Latest / Hurdle with Emily Abbate / 273. Sober Curious: What It Means & Alcohol's Impact On The Body With Dr. Sarah Wakeman

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273. Sober Curious: What It Means & Alcohol's Impact On The Body With Dr. Sarah Wakeman · Hurdle with Emily Abbate

0:00
Speaker 1: The positive thing about this shift in the conversation towards
0:02
Speaker 1: sober curious or beginning to think about your relationship with
0:06
Speaker 1: alcohol earlier, is that it's so much easier to make
0:08
Speaker 1: changes before you get to a place where you have
0:10
Speaker 1: lost control, where you are dealing with major consequences in
0:13
Speaker 1: your life. And so I love it that people are
0:15
Speaker 1: starting to be more mindful and explore their relationship with alcohol.
0:33
Speaker 2: What's going on? Hurdler's Emily A Vadi Here.
0:35
Speaker 3: You are listening to episode two hundred and seventy three
0:38
Speaker 3: of Hurdle, a wellness focused podcast where I connect with
0:41
Speaker 3: everyone from your favorite athletes to top experts and industry
0:44
Speaker 3: CEOs about their highest highs, toughest moments, and everything in between.
0:49
Speaker 3: We all go through hurdles in life, and my goal
0:52
Speaker 3: through these discussions is to empower you to better navigate
0:55
Speaker 3: yours and move with intention so that you can stride
0:58
Speaker 3: towards your own big potential and of course have some
1:02
Speaker 3: fun along the way. Today on the show, I am
1:06
Speaker 3: chatting all about sober curiosity with doctor Sarah Wakeman. She's
1:11
Speaker 3: the senior medical director for the Mass General Hospital Substance
1:16
Speaker 3: Use Disorder Initiative She's also the program director of the
1:19
Speaker 3: Mass General Addiction Medicine Fellowship and an assistant Professor of
1:23
Speaker 3: Medicine at Harvard Medical School.
1:26
Speaker 2: AKA. This woman has a lot of knowledge to give
1:30
Speaker 2: us on all things sober curiosity.
1:34
Speaker 3: We kick off our discussion today by defining what it
1:37
Speaker 3: means to be sober curious, and we also get into
1:40
Speaker 3: the basics surrounding alcohol use disorder, which, believe it or not,
1:45
Speaker 3: is extremely wide spread. Doctor Wakeman and I have a
1:49
Speaker 3: really interesting conversation about what it means to be sober curious,
1:53
Speaker 3: what incorporating this lifestyle into your every day might look like.
1:58
Speaker 3: How to talk about your to forego alcohol if this
2:02
Speaker 3: is something that is important to you, and that is
2:05
Speaker 3: really purposeful, knowing your why if you are someone that
2:08
Speaker 3: wants to reduce the amount of alcohol you're drinking, being
2:11
Speaker 3: specific about.
2:12
Speaker 2: Your why behind it.
2:14
Speaker 3: Just like any major lifestyle change, when you have a
2:17
Speaker 3: firm why, you can articulate why this specific act is
2:20
Speaker 3: important to you, you are more likely to stick with it.
2:23
Speaker 2: So we chat about that, and I also shed some light.
2:27
Speaker 3: On what it was like for me to cut down
2:29
Speaker 3: on alcohol over the past year, specifically last January, I
2:33
Speaker 3: did a little experiment of sorts that really taught me
2:38
Speaker 3: a lot about myself about the circumstances in which I
2:41
Speaker 3: was reaching for alcohol. Really helped shape my perspective on
2:45
Speaker 3: my personal relationship with drinking. As always, love interacting with
2:51
Speaker 3: you about these episodes. So if you love what you're
2:53
Speaker 3: listening to, share it on social, share it with a friends,
2:56
Speaker 3: share it with the family member, and tag Hurdle. Find
3:00
Speaker 3: the podcast over on social at Hurdle podcast.
3:03
Speaker 2: I am over at Emily a body and.
3:05
Speaker 3: If you have any more questions on sober curiosity or
3:09
Speaker 3: anything else, I am all ears. You can ask me
3:13
Speaker 3: a question by leaving me a voice message. The link
3:16
Speaker 3: to do that is in the show notes and be
3:17
Speaker 3: featured in an upcoming episode of the show. With that,
3:22
Speaker 3: let's get to it. Let's get to hurdling. Today, I
3:35
Speaker 3: am sitting down with doctor Sarah Wakeman. She's the senior
3:38
Speaker 3: medical director for Substance Use Disorder at Mass General Brigham.
3:43
Speaker 1: How are you doing today, Sarah, I'm doing great, Thanks
3:45
Speaker 1: for having me.
3:46
Speaker 2: Thank you for coming in.
3:48
Speaker 3: This is a topic that I have wanted to chat
3:51
Speaker 3: with someone about for some time, and I was waiting
3:55
Speaker 3: for the right person to do it with, So I
3:57
Speaker 3: couldn't be happier that we're here to sit down today
4:00
Speaker 3: and chat a little bit about sober curiosity, alcohol consumption,
4:05
Speaker 3: all the things. Over the last few years, the concept
4:08
Speaker 3: of sober curiosity has been trending like wildfire.
4:13
Speaker 2: Is that what you're finding in your practice as well?
4:16
Speaker 1: You know, I'm seeing it more and more just as
4:18
Speaker 1: a member of society and being on social media and
4:20
Speaker 1: reading about it, and as an addiction specialist. You know,
4:23
Speaker 1: I think it's great that we're starting to talk more
4:25
Speaker 1: about the full spectrum of substance use and recognizing that
4:28
Speaker 1: it is a spectrum that people can fall anywhere along
4:31
Speaker 1: that from not using any type of substance, including alcohol,
4:34
Speaker 1: to using in a way that doesn't have any problems
4:37
Speaker 1: associated with it, to using in a way that maybe
4:39
Speaker 1: you just feel like you don't like the impact on
4:41
Speaker 1: your life or the way you feel after drinking, or
4:44
Speaker 1: it may be affecting a relationship or your work, but
4:46
Speaker 1: you don't actually meet criteria for what we think of
4:48
Speaker 1: as alcohol use disorder. And then all the way, of
4:51
Speaker 1: course to that far end of the spectrum. And that's
4:54
Speaker 1: so important because for a long time, I think we've
4:55
Speaker 1: only thought of substance use problems as being really a
4:59
Speaker 1: binary either you have a problem where you don't, and
5:01
Speaker 1: the reality is that's not true. It is a full continuum.
5:04
Speaker 1: And so expanding that conversation in the general public I
5:07
Speaker 1: think is a really really important change.
5:09
Speaker 3: Yeah, and that's a really interesting point to shed some
5:13
Speaker 3: light on here, is that there is such a spectrum
5:16
Speaker 3: on what different levels of substance abuse might look like. Now,
5:21
Speaker 3: first and foremost, let's talk about alcohol's impact on the body.
5:26
Speaker 2: Where do we even begin.
