ALCOHOL: OTC MEDICATION?

Posted on May 15, 2020May 15, 2020 by vlaw759

Stress and alcohol go together like peanut butter and jelly—a burger and fries, mac and cheese, bread and butter, mashed potatoes and gravy, milk and cookies, or any other iconic duo you can think of. Yes, they can be separated but—oh, so often—you don’t have one without the other.

I started thinking about this when the Richmond Times-Dispatch ran a front page story (above the fold!) about liquor sales in Virginia. You will recall that ABC Stores have remained open as “essential” services. And according to numbers from the Virginia Alcoholic Beverage Control Authority, sales now hover around $22 million a week.

In March, as the social distancing began, the ABC stores had more than $30 million per week. Sales in April 2020 were up about 15% over a year ago. The article goes on to identify the top selling brands for the state and for the Richmond Planning District (City of Richmond, Henrico, Goochland, Hanover, Chesterfield, and Powhatan counties). I was less interested in the rankings than in the sheer volume!

Alcohol consumption is up all over the country. To look at one other location, in Tulsa, OK, one liquor store reported that looking at sales March 15 to April 15, liquor sales were up 56% and beer 48%. Compared to a similar date in April of 2019, one-day sales in April 2020 were up by 100%.

According to one store owner, buying habits are changing in that people are buying more at a time, shopping more during the day and less in the evenings and on weekends.

In order to facilitate buying alcohol, providers are offering digital ordering and delivery, curbside pick-up, hosting, hosting virtual tastings and/or cocktail hours. And some are branching out by stocking hand sanitizers and face masks. Virtual cocktail parties among friends and families are now common.

*If your aim is absolutely perfect, your cocktail parties with neighbors don’t have to be virtual!*

Estimates of the increase in U.S. alcohol consumption from now to the same time last year vary from 25% (WHO) to 55% (Healthcare Home [//healthcare.utah.edu]).

The uptick in alcohol consumption is not solely a U.S. phenomenon. The World Health Organization has issued statements urging countries world-wide to try to curb drinking during the current pandemic. They cite several health reasons to try to control excessive alcohol consumption. No matter how bad a situation is, excess drinking can always make it worse!

*Magic Snowman Tea is guaranteed to be 100% alcohol free.*

Weaken the immune system, actually making people more vulnerable to infection
Exacerbate existing health problems
Increase risk-taking
Increase violence (“a horrifying global surge in domestic violence”)
- As victims of domestic abuse find themselves trapped at home under constant surveillance by their abuser, many have trouble accessing resources. Some organizations are offering discreet assistance for people with no physical or virtual privacy.
  - Circle of 6
  - One Love Foundation
  - Private sellers of make-up or beauty products who will not be listed here as that would defeat their anonymity
- The National Domestic Violence Hotline (1-800-799-7233), Futures Without Violence, National Network to End Domestic Violence, National Coalition Against Domestic Violence, Stronghearts Native Helpline (1−844-762-8483) and other organizations provide more information about available resources during the pandemic.

*There are other substances one can turn to in times of stress. This is one of my favorites.*

Contribute to or worsen mental health problems
- If you are in a crisis, please call (1-800-273-8255).
- The Suicide Prevention Lifeline, Zero Suicide, the Suicide Prevention Resource Center, and the National Alliance on Mental Illness have all updated their websites with information about mental health assistance during the pandemic.

Also according to WHO, alcohol-related deaths number 3 million every year—before the pandemic. And the WHO now has the added difficulty of trying to quash the misinformation that has circulated to the effect that drinking can make someone immune to the COVID-19 virus and/or cure one if infected. The presumed medicinal value of alcohol has a long history (see below), perhaps with roots in the dulling of physical pain.

Jackie Chan is a master of Drunken Fist Kung Fu ( 醉拳 )

The link between stress and alcohol consumption is so well established that it’s actually called “self-medication.” In fact, such self-medication can be pretty effective, at least initially, in relieving anxiety and depression. Alcohol is a “downer” (i.e., a system depressant) so if people are wound up, rapid heart beat, etc., alcohol can definitely make those symptoms of stress go down. But as mentioned above, alcohol also depresses inhibitions, increases risk-taking, decreases logical decision making, increases violence, and — after all that — is still likely to interfere with restful sleep.

