case study on alcoholic person

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

View all journals
Explore content
About the journal
Publish with us
Sign up for alerts
Published: 02 May 2024

Changes in alcohol consumption and alcohol problems before and after the COVID-19 pandemic: a prospective study in heavy drinking young adults

Kasey G. Creswell ORCID: orcid.org/0000-0002-6659-0651 1 ,
Garrett C. Hisler ORCID: orcid.org/0000-0001-7099-8417 2 ,
Greta Lyons 1 ,
Francisco A. Carrillo-Álvarez 1 nAff6 ,
Catharine E. Fairbairn 3 &
Aidan G. C. Wright ORCID: orcid.org/0000-0002-2369-0601 4 , 5

Nature Mental Health ( 2024 ) Cite this article

86 Accesses

98 Altmetric

Metrics details

Risk factors

Most past studies examining changes in alcohol use from before to during the COVID-19 pandemic used cross-sectional designs that required participants to retrospectively report on their pre-pandemic alcohol consumption. The few longitudinal studies conducted so far also commonly relied on retrospective reports of pre-pandemic alcohol use, and no previous longitudinal studies included multiple assessments that occurred both prior to and after the onset of the pandemic. Here, in 234 heavy drinking young adults (aged 21–29 years), we (1) prospectively examined within-person changes in alcohol consumption/patterns and alcohol problems assessed at multiple timepoints before and after the pandemic onset (February 2018 to March 2022), to examine trajectories of changes in alcohol involvement after the start of COVID in the context of deviations from pre-COVID trajectories (using individual growth models fitted in a multilevel structural equation modeling framework), and (2) tested theoretically informed mechanisms (that is, changes in negative affectivity, coping-motivated drinking and solitary drinking) in explaining pandemic-associated changes in alcohol consumption/patterns and alcohol problems using correlated slopes models. The results showed significant reductions in alcohol use quantity and frequency, as well as alcohol problems, from pre- to post-pandemic onset, which were largely driven by significant decreases in weekend (versus weekday) drinking quantity and frequency and drinks per drinking day. Negative affectivity significantly decreased, and solitary drinking significantly increased, from pre- to post-pandemic onset, with no significant change to coping drinking motives; changes in these variables were not related to decreases in alcohol involvement, and the magnitude of changes in all variables from pre- to post-pandemic onset did not generally differ for males and females. The results indicate that alcohol use and concomitant alcohol-related problems significantly decreased in these heavy drinking young adults during the pandemic, and these decreases were evident up to two years post pandemic onset.

This is a preview of subscription content, access via your institution

Access options

Subscribe to this journal

Receive 12 digital issues and online access to articles

55,14 € per year

only 4,60 € per issue

Buy this article

Purchase on Springer Link
Instant access to full article PDF

Prices may be subject to local taxes which are calculated during checkout

Loneliness trajectories over three decades are associated with conspiracist worldviews in midlife

Microdosing with psilocybin mushrooms: a double-blind placebo-controlled study

Adults who microdose psychedelics report health related motivations and lower levels of anxiety and depression compared to non-microdosers

Data availability.

Study aims, hypotheses and the data analytic plan were pre-registered on OSF prior to any data analyses being completed ( https://osf.io/kjfa6 ). Study designs for the parent study were pre-registered at ClinicalTrials.gov (under ID NCT03467191 ). Data, analysis code and analysis results can be found on OSF ( https://osf.io/kjfa6 ). Supplementary Information is available online.

WHO Director-General’s opening remarks at the media briefing on COVID-19—11 March 2020. WHO https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020 (2020).

Salazar de Pablo, G. et al. Impact of coronavirus syndromes on physical and mental health of health care workers: systematic review and meta-analysis. J. Affect. Disord. 275 , 48–57 (2020).

Article PubMed PubMed Central Google Scholar

Solmi, M. et al. Physical and mental health impact of COVID-19 on children, adolescents and their families: The Collaborative Outcomes Study on Health and Functioning during Infection Times – Children and Adolescents (COH-FIT-C&A). J. Affect. Disord. 299 , 367–376 (2022).

Article PubMed Google Scholar

Patel, K. et al. Psychological distress before and during the COVID-19 pandemic among adults in the United Kingdom based on coordinated analyses of 11 longitudinal studies. JAMA Netw. Open 5 , e227629 (2022).

Robinson, E., Sutin, A. R., Daly, M. & Jones, A. A systematic review and meta-analysis of longitudinal cohort studies comparing mental health before versus during the COVID-19 pandemic in 2020. J. Affect. Disord. 296 , 567–576 (2022).

Kuhfeld, M., Soland, J., Lewis, K. & Morton, E. The pandemic has had devastating impacts on learning. What will it take to help students catch up? Brookings https://www.brookings.edu/articles/the-pandemic-has-had-devastating-impacts-on-learning-what-will-it-take-to-help-students-catch-up/ (2022).

Acuff, S. F., Strickland, J. C., Tucker, J. A. & Murphy, J. G. Changes in alcohol use during COVID-19 and associations with contextual and individual difference variables: a systematic review and meta-analysis. Psychol. Addict. Behav. 36 , 1–19 (2022).

González-Monroy, C., Gómez-Gómez, I., Olarte-Sánchez, C. M. & Motrico, E. Eating behaviour changes during the COVID-19 pandemic: a systematic review of longitudinal studies. Int. J. Environ. Res. Public Health 18 , 11130 (2021).

Kilian, C. et al. Changes in alcohol use during the COVID-19 pandemic in Europe: a meta-analysis of observational studies. Drug Alcohol Rev. 41 , 918–931 (2022).

Roberts, A. et al. Alcohol and other substance use during the COVID-19 pandemic: a systematic review. Drug Alcohol Depend. 229 , 109150 (2021).

Schmidt, R. A. et al. The early impact of COVID-19 on the incidence, prevalence, and severity of alcohol use and other drugs: a systematic review. Drug Alcohol Depend. 228 , 109065 (2021).

Sohi, I. et al. Changes in alcohol use during the COVID-19 pandemic and previous pandemics: a systematic review. Alcohol Clin. Exp. Res. 46 , 498–513 (2022).

Jager, J. & Keyes, K. M. Is substance use changing because of the COVID‐19 pandemic? Conceptual and methodological considerations to delineating the impact of the COVID‐19 pandemic on substance use and disorder. Addiction 116 , 1301–1303 (2021).

Bollen, Z. et al. Longitudinal assessment of alcohol consumption throughout the first COVID-19 lockdown: contribution of age and pre-pandemic drinking patterns. Eur. Addict. Res. 28 , 48–55 (2021).

Minhas, M. et al. COVID‐19 impacts on drinking and mental health in emerging adults: longitudinal changes and moderation by economic disruption and sex. Alcohol. Clin. Exp. Res. 45 , 1448–1457 (2021).

Sharma, P. et al. Longitudinal correlates of increased alcohol use among adolescents and young adults during the COVID-19 pandemic. Alcohol Alcohol. 57 , 648–655 (2022).

PubMed Google Scholar

Venanzi, L. et al. Longitudinal predictors of depression, anxiety and alcohol use following COVID-19-related stress. Stress Health 38 , 679–691 (2022).

Johnston, L. D. et al. Monitoring the Future National Survey Results on Drug Use , 1975–2021 : Overview , Key Findings on Adolescent Drug Use (Institute for Social Research, 2022).

Patrick, M. E. et al. Alcohol use and the COVID-19 pandemic: historical trends in drinking, contexts and reasons for use among US adults. Social Sci. Med. 301 , 114887 (2022).

Article Google Scholar

Sylvestre, M.-P. et al. A longitudinal study of change in substance use from before to during the COVID-19 pandemic in young adults. Lancet Reg. Health Am 8 , 100168 (2022).

PubMed PubMed Central Google Scholar

Creswell, K. G. & Bachrach, R. L. A commentary on drinking to cope during the COVID-19 pandemic: the role of external and internal factors in coping motive pathways to alcohol use, solitary drinking and alcohol problems. Alcohol Clin. Exp. Res. 44 , 2150–2153 (2020).

Wardell, J. D. et al. Drinking to cope during COVID-19 pandemic: the role of external and internal factors in coping motive pathways to alcohol use, solitary drinking and alcohol problems. Alcohol Clin. Exp. Res. 44 , 2073–2083 (2020).

Penninx, B. W. J. H., Benros, M. E., Klein, R. S. & Vinkers, C. H. How COVID-19 shaped mental health: from infection to pandemic effects. Nat. Med 28 , 2027–2037 (2022).

Rehm, J. et al. Alcohol use in times of the COVID 19: implications for monitoring and policy. Drug Alcohol Rev. 39 , 301–304 (2020).

Cooper, M. L., Kuntsche, E., Levitt, A., Barber, L. L. & Wolf, S. in The Oxford Handbook of Substance Use and Substance Use Disorders Vol. 1, 375–421 (Oxford Univ. Press, 2016).

Creswell, K. G. et al. Drinking beyond the binge threshold in a clinical sample of adolescents. Addiction 115 , 1472–1481 (2020).

King, S. E., Skrzynski, C. J., Bachrach, R. L., Wright, A. G. C. & Creswell, K. G. A reexamination of drinking motives in young adults: the development and initial validation of the Young Adult Alcohol Motives Scale. Assessment 30 , 2398–2416 (2023).

Kuntsche, E., Knibbe, R., Gmel, G. & Engels, R. Why do young people drink? A review of drinking motives. Clin. Psychol. Rev. 25 , 841–861 (2005).

Merrill, J. E., Wardell, J. D. & Read, J. P. Drinking motives in the prospective prediction of unique alcohol-related consequences in college students. J. Stud. Alcohol Drugs 75 , 93–102 (2014).