5:27
Speaker 1: I know there's so much, and I think, you know,
5:30
Speaker 1: my hope is to not demonize anything, and so you
5:32
Speaker 1: won't hear that from me. I think, sort of stepping back,
5:35
Speaker 1: it's been really interesting to watch this swing from the
5:38
Speaker 1: kind of conversation in popular media used to be around
5:42
Speaker 1: sort of the protective effects of low risk drinking. You
5:45
Speaker 1: know that it was good for your heart or that
5:47
Speaker 1: it had health related benefits, And now we've seen this
5:50
Speaker 1: very different swing than any amount of alcohol is not
5:52
Speaker 1: good for your health. And I think, stepping back, it's
5:54
Speaker 1: important to understand the evidence and also to not think
5:58
Speaker 1: of using alcohol as a health promoting behavior. You know,
6:01
Speaker 1: if you are looking to improve your health. There's no
6:03
Speaker 1: amount of alcohol that is going to be sort of
6:06
Speaker 1: beneficial in terms of your health outcomes. Now that doesn't
6:09
Speaker 1: mean that it's a black and white or that using
6:12
Speaker 1: lower risk amounts of alcohol are hugely detrimental to your health,
6:16
Speaker 1: but just we shouldn't be thinking about starting drinking as
6:18
Speaker 1: a healthy thing, just like you know, there are other
6:20
Speaker 1: habits like exercise or brushing your teeth where it's pretty
6:22
Speaker 1: much more is better or up to a point, and
6:24
Speaker 1: that's not going to be the case of alcohol. You know.
6:27
Speaker 1: More recent evidence has really expanded our understanding of the
6:31
Speaker 1: health harms of alcohol use, in particular cancer risk for women.
6:35
Speaker 1: That's really relevant because any amount of alcol use is
6:37
Speaker 1: associated with an increased risk of breast cancer. But there's
6:41
Speaker 1: also all different types of cancer that are associated without
6:44
Speaker 1: call use, including cancers of your stomach and your intestinal track,
6:48
Speaker 1: liver cancer, breast cancer as I mentioned, and then other
6:51
Speaker 1: health problems from everything sort of relatively minor like acid
6:56
Speaker 1: reflux or heartburn to much more severe problems. As an
7:00
Speaker 1: addiction specialist, of course, we worry about alcohol use disorder,
7:03
Speaker 1: which is also a chronic health condition that can cause
7:06
Speaker 1: really huge impacts on people's lives in their physical and
7:08
Speaker 1: mental health.
7:09
Speaker 3: So when it comes to alcohol use disorder, talk to
7:12
Speaker 3: me about what characterizes that.
7:15
Speaker 1: Yeah, so alcohol use disorders defined as compulsively using alcohol
7:19
Speaker 1: despite bad things happening to you in your life. So
7:21
Speaker 1: we make the diagnosis based on eleven criteria, but they
7:24
Speaker 1: really boil down to a couple main buckets. Wanting to
7:28
Speaker 1: control your use and not being able to. So that
7:30
Speaker 1: might look like you've tried to cut back, or you've
7:32
Speaker 1: tried to stop and you found that you actually couldn't
7:34
Speaker 1: once you sent your mind to it. It looks like
7:37
Speaker 1: using to spite consequences. So that can mean using despite
7:40
Speaker 1: having problems in your relationships and your ability to do
7:43
Speaker 1: the things that are important to you in your life
7:44
Speaker 1: like parent or work, or using despite bad consequences in
7:48
Speaker 1: your health. So if a doctor has said to you,
7:50
Speaker 1: you know, you have inflammation of your liver because of
7:53
Speaker 1: alcohol use, and I recommend that you stop using alcohol,
7:55
Speaker 1: and you find that you're not able to stop, and
7:57
Speaker 1: you continue using despite that, and then the other main
8:00
Speaker 1: bucket is craving, which is sort of the strong psychological
8:03
Speaker 1: urge to want to use a substance. So that's the
8:05
Speaker 1: idea that you just like can't get it out of
8:07
Speaker 1: your mind. You're thinking about getting to that drink that
8:09
Speaker 1: you really find yourself mentally consumed by the idea of
8:12
Speaker 1: using alcohol. And so those are kind of the main buckets.
8:15
Speaker 1: And then depending on how many criteria you meet, you
8:17
Speaker 1: can either have a mild alcohol use disorder, a moderate
8:20
Speaker 1: alcohol use disorder, a severe alcohol use disorder.
8:23
Speaker 2: Yeah.
8:23
Speaker 3: And you know, listening to you explain all of these
8:25
Speaker 3: different buckets and then again hearing the word disorder, I
8:28
Speaker 3: think so often, so many individuals think, oh, it's just
8:33
Speaker 3: a drink, it's a drink every night, it's two drinks
8:35
Speaker 3: a night, it's something like this, And to hear that
8:38
Speaker 3: buzzword disorder with this can be really scary.
8:43
Speaker 1: Yeah, And I think that's totally true. And I think
8:46
Speaker 1: it's important to have these conversations and really talk honestly
8:50
Speaker 1: about the potential harms. I think the good news is
8:53
Speaker 1: that this is a very treatable health condition and wherever
8:56
Speaker 1: you fall on that spectrum, it is very possible to
8:59
Speaker 1: get how and to make changes to your alcohol use.
9:02
Speaker 1: And I think the positive thing about this shift in
9:04
Speaker 1: the conversation towards sober, curious or beginning to think about
9:08
Speaker 1: your relationship with alcohol earlier. Is that it's so much
9:11
Speaker 1: easier to make changes before you get to a place
9:13
Speaker 1: where you have lost control, where you are dealing with
9:15
Speaker 1: major consequences in your life. And so I love it
9:17
Speaker 1: that people are starting to be more mindful and explore
9:20
Speaker 1: their relationship with alcohol.
9:21
Speaker 2: Yeah, doctor Weakman.
9:23
Speaker 3: I noticed before when we were touching upon the concept
9:27
Speaker 3: of the swinging of the media rate and for so long,
9:30
Speaker 3: especially when I was an editor at traditional women's media outlets,
9:34
Speaker 3: we would cover studies that set things like one glass
9:37
Speaker 3: of red wine today is really good for you? And
9:40
Speaker 3: now yes, it has gone completely the other ways that
9:43
Speaker 3: alcohol is awful, Alcohol is awful, alcohol is a devil.
9:46
Speaker 3: Is there any truth to the former?
9:49
Speaker 2: Yeah?
9:50
Speaker 1: So there was long this sense of this idea that
9:52
Speaker 1: when people looked at big population studies, they found that
9:55
Speaker 1: people who drank at a low risk level, like a
9:57
Speaker 1: glass of wine a day, actually had lower of dying
10:00
Speaker 1: from heart disease, and people who didn't drink at all,
10:03
Speaker 1: or people who drank very heavily. And that's actually still true.
10:07
Speaker 1: The problem is that those studies, when you look at
10:09
Speaker 1: people who choose not to drink. It's actually a very
10:11
Speaker 1: mixed bucket. And some people who choose not to drink
10:14
Speaker 1: do so because they're really ill with other medical problems
10:16
Speaker 1: or because they're actually in recovery from alcohol use disorder.
10:19
Speaker 1: And so the newer sort of wave of population data
10:22
Speaker 1: has looked and has sort of redefined how we do
10:24
Speaker 1: the comparison groups. Now, the health harms in that low
10:27
Speaker 1: risk group are still pretty low, So I think it
10:30
Speaker 1: is important not to over pathologize or sort of overscare
10:33
Speaker 1: people about substance use, like, yes, there are linear risks
10:38
Speaker 1: to cancer association without caol use. And also if you're drinking,
10:42
Speaker 1: you know, under lower risk drinking limits, which is really
10:44
Speaker 1: seven drinks a week for a woman or fourteen drinks
10:46
Speaker 1: a week for a man under sixty five, the association
10:49
Speaker 1: with significant health risk is very very low. So I
10:52
Speaker 1: think the real opportunity here is to think about people's
10:55
Speaker 1: relationship with alcohol. What positives do they get in their life,
10:58
Speaker 1: what are the downsides, what are their personal goals when
11:01
Speaker 1: it comes to their health. What's their personal family history?
11:03
Speaker 1: So if you have a strong family history of breast cancer,
11:06
Speaker 1: for example, or you're in remission from breast cancer. Your
11:10
Speaker 1: decisions about alcohol are probably going to be very different
11:12
Speaker 1: from someone who doesn't have those risks, So I think
11:14
Speaker 1: it just opens us up to a much more nuanced
11:16
Speaker 1: conversation to really explore kind of the pros and cons.