*Being home all day with bored and curious toddlers is a very stressful circumstance.*

COVID-19 presents a set of circumstances that are problematic with regard to alcohol consumption.

High levels of anxiety associated with the unknown
Isolation from one’s usual support system
Loneliness
Economic distress/job loss
Food insecurity
Fear of infection/death
Mourning the loss of a loved one
Stress at having to work from home
Stress of having to work in an “essential” job interacting with the public

COVID-19 is dominating today’s headlines, but it is far from unique. Research indicates that alcohol use and abuse increase during and after “violent conflicts”—e.g., wars, periods of martial law, government coups. Other psychotropic substances are also used to deal with psychic strains and trauma, but alcohol is generally the most likely to be readily available, legal, and (at least within limits) socially acceptable.

During the 1918 Influenza Pandemic, bootleg whiskey was viewed as a respectable medicine. At the time, more than half the states in the U.S. had passed Prohibition laws and thus were “dry.” But for medicinal purposes, some officials decided to tap the vast stores of liquor that had been confiscated initially to aid the military, although the Army mostly remained silent about using it. In Richmond, Virginia—reportedly—two railroad cars of confiscated whiskey arrived for the benefit of Camp Lee. Over time, confiscated whiskey was distributed to civilian hospitals, too.

Medical isopropyl alcohol is now available at vending machines in Moscow.

The United States Pharmacopeia dropped whiskey, brandy, and wine from its listing of therapeutics in 1916. In 1917, the American Medical Association resolved that “the use of alcohol as a therapeutic agent should be discouraged.” Even so, more than half of physicians believed it was “a necessary therapeutic agent.” It continued to be available by prescription in dry states. To this day, strong alcohol is prescribed for medicinal purposes in some areas, even by doctors!

Besides the demand for alcohol, the Spanish Flu pandemic shared other characteristics with COVID-19:

Wearing masks
Social isolation
Use of disinfectants
Limiting group gatherings, including churches
Hospitals and funeral homes were overwhelmed
During Spanish Flu the treatment of choice was aspirin, up to 30 grams daily which is a toxic dose; currently, think ingesting bleach or disinfectants.

*Bootlegger tunnels in Miami during Prohibition*

Bottom line for writers: people use alcohol to self-medicate for stress. The current stressor is COVID-19 BUT consider all the other stressors out there, which might occur alone or in combination with COVID-19: death of a loved one, job loss, divorce, physical illness, mental illness, physical disability, too little money, going hungry, being homeless… Do you have a character who does—who could—self-medicate with alcohol?

From the Archives: Alcohol for Writers

Posted on August 6, 2019 by vlaw759

In 2016, I wrote Alcohol for Writers: the famous authors infamous for drinking, facts writers should know about alcohol (even if they don’t imbibe), and what to know about your characters’ interactions with drink.

On the subject of alcohol, you can read about its consumption with tobacco in Smokers Drink and Drinkers Smoke. Perhaps not surprisingly, the people who drink the most, as a group, also consume the most tobacco.

Each of these posts explore the dangers of addiction, which I dive into in The Upside of Addiction for Writers. In addition to substance abuse, writers should also consider behavioral addiction, such as gambling, eating, or working. (And don’t forget Workaholics Day.)

Now it’s your turn: how do you treat alcohol in your writing? Let me know in the comments.

The Morning After the Night Before

Posted on January 25, 2019January 25, 2019 by vlaw759

I have already written about smoking and drinking, but realized that there are several facts about alcohol—potentially helpful to writers—that I omitted heretofore. Other factors are so crucial to reality that I’ve repeated them here.

How much is too much?