Waddell, J. T., Corbin, W. R. & Marohnic, S. D. Putting things in context: longitudinal relations between drinking contexts, drinking motives and negative alcohol consequences. Psychol. Addict. Behav. 35 , 148–159 (2021).

Crum, R. M. et al. A prospective assessment of reports of drinking to self-medicate mood symptoms with the incidence and persistence of alcohol dependence. JAMA Psychiatry 70 , 718–726 (2013).

Fruehwirth, J. C., Gorman, B. L. & Perreira, K. M. The effect of social and stress-related factors on alcohol use among college students during the COVID-19 pandemic. J. Adolesc. Health 69 , 557–565 (2021).

Irizar, P. et al. Longitudinal associations with alcohol consumption during the first COVID-19 lockdown: associations with mood, drinking motives, context of drinking and mental health. Drug Alcohol Depend. 226 , 108913 (2021).

Bonar, E. E. et al. Binge drinking before and after a COVID-19 campus closure among first-year college students. Addict. Behav. 118 , 106879 (2021).

Jackson, K. M., Merrill, J. E., Stevens, A. K., Hayes, K. L. & White, H. R. Changes in alcohol use and drinking context due to the COVID‐19 pandemic: a multimethod study of college student drinkers. Alcohol. Clin. Exp. Res. 45 , 752–764 (2021).

Caudill, B. D. & Marlatt, G. A. Modeling influences in social drinking: an experimental analogue. J. Consult. Clin. Psychol. 43 , 405–415 (1975).

Creswell, K. G. Drinking together and drinking alone: a social-contextual framework for examining risk for alcohol use disorder. Curr. Dir. Psychol. Sci. 30 , 19–25 (2021).

Marlatt, G. A. Taxonomy of high-risk situations for alcohol relapse: evolution and development of a cognitive-behavioral model. Addiction 91 , 37–50 (1996).

Google Scholar

Steele, C. M. & Josephs, R. A. Alcohol myopia: its prized and dangerous effects. Am. Psychol. 45 , 921–933 (1990).

Zapolski, T. C. B., Pedersen, S. L., McCarthy, D. M. & Smith, G. T. Less drinking, yet more problems: understanding African American drinking and related problems. Psychol. Bull. 140 , 188–223 (2014).

Corbin, W. R., Waddell, J. T., Ladensack, A. & Scott, C. I drink alone: mechanisms of risk for alcohol problems in solitary drinkers. Addict. Behav. 102 , 106147 (2020).

Creswell, K. G., Chung, T., Clark, D. B. & Martin, C. S. Solitary alcohol use in teens is associated with drinking in response to negative affect and predicts alcohol problems in young adulthood. Clin. Psychol. Sci. J. Assoc. Psychol. Sci. 2 , 602–610 (2014).

Creswell, K. G., Terry-McElrath, Y. M. & Patrick, M. E. Solitary alcohol use in adolescence predicts alcohol problems in adulthood: a 17-year longitudinal study in a large national sample of US high school students. Drug Alcohol Depend. 238 , 109552 (2022).

Skrzynski, C. J. & Creswell, K. G. Associations between solitary drinking and increased alcohol consumption, alcohol problems, and drinking to cope motives in adolescents and young adults: a systematic review and meta-analysis. Addiction 115 , 1989–2007 (2020).

Skrzynski, C. J. & Creswell, K. G. A systematic review and meta-analysis on the association between solitary drinking and alcohol problems in adults. Addiction 116 , 2289–2303 (2021).

Saunders, J. B., Aasland, O. G., Babor, T. F., De La Fuente, J. R. & Grant, M. Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction 88 , 791–804 (1993).

Read, J. P., Kahler, C. W., Strong, D. R. & Colder, C. R. Development and preliminary validation of the young adult alcohol consequences questionnaire. J. Stud. Alcohol 67 , 169–177 (2006).

Fairbairn, C. E. & Sayette, M. A. A social-attributional analysis of alcohol response. Psychol. Bull. 140 , 1361–1382 (2014).

Monk, R. L., Qureshi, A. & Heim, D. An examination of the extent to which mood and context are associated with real-time alcohol consumption. Drug Alcohol Depend. 208 , 107880 (2020).

Smit, K., Groefsema, M., Luijten, M., Engels, R. C. M. E. & Kuntsche, E. Drinking motives moderate the effect of the social environment on alcohol use: an event-level study among young adults. J. Stud. Alcohol Drugs 76 , 971–980 (2015).

Thrul, J., Labhart, F. & Kuntsche, E. Drinking with mixed-gender groups is associated with heavy weekend drinking among young adults. Addiction 112 , 432–439 (2017).

Lau-Barraco, C. & Linden, A. N. Drinking buddies: who are they and when do they matter? Addict. Res. Theory 22 , 57–67 (2014).

Cullum, J., O’Grady, M., Armeli, S. & Tennen, H. The role of context-specific norms and group size in alcohol consumption and compliance drinking during natural drinking events. Basic Appl. Soc. Psychol. 34 , 304–312 (2012).

Sayette, M. A. et al. Alcohol and group formation: a multimodal investigation of the effects of alcohol on emotion and social bonding. Psychol. Sci. 23 , 869–878 (2012).

Venerable, W. J. & Fairbairn, C. E. A multimodal, longitudinal investigation of alcohol’s emotional rewards and drinking over time in young adults. Psychol. Addict. Behav. 34 , 601–612 (2020).

Gonzalez, V. M., Collins, R. L. & Bradizza, C. M. Solitary and social heavy drinking, suicidal ideation and drinking motives in underage college drinkers. Addict. Behav. 34 , 993–999 (2009).

Tucker, J. S., Ellickson, P. L., Emery, R. L. & Klein, D. J. Does solitary substance use increase adolescents’ risk for poor psychosocial and behavioral outcomes? A 9-year longitudinal study comparing solitary and social users. Psychol. Addict. Behav. 20 , 363–372 (2006).

Berlin, J. A., Santanna, J., Schmid, C. H., Szczech, L. A. & Feldman, H. I. Individual patient- versus group-level data meta-regressions for the investigation of treatment effect modifiers: ecological bias rears its ugly head. Stat. Med. 21 , 371–387 (2002).

Reade, M. C., Delaney, A., Bailey, M. J. & Angus, D. C. Bench-to-bedside review: avoiding pitfalls in critical care meta-analysis—funnel plots, risk estimates, types of heterogeneity, baseline risk and the ecologic fallacy. Crit. Care 12 , 220 (2008).

Sayette, M. A., Goodwin, M. E., Creswell, K. G., Esmacher, H. J. & Dimoff, J. D. A person-centered analysis of craving in smoking-cue-exposure research. Clin. Psychol. Sci. 10 , 570–583 (2022).

Fairbairn, C. E., Creswell, K. G., Hales, A. H., Williams, K. D. & Wilkins, K. V. Mixing misery and gin: the effect of alcohol administration on ostracism response. Pers. Soc. Psychol. Bull. 48 , 1269–1283 (2021).

Sobell, L. C. & Sobell, M. B. in Measuring Alcohol Consumption : Psychosocial and Biochemical Methods (eds Litten, R. Z. & Allen, J. P.) 41–72 (Humana Press, 1992); https://doi.org/10.1007/978-1-4612-0357-5_3

Pedersen, E. R., Grow, J., Duncan, S., Neighbors, C. & Larimer, M. E. Concurrent validity of an online version of the Timeline Followback assessment. Psychol. Addict. Behav. 26 , 672–677 (2012).

Roy, M. et al. Comparison of the quick drinking screen and the alcohol timeline followback with outpatient alcohol abusers. Substance Use Misuse 43 , 2116–2123 (2008).

Tonigan, J. S., Miller, W. R. & Brown, J. M. The reliability of Form 90: an instrument for assessing alcohol treatment outcome. J. Stud. Alcohol 58 , 358–364 (1997).

Hoeppner, B. B. et al. Daily college student drinking patterns across the first year of college. J. Stud. Alcohol Drugs 73 , 613–624 (2012).

Kushner, M. G., Abrams, K. & Borchardt, C. The relationship between anxiety disorders and alcohol use disorders: a review of major perspectives and findings. Clin. Psychol. Rev. 20 , 149–171 (2000).

Tremblay, P. F. et al. When do first-year college students drink most during the academic year? An Internet-based study of daily and weekly drinking. J. Am. College Health 58 , 401–411 (2010).

Kokotailo, P. K. et al. Validity of the alcohol use disorders identification test in college students. Alcohol. Clin. Exp. Res. 28 , 914–920 (2004).

Babor, T. F. & Grant, M. From clinical research to secondary prevention: international collaboration in the development of the Alcohol Disorders Identification Test (AUDIT). Alcohol Health Res. World 13 , 371–375 (1989).

Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B. & Monteiro, M. G. AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Health Care (WHO, 2001); https://apps.who.int/iris/handle/10665/67205

Kahler, C. W., Hustad, J., Barnett, N. P., Strong, D. R. & Borsari, B. Validation of the 30-day version of the Brief Young Adult Alcohol Consequences Questionnaire for use in longitudinal studies. J. Stud. Alcohol Drugs 69 , 611–615 (2008).

Cooper, M. L. Motivations for alcohol use among adolescents: development and validation of a four-factor mode. Psychol. Assess. 6 , 117–128 (1994).

MacLean, M. G. & Lecci, L. A comparison of models of drinking motives in a university sample. Psychol. Addict. Behav. 14 , 83–87 (2000).

Maples, J. L. et al. Testing whether the DSM-5 personality disorder trait model can be measured with a reduced set of items: an item response theory investigation of the Personality Inventory for DSM-5. Psychol. Assess. 27 , 1195–1210 (2015).

Al-Dajani, N., Gralnick, T. M. & Bagby, R. M. A psychometric review of the Personality Inventory for DSM-5 (PID-5): current status and future directions. J. Pers. Assess. 98 , 62–81 (2016).