11:20
Speaker 3: Definitely, So let's then transition into this conversation surrounding sober curiosity,
11:26
Speaker 3: and it's very foundation.
11:28
Speaker 2: What does it mean to be a sober curious person?
11:33
Speaker 1: You know? I think this is one of those themes
11:34
Speaker 1: where there's not a totally clear definition, but generally it
11:38
Speaker 1: means people who are beginning to explore their relationship with
11:40
Speaker 1: alcohol and decide to have periods where they're not drinking.
11:44
Speaker 1: So a common sort of version of this that began,
11:47
Speaker 1: you know, many years ago, was this idea of dry January,
11:50
Speaker 1: which was a change that people would make. They'd sort
11:52
Speaker 1: of challenge themselves to not drink for the month of January,
11:55
Speaker 1: and I think it was an interesting trend that did
11:57
Speaker 1: allow people to just sort of step back and take
11:59
Speaker 1: a pause and be more mindful about what role alcohol
12:02
Speaker 1: played in their life. And that has since expanded to people,
12:05
Speaker 1: you know, outside of January, just in their life thinking well,
12:07
Speaker 1: maybe I don't want to drink during the week, or
12:09
Speaker 1: maybe I don't want to drink at all, or maybe
12:12
Speaker 1: I want to drink less without having to sort of again,
12:15
Speaker 1: see this binary of like I have an alcohol use
12:17
Speaker 1: disorder and therefore need treatment and going into recovery instead.
12:21
Speaker 1: Just there's a continuum here, and for whatever reason, I
12:24
Speaker 1: feel better drinking less or not drinking at all, and
12:26
Speaker 1: I'm going to make that health related choice for myself.
12:28
Speaker 3: Just for the context of this conversation of your comfortable sharing.
12:31
Speaker 3: Do you consume alcohol? Yes, I do, Okay, so I
12:35
Speaker 3: also consume alcohol. But for your point talking about dry January,
12:39
Speaker 3: I at the most have done what was like a
12:43
Speaker 3: modified dry January in my past, where I would not
12:46
Speaker 3: drink during the week, I would allow myself to drink
12:48
Speaker 3: on Saturdays. And the other caveat was if I happened
12:52
Speaker 3: to have a date, which I actually found was a
12:56
Speaker 3: motivating way for me to try dating more last year.
13:01
Speaker 3: So I'm hearing you when you're talking about the different
13:03
Speaker 3: parameters that people place around it just experimenting to see
13:06
Speaker 3: how they feel with or without consuming regularly exactly.
13:10
Speaker 1: You know, people may find that they sleep better, or
13:12
Speaker 1: they feel better in the morning, or they're able to
13:15
Speaker 1: get more work done in the evening if they didn't
13:17
Speaker 1: drink with dinner, or that they lose some weight if
13:19
Speaker 1: that's a goal for them. And so I think it's,
13:21
Speaker 1: like many things, being mindful of your behaviors is actually
13:24
Speaker 1: an intervention in and of itself. So if you take
13:26
Speaker 1: something like eating or exercise, you know, often we'll encourage
13:29
Speaker 1: people as a first step to just be more mindful,
13:32
Speaker 1: like how much are you eating? When are you snacking?
13:34
Speaker 1: Are you getting to the gym? And to sort of
13:36
Speaker 1: understand are there areas where their current behaviors are getting
13:40
Speaker 1: in the wave goals that they have for themselves. And
13:42
Speaker 1: so I sort of think of this sober curious as
13:44
Speaker 1: a part of that to really be mindful, think about
13:47
Speaker 1: there maybe times when having a glass of wine with
13:48
Speaker 1: dinner is a wonderful thing and it allows you to
13:50
Speaker 1: enjoy the food more, allows you to have fun whatever
13:53
Speaker 1: social setting you're in, and that's not a bad thing.
13:56
Speaker 2: And also you.
13:56
Speaker 1: May find that like, hey, I'm drinking two or three
13:58
Speaker 1: glasses of one a night, I feel really crummy. You know,
14:01
Speaker 1: my skin doesn't look great, I've gained some weight, I'm
14:03
Speaker 1: having more heartburn and that's a great moment to pause
14:06
Speaker 1: and say, you know, this is not actually where I
14:08
Speaker 1: want my life to be or the way I want
14:10
Speaker 1: alcohol to be functioning in my life, and so therefrom
14:12
Speaker 1: to make this very intentional change.
14:14
Speaker 3: Yeah, we've kind of covered here some of the things
14:16
Speaker 3: that can happen if you are involving a decent amount
14:19
Speaker 3: of alcohol in your regular rotation. Inversely, let's touch on
14:23
Speaker 3: some of the health benefits that go hand in hand
14:25
Speaker 3: with lowering or cutting out your alcohol intake.
14:29
Speaker 1: Yeah, definitely. I think first it's really important for people
14:32
Speaker 1: to have those kind of general numbers in their mind
14:35
Speaker 1: of what are lower risk drinking limits. And I mentioned
14:37
Speaker 1: that before, but I'll say it again because I think
14:38
Speaker 1: we don't talk about it enough with the average public.
14:41
Speaker 1: So it's seven drinks a week for a woman or
14:43
Speaker 1: anyone over sixty five, and no more than three drinks
14:46
Speaker 1: on a drinking occasion, So you can't like save up
14:48
Speaker 1: all seven for Saturday night. You know, it's really thinking
14:51
Speaker 1: about cutting back and thinking of your overall weekly intake.
14:54
Speaker 1: And then for men under sixty five, it's fourteen drinks
14:56
Speaker 1: a week and no more than four on an occasion.
14:59
Speaker 1: So I think those are helpfuln if you know, like, oh,
15:01
Speaker 1: I have this party coming up, and I know I'm
15:03
Speaker 1: likely to have two or three drinks, then maybe you
15:06
Speaker 1: don't drink during the week and you're still sort of
15:08
Speaker 1: keeping within that seven or so drink per week limit,
15:12
Speaker 1: And it just gives people a benchmark of what is
15:15
Speaker 1: a lower risk level. And what that means is that
15:18
Speaker 1: in big studies, when people are drinking consistently above those limits,
15:21
Speaker 1: we start to see more health related problems, and that
15:24
Speaker 1: can take lots of different forms. So we talked about
15:26
Speaker 1: cancer risk, you know, there's also risk to your liver,
15:30
Speaker 1: including sort of liver inflammation and liver fibrosis or scarring.
15:34
Speaker 1: And that's a really scary one that's good to mention
15:37
Speaker 1: because you know, we've seen actually since COVID, this really
15:40
Speaker 1: increasing rate of serious liver damage to very young people,
15:44
Speaker 1: like people in their thirties who are coming into the
15:46
Speaker 1: hospital in fulminent sort of at death's door liver failure
15:51
Speaker 1: from alcohol use. And they had no idea that that
15:53
Speaker 1: could happen at such an early age. And those are
15:55
Speaker 1: some of the most devastating cases that I see in
15:58
Speaker 1: the inpatient hospital setting, people that literally didn't know, had
16:02
Speaker 1: no idea that could get that sick that early and
16:04
Speaker 1: are coming in and sometimes do actually die from that.
16:07
Speaker 1: So so liver is a big one. But then there's
16:10
Speaker 1: also lots of other ways that alcohol can impact your
16:12
Speaker 1: health and cutting back can make you feel better. So
16:15
Speaker 1: one is your mood. We know that drinking alcohol can
16:18
Speaker 1: be related worsening sort of depression and anxiety, and so
16:21
Speaker 1: cutting back or stopping may help your mood feel better.