When writing realistic drinking scenes, be aware of factors that affect the effects of alcohol. You probably know that eating—particularly fatty foods—slows the metabolism of alcohol and thus one gets high faster on an empty stomach. (I once read that ancient Romans drank straight olive oil to increase their tolerance before big feasts. Just saying.) You may also know that people who drink regularly and heavily have a higher tolerance. But regardless of anything else—as these two charts show—weight and gender are huge factors in alcohol effects.

Causes of gender differences: Besides weighing more in general, the male body tends to have more water to dilute alcohol. Also, women have significantly less of the enzyme that breaks down alcohol in the stomach.

Bottom line: Even when controlling for weight, women get drunk faster and stay drunk longer than men.

How long does alcohol stay in your system?

A normal, healthy liver can process approximately one drink per hour. To put it another way, one drink of alcohol stays in your blood approximately one hour. More than that, and it takes proportionately longer to get clear.

Alcohol stays in your urine about 80 hours.

Alcohol stays in your hair follicles approximately three months.

Alcohol can be detected on the breath as long as there is alcohol in the system. E.g., with a blood alcohol of .20, that would be approximately 13 hours.

Using the EtG test, one beer was detectable 16 hours later; six shots of vodka taken in 3 hours was detectable 54 hours later. Important note: this is the most sensitive test to detect whether a person has had alcohol. It does not detect drunkenness, which can have passed off during the intervening hours.

So, consider those factors when your are writing about alcohol testing, e.g. for a job application or entrance into a treatment program.

How long does it take to sober up?

Short answer: it depends on how much you’ve had to drink. (See above.) In many states, a blood alcohol concentration (BAC) of .10 means that 1% of your bloodstream is alcohol—and therefore drunk. Writers: Be sure to confirm the level for legally drunk in the locale of your story.

More technical answer: most alcohol metabolism depends on the liver, which takes one hour to metabolize 1.0 to 1.5 ounces of alcohol (depending on study cited). If one ounce of alcohol produces a blood alcohol concentration of .015 will have no alcohol in his/her system after 10 hours. The healthy, average liver metabolizes alcohol at a constant rate.

Ramping up the problems

One sure way to do this is to write a character with other health problems that require medication. (See list above.)

Given the frequency of use for pain, over-the-counter NSAIDS (non-steroidal anti-inflamatory drugs) deserve special mention. According to my reading, Tylenol is the worst because it can cause severe liver damage from regular doses that are taken when drinking alcohol daily. Others are more likely to cause internal bleeding, ulcers, etc., which (in my opinion) would be likely to be detected sooner.

Conveying drinking problems without labeling them

You can find many self-tests online that would give you thoughts and/or worries for your character. Answers to the four questions on the CAGE assessment identifies 9 out of 10 alcoholics! Other resources include the MAST Alcohol Assessment Quiz, which comes in various lengths, and the 10-multiple-choice-question AUDIT Alcohol Assessment Quiz.

If the drinker is the POV character, these might be private concerns. If not, perhaps the character talks about these concerns with others.

Realistically, which characters are most likely to be problem drinkers?

Bottom line: I’ve tried to provide helpful info for realistic writing. Did I succeed?

Alcohol for Writers

Posted on July 15, 2016 by vlaw759

Keep it on the page!

Surely everyone can name at least one famous writer also famous for drinking. Think Raymond Chandler, Tennessee Williams, Dorothy Parker, Edgar Allen Poe. . . . If not, an internet search will turn up titles like these.

Top 15 Great Alcoholic Writers
Drinking Habits of Famous Authors
Top 10 Drunk American Writers
99 Writers who Were Alcoholics, Drunks, Addicted To Booze, Etc.
25 Great Writers Who Battled Drug Addiction and Alcoholism
All The Drunk Dudes: The Parodic Manliness Of The Alcoholic Writer
‘Every hour a glass of wine’—the female writers who drank
What drives writers to drink?

This last question has led to numerous academic examinations and investigations of the topic.

As for “How to Drink Like Kerouac, Hemingway, and Other Famous Writers,” don’t try this at home, lest you end up on the list of “Famous Alcoholic Writers Who Died of Alcoholism.”