Anderson, J. L., Sellbom, M. & Salekin, R. T. Utility of the Personality Inventory for DSM-5–Brief Form (PID-5-BF) in the measurement of maladaptive personality and psychopathology. Assessment 25 , 596–607 (2018).

Muthen, L. K. & Muthen, B. O. Mplus User’s Guide 8th edn (Muthen & Muthen, 2017).

Marvin, L., Liu, H. & Depaoli, S. Using Bayesian piecewise growth curve models to handle complex nonlinear trajectories. J. Behav. Data Sci 3 , 1–33 (2023).

Burnham, K. P. & Anderson, D. R. Multimodel inference: understanding AIC and BIC in model selection. Sociol. Methods Res. 33 , 261–304 (2004).

Download references

Acknowledgements

This study was supported by National Institutes of Health (NIH) grant no. R01 AA025936 to K.G.C. The work by A.G.C.W. was supported by NIH grant no. R01 AA026879. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The NIH did not have any role in the study design, collection, analysis or interpretation of the data, writing the manuscript or the decision to submit the paper for publication. We thank the staff and students of the Behavioral Health Research Lab at Carnegie Mellon University for their help in conducting this study, as well as S. Yadav for help with creating Fig. 1 .

Author information

Francisco A. Carrillo-Álvarez

Present address: VA Boston Healthcare System, Boston, MA, USA

Authors and Affiliations

Psychology Department, Carnegie Mellon University, Pittsburgh, PA, USA

Kasey G. Creswell, Greta Lyons & Francisco A. Carrillo-Álvarez

Psychology Department, University of Pittsburgh, Pittsburgh, PA, USA

Garrett C. Hisler

Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, USA

Catharine E. Fairbairn

Department of Psychology, University of Michigan, Ann Arbor, MI, USA

Aidan G. C. Wright

Eisenberg Family Depression Center, University of Michigan, Ann Arbor, MI, USA

You can also search for this author in PubMed Google Scholar

Contributions

Conceptualization was provided by K.G.C. and A.G.C.W., methodology by K.G.C. and C.E.F., formal analysis by G.C.H. and A.G.C.W., funding acquisition by K.G.C. and investigations by G.L., K.G.C. and F.A.C.-Á. The original draft was written by K.G.C., and review and editing was provided by A.G.C.W., G.C.H., C.E.F., G.L. and F.A.C.Á.

Corresponding author

Correspondence to Kasey G. Creswell .

Ethics declarations

Competing interests.

The authors declare no competing interests.

Peer review

Peer review information.

Nature Mental Health thanks Samuel F. Acuff, Patricia Irizar and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Extended data

Extended data fig. 1 audit scores from pre- to post-pandemic onset..

Model estimated changes for Alcohol Use Disorder Identification Test (AUDIT) scores from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 2 B-YAACQ scores from pre- to post-pandemic.

Model estimated changes for Brief-Young Adult Alcohol Consequences Questionnaire (B-YAACQ) scores from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 3 Coping motives from pre- to post-pandemic.

Model estimated changes for coping drinking motives from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 4 Drinks per drinking day from pre- to post-pandemic.

Model estimated changes for drinks per drinking day from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 5 Negative affectivity from pre- to post-pandemic.

Model estimated changes for negative affectivity from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 6 Solitary drinking from pre- to post-pandemic.

Model estimated changes for solitary drinking from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 7 Total drinking frequency from pre- to post-pandemic.

Model estimated changes for total drinking frequency from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 8 Total drinking quantity from pre- to post-pandemic.

Model estimated changes for total drinking quantity from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 9 Weekday drinking frequency from pre- to post-pandemic.

Model estimated changes for weekday drinking frequency from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 10 Weekday drinking quantity from pre- to post-pandemic.

Model estimated changes for weekday drinking quantity from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 11 Weekend drinking frequency from pre- to post-pandemic.

Model estimated changes for weekend drinking frequency from pre- to post-pandemic overlaid on the raw data.

Extended Data Fig. 12 Weekend drinking quantity from pre- to post-pandemic.

Model estimated changes for weekend drinking quantity from pre- to post-pandemic overlaid on the raw data.

Supplementary information

Supplementary information.

Supplementary Tables 1-6.

Reporting Summary

Rights and permissions.

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Cite this article.

Creswell, K.G., Hisler, G.C., Lyons, G. et al. Changes in alcohol consumption and alcohol problems before and after the COVID-19 pandemic: a prospective study in heavy drinking young adults. Nat. Mental Health (2024). https://doi.org/10.1038/s44220-024-00247-9

Download citation

Received : 27 June 2023

Accepted : 26 March 2024

Published : 02 May 2024

DOI : https://doi.org/10.1038/s44220-024-00247-9

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Quick links

Explore articles by subject
Guide to authors
Editorial policies

Experiences of alcohol dependence: a qualitative study

Affiliation.

1 The Open University.
PMID: 18201015

Introduction and aims of the study: Despite the increasing incidence of alcohol misuse and the costs it incurs, British society continues to hold equivocal and ambiguous attitudes towards drinking, and understanding of the nature of alcohol dependence and related issues is limited. This qualitative study aimed to investigate the experiences of individuals with alcohol dependence to enhance understanding of the illness, identify key issues and common themes and provide insight into the experiences of the participants during their alcohol dependent period and recovery.

Method: A qualitative approach, using narrative method, was used. Eight participants, all members of Alcoholics Anonymous (AA), were interviewed by the researchers. Using a grounded theory approach and content analysis, the in-depth narratives of the eight participants were systematically analysed.

Results: While participants continued to deny the existence of a problem to those around them, their behaviours indicated that they were aware of the problem but were afraid to admit it openly through fear of other people's reactions. Participants generally regarded GPs as helpful but other health professionals less so, especially nurses and Accident and Emergency staff. Participants considered that the success of treatment depended on their own motivation and willingness to engage in radical behaviour change. They considered that reaching this stage represented a turning point in their illness. The point at which this stage was reached appeared to be different for each participant.

Conclusions: This systematic analysis of a small sample of alcohol dependent individuals gives insight into their experiences during alcohol dependency and the journey to recovery. The findings suggest that denial of the problem to the outside world occurs simultaneously with individuals being aware of their problem. Participants felt the illness carries a stigma and their negative experiences of health professionals other than GPs suggests that nurses and other health workers need to revise their understanding of alcohol dependence and their approach to it. AA was a significant factor in recovery for these participants.

Adaptation, Psychological*
Alcoholics Anonymous
Alcoholism / complications
Alcoholism / prevention & control
Alcoholism / psychology*
Attitude to Health*
Cost of Illness
Denial, Psychological
Health Services Needs and Demand
Helping Behavior
Middle Aged
Nursing Methodology Research
Professional Role / psychology
Qualitative Research
Self Disclosure
Social Support
Stereotyping
Surveys and Questionnaires

Module 9: Substance-Related and Addictive Disorders

Case studies: substance-abuse disorders, learning objectives.

Identify substance abuse disorders in case studies

Case Study: Benny

The following story comes from Benny, a 28-year-old living in the Metro Detroit area, USA. Read through the interview as he recounts his experiences dealing with addiction and recovery.

Q : How long have you been in recovery?

Benny : I have been in recovery for nine years. My sobriety date is April 21, 2010.

Q: What can you tell us about the last months/years of your drinking before you gave up?

Benny : To sum it up, it was a living hell. Every day I would wake up and promise myself I would not drink that day and by the evening I was intoxicated once again. I was a hardcore drug user and excessively taking ADHD medication such as Adderall, Vyvance, and Ritalin. I would abuse pills throughout the day and take sedatives at night, whether it was alcohol or a benzodiazepine. During the last month of my drinking, I was detached from reality, friends, and family, but also myself. I was isolated in my dark, cold, dorm room and suffered from extreme paranoia for weeks. I gave up going to school and the only person I was in contact with was my drug dealer.

Q : What was the final straw that led you to get sober?

Benny : I had been to drug rehab before and always relapsed afterwards. There were many situations that I can consider the final straw that led me to sobriety. However, the most notable was on an overcast, chilly October day. I was on an Adderall bender. I didn’t rest or sleep for five days. One morning I took a handful of Adderall in an effort to take the pain of addiction away. I knew it wouldn’t, but I was seeking any sort of relief. The damage this dosage caused to my brain led to a drug-induced psychosis. I was having small hallucinations here and there from the chemicals and a lack of sleep, but this time was different. I was in my own reality and my heart was racing. I had an awful reaction. The hallucinations got so real and my heart rate was beyond thumping. That day I ended up in the psych ward with very little recollection of how I ended up there. I had never been so afraid in my life. I could have died and that was enough for me to want to change.

Q : How was it for you in the early days? What was most difficult?

Benny : I had a different experience than most do in early sobriety. I was stuck in a drug-induced psychosis for the first four months of sobriety. My life was consumed by Alcoholics Anonymous meetings every day and sometimes two a day. I found guidance, friendship, and strength through these meetings. To say early sobriety was fun and easy would be a lie. However, I did learn it was possible to live a life without the use of drugs and alcohol. I also learned how to have fun once again. The most difficult part about early sobriety was dealing with my emotions. Since I started using drugs and alcohol that is what I used to deal with my emotions. If I was happy I used, if I was sad I used, if I was anxious I used, and if I couldn’t handle a situation I used. Now that the drinking and drugs were out of my life, I had to find new ways to cope with my emotions. It was also very hard leaving my old friends in the past.

Q : What reaction did you get from family and friends when you started getting sober?

Benny : My family and close friends were very supportive of me while getting sober. Everyone close to me knew I had a problem and were more than grateful when I started recovery. At first they were very skeptical because of my history of relapsing after treatment. But once they realized I was serious this time around, I received nothing but loving support from everyone close to me. My mother was especially helpful as she stopped enabling my behavior and sought help through Alcoholics Anonymous. I have amazing relationships with everyone close to me in my life today.