16:24
Speaker 1: Sleep is a big one. Even though people think about
16:26
Speaker 1: alcohol helping you fall asleep, it actually leads to really
16:28
Speaker 1: disordered sleep architecture. So if you've ever drank too much,
16:32
Speaker 1: you may fall asleep easily, but then wake up feeling
16:34
Speaker 1: really not refreshed. I mean that's a reminder of alcohol
16:38
Speaker 1: sort of disruption to your sleep. So sleep definitely gets better.
16:42
Speaker 1: You know, weight, there's a lot of calories and alcohol,
16:44
Speaker 1: so if you are trying to watch your weight, if
16:45
Speaker 1: you have diabetes or pre diabetes, cutting back on alcohol
16:48
Speaker 1: could be really beneficial in that way. And then drinking
16:51
Speaker 1: at high levels can actually cause heart problems and elevated
16:55
Speaker 1: blood pressure. So if you you know someone who has
16:57
Speaker 1: high blood pressure or a family history highlod pres sure,
17:00
Speaker 1: you know, that's another area where you might think of
17:02
Speaker 1: coming back.
17:03
Speaker 3: I love this term sleep architecture. I'm not entirely sure
17:06
Speaker 3: if I've heard it before referencing sleep quality.
17:09
Speaker 2: That's a super important takeaway.
17:11
Speaker 3: And I know something that I've been focusing on a
17:13
Speaker 3: lot over the last few years. A couple of things
17:16
Speaker 3: that I do want to double click on. Here, the
17:18
Speaker 3: seven for women versus the fourteen for men? What is
17:21
Speaker 3: that based on a side from perhaps general stature between
17:25
Speaker 3: the sexes.
17:26
Speaker 1: Yeah, so women tend to have a higher percentage of
17:29
Speaker 1: body fat than men, and also they metabolize alcohols slightly different,
17:32
Speaker 1: So the amount of alcohol you need to get to
17:35
Speaker 1: the same sort of level of intoxication or blood alcohol
17:37
Speaker 1: content is different between biological sexes.
17:40
Speaker 2: Got it?
17:40
Speaker 3: And then you touched on the liver scarring, which really
17:43
Speaker 3: like sent some whistles off in my head. You said,
17:47
Speaker 3: you're seeing more and more patients coming in unsure that
17:49
Speaker 3: this could happen to them at such a young age.
17:51
Speaker 3: Helpful to hear a little bit perhaps about the symptoms
17:55
Speaker 3: that go hand in hand with that, so someone might
17:56
Speaker 3: be able to have some insight on what that could
17:59
Speaker 3: look like for them.
18:00
Speaker 1: Sure, yeah, So when you start having liver problems, the
18:03
Speaker 1: kind of spectrum that happens is first inflammation in your liver,
18:06
Speaker 1: and then that can progress to really severe what we
18:09
Speaker 1: call hepatitis. Maybe your whole liver is inflamed or then
18:12
Speaker 1: even scarring, which at this sort of advanced end is
18:15
Speaker 1: called crhosis. And people have maybe heard of sorrhosis, and
18:18
Speaker 1: I think most of us have in our mind that
18:19
Speaker 1: that's something that happens to like people in their sixties
18:22
Speaker 1: after decades of drinking heavily. But we are seeing people
18:25
Speaker 1: in their late twenties or early thirties. You're coming in with sorrhosis,
18:28
Speaker 1: which is really scary and something that I think is
18:31
Speaker 1: important for people to know about. If you were starting
18:33
Speaker 1: to have really serious liver inflammation or liver problems, that
18:37
Speaker 1: things to watch out for would be pain in the
18:39
Speaker 1: right upper side of your belly, so your liver sits
18:42
Speaker 1: right under your ribs on the right side. As that
18:44
Speaker 1: gets worse, you may see changes to your skin color.
18:46
Speaker 1: So if your skin or your eyes start looking yellow,
18:49
Speaker 1: or changes to your urine, if your urine starts looking
18:51
Speaker 1: really dark, like kind of Coca cola colored or tea colored.
18:55
Speaker 1: Those are some of the signs that you would see
18:57
Speaker 1: as that progresses.
18:59
Speaker 2: Super helps.
19:00
Speaker 3: So here we're talking about how clearly there is a
19:03
Speaker 3: rise in the interest around sober curiosity, clearly starting with
19:09
Speaker 3: that idea, that concept, that occasion of the dry January.
19:12
Speaker 3: Do you have any information perhaps on just how many
19:17
Speaker 3: people are trying to get on board with this movement?
19:21
Speaker 1: You know, I don't think there's any good data. I've
19:23
Speaker 1: looked into this, and I think because it is sort
19:25
Speaker 1: of a social movement, it's not something that's been well captured.
19:28
Speaker 1: You know. I think we know most Americans consume alcohol,
19:32
Speaker 1: and many people actually will meet criteria for an alcohol
19:35
Speaker 1: use disorder. So around fifteen percent of people at some
19:38
Speaker 1: point we'll meet criteria for alcoholics disorders. This is not
19:40
Speaker 1: an uncommon health condition. And I think, you know, social
19:44
Speaker 1: media and news articles are any hint it definitely this
19:47
Speaker 1: idea of sober curious and even the companies that are
19:50
Speaker 1: coming from it. You know, there's lots more sort of
19:52
Speaker 1: alcohol free, interesting beverage companies that are out there that
19:56
Speaker 1: I think are really pitching themselves to this group of
19:59
Speaker 1: people who want to begin to think differently about how
20:02
Speaker 1: they use alcohol. And so it seems to be growing
20:04
Speaker 1: in popularity, but I think the data is still limited.
20:07
Speaker 3: The alcohol alternative beverages are really interesting to me because
20:10
Speaker 3: some of them are truly taking over the shelves at
20:14
Speaker 3: both my traditional liquor store as well as within my
20:16
Speaker 3: grocery store. I do know that there are some things
20:19
Speaker 3: to be mindful of when you're looking at these beverages. Specifically,
20:23
Speaker 3: what comes first and foremost to mine is the sugar
20:25
Speaker 3: content that is in some of these. What else should
20:27
Speaker 3: you be looking at when you are looking at a
20:31
Speaker 3: non alcoholic alternative in lieu of one of its alcoholic cousins.
20:37
Speaker 1: Yeah, I think you know, if you are well. For everyone,
20:40
Speaker 1: having a ton of sugar is not a great thing.
20:41
Speaker 1: But if certainly, if you're watching your weight or if you
20:43
Speaker 1: have diabetes, being mindful of the calories and the sugar
20:46
Speaker 1: and it is important.
20:47
Speaker 2: I think you know.
20:48
Speaker 1: The other thing to be cautious of, as many of
20:50
Speaker 1: them are marketing themselves as sort of having other herbal properties,
20:54
Speaker 1: that they're relaxing, or that they have certain sort of
20:58
Speaker 1: alternative herbal product in them, and that that's always something
21:02
Speaker 1: just to be careful with because those are often unregulated
21:04
Speaker 1: in terms of what they say it's going to do.
21:06
Speaker 1: So I've seen them, you know my Instagram feed saying
21:08
Speaker 1: it's gonna it has this vitamin in it and it's
21:11
Speaker 1: going to cause this mindfulness or relaxation, and just to
21:15
Speaker 1: be aware that there's no sort of oversight and in
21:18
Speaker 1: that type of regulation. So I think generally finding something
21:22
Speaker 1: fun to drink that doesn't have alcohol and is a
21:25
Speaker 1: healthier alternative if you're making changes to your use, can
21:28
Speaker 1: be a really great thing, and it gives you something,
21:30
Speaker 1: you know, that's more fun than just water, if that,
21:33
Speaker 1: if that helps, and may taste good and is just
21:37
Speaker 1: broadening your range of options in social settings, which can
21:40
Speaker 1: be helpful too.