So, although I don’t advise writers to drink, I do advise knowing about alcohol. It’s such an integral part of life in America—celebrations, business dinners, relaxation, sports events, picnics, parties, all sorts of gatherings from weddings to funerals—that one can hardly write realistically without scenes involving alcohol. So here are a few basic facts you should be aware of and ready to justify if you go against them. See below for why your petite female PI would be unlikely to drink a hulking athlete under the table.

Alcohol for Writers: The Facts

In general, bigger people, more muscular people, and males get drunk slower than smaller people, less-muscular people, and females.
Even controlling for height and weight, women absorb alcohol faster and metabolize it slower than men. In other words, they get drunk faster and stay drunk longer.
In general, the health-related problems for women drinkers come on faster and are more devastating than for men.
People get drunk faster on an empty stomach than after a full meal. I’ve read that ancient Romans drank olive oil to coat the stomach before their binges, because that slows-down the absorption of alcohol into the bloodstream.
People who drink regularly and heavily have a greater capacity (tolerance) than those who drink less.
People are more likely to blackout from fast drinking than from slow drinking of the same amount of alcohol.
A standard drink is defined as 1.5 oz.shot of liquor, 5 oz. of wine, or 12 oz. of beer. Most wine coolers are the equivalent of one standard drink. FYI, heavy drinking = anything more than two drinks per day for men or 1 drink per day for women.

Having 2-3 drinks can cause a loss of motor control 12 to 18 hours after drinking. Name your accidental injury—falls, drownings, automobile accidents, etc.—and the incidence goes up with alcohol consumption. Name your intentional injuries—shooting, stabbing, physical violence, rape—it’s more likely to happen with alcohol.
There’s a reason athletes don’t drink before big events. Two to three drinks can deplete aerobic capacity and decrease endurance up to 48 hours after consumption.
Alcohol impairs both learning new information and recalling previously learned information.
Alcohol is a depressant for the central nervous system. People initially get “high” because the first thing to get depressed is inhibitions, creating a willingness to party and live dangerously. But beyond the buzz is the risk of seriously depressing metabolic functioning. A pulse rate below 40 or a breathing rate slower than 8-10 per minute is a medical emergency!
The website brad21.org is a great resource for writers! B.R.A.D. stands for Be Responsible About Drinking. It’s a series of bullet facts, well-footnoted for further reading.

Other Things Writers Should Know

…especially if a main character drinks.

First, perhaps most obviously, you need to decide on a preferred drink. According to bartenders, here are 10 drink stereotypes to help you create the desired impression. (Taken from complex.com, “The Funny Ways Bartenders Stereotype You Based On What You Drink.”)

-Vodka sodas are for people who want to lose weight—or want people to think so—but not enough to quit drinking.

-Jager bombs and vodka Red Bull are for basic bros.

-Blue Moon is for craft beer posers.

-Real craft beer drinkers are actually pretty cool.

-Annoying people act like they invented picklebacks. (Apparently a shot of whisky followed by a shot of pickle juice—really.)

-Buttery Chardonnays are for soccer moms.

-Only rookies drink Appletinis.

-Bud Light is for sporting events and day drinking, not Saturday night.

-Martinis are a classic, classy drink.

-Shots should be taken with a beer or a celebration. (Otherwise they’re for alcoholics.)

For a funny but useful commentary on everything from absinthe to wine see pointsincase.com, in an article titled “What Your Drink Says About You.”

Second, know your character’s drink. Know what it looks like, how it smells, how strong it is, and its taste. Also, whether wine, beer, or liquor, a drinker is likely to have the everyday brand and the special-occasion brand.

Third, know your character’s drinking habits and reactions. Know when, where, under what circumstances, and how much s/he drinks. People usually have a pattern of reaction to alcohol, roughly: fall asleep, talk more, repeat him/herself, verbal abusiveness, physical violence.

Takeaway for Writers

What’s good for characters isn’t good for authors!