Q : Have you ever experienced a relapse?

Benny : I experienced many relapses before actually surrendering. I was constantly in trouble as a teenager and tried quitting many times on my own. This always resulted in me going back to the drugs or alcohol. My first experience with trying to become sober, I was 15 years old. I failed and did not get sober until I was 19. Each time I relapsed my addiction got worse and worse. Each time I gave away my sobriety, the alcohol refunded my misery.

Q : How long did it take for things to start to calm down for you emotionally and physically?

Benny : Getting over the physical pain was less of a challenge. It only lasted a few weeks. The emotional pain took a long time to heal from. It wasn’t until at least six months into my sobriety that my emotions calmed down. I was so used to being numb all the time that when I was confronted by my emotions, I often freaked out and didn’t know how to handle it. However, after working through the 12 steps of AA, I quickly learned how to deal with my emotions without the aid of drugs or alcohol.

Q : How hard was it getting used to socializing sober?

Benny : It was very hard in the beginning. I had very low self-esteem and had an extremely hard time looking anyone in the eyes. But after practice, building up my self-esteem and going to AA meetings, I quickly learned how to socialize. I have always been a social person, so after building some confidence I had no issue at all. I went back to school right after I left drug rehab and got a degree in communications. Upon taking many communication classes, I became very comfortable socializing in any situation.

Q : Was there anything surprising that you learned about yourself when you stopped drinking?

Benny : There are surprises all the time. At first it was simple things, such as the ability to make people smile. Simple gifts in life such as cracking a joke to make someone laugh when they are having a bad day. I was surprised at the fact that people actually liked me when I wasn’t intoxicated. I used to think people only liked being around me because I was the life of the party or someone they could go to and score drugs from. But after gaining experience in sobriety, I learned that people actually enjoyed my company and I wasn’t the “prick” I thought I was. The most surprising thing I learned about myself is that I can do anything as long as I am sober and I have sufficient reason to do it.

Q : How did your life change?

Benny : I could write a book to fully answer this question. My life is 100 times different than it was nine years ago. I went from being a lonely drug addict with virtually no goals, no aspirations, no friends, and no family to a productive member of society. When I was using drugs, I honestly didn’t think I would make it past the age of 21. Now, I am 28, working a dream job sharing my experience to inspire others, and constantly growing. Nine years ago I was a hopeless, miserable human being. Now, I consider myself an inspiration to others who are struggling with addiction.

Q : What are the main benefits that emerged for you from getting sober?

Benny : There are so many benefits of being sober. The most important one is the fact that no matter what happens, I am experiencing everything with a clear mind. I live every day to the fullest and understand that every day I am sober is a miracle. The benefits of sobriety are endless. People respect me today and can count on me today. I grew up in sobriety and learned a level of maturity that I would have never experienced while using. I don’t have to rely on anyone or anything to make me happy. One of the greatest benefits from sobriety is that I no longer live in fear.

Case Study: Lorrie

Lorrie, image of a smiling woman wearing glasses.

Figure 1. Lorrie.

Lorrie Wiley grew up in a neighborhood on the west side of Baltimore, surrounded by family and friends struggling with drug issues. She started using marijuana and “popping pills” at the age of 13, and within the following decade, someone introduced her to cocaine and heroin. She lived with family and occasional boyfriends, and as she puts it, “I had no real home or belongings of my own.”

Before the age of 30, she was trying to survive as a heroin addict. She roamed from job to job, using whatever money she made to buy drugs. She occasionally tried support groups, but they did not work for her. By the time she was in her mid-forties, she was severely depressed and felt trapped and hopeless. “I was really tired.” About that time, she fell in love with a man who also struggled with drugs.

They both knew they needed help, but weren’t sure what to do. Her boyfriend was a military veteran so he courageously sought help with the VA. It was a stroke of luck that then connected Lorrie to friends who showed her an ad in the city paper, highlighting a research study at the National Institute of Drug Abuse (NIDA), part of the National Institutes of Health (NIH.) Lorrie made the call, visited the treatment intake center adjacent to the Johns Hopkins Bayview Medical Center, and qualified for the study.

“On the first day, they gave me some medication. I went home and did what addicts do—I tried to find a bag of heroin. I took it, but felt no effect.” The medication had stopped her from feeling it. “I thought—well that was a waste of money.” Lorrie says she has never taken another drug since. Drug treatment, of course is not quite that simple, but for Lorrie, the medication helped her resist drugs during a nine-month treatment cycle that included weekly counseling as well as small cash incentives for clean urine samples.

To help with heroin cravings, every day Lorrie was given the medication buprenorphine in addition to a new drug. The experimental part of the study was to test if a medication called clonidine, sometimes prescribed to help withdrawal symptoms, would also help prevent stress-induced relapse. Half of the patients received daily buprenorphine plus daily clonidine, and half received daily buprenorphine plus a daily placebo. To this day, Lorrie does not know which one she received, but she is deeply grateful that her involvement in the study worked for her.

The study results? Clonidine worked as the NIDA investigators had hoped.

“Before I was clean, I was so uncertain of myself and I was always depressed about things. Now I am confident in life, I speak my opinion, and I am productive. I cry tears of joy, not tears of sadness,” she says. Lorrie is now eight years drug free. And her boyfriend? His treatment at the VA was also effective, and they are now married. “I now feel joy at little things, like spending time with my husband or my niece, or I look around and see that I have my own apartment, my own car, even my own pots and pans. Sounds silly, but I never thought that would be possible. I feel so happy and so blessed, thanks to the wonderful research team at NIDA.”

Liquor store. Authored by : Fletcher6. Located at : https://commons.wikimedia.org/wiki/File:The_Bunghole_Liquor_Store.jpg . License : CC BY-SA: Attribution-ShareAlike
Benny Story. Provided by : Living Sober. Located at : https://livingsober.org.nz/sober-story-benny/ . License : CC BY: Attribution
One patientu2019s story: NIDA clinical trials bring a new life to a woman struggling with opioid addiction. Provided by : NIH. Located at : https://www.drugabuse.gov/drug-topics/treatment/one-patients-story-nida-clinical-trials-bring-new-life-to-woman-struggling-opioid-addiction . License : Public Domain: No Known Copyright

0800 118 2892

+44 (0)203 151 1280

[email protected]

Alcohol Addiction: Alan's Story

Alcohol can be an easily hidden problem, and alcohol addiction is something we’re seeing more and more requests for help with. Our alcohol detox programmes are professionally managed in our exclusive facilities, and help our clients escape from the grip of alcohol, putting the individual needs of the patient at the heart of their recovery plan.

One person who can speak about this with expertise is Alan, who came to Serenity Addiction Centres on the recommendation of his GP. By his own admission, Alan’s alcohol problem was a longstanding one.

Alan’s problems started when he was at school, when his shyness made him the victim of bullying. This set in motion a series of problems with self-confidence and identity, which followed him into adulthood. The only way to escape the problems seemed to be through drinking, which blocked out how he was feeling.

With his alcohol intake increasing, Alan went to see his GP, and it was his GP who suggested Serenity Addiction Centre’s alcohol rehab programme. Alan initially found the idea of rehab clinics intimidating, but he visited Serenity Addiction Centres for himself and was pleasantly surprised by what he saw – he describes it as “A truly welcoming atmosphere.”

First Steps To Recovery

The volunteer who showed Alan around recognised how much courage it had taken for Alan to make the first step towards treating his drinking, and the doctors and clients at Serenity Addiction Centres gave him the reassurance he needed that this was the right place for his recovery.

Doctors helped Alan to develop a detox regime which would work for him, and a start date which they were comfortable with. Alan booked his stay and returned home, knowing that this was the beginning of a new chapter.

The support continued from the minute Alan unpacked his bags for his stay at Serenity Addiction Centres. Everyone listened to him and shared their own experiences with alcohol. Learning to trust and share with others helped him learn why he’d started drinking so heavily, and how to address his triggers.

Before he even knew it, Alan had completed his detox. Not only did he have a healthier attitude to drinking, the experience had taught him more about himself, and how to avoid the triggers.

After Rehab

Support didn’t stop with the completion of Alan’s inpatient stay though. After the initial stay, Alan opted to continue his programme by attending day clinics, and he can’t praise those highly enough. He’d learned how to put down the drink – this helped him to keep it out of his life on a long-term basis.

In fact, Alan found the whole Serenity Addiction Centres programme so inspirational that he now volunteers as a mentor, helping others who are on their own detox journey. Full of confidence, he decided to give something back, and now works with people embarking on their journey away from alcohol, providing support and advice.

Alan’s story is by no means unique. He finished his alcohol detox programme full of pride in his achievement and has turned his life around. Healthier and happier, Alan is proof that with the right help, alcohol doesn’t need to be a problem anymore.

FREE CONSULTATION

Get a no-obligation confidential advice from our medical experts today

Request a call back

We provide a healthy environment uniquely suited to support your growth and healing.

Rehab Clinic - Serenity Rehabilitation LTD. Arquen House,4-6 Spicer Street, St Albans, Hertfordshire AL3 4PQ
0800 118 2892 +44(0)203 151 1280

Testimonials
Case Studies

Popular Pages

Alcohol Addiction
How To Home Detox From Alcohol
Alcohol Rehab Centres
Methadone addiction

Top Locations

Leicestershire

Cookies on the NHS England website

We’ve put some small files called cookies on your device to make our site work.

We’d also like to use analytics cookies. These send information about how our site is used to a service called Google Analytics. We use this information to improve our site.

Let us know if this is OK. We’ll use a cookie to save your choice. You can read more about our cookies before you choose.

Change my preferences I'm OK with analytics cookies

Robert’s story

Robert was living with an alcohol addiction and was homeless for over 25 years. He was well known in the local community and was identified as one of the top 100 A&E attendees at the Local General Hospital.