21:41
Speaker 3: Yeah, you know, I feel like adaptagens are in absolutely
21:44
Speaker 3: everything now. So I hear you on all the extra
21:47
Speaker 3: little additives that we're finding in these beverages. Aside from
21:51
Speaker 3: leaning into NA options, for someone who is interested in
21:54
Speaker 3: a sober curious lifestyle, what are some other ways that
21:58
Speaker 3: they can ease into it and what should they avoid?
22:01
Speaker 1: I would say probably the first thing is to just
22:04
Speaker 1: take stock of your alcohol use. So I would spend
22:07
Speaker 1: a week or a month sort of journaling, like keeping
22:09
Speaker 1: track of when do you drink, what situations are you
22:11
Speaker 1: drinking in, how do you feel the next day? I
22:14
Speaker 1: think that mindfulness is really important. And then if you
22:17
Speaker 1: want to make a change, any change, but especially with
22:19
Speaker 1: alcohol use, it's important to know what your why is.
22:22
Speaker 1: You know, people don't change unless they have a reason change.
22:25
Speaker 1: Change is very hard, and so it's important to have
22:27
Speaker 1: something that you're working towards and to make that as
22:30
Speaker 1: specific and sort of personalized and measurable as possible. So
22:33
Speaker 1: just saying something vague like I'm going to cut back
22:35
Speaker 1: on alcohol because alcohol is bad, it's not very likely
22:39
Speaker 1: or going to make that change, right, That's like a
22:40
Speaker 1: very vague sort of general statement. There's no real why there.
22:44
Speaker 1: But instead to say, you know, my goal this year
22:46
Speaker 1: is to run my first marathon, and in order to
22:50
Speaker 1: get up and do my long runs on the weekend,
22:52
Speaker 1: I need to have a good sleep and so therefore
22:54
Speaker 1: I'm not going to drink more than two nights a
22:56
Speaker 1: week and I'm going to keep it to two drinks
22:58
Speaker 1: a night. Like that's a very calm, create very measurable
23:01
Speaker 1: goal that is actually linked to something that you're also
23:03
Speaker 1: working on, or maybe it's something totally different. Maybe it's
23:06
Speaker 1: that you know you want to get better sleep during
23:07
Speaker 1: the week and so you're only going to drink on
23:09
Speaker 1: Friday Saturday. But I think that type of idea of
23:11
Speaker 1: really specific, measurable and sort of centered on your goals
23:15
Speaker 1: as your why, is really important. And then the last
23:18
Speaker 1: thing is let people know about it. I think we're
23:20
Speaker 1: all humans are much more likely to change if they
23:22
Speaker 1: make themselves accountable. So whether that's sharing it on social media,
23:25
Speaker 1: sharing it with your friends, or your partner putting it
23:27
Speaker 1: up on your refrigerator so you sort of see your
23:29
Speaker 1: goal that you're working towards, whatever works for you. But
23:32
Speaker 1: I think bringing people in so that the people that
23:34
Speaker 1: love you and that you're interacting with regularly can help
23:37
Speaker 1: support and reinforce and maybe even make changes too, if
23:40
Speaker 1: this is really something that you're working on, Because whenever
23:43
Speaker 1: you make a change, the easier we can make it,
23:45
Speaker 1: the more likely it is that you'll adapt it. So
23:46
Speaker 1: if you have friends who are texting you to go
23:49
Speaker 1: out for drinks every night and you're trying to cut back,
23:51
Speaker 1: or they're offering you wine when you come over, it's
23:53
Speaker 1: going to be a lot harder than if your friends
23:54
Speaker 1: are on board and say, hey, I know you're trying
23:56
Speaker 1: to make this change, and so let's go for a
23:57
Speaker 1: walk instead, or go you know, go out to a movie,
24:01
Speaker 1: or do something that doesn't involve alcohol.
24:07
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24:11
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24:16
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24:17
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24:20
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24:24
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24:29
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24:34
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24:38
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24:41
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24:45
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24:48
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24:51
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24:53
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25:03
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25:07
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25:56
Speaker 2: Definitely, definitely.
25:57
Speaker 3: I'm happy you brought up the friendships relationships angle and
26:00
Speaker 3: getting them on board with your choices. I think this
26:02
Speaker 3: can also shed a lot of light on the different
26:05
Speaker 3: relationships you have in your life. If you are realizing
26:08
Speaker 3: that the people that you thought supported you are actually
26:11
Speaker 3: really resistant to your choice. For someone that is dealing
26:15
Speaker 3: with this conflict, so to speak, a little bit of
26:19
Speaker 3: friction when it comes to adopting this new lifestyle within
26:23
Speaker 3: their relationships, what advice do you have for them?
26:27
Speaker 1: Yeah, I think that can be really tough and also
26:28
Speaker 1: really enlightening to see that you know. I'd suggest first
26:32
Speaker 1: sharing your why, your purpose with that friend if they're
26:35
Speaker 1: truly someone that loves and supports you, even if you
26:38
Speaker 1: know this choice may make them a little uncomfortable or
26:40
Speaker 1: they may not see sort of the reason behind it,
26:42
Speaker 1: if you explain that and why you want their help
26:44
Speaker 1: and sort of bring them in to be a partner
26:47
Speaker 1: with you, I think that that often can help. So
26:50
Speaker 1: to against explain what your goal is and ask them
26:53
Speaker 1: for a concrete thing, like do you think next week
26:55
Speaker 1: we could go to yoga class together instead of meeting
26:57
Speaker 1: for drinks, so that they're then contributing and film like
27:00
Speaker 1: they're a partner with you and that there's something very
27:02
Speaker 1: clear that they can do. That's still nice. If you
27:04
Speaker 1: find that someone's really like actively resisting that or sabotaging
27:08
Speaker 1: your goals, you may need to take a more active
27:10
Speaker 1: role on sort of removing yourself from different pieces of
27:14
Speaker 1: that relationship. You know, maybe that you are really thoughtful
27:17
Speaker 1: about what sort of things you say yes to and
27:20
Speaker 1: which times you make plans with that person, and then
27:23
Speaker 1: at the end of the day, you know, we do
27:24
Speaker 1: sometimes outgrow relationships, and if you have decided that there's
27:28
Speaker 1: something that really matters to you and a person that
27:30
Speaker 1: you love doesn't support you on that. That is always
27:32
Speaker 1: a little worrisome because you know, relationships, friendship or otherwise should
27:36
Speaker 1: be about helping you be your best self, whatever that
27:38
Speaker 1: means to you.
27:39
Speaker 3: Definitely, Yeah, it's certainly something you see all over social media,
27:44
Speaker 3: to say the least, if someone's talking about their decision
27:47
Speaker 3: not to drink, or perhaps the fact that they simply
27:49
Speaker 3: just enjoy drinking a mocktail more than a cocktail. That
27:53
Speaker 3: comments are always written with individuals who have many opinions
27:57
Speaker 3: on this, and sometimes it's truly candidly frightening to see.
