ALCOHOL: OTC MEDICATION?

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

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.

Totally non-addictive!

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?

WRITING ISOLATION

Sleuth of Bears

There is a whole cadre—Heidegger (1889-1976) arguably the most famous—who argue that being-with-others is part of the “structure of human existence.” In other words, we are hard-wired to socialize. Whether you believe that or not, there are a gazillion (by actual count) studies that have found isolation to be harmful to humans, both physically and psychologically. 

Litter of Puppies

(Editor’s note: Including photographs of isolated and lonely people was too depressing, so I invite you to enjoy these photos of animals not social distancing instead.)

For writers, bad is good

Pod of Dolphins

How bad is it?  Some researchers posit that social isolation and loneliness are twice as harmful as obesity. Others compare the effects on mortality to be equal to smoking 15 cigarettes per day. Others say the magnitude of risk is right up there with physical inactivity and lack of access to health care.

N.B.  Degrees or levels of isolation are difficult to define and measure.  Perceived isolation is what produces feelings of loneliness. In many ways, it is easier to study social isolation, though they are closely linked.

Pandemonium of Parrots

As a writer, the first question is, “Why is your character isolated?” Your options may be more numerous than you think. Here are a few examples.

  • Death of a loved one
  • Divorce
  • Move to a new place
  • Researcher in isolated places, like Antarctica 
  • Mission/mission training, e.g., astronauts
  • Immune compromised
Leap of Leopards
  • A child/infant in understaffed orphanage
  • Being shunned for any reason  
    • Behavior  
    • Appearance 
    • Membership in a marginalized subgroup
  • Medical quarantine
  • As a form of torture
    • Solitary confinement in prison (currently about 80,000 in the U.S. each year)
Tower of Giraffes

The second set of questions for a writer:

  • How complete is the isolation?
  • How long does it last?
  • Is it repeated?
  • In general, the more complete the isolation, the longer it lasts, and repetition all increase the number and seriousness of the effects. 
Mob of Kangaroos

The third question is, which effects will your character display? 

Parliament of Owls
  • Fatigue
  • Insomnia
  • Headaches
  • Sweaty palms
  • Heart palpitations
  • Lowered immunity
  • Increased inflammation 
  • Trembling
  • Diarrhea
  • Stomach pains
  • Lack of appetite
  • Drastic weight loss
Stand of Flamingos
  • Muscle pains (esp. neck and back)
  • Oversensitivity to sensory stimuli
  • Difficulty concentrating
  • Dizziness
  • Distorted sense of time
  • Severe boredom
  • Impaired memory
  • Inability to think coherently
  • Apathy
Conspiracy of Lemurs
  • Anxiety
  • Panic
  • Feelings of inadequacy
  • Feelings of inferiority
  • Irritability
  • Withdrawal
  • Rage/anger/aggression
  • Confusion
  • Paranoia
  • Depression
  • Suicidal thoughts
  • Hallucinations

Many of these effects mimic PTSD and, like PTSD, can last for years after the event.

Bale of Turtles

In the last couple of months, researchers are finding that COVID-19 isolation tends to evoke one of two responses.

Smack of Jellyfish
  • Those who hunker down and enjoy it—take it as a time to relax, read, bake, pursue a hobby, accomplish things around the house. In short, they’re getting along fine.
  • But for others—especially extroverts—the isolation can be harmful to both mind and body.

Not surprisingly, the effects of COVID-19 isolation are many of the same effects as other reasons for isolation.

Drift of Pigs
  • Boredom
  • Lethargy
  • Anxiety
  • Depression
  • Distorted sense of time
  • Poor sleep quality
  • Develop or increase unhealthy habits

Dr. Samantha Brooks wrote in The Lancet: “A huge factor in the negative psychological impact [of isolation] seems to be confusion about what’s going on, not having clear guidelines, or getting different messages from different organizations.” In addition, not knowing how long isolation will last exacerbates the negative effects of isolation. Think of the current differences within the U.S. and how similar circumstances could be applied to a fictional setting.

Obstinacy of Buffalo

People who are at increased risk from COVID-19 isolation are those at heightened risk for social isolation in the first place:

Gang of Elk
  • Older adults, especially with physical limitations and/or poor family support
  • Men who didn’t develop social networks outside work
  • Being non-white is a bigger risk factor than sex
  • Lower income people who may not afford the technology for distance socializing
  • Anyone who is marginalized (LGBTQ, survivor of domestic abuse, living in an isolated rural area)
  • People incarcerated for any reason
Cete of Badgers
Shiver of Sharks

Evidence of stress is apparent in the increased number of calls to suicide prevention (1-800-273-8255) and addiction (1-844-289-0879) hotlines.

Bottom line for writers: consider isolating your character and/or increasing his/her loneliness. You can take it almost anywhere.

Murmuration of Starlings