He drank all day every day until he would pass out and this was either in the town centre or just by the roadside. In addition, Robert was also incontinent and really struggled with any meaningful communication or positive decision making due to his alcohol usage. This often resulted in local services such as police, ambulance being called in to help. He had no independent living skills and was unable to function without alcohol.

In addition, and due to his lifestyle and presenting behaviours, Robert had a hostile relationship with his family and had become estranged from them for a long period of time.

Robert needed ongoing support and it was identified at the General Hospital that if he was to carry on “living” the way he currently was, then he wouldn’t survive another winter.

On the back of this, Robert was referred to Calico who organised a multi-disciplinary support package for him, which included support with housing as part of the Making Every Adult Matter programme.

After some initial challenges, Robert soon started to make some positive changes.

The intensive, multidisciplinary support package taught him new skills to support him to live independently, sustain his tenancy and make some positive lifestyle changes which in turn would improve his health and wellbeing.

This included providing daily visits in the morning to see Robert and to support him with some basic activities on a daily/weekly basis. This included getting up and dressed; support with shopping and taking to appointments; guidance to help make positive decisions around his associates; support about his benefits and managing his money. In addition, he was given critical support via accessing local groups such as RAMP (reduction and motivational programme) and Acorn (drugs and alcohol service), as well as 1 to 1 sessions with drugs workers and counsellors to address his alcohol addiction.

After six months Robert continued to do well and was leading a more positive lifestyle where he had greatly reduced his A&E attendance. He had significantly reduced his alcohol intake with long periods of abstinence and was now able to communicate and make positive decisions around his lifestyle.

Critically he had maintained his tenancy and continued to regularly attend local groups and other support for his alcohol addiction and had reconnected with some of his family members.

By being able to access these community resources and reduce his isolation he is now engaged in meaningful activities throughout the day and has been able to address some of his critical issues. A small but significant example is that Robert is now wearing his hearing aids which means that he can now interact and communicate more effectively.

Introduction
Article Information

eTable 1. ICD-10-CM Alcohol-Related Death Codes

eTable 2. Health Care Worker Groups and Constituent Occupations (Occupation Codes)

Data Sharing Statement

See More About

Customize your JAMA Network experience by selecting one or more topics from the list below.

Academic Medicine
Acid Base, Electrolytes, Fluids
Allergy and Clinical Immunology
American Indian or Alaska Natives
Anesthesiology
Anticoagulation
Art and Images in Psychiatry
Artificial Intelligence
Assisted Reproduction
Bleeding and Transfusion
Caring for the Critically Ill Patient
Challenges in Clinical Electrocardiography
Climate and Health
Climate Change
Clinical Challenge
Clinical Decision Support
Clinical Implications of Basic Neuroscience
Clinical Pharmacy and Pharmacology
Complementary and Alternative Medicine
Consensus Statements
Coronavirus (COVID-19)
Critical Care Medicine
Cultural Competency
Dental Medicine
Dermatology
Diabetes and Endocrinology
Diagnostic Test Interpretation
Drug Development
Electronic Health Records
Emergency Medicine
End of Life, Hospice, Palliative Care
Environmental Health
Equity, Diversity, and Inclusion
Facial Plastic Surgery
Gastroenterology and Hepatology
Genetics and Genomics
Genomics and Precision Health
Global Health
Guide to Statistics and Methods
Hair Disorders
Health Care Delivery Models
Health Care Economics, Insurance, Payment
Health Care Quality
Health Care Reform
Health Care Safety
Health Care Workforce
Health Disparities
Health Inequities
Health Policy
Health Systems Science
History of Medicine
Hypertension
Images in Neurology
Implementation Science
Infectious Diseases
Innovations in Health Care Delivery
JAMA Infographic
Law and Medicine
Leading Change
Less is More
LGBTQIA Medicine
Lifestyle Behaviors
Medical Coding
Medical Devices and Equipment
Medical Education
Medical Education and Training
Medical Journals and Publishing
Mobile Health and Telemedicine
Narrative Medicine
Neuroscience and Psychiatry
Notable Notes
Nutrition, Obesity, Exercise
Obstetrics and Gynecology
Occupational Health
Ophthalmology
Orthopedics
Otolaryngology
Pain Medicine
Palliative Care
Pathology and Laboratory Medicine
Patient Care
Patient Information
Performance Improvement
Performance Measures
Perioperative Care and Consultation
Pharmacoeconomics
Pharmacoepidemiology
Pharmacogenetics
Pharmacy and Clinical Pharmacology
Physical Medicine and Rehabilitation
Physical Therapy
Physician Leadership
Population Health
Primary Care
Professional Well-being
Professionalism
Psychiatry and Behavioral Health
Public Health
Pulmonary Medicine
Regulatory Agencies
Reproductive Health
Research, Methods, Statistics
Resuscitation
Rheumatology
Risk Management
Scientific Discovery and the Future of Medicine
Shared Decision Making and Communication
Sleep Medicine
Sports Medicine
Stem Cell Transplantation
Substance Use and Addiction Medicine
Surgical Innovation
Surgical Pearls
Teachable Moment
Technology and Finance
The Art of JAMA
The Arts and Medicine
The Rational Clinical Examination
Tobacco and e-Cigarettes
Translational Medicine
Trauma and Injury
Treatment Adherence
Ultrasonography
Users' Guide to the Medical Literature
Vaccination
Venous Thromboembolism
Veterans Health
Women's Health
Workflow and Process
Wound Care, Infection, Healing

Get the latest research based on your areas of interest.

Others also liked.

Download PDF
X Facebook More LinkedIn

Olfson M , Cosgrove CM , Wall MM , Blanco C. Alcohol-Related Deaths of US Health Care Workers. JAMA Netw Open. 2024;7(5):e2410248. doi:10.1001/jamanetworkopen.2024.10248

Manage citations:

Permissions

Alcohol-Related Deaths of US Health Care Workers

1 Department of Psychiatry, College of Physicians and Surgeons, Columbia University and the New York State Psychiatric Institute, New York, New York
2 Census Bureau, Mortality Research Group, Suitland, Maryland
3 Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Rockville, Maryland

Despite an increase in alcohol-related deaths in the US over the last 2 decades, 1 , 2 little is known about alcohol-related mortality risks among physicians 3 and other health care workers. Compared with non–health care workers, health care workers have increased drug overdose death risks. 4 An occupational liability to substance use or to risks of painful injuries and access to controlled substances may explain these findings. Only the first hypothesis would contribute to an increased risk of alcohol-related mortality. We estimated risks for alcohol-related deaths among US health care workers compared with non–health care workers.

This cross-sectional study was deemed exempt from review and the need for informed consent by the institutional review board of the New York State Psychiatric Institute owing to the use of only deidentified data. We followed the STROBE reporting guideline.

The 2008 American Community Survey (ACS) was a cross-sectional, nationally representative survey of approximately 2.9 million addresses with a 97.9% response rate. Data were linked to National Death Index records from 2008 to 2019. 5 After excluding unemployed individuals and those younger than 26 years, the cohort included 1 838 000 individuals. Alcohol-related underlying or contributing causes of death were identified (eTable 1 in Supplement 1 ). Health care workers included (1) registered nurses, (2) support workers, (3) technicians, 4) social and behavioral workers, (5) other diagnosing or treating clinicians (eg, dentists), and (6) physicians (eTable 2 in Supplement 1 ). Event time was from ACS administration to alcohol-related death, death from other causes, or December 31, 2019, whichever came first, with follow-up between 11 and 12 years for participants still living.

Analyses were performed in SAS, version 9.4 (SAS Institute Inc). Unadjusted and age- and sex-standardized alcohol-related death rates per 100 000 person-years with 95% CIs were calculated (2-sided P < .05 indicated statistical significance). Cox proportional hazards regression models estimated alcohol-related death hazard ratios for the 6 health care groups adjusted for age, sex, race and ethnicity, marital status, educational level, and income. Race and ethnicity were included as covariates given known disparities in alcohol-related deaths among US racial and ethnic groups. We applied ACS weights. 6

The median age of the overall cohort was 44 (IQR, 35-53) years; 47.7% were female and 52.3% were male. Group sociodemographic characteristics are presented in Table 1 . Unadjusted alcohol-related death rates per 100 000 person-years were significantly lower for each health care worker group than for non–health care workers. Following age and sex standardization, only physicians (4.2) and other diagnosing or treating clinicians (11.6) had significantly lower alcohol-related death rates than non–health care workers (18.1). Controlling for the other sociodemographic characteristics, alcohol-related mortality hazards did not significantly differ between each health care worker group and non–health care workers ( Table 2 ).

Compared with non–health care workers, health care workers, especially physicians, had lower crude alcohol-related death rates. Following sociodemographic adjustment, however, significant group differences were no longer observed.

When viewed in relation to elevated drug overdose death rates for some health care worker groups, 2 the alcohol-related mortality results suggest health care workers do not have a general underlying liability to substance-related deaths. Specific occupational factors, such as access to controlled medications, may pose drug overdose risks that do not extend to alcohol-related deaths. However, alcohol-related mortality represents an extreme end point and alcohol-related morbidity remains a common problem. Study limitations include termination of mortality data before the COVID-19 pandemic, misclassification of alcohol-related cause of death in death records, 1 absence of key alcohol-related risk factors such as personal or family history of alcohol use, and an inability to measure occupational transitions during the 11-year follow-up.

The risks of alcohol-related deaths among health care workers did not exceed those of non–health care workers. However, this finding does not diminish the importance of improving management of alcohol-related problems among health care workers. Future research should compare problematic alcohol use among health care worker groups during the COVID-19 and post–COVID-19 periods.

Accepted for Publication: March 7, 2024.