28:01
Speaker 1: Yeah, totally, And you know, I think sometimes when you
28:05
Speaker 1: see that type of reaction, it may be that that
28:08
Speaker 1: person's feeling a little uncomfortable about their own choices. You know,
28:10
Speaker 1: it can be that you're shining a light or holding
28:13
Speaker 1: up a mirror that makes them have to reflect a
28:15
Speaker 1: little bit on alcohol's role in their life. And so
28:18
Speaker 1: I think I was trying to approach those situations with
28:20
Speaker 1: the most generous interpretation that maybe this person is struggling
28:25
Speaker 1: or doesn't understand why this is important to me. But
28:28
Speaker 1: if they're struggling. I think the important thing to know
28:31
Speaker 1: is that there is help out there. And that's the
28:32
Speaker 1: other side of sober curious, is that for people who
28:35
Speaker 1: try to make these changes and actually find whoa this
28:38
Speaker 1: is actually harder than I thought it was going to be,
28:40
Speaker 1: and maybe alcohols playing a different role in my life
28:42
Speaker 1: than I realize. To know that treatment is available, treatment works,
28:46
Speaker 1: Most people get better even when they have truly meet
28:48
Speaker 1: criteria for an alcohol you stack disorder.
28:50
Speaker 3: I do think that this is another good opportunity when
28:52
Speaker 3: we're talking about relationships, to talk about how one can
28:55
Speaker 3: transition socially when alcohol otherwise is traditionally a central point
29:01
Speaker 3: of gathering. What advice do you have for someone who
29:03
Speaker 3: is interested in sober curiosity and maybe removing alcohol entirely
29:08
Speaker 3: from their regular routine, but is scared about some of
29:11
Speaker 3: the repercussions of that.
29:13
Speaker 1: Yeah, I think early on the answer to that's different
29:17
Speaker 1: than later. So the hardest time to make a change
29:19
Speaker 1: is the first sort of three months. Once you get
29:20
Speaker 1: used to something and you start to see the benefits
29:23
Speaker 1: and you're more familiar with your routines, it becomes easier
29:25
Speaker 1: and easier. But in those early months, if this really
29:28
Speaker 1: matters to you, and you're making this change, you want
29:29
Speaker 1: to set yourself up for success, and so that may
29:32
Speaker 1: mean making really thoughtful decisions about what types of activities
29:35
Speaker 1: you're doing, who you're surrounding yourself with, how you're connecting
29:37
Speaker 1: with people. I think, thankfully, especially as we emerge from
29:41
Speaker 1: the acute pandemic phases, there are more wonderful and diverse
29:45
Speaker 1: range of in person activities you can do with people
29:48
Speaker 1: you know. Many people who are making changes to their
29:49
Speaker 1: alcohol use are also thinking about other health benefits, and
29:53
Speaker 1: so there's obviously lots of health related activities you can do,
29:57
Speaker 1: running groups, yoga, mindfulness, getting involved, and something that doesn't
30:01
Speaker 1: center around alcohol. And so maybe that's joining like an
30:03
Speaker 1: adult physical activity group like a running group, or maybe
30:07
Speaker 1: it's running a book group, or something that doesn't center
30:09
Speaker 1: on sort of a social activity that's in a bar
30:12
Speaker 1: or revolving around sort of alcohol and a meal. If
30:15
Speaker 1: you're going over to someone's house, you can offer to
30:16
Speaker 1: bring something, bring a mocktail, bring you know, whatever flavor
30:20
Speaker 1: of sprinkling water you'd like, so that you have an
30:22
Speaker 1: easy thing that you can put in your hand and
30:24
Speaker 1: sort of know that that's your plan walking in and
30:27
Speaker 1: then over time as you become more comfortable that I
30:29
Speaker 1: think you can loosen that up a little bit, you know,
30:31
Speaker 1: like anything else. The maintenance phase is different than that
30:34
Speaker 1: early change phase, but I do think those early days
30:37
Speaker 1: you want to make it as easy as possible to
30:38
Speaker 1: not have alkoho on your mind and not be sort
30:40
Speaker 1: of having the default be that you have a drink
30:42
Speaker 1: in your hand.
30:44
Speaker 2: Yeah.
30:44
Speaker 3: This really brings me back to when I was in
30:46
Speaker 3: the height of my personal weight loss journey and I
30:50
Speaker 3: had such a target, such tunnel vision on what my
30:55
Speaker 3: goal was that I really adapted the behaviors when it
30:58
Speaker 3: came to going out to eat, specifically with friends. That
31:02
Speaker 3: wasn't centralizing around alcohol at that time. It was centralizing
31:05
Speaker 3: around the different types of foods that I wanted to
31:07
Speaker 3: be around.
31:08
Speaker 2: But I knew that there were certain circumstances.
31:11
Speaker 3: That actually made me feel good versus situations that made
31:14
Speaker 3: me feel out of control and being able to temper that.
31:19
Speaker 3: As I moved forward in that journey and get to
31:23
Speaker 3: what you're calling the maintenance phase. Now at this chapter
31:26
Speaker 3: of my life, it's very different when it comes to
31:28
Speaker 3: making plans and going out to eat and whatnot. But
31:31
Speaker 3: in the height of that different era, it was entirely different.
31:34
Speaker 3: So I do think that there is a bit of
31:36
Speaker 3: comfort after you are able to articulate your why, knowing
31:40
Speaker 3: that there might be some discomfort at one period, But
31:44
Speaker 3: that doesn't mean that it's going to feel like that forever.
31:46
Speaker 1: Yeah, I think that's so important. And what you just described,
31:49
Speaker 1: you know, you built a new skill set and a
31:51
Speaker 1: new toolkit over that time too, and so you're in
31:53
Speaker 1: a different place, you know, three six, nine months down
31:56
Speaker 1: the road than you are when you're starting out. Your
31:58
Speaker 1: confidence in your ability to make different deccisions around food,
32:01
Speaker 1: you're sort of seeing all the positive benefits and focus
32:04
Speaker 1: on your goal. That changes over time too, And the
32:06
Speaker 1: SAME's true for alcohol. I think food is often a
32:10
Speaker 1: really great one to think about because I think many
32:12
Speaker 1: of us understand sort of complicated relationships of food and
32:15
Speaker 1: the spectrum of food and weight related issues and an
32:19
Speaker 1: alcohol in a very similar way, you know, making different decisions.
32:22
Speaker 1: You can't avoid it entirely, just like you can't avoid
32:25
Speaker 1: food entirely. It's everywhere that you look. But really consciously
32:29
Speaker 1: setting yourself up for success to meet whatever goal you
32:31
Speaker 1: have in mind.
32:32
Speaker 3: Definitely now I know another topic that a lot of
32:36
Speaker 3: individuals have questions on when it comes to sober curiosity
32:40
Speaker 3: is athletic performance.
32:42
Speaker 2: Generally speaking, let's go broad here.
32:44
Speaker 3: Can you enjoy alcohol regularly without hurting your athletic performance?
32:51
Speaker 1: Yeah, that's a great question. I think, you know, depends
32:53
Speaker 1: a little on what performance you're aiming for. So if
32:56
Speaker 1: you're training for the Olympics, you know, probably you don't
32:58
Speaker 1: want to drink, and you also are making lots of
33:00
Speaker 1: other decisions about sort of absolutely maximizing your athletic performance.
33:05
Speaker 1: If you are, you know, running your first race, or
33:07
Speaker 1: trying to stay in shape, or you know, making it
33:11
Speaker 1: to peloton every morning, you know drinking in those lower
33:14
Speaker 1: risk levels is probably not going to get in the way.
