing the options can be an important first step.
Your primary care physician can be an important first step in treatment—he or she can be a good source for referrals and medications.
Behavioral treatments are aimed at changing drinking behavior through counseling and tend to incorporate empathy, motivational support, and a focus on changing drinking behavior. Behavioral treatment is provided by psychiatrists, psychologists, and other licensed mental health professionals.
Mutual-support groups, like Alcoholics Anonymous (AA) and other 12-step programs, provide peer support for people quitting or cutting back on drinking. Combined with treatment led by health professionals, these groups can offer a valuable added layer of support.
Three medications are currently approved in the United States to help people stop or reduce drinking and prevent relapse. These FDA-approved medications are not addictive and can be used alone or as part of other treatments. Consult with your health professional to understand if medications are a good fit for you and your treatment plan.
Additional research-based information on alcohol use and treatment can be found at https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/. Ultimately, there is no one-size-fits-all solution to treatment. Your health care professional can advise and help you to find the right options.
Dr. Richard J. Capiola
With triple board certification in general psychiatry, addiction psychiatry and forensic psychiatry, Dr. Richard J. Capiola has been in practice for 27 years. During his training at Tulane Medical School and UCLA, Dr. Capiola developed a keen interest in the treatment of depression and anxiety overlapping with drug and alcohol abuse. This focus led to his role as chief medical officer for Oglethorpe Inc., which specializes in the treatment of mental health and addiction. He has been instrumental in the clinical development and oversight of 12 specialty treatment centers in five states.
Dr. Capiola’s specialties include adult and adolescent psychiatry, treatment of anxiety, depression, and substance use problems, and forensic psychiatry, where he evaluates patients with legal issues related to mental health.
Dr. Capiola is the chief of psychiatry for Physicians Regional Medical Center and was the medical director for the Wilough at Naples for many years. He’s served 10 years with The Joint Commission, which evaluates hospitals nationwide for quality of care and safety.
Dr. Capiola was the featured neuropsychiatrist in the recent book “Don’t Give Up On Me” with Darryl Strawberry. His confidential private practice focuses on using each individual’s inherent strengths to achieve the goal of living a healthy, well-balanced life.
Dr. Richard J. Capiola
239.649.7494
704 Goodlette Frank Road North, Suite 222
Naples, Florida 34102