Published: May 8, 2024. doi:10.1001/jamanetworkopen.2024.10248

Corresponding Author: Mark Olfson, MD, MPH, Psychiatry & Epidemiology, Columbia University, 1051 Riverside Dr, New York, NY 10032 ( [email protected] ).

Author Contributions: Ms Cosgrove had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Olfson, Wall, Blanco.

Acquisition, analysis, or interpretation of data: Olfson, Cosgrove, Blanco.

Drafting of the manuscript: Olfson, Wall.

Critical review of the manuscript for important intellectual content: Olfson, Cosgrove, Blanco.

Statistical analysis: Cosgrove, Wall.

Administrative, technical, or material support: Olfson, Cosgrove.

Conflict of Interest Disclosures: None reported.

Funding/Support: This study was supported by interagency agreements of National Heart, Lung, and Blood Institute and National Institute on Aging with the US Census Bureau.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: Any opinions and conclusions expressed herein are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute, the National Institute on Drug Abuse, or the US Census Bureau.

Data Sharing Statement: See Supplement 2 .

Additional Information: The Census Bureau has ensured appropriate access and use of confidential data and has reviewed these results for disclosure avoidance protection (Project 7532119: CBDRB-FY23-CES004-029 and CBDRB-FY23-CES004-031).

Register for email alerts with links to free full-text articles
Access PDFs of free articles
Manage your interests
Save searches and receive search alerts

Ohio State nav bar

The Ohio State University

BuckeyeLink
Find People
Search Ohio State

Obstacles to alcohol, drug treatment higher for rural Americans

Study finds fewer seek, continue treatment outside of urban areas.

Rural Americans are less likely to initiate care for substance use disorders and to receive ongoing care compared with those who live in urban areas, according to a new study.

When they do access care, people who live in less populated areas are more likely to have to go outside their provider network to receive treatment, which comes with higher out-of-pocket costs, found a team of researchers at The Ohio State University College of Public Health . Their study appears in the journal Health Services Research .

“If we find problems among this group, you know it’s going to be worse for everybody else.”

Looking at an employer-sponsored health care database, the research team examined data collected from 2016 through 2018 that included about 40 million adult patients each year.

Treatment rates for substance use disorders were low across the board – less than half of people received care. But the picture was worse for rural Americans.

Among the disparities found in the study:

Rural patients experienced lower treatment initiation rates for disorders involving alcohol (37% vs. 38%), opioids (41% vs. 44%) and other drugs (38% vs. 40%) compared to those in urban areas.
Rural patients were also less likely than urban patients to engage in ongoing treatment for alcohol (15% vs. 17%), opioids (21% vs. 23%) and other drugs (16% vs. 18%).
More rural patients than urban patients received out-of-network initial treatment and continued treatment for drug use disorders other than alcohol and opioids. Rural patients were also more likely to pay higher rates for ongoing treatment for alcohol use disorders.

While substance use disorders and struggles finding and completing successful treatment are widespread concerns, matters are worse for those who live in rural areas, and this new research contributes more understanding about the obstacles people face, said Wendy Xu , the study’s senior author and an associate professor of health services management and policy at Ohio State.

“Rural areas are continuously plagued with a shortage of behavioral health providers and more limited health resources overall. These challenges are compounded by the fact that most insurance plans use managed care arrangements, some of which use highly limited provider networks,” Xu said.

One potential approach to tackling these problems could be the Collaborative Care Model, which has grown in popularity in recent years, she said: “This model allows primary care clinicians working with a behavioral health care manager, who often is not an advanced clinician, to treat substance use disorders in collaboration with a psychiatric consultant who doesn’t have to live and work in the area.”

In fact, the entire collaborative process of treatments, prescribing and ongoing care are typically delivered through virtual health appointments and billed through the patient’s primary care practice.

Raver said it’s important to note that while much of policymakers’ attention is focused on opioid use disorders, the disparities identified in this study exist across the spectrum of substance use disorders.

“A lot of policy focus has been on the opioid crisis, as it should be, but I think it’s interesting and troubling to see that, regardless of which substance we’re talking about, there is high out-of-network usage and low overall participation in care,” he said.

Study co-authors include Sheldon Retchin of Ohio State, Yiting Li of Nationwide Children’s Hospital and Andrew Carlo of Northwestern University.

More Ohio State News

Ohio state president champions university mission at ohio statehouse.

Ohio State President Walter “Ted” Carter Jr. testified before the Ohio Senate Workforce and Higher Education Committee today. The hearing was part of the state’s capital budget process, and Carter was one of more than a dozen higher education leaders in Ohio to appear before the committee.

Ohio State grad taking public health research gap year

“In high school, I had done a lot of advocacy work related to vaccines and vaccine hesitancy,” she said.

Event prepares Ohio State graduating students for hospitality careers

Ohio State students honed skills in leadership, communication, organization and many other areas essential to success by organizing The Big Dish at Ohio Stadium.

Contact: Admissions | Webmaster | Page maintained by University Communications

Request an alternate format of this page | Web Services Status | Nondiscrimination notice

Man or bear? Hypothetical question sparks conversation about women's safety

Women explain why they would feel safer encountering a bear in the forest than a man they didn't know. the hypothetical has sparked a broader discussion about why women fear men..

If you were alone in the woods, would you rather encounter a bear or a man? Answers to that hypothetical question have sparked a debate about why the vast majority say they would feel more comfortable choosing a bear.

The topic has been hotly discussed for weeks as men and women chimed in with their thoughts all over social media.

Screenshot HQ , a TikTok account, started the conversation, asking a group of women whether they would rather run into a man they didn't know or a bear in the forest. Out of the seven women interviewed for the piece, only one picked a man.

"Bear. Man is scary," one of the women responds.

A number of women echoed the responses given in the original video, writing in the comments that they, too, would pick a bear over a man. The hypothetical has people split, with some expressing their sadness over the state of the world and others cracking jokes. Some men were flabbergasted.

Here's what we know.

A bear is the safer choice, no doubt about it, many say

There were a lot of responses, more than 65,000, under the original post. Many wrote that they understood why the women would choose a bear.

"No one’s gonna ask me if I led the bear on or give me a pamphlet on bear attack prevention tips," @celestiallystunning wrote.

@Brennduhh wrote: "When I die leave my body in the woods, the wolves will be gentler than any man."

"I know a bear's intentions," another woman wrote. "I don't know a man's intentions. no matter how nice they are."

Other TikTok users took it one step further, posing the hypothetical question to loved ones. Meredith Steele, who goes by @babiesofsteele , asked her husband last week whether he would rather have their daughter encounter a bear or a man in the woods. Her husband said he "didn't like either option" but said he was leaning toward the bear.

"Maybe it's a friendly bear," he says.

Diana, another TikTok user , asked her sister-in-law what she would choose and was left speechless.

"I asked her the question, you know, just for giggles. She was like, 'You know, I would rather it be a bear because if the bear attacks me, and I make it out of the woods, everybody’s gonna believe me and have sympathy for me," she said. "But if a man attacks me and I make it out, I’m gonna spend my whole life trying to get people to believe me and have sympathy for me.'"

Bear vs. man debate stirs the pot, woman and some men at odds

The hypothetical has caused some tension, with some women arguing that men will never truly understand what it's like to be a woman or the inherent dangers at play.

Social media users answered this question for themselves, producing memes, spoken word poetry and skits in the days and weeks since.

So, what would you choose?

NIOSH Science Blog: The Problem of Falls from Elevation in Construction and Prevention Resources

The current situation with falls.

In 2022 falls from elevation represented approximately 81% of all fatal and 20% of all nonfatal slips, trips, and falls for all industry workers (BLS 2023a, BLS 2023b). Many of these falls occurred in the construction industry, and significantly impact construction employers, workers, and their families. In fact, construction workers made up nearly half (49%) of all fatal occupational slips, trips, and falls (BLS 2023). Since 2013, construction workers have suffered approximately 300 fatal and 20,000 nonfatal fall-related injuries per year (CPWR 2024). Four out of 10 of the Occupational Safety and Health Administration’s (OSHA) top citations involved falls, including general fall protection, ladders, scaffolding, and fall protection training.

Roofing contractors, residential building construction, and commercial/institutional building construction had the highest number of fatalities in 2022 compared to previous years and other industries (CPWR 2024). In addition, approximately 70% of all fatal falls in construction occurred to those working for employers with less than 10 employees (CPWR 2024).

Causes of Falls

The causes of construction workers’ falls from elevation are complex and multifaceted. There are many different factors at play. In 2021, CPWR conducted a fall experience survey that found that insufficient or ineffective planning is a key underlying cause of falls.

In addition, lack of planning was associated with reduced likelihood of using fall protection. Using fall protection was 71% lower for workers whose employer did not do any planning. Approximately half (49%) of survey respondents said that no fall protection was being used at the time of the fall. Lack of fall protection is particularly problematic for small residential construction firms with fewer than 10 employees (CPWR 2022).

Ladders and Ladder Safety

Falls from ladders are a common cause of injury for construction workers (CPWR 2024). Employers should be familiar with safety and regulatory requirements before using a ladder, including:

Planning work tasks to eliminate or reduce the need to work at elevation.

Providing the right equipment. This includes alternative equipment for extended work periods at elevation, such as aerial lifts, supported scaffolds, or mast climbing platforms. If a ladder must be used, properly select the ladder for the location and height of the task and the weight of the worker. Ensure it is thoroughly inspected before each use.

Training all workers in a language they understand on the proper use, care, and inspection of each type of ladder being used.

A recent webinar hosted by CPWR – The Center for Construction Research and Training (CPWR) discussed ladder safety and ways to improve ladder design, usage, and training. The webinar included a panel of experts who conduct laboratory research on ways to prevent common ladder fall injuries, such as slipping off a ladder and falling with the ladder. The audio from the webinar is also available in Spanish .