33:16
Speaker 1: So I think it's not an absolute question one way
33:19
Speaker 1: or the other, And again depends on those other goals
33:22
Speaker 1: you know you're sensing. I always have this kind of
33:25
Speaker 1: nuanced answer, but I do think it's such an important
33:27
Speaker 1: way to recognize that these are issues that have lots
33:31
Speaker 1: of different factors that play into them. And I remember
33:34
Speaker 1: talking to a dear colleague of mine who is a
33:36
Speaker 1: leading alcohol expert in the globe, really and I knew
33:40
Speaker 1: that he would drink an occasional cocktail. He wasn't someone
33:42
Speaker 1: who didn't drink at all, And I was interested in
33:44
Speaker 1: his perspective on all of these new studies showing that
33:47
Speaker 1: really there was no safe amount of alcohol. And his
33:50
Speaker 1: perspective was that our framing had been all wrong. This
33:52
Speaker 1: idea that you would ever drink for your health was
33:55
Speaker 1: really the wrong way to think about it, and that
33:57
Speaker 1: we do many things like driving a car, or go
34:00
Speaker 1: swimming or eat bacon that don't have zero risk. Many
34:03
Speaker 1: things that we enjoy in life have some amount of
34:05
Speaker 1: risk attached to them, and then we make calculated decisions
34:08
Speaker 1: on sort of how much risk are we comfortable taking
34:10
Speaker 1: and where do we want to cut back, based on
34:12
Speaker 1: our own life and what our sort of goals are
34:14
Speaker 1: and what our personal situation is. And I think that's
34:16
Speaker 1: probably the best way to think of alcohol, That it's
34:19
Speaker 1: not something to start for health related reasons. And also
34:24
Speaker 1: there are many things that we find pleasure and that
34:26
Speaker 1: don't have health related benefits associated with them.
34:28
Speaker 3: That eating bacon, man, that's really going to be the
34:31
Speaker 3: thing that gets you at the end, right totally, If
34:36
Speaker 3: I go out because I'm eating bacon, then I feel
34:38
Speaker 3: like I'm doing it right now. We did address perhaps
34:41
Speaker 3: some of the things to be mindful of when it
34:43
Speaker 3: comes to choosing your NA beverage, but when it comes
34:47
Speaker 3: to your choice alcohol, what should we be cognizant of?
34:51
Speaker 1: You know, so generally a drink is a drink, but
34:53
Speaker 1: having some sense of what the equivalence is across drinks.
34:55
Speaker 1: So you know, a shot of liquor versus a glas
35:00
Speaker 1: glass of wine versus a can of beer, we really
35:02
Speaker 1: sort of equate based on the grams of alcohol that
35:05
Speaker 1: are in that. So it's roughly kind of five ounces
35:07
Speaker 1: of table wine. You know, a can of regular alcohol
35:11
Speaker 1: by volume content beer or one and a half ounces
35:13
Speaker 1: of liquor would be equivalent in terms of the drink ratio.
35:17
Speaker 1: You know, the lower alcohol by volume beverages are, you're
35:22
Speaker 1: going to be able to drink more without running into trouble.
35:24
Speaker 1: So that's one thing. If you're drinking, you know, a
35:27
Speaker 1: martini is going to have a lot more alcohol in
35:29
Speaker 1: it than if you're drinking a glass of you know,
35:31
Speaker 1: twelve percent abb wine at the table. So just thinking
35:35
Speaker 1: roughly that it's about the grams of alcohol that matter,
35:37
Speaker 1: and so therefore the volume contributes. I think, you know,
35:41
Speaker 1: does red wine have more sort of antioxidants, maybe, but
35:44
Speaker 1: that's not really why we should be drinking red wine.
35:46
Speaker 1: So I wouldn't really think in the realm of like
35:47
Speaker 1: one is healthier than the other. I would just think
35:49
Speaker 1: of it as sort of the equivalence of drinks across.
35:52
Speaker 1: And then we've talked a lot about sort of sugar
35:53
Speaker 1: and weight and health, and definitely there's lots of like
35:56
Speaker 1: cocktails out there that have lots of sugar in them
35:59
Speaker 1: and lots of other things. So if you are being
36:01
Speaker 1: mindful of that, you know, being thoughtful about the what
36:04
Speaker 1: sort of the context, the composition of whatever drink it
36:06
Speaker 1: is that you're drinking is in. And then lastly, if
36:08
Speaker 1: you're trying to make changes, you know in the realm
36:11
Speaker 1: of not all or nothing, but just cutting back, mixing
36:14
Speaker 1: up your drinking, so you may like start with a
36:16
Speaker 1: glass of seltzer, have a glass of wine, switch back
36:18
Speaker 1: to seltzer, so that it doesn't have to be that
36:19
Speaker 1: just because you're drinking, you're going to drink the whole
36:21
Speaker 1: night and everything that you order is an alcoholic beverage.
36:23
Speaker 1: But to give yourself some choice within that too, can
36:26
Speaker 1: be helpful.
36:27
Speaker 3: Yeah, I think that's really really helpful recommendation there. I
36:30
Speaker 3: love the Seltzer on and off. Now, I know we
36:33
Speaker 3: started this conversation chatting about alcohol use disorder, and I
36:37
Speaker 3: kind of want to circle back to that topic just briefly,
36:41
Speaker 3: because I know that for some maybe hearing the definition
36:45
Speaker 3: of what that entails and the different buckets of things
36:48
Speaker 3: that you should be looking for may have raised a
36:51
Speaker 3: couple of red flags. Admittedly, those red flags can be
36:55
Speaker 3: really scary, right, So for someone who heard us talk
36:59
Speaker 3: about this today and a little concerned about their use,
37:03
Speaker 3: what do you tell them?
37:05
Speaker 1: Yeah, I mean, I think it's absolutely scary to hear.
37:07
Speaker 1: I also want to name that there's still so much
37:09
Speaker 1: stigma about substance use disorder. This idea that you know,
37:13
Speaker 1: if you have an alcoholus to sort of, for example,
37:15
Speaker 1: there's something wrong with you that you don't have willpower,
37:19
Speaker 1: you're morally bad in some way, I think is very
37:22
Speaker 1: pervasive in our society. Despite the fact that it's now
37:25
Speaker 1: more common to talk about these things is health issues,
37:28
Speaker 1: We've long approached it as an issue of sort of
37:30
Speaker 1: being bad or being weak, And so for just to
37:32
Speaker 1: name that and say that that's wrong and that is
37:35
Speaker 1: not true. This is a treatable health condition. It is
37:37
Speaker 1: not someone's fault. And also that's very real to feel
37:41
Speaker 1: that sort of fear and sense of stigma. I think,
37:44
Speaker 1: you know, the first thing to do is talk to someone,
37:45
Speaker 1: and whether that is someone you trust in your life
37:48
Speaker 1: or you know, I hope maybe people have a doctor
37:51
Speaker 1: or a healthcare provider they trust in their lives too,
37:53
Speaker 1: you know, in addition to being an addiction specialist and
37:55
Speaker 1: also primary care doctor, and if you have a primary
37:57
Speaker 1: care doctor, that's a perfect person to talk to you
37:59
Speaker 1: about that, because there are ways that we can assess
38:02
Speaker 1: in that encounter whether or not you do in fact,
38:04
Speaker 1: I'm an alcohol use disorder, and if you do, there's
38:06
Speaker 1: treatments that can help, including medication treatments that people don't
38:09
Speaker 1: know much about that can help you cut back how
38:12
Speaker 1: much you're drinking or stop entirely. And that is a
38:15
Speaker 1: really underutilized tool, in addition to many other types of
38:18
Speaker 1: supports like therapy or group supports.
38:20
Speaker 3: Even just talking about it openly with a friend, Although
38:23
Speaker 3: that might feel scary at first, it's an opportunity for
38:27
Speaker 3: you to really be honest about what is happening with
38:30
Speaker 3: you and your body. And it's not until you take
38:32
Speaker 3: that opportunity to be honest that you can realize that
38:35
Speaker 3: you're really not as alone as you might feel, that
38:38
Speaker 3: there are so many other individuals who are dealing with
38:41
Speaker 3: similar circumstances, whether it be here as we talk about
38:44
Speaker 3: this alcohol use disorder or you know, whatever else you
38:47
Speaker 3: may be dealing with totally.
38:49
Speaker 1: And you know, we often say in the addiction world
38:51
Speaker 1: that the opposite of addiction is not sobriety. Actually the
38:53
Speaker 1: opposite of addiction is connection. Because many times when people
38:57
Speaker 1: are struggling with an alcoholics disorder or substance use disorder,
39:00
Speaker 1: they feel really alone. And so even just reaching out
39:02
Speaker 1: and having that connection with another human being can be
39:05
Speaker 1: therapeutic and of itself.
39:07
Speaker 3: The way that I want to round us out here
39:10
Speaker 3: is talking about integration, and that for someone who may
39:14
Speaker 3: be listening to this we're recording us at the close
39:17
Speaker 3: to the end of twenty twenty three, many individuals may
39:19
Speaker 3: be thinking about doing some sort of a dry January.
39:23
Speaker 3: I'm curious to know your thoughts, your advice, your takeaways
39:26
Speaker 3: for the individual who's down to give it a try,
39:29
Speaker 3: but then realizes that they want to bring it back,
39:31
Speaker 3: because I feel like that transitionary period can be pretty
39:35
Speaker 3: troublesome for some So let's talk about that. What would
39:39
Speaker 3: you tell that person who maybe gave sober curiosity a
39:43
Speaker 3: try and then realize it's just not for them. Is
39:45
Speaker 3: there a safe way to integrate drinking back into your routine.
39:49
Speaker 1: Yeah, it's a great question. I mean, I think first
39:52
Speaker 1: recognizing and sort of honoring the fact that you made
39:54
Speaker 1: a change and you did something different for your health
39:56
Speaker 1: that month, and that's awesome, and there may be lots
39:58
Speaker 1: of reasons why you're deciding that's not the right thing
40:00
Speaker 1: for you. I think having that sense of what our
40:03
Speaker 1: lower risk drinking limits, especially if you're drinking above them before,
40:07
Speaker 1: like maybe you're drinking actually ten or fourteen drinks a
40:10
Speaker 1: week before you tried a period of not drinking, and
40:12
Speaker 1: now you want to start drinking again, it's an awesome
40:14
Speaker 1: opportunity to really keep it within that sort of healthier limit.
40:18
Speaker 1: After a period of not drinking, your tolerance is going
40:21
Speaker 1: to go down. So the first thing I know is
40:22
Speaker 1: you're going to react differently to alcohol when you do
40:24
Speaker 1: introduce it back, so you may feel the effects of
40:27
Speaker 1: one or two drinks in a way that you wouldn't
40:28
Speaker 1: have if you've been drinking that way consistently. So being
40:31
Speaker 1: cautious when you restart, But I would say being intentional
40:34
Speaker 1: is probably the most important thing. You've just done, a
40:36
Speaker 1: really important thing for your health. You've explored your relationship
40:39
Speaker 1: with alcohol, You've made changes. Now is a great reset
40:42
Speaker 1: moment to really go into it with mindfulness to say,
40:45
Speaker 1: you know, I do actually value the role of alcohol
40:47
Speaker 1: in some ways in my life, but I want to
40:48
Speaker 1: keep it to lower risk limits. And so therefore I'm
40:51
Speaker 1: going to only drink, you know, Friday, Saturday, Sunday or whatever.
40:54
Speaker 1: I'm going to drink every day, but only one drink
40:56
Speaker 1: a day. But to really be sort of clear with
40:58
Speaker 1: yourself about those guidelines, because otherwise it's easy to just
41:01
Speaker 1: fall right back in and even worse, sometimes when we
41:04
Speaker 1: go through a period of kind of restricting something, there's
41:06
Speaker 1: a wish to do the opposite, to kind of, you know,
41:09
Speaker 1: bend afterwards and celebrate the fact that you haven't been
41:13
Speaker 1: drinking for this month, and that can actually lead to
41:15
Speaker 1: sort of a worse outcome that you're then drinking even more.
41:17
Speaker 1: And so I think that that pause, that reflection, that
41:20
Speaker 1: mindfulness could be really helpful as you restart drinking.
41:24
Speaker 2: Yeah, you know, it's interesting.
41:25
Speaker 3: I remember during the month of time that I was
41:29
Speaker 3: drinking a lot less, I realized that in the former
41:34
Speaker 3: so in you know, the rest of my life, so
41:37
Speaker 3: often I would go out with someone, whether it be
41:39
Speaker 3: for a work meeting or a date or just out
41:41
Speaker 3: with a friend, and I could tell you within the
41:43
Speaker 3: first ten minutes what their drink order was, but I
41:46
Speaker 3: wouldn't be able to tell you much else. And so
41:49
Speaker 3: being able to come back into self, coming into body,
41:51
Speaker 3: it allowed me to be a little bit more present
41:53
Speaker 3: with where I was, and that experience taught me that,
41:56
Speaker 3: so that when I moved forward and did integrate alcohol
41:59
Speaker 3: back into my life, I was a little bit more
42:01
Speaker 3: cognizant about what was happening in my interactions, the questions
42:04
Speaker 3: that I was asking, being where my feet are. And
42:06
Speaker 3: so I do think, aside from the health benefits that
42:09
Speaker 3: you may find from lessening the amount of alcohol you're
42:13
Speaker 3: taking in, you'll actually also find some lasting insights about
42:18
Speaker 3: who you are and the way that you conduct yourself
42:21
Speaker 3: when you're in social situations.
42:24
Speaker 1: I think that's so true and so important. And the
42:26
Speaker 1: flip side, if you find you can only tolerate hanging
42:28
Speaker 1: out with someone if you have three or four drinks,
42:30
Speaker 1: that may be you know, a moment to say, hey,
42:32
Speaker 1: is this really a relationship I want to spend my
42:34
Speaker 1: very precious time with. So it definitely is a great
42:37
Speaker 1: opportunity for reflection.
42:38
Speaker 3: This makes me laugh about a friend who once told
42:40
Speaker 3: me that she had what she liked to call summer boyfriend,
42:43
Speaker 3: and summer boyfriend could only be in the picture when
42:46
Speaker 3: there was like.
42:47
Speaker 2: Fun and son and alcohol and cocktails.
42:50
Speaker 3: And then she was like, this relationship actually is extremely
42:53
Speaker 3: unhealthy for me.
42:55
Speaker 2: Summer Boyfriend's got to go totally.
42:57
Speaker 1: Yeah, those moments of clarity can be really important for sure.
43:01
Speaker 3: Now, before I let you go today, I know we
43:03
Speaker 3: covered a ton in our conversation. Is there anything else
43:07
Speaker 3: that you think that we should touch on, doctor Wakeman
43:10
Speaker 3: before I let you go today?
43:12
Speaker 1: No, I think this is great. We covered a full
43:14
Speaker 1: range and I'm just so happy that people are listening
43:16
Speaker 1: and interested in this topic.
43:18
Speaker 2: I love it well.
43:19
Speaker 3: Of course, thank you so much for your time, your
43:21
Speaker 3: care and concern of this conversation is super helpful for
43:24
Speaker 3: those that want to follow along. With you or want
43:27
Speaker 3: to get more information? Where would you recommend that they
43:31
Speaker 3: do that?
43:33
Speaker 1: Sure, so you can find me. I'm still on x
43:36
Speaker 1: or formally Twitter and also on Instagram at doctor Sarah
43:40
Speaker 1: Wakeman or check out our website MDB Dash Substance Youth Services.
43:45
Speaker 2: Thank you so much.
43:46
Speaker 3: I'm over at Emily Body and at Hurdle Podcast Another
43:49
Speaker 3: Hurdle Conquered.
43:51
Speaker 2: Catch you guys next time
44:00
Speaker 3: You