Ladder Safety Resources

Ladder Safety App

National Ladder Safety Month website

ALI Training

ANSI blog on 5 most common causes of ladder incidents based on ALI study

OSHA Stairways and Ladders

OSHA Letter of Interpretation on three points of contact

Rescue Planning

Falls can occur quickly, even when all precautions are taken and using proper fall prevention and protection methods. Personal Fall Arrest Systems are a critical option to keep workers safe when performing tasks at heights, but rescue planning is essential.

If a fall occurs and a worker is suspended in a harness for more than a few minutes, a lack of circulation can cause unconsciousness, suspension trauma, and even death.

Every fall protection plan must include a rescue strategy to help workers after a fall and reduce fall-related injuries including suspension trauma even when using a Personal Fall Arrest System. Another finding from CPWR’s fall experience survey was that the odds of a fall being fatal were 76% lower for those who had self-rescue training compared to those who did not have this training. The rescue plan should be tailored to each jobsite and prioritize methods to preserve blood circulation for the worker. Ensure equipment for self-rescue is available, such as trauma straps and self-rescue harness units. The rescue plan should ensure other equipment is available, ready to be used, and in good condition, such as a ladder, aerial lift, or bucket truck.

Rescue Planning Resources

CPWR General Fall Protection Plan (English)

CPWR General Fall Protection Plan (Spanish)

OSHA Model Fall Protection Plan

OSHA Standard Interpretations – Rescue of a suspended worker following a fall event

CPWR Fall Rescue Planning Tipsheet

CPWR Fall Rescue Planning Tipsheet (Spanish)

The National Safety Stand-Down to Prevent Falls in Construction

The National Campaign to Prevent Falls in Construction (Falls Campaign) began in 2012 and was followed in 2014 by the National Safety Stand-Down to Prevent Falls in Construction (Stand-Down). The Falls Campaign idea originated with the National Occupational Research Agenda (NORA) Construction Sector Council. The Sector Council consists of industry experts on health and safety representing contractors, trade associations, labor, government, and academia. The National Institute for Occupational Safety and Health (NIOSH), OSHA, and CPWR are the Falls Campaign organizing partners. The Falls Campaign and Stand-Down are important events because of the high burden falls place on construction workers and their families.

Safety stand-downs originated in the military and are a time to focus on worker safety by stopping work and reinforcing the importance of fall prevention and fall protection.

This year’s Stand-Down will take place May 6-10, 2024. CPWR, NIOSH, and OSHA are hosting a virtual event on Tuesday May 7 th at 2 pm (Eastern Time) to educate employers and crew leaders on how rescue planning can save lives. Click here to register and submit a question in advance. Attendees will learn more about identifying a competent person to lead fall prevention and rescue planning, incorporating key components of a rescue plan into the pre-job planning process, and using FREE resources and templates to tailor your plans to each unique jobsite. The webinar will be in English with simultaneous translation into Spanish available.

On May 8 th at 2pm (Eastern Time) a second Stand-Down webinar presented entirely in Spanish will be hosted. Click here to register and submit a question in advance.

Hosting a Stand-Down

Thousands of companies have held fall safety stand-downs , reaching millions of workers across all 50 states and internationally. Industry and business leaders, universities, labor organizations, and community groups have all participated. In 2023, there were 3,554 stand-downs reaching more than 463,000 workers.

Construction employers and workers are invited to host a Safety Stand-Down or join one.

Your involvement can be as simple as sharing NIOSH, OSHA, or CPWR resources at your worksite. If you would like to host or join a free event that is open to the public, contact your Regional Stand-Down Coordinator . You can find resources to host a Stand-Down and activities at CPWR’s Promotion and Planning Page .

If you do participate in the Stand-Down, make sure you get a Certificate of Participation from OSHA. The certificates provide recognition for your event(s). After removing all personal information, CPWR used the data to evaluate and improve the Falls Campaign and Stand-Down every year. Previous evaluation reports and factsheets can be found on the Stop Construction Falls Evaluation page .

Stand-down Resources

About the Campaign

CPWR’S Planning and Promotion Page on StopConstructionFalls.com

Suggestions to prepare successful Stand-Downs

Highlights from previous Stand-Downs

OSHA Regional Stand-Down Coordinators

OSHA Certificates of Participation

Additional Tools and Resources

National Falls Campaign & Safety Stand-Down Website

CPWR Data Bulletin

Bilingual Fall Hazards & Prevention YouTube Playlist

Spanish Fall Safety YouTube Playlist (Prevención de caídas)

Christina Socias-Morales, DrPH is a Research Epidemiologist in the NIOSH Office of Construction Safety and Health.

Scott Earnest, PhD, PE, CSP, is the Associate Director for the NIOSH Office of Construction Safety and Health.

Jessica Bunting, MPH, is the Research to Practice Director at the Center for Construction Research and Training (CPWR).

Rosa Greenberg, MPH, is a Research Analyst in Research to Practice at CPWR

Scott Breloff, Ph.D. is a Senior Biomechanical Research Engineer in the Division of Field Studies & Engineering and the Co-Coordinator for the Construction Program in the Office of Construction Safety and Health at NIOSH.

Asha Brogan, MS, is a Heath Communication Fellow in the NIOSH Division of Field Studies & Engineering.

Douglas Trout, MD, MHS, is Deputy Director, Office of Construction Safety and Health at NIOSH.

Bureau of Labor Statistics (2023a). News Release National Census of Fatal Occupational Injuries in 2022. USDL-23-2615. December 19, 2023. Available from: https://www.bls.gov/news.release/pdf/cfoi.pdf .

Bureau of Labor Statistics (2023b). Number of nonfatal occupational injuries and illnesses involving days away from work, restricted activity, or job transfer (DART), days away from work (DAFW), and days of restricted work activity, or job transfer (DJTR) by event or exposure leading to injury or illness and industry sector, private industry, 2021-2022 (TABLE R64). November 8, 2023. Available from: https://www.bls.gov/iif/nonfatal-injuries-and-illnesses-tables/case-and-demographic-characteristics-table-r64-2021-2022.xlsx

CPWR (2024). Data Bulletin: Fatal and Nonfatal Falls in the US Construction Industry. The Center for Construction Research and Training. Silver Spring, MD. March 2024. https://www.cpwr.com/wp-content/uploads/DataBulletin-March2024.pdf.

CPWR (2022). Underlying Causes of Falls from Heights (Highlighted Findings from a CPWR Survey). The Center for Construction Research and Training. Silver Spring, MD. March 2022. https://www.cpwr.com/wp-content/uploads/RR-falls_experience_survey.pdf.

Exit Notification / Disclaimer Policy

The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
You will be subject to the destination website's privacy policy when you follow the link.
CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.

Share full article

Supported by

When Is the Best Time to Work Out?

It’s an age-old question. But a few recent studies have brought us closer to an answer.

A silhouetted woman running along a body of water with the sun glistening behind her.

By Alexander Nazaryan

What is the best time of day to exercise?

It’s a straightforward question with a frustrating number of answers, based on research results that can be downright contradictory.

The latest piece of evidence came last month from a group of Australian researchers, who argued that evening was the healthiest time to break a sweat, at least for those who are overweight. Their study looked at 30,000 middle-aged people with obesity and found that evening exercisers were 28 percent less likely to die of any cause than those who worked out in the morning or afternoon.

“We were surprised by the gap,” said Angelo Sabag, an exercise physiologist at the University of Sydney who led the study. The team expected to see a benefit from evening workouts, but “we didn’t think the risk reduction would be as pronounced as it was.”

So does that mean that evening swimmers and night runners had the right idea all along?

“It’s not settled,” said Juleen Zierath, a physiologist at the Karolinska Institute in Sweden. “It’s an emerging area of research. We haven’t done all the experiments. We’re learning a lot every month.”

No single study can dictate when you should exercise. For many people, the choice comes down to fitness goals, work schedules and plain old preferences. That said, certain times of day may offer slight advantages, depending on what you hope to achieve.

The case for morning exercise

According to a 2022 study , morning exercise may be especially beneficial for heart health. It may also lead to better sleep .

And when it comes to weight loss, there have been good arguments made for morning workouts. Last year, a study published in the journal Obesity found that people who exercised between the hours of 7 a.m. and 9 a.m. had a lower body mass index than counterparts who exercised in the afternoon or at night, though it did not track them over time, unlike the Australian study, which followed participants for an average of eight years.

Of course, the biggest argument for morning exercise may be purely practical. “For a lot of people, the morning is more convenient,” said Shawn Youngstedt, an exercise science professor at Arizona State University. Even if rising early to work out can be challenging at first , morning exercise won’t get in the way of Zoom meetings, play dates or your latest Netflix binge.

The case for afternoon exercise

A few small studies suggest that the best workout time, at least for elite athletes, might be the least convenient for many of us.

Body temperature, which is lower in the morning but peaks in late afternoon, plays a role in athletic performance. Several recent small studies with competitive athletes suggest that lower body temperature reduces performance (though warm-ups exercises help counter that) and afternoon workouts help them play better and sleep longer .

If you have the luxury of ample time, one small New Zealand study found that it can help to nap first. As far as the rest of us are concerned, a Chinese study of 92,000 people found that the best time to exercise for your heart was between 11 a.m. and 5 p.m.

“The main difference is our population,” Dr. Sabag said. While his study was restricted to obese people, the Chinese study was not. “Individuals with obesity may be more sensitive to the time-of-day effects of exercise,” he said.

The case for evening exercise

This latest study may not settle the debate, but it certainly suggests that those struggling with obesity might benefit from a later workout.

Exercise makes insulin more effective at lowering blood sugar levels, which in turn fends off weight gain and Type 2 diabetes, a common and devastating consequence of obesity.

“In the evening, you are most insulin resistant,” Dr. Sabag said. “So if you can compensate for that natural change in insulin sensitivity by doing exercise,” he explained, you can lower your blood glucose levels, and thus help keep diabetes and cardiovascular disease at bay.

One persistent concern about evening exercise is that vigorous activity can disturb sleep. However, some experts have argued that these concerns have been overstated.

The case that it may not matter

While many of these studies are fascinating, none of them is definitive. For one thing, most are simply showing a correlation between exercise times and health benefits, not identifying them as the cause.

“The definitive study would be to actually randomize people to different times,” Dr. Youngstedt said, which would be phenomenally expensive and difficult for academics.

One thing public health experts do agree on is that most Americans are far too sedentary. And that any movement is good movement.

“Whenever you can exercise,” Dr. Sabag urged. “That is the answer.”

In a recent edition of his newsletter that discussed the Australian study, Arnold Schwarzenegger — bodybuilder, actor, former governor — seemed to agree. He cited a 2023 study suggesting that there really isn’t any difference in outcomes based on which time of day you exercise. In which case, it’s all about what works best for you.

“I will continue to train in the morning,” the former Mr. Universe wrote. “It’s automatic for me.”

Alexander Nazaryan is a science and culture writer who prefers to run in the early evening.

Let Us Help You Pick Your Next Workout

Looking for a new way to get moving we have plenty of options..

What is the best time of day to exercise? A few recent studies have brought us closer to an answer .

Sprinting, at least for short distances, can be a great way to level up your workout routine .

Cycling isn’t just fun. It can also deliver big fitness gains with the right gear and strategy.

VO2 max has become ubiquitous in fitness circles. But what does it measure and how important is it to know yours?

Is your workout really working for you? Take our quiz to find out .

Pick the Right Equipment With Wirecutter’s Recommendations

Want to build a home gym? These five things can help you transform your space into a fitness center.

Transform your upper-body workouts with a simple pull-up bar and an adjustable dumbbell set .

Choosing the best running shoes and running gear can be tricky. These tips make the process easier.

A comfortable sports bra can improve your overall workout experience. These are the best on the market .

Few things are more annoying than ill-fitting, hard-to-use headphones. Here are the best ones for the gym and for runners .

IMAGES

Case Study About Alcoholism
Understanding Alcohol
11. a case study on chronic alcoholic liver disease
Hazardous alcohol drinking and premature mortality in Russia: a
Case study examples of alcohol
Case Study Alcoholism

VIDEO

Alcoholism
Steve case study: Psychosis, drug and alcohol use
Alcohol and consent Case Study
Case Study 11: Confusion in an Alcoholic
SFMC Case Study
Doctor Uses Motivational Interviewing to Discuss Alcohol Use

COMMENTS

A 16-Year-old Boy with Combined Volatile and Alcohol Dependence: A Case Report
This case is first of the kind depicting clinical features as well as withdrawal of combined volatile and moderate alcohol abuse. The feature of combined intoxication of the two abused substances makes it difficult for the clinician to reach a diagnosis. Our case report thus puts forward the scenario of increasing combined alcohol and volatile ...
Case 13-2019: A 54-Year-Old Man with Alcohol Withdrawal and Altered
Dr. Andrew Z. Fenves: This 54-year-old man with a history of alcohol use disorder was admitted to the hospital with concerns about alcohol withdrawal symptoms. He had recent binges in which he ...
A Case of Alcohol Abuse
A Case of Alcohol Abuse. The patient is a 65-year-old white woman, married for 35 years to an accountant. They have 5 grown children and 12 grandchildren. She taught elementary school for 28 years and has not worked since retiring 15 years ago.
Navigating Alcohol Use Disorder in Adults: A Case Report
This case study presents the diagnosis and treatment of a male patient with an alcohol use disorder (AUD). Although medications are helpful in AUD, nurse practitioners must be cognizant when combining them with other approaches, such as therapy. Some clinicians prefer to control AUD use before treating other issues, under the theory that alcohol can obscure and aggravate underlying physical ...
ARTICLE CATEGORIES
How would you diagnose and treat a 54-year-old man with alcohol withdrawal and altered mental status? Read this case challenge and test your knowledge.
(PDF) A case study of alcohol dependence syndrome with ...
This case study is an attempt to assess the impact of psychiatric social work intervention in person with alcohol dependence. Psychiatric social work intervention (brief intervention) was provided ...
Alcohol, Aggression, and Violence: From Public Health to Neuroscience
Alcohol and Domestic Abuse/Violence. There is a strong evidence linking alcohol with domestic abuse or domestic violence (Gadd et al., 2019).A study conducted within the metropolitan area of Melbourne, Australia found that alcohol outlet density was significantly associated with domestic violence rates over time (Livingston, 2011).In Australia, alcohol-related domestic violence is twice more ...
PDF Chronic Alcoholism and Its Health Implications: A Case Report
This case report discusses a 60-year-old male with severe alcohol use disorder who presented with a newly diagnosed AF with RVR, DCM, and cirrhosis. Our case demonstrates the consequential health risks of chronic alcoholism and highlights the significance of timely screening and early intervention for at-risk alcohol use.
Changes in alcohol consumption and alcohol problems before and ...
This study will prospectively examine within-person changes in alcohol consumption/patterns and alcohol-related problems in heavy drinking young adults before and after the start of the COVID-19 ...
CASE STUDY Jeff (alcohol use disorder, mild/moderate)
Case Study Details. Jeff is a 66-year-old Caucasian man whose wife has encouraged him to seek treatment. He has never been in therapy before, and has no history of depression or anxiety. However, his alcohol use has recently been getting in the way of his marriage, and interfering with his newly-retired life.
Experiences of alcohol dependence: a qualitative study
Introduction and aims of the study: Despite the increasing incidence of alcohol misuse and the costs it incurs, British society continues to hold equivocal and ambiguous attitudes towards drinking, and understanding of the nature of alcohol dependence and related issues is limited. This qualitative study aimed to investigate the experiences of individuals with alcohol dependence to enhance ...
Case Studies: Substance-Abuse Disorders
Case Study: Lorrie. Figure 1. Lorrie. Lorrie Wiley grew up in a neighborhood on the west side of Baltimore, surrounded by family and friends struggling with drug issues. She started using marijuana and "popping pills" at the age of 13, and within the following decade, someone introduced her to cocaine and heroin.
Alcohol Addiction Case Study: Steven's Story
Steven's story of alcohol addiction: a case study. Serenity health offers drug & alcohol rehab, detox & counselling services for successful recovery. Skip to content. 0800 118 2892 +44 (0)203 151 1280; [email protected]; ... Not understanding why people around him are worried about him.
PDF Example Case Conceptualization and Treatment Plan for Kevin J. Scott
J. Scott Branson, Ph.D., LPC, NCC. Wayne State University Example Case Conceptualization and Treatment Plan for Kevin. Kevin is a Caucasian male in his mid-30s who has been struggling with alcohol use since. he was 21 years old. Recently, Kevin lost his job, which resulted in a fourfold increase in the. volume of alcohol he consumes during an ...
Alcohol abuse: Analysis of a case study
A Survey of Substance Use Disorder. Henry drinks beer daily and has done so for the past 15 years. He drinks 5-6 cans on weekdays and 8-12 cans on the weekends, as well as liquor. Henry also smokes half a pack per day of cigarettes. He smoked marijuana as a teen, but took no other drugs.
PDF A case study of Person with Alcohol dependence Syndrome with ...
Hohman suggests Motivational interviewing (MI ) for person with substance abuse disorder, as a useful intervention technique, 8by applying it to a case study . A meta-analysis by Hettema et al. published in 2005 studied 72 clinical trials spanning a range of target problems, 31 of which focused on alcohol.
Alcohol Addiction: Alan's Story
The only way to escape the problems seemed to be through drinking, which blocked out how he was feeling. With his alcohol intake increasing, Alan went to see his GP, and it was his GP who suggested Serenity Addiction Centre's alcohol rehab programme. Alan initially found the idea of rehab clinics intimidating, but he visited Serenity ...
NHS England » Robert's story
Robert's story. Robert was living with an alcohol addiction and was homeless for over 25 years. He was well known in the local community and was identified as one of the top 100 A&E attendees at the Local General Hospital. He drank all day every day until he would pass out and this was either in the town centre or just by the roadside.
Study reveals decline in alcohol consumption during and after pandemic
May 3 2024 Carnegie Mellon University. A new study examined the drinking levels and patterns of young adults before, during and after the pandemic. The researchers found alcohol use and alcohol ...
Alcohol-Related Deaths of US Health Care Workers
Despite an increase in alcohol-related deaths in the US over the last 2 decades, 1,2 little is known about alcohol-related mortality risks among physicians 3 and other health care workers. Compared with non-health care workers, health care workers have increased drug overdose death risks. 4 An occupational liability to substance use or to risks of painful injuries and access to controlled ...
Alcoholism Case Study Flashcards
Study with Quizlet and memorize flashcards containing terms like Meet the client:, One of the simplest tools that a nurse can use to screen for alcoholism is the CAGE questionnaire. CAGE is an acronym that represents the four questions it contains. What is the first question that the nurse should ask Nick?, Nick answers "yes" to two of the four questions on the CAGE questionnaire.
Obstacles to alcohol, drug treatment higher for rural Americans
But the picture was worse for rural Americans. Among the disparities found in the study: Rural patients experienced lower treatment initiation rates for disorders involving alcohol (37% vs. 38%), opioids (41% vs. 44%) and other drugs (38% vs. 40%) compared to those in urban areas. Rural patients were also less likely than urban patients to ...
7-2 Case Study Final Paper (docx)
2 Case Study 1: Robert's Alcoholism Robert is a 66-year-old male who has been retired for the last four years. He is a husband, father, grandfather, and friend. Robert presents with an alcohol addiction. He has been married to his wife, Colleen, for 44 years, and together they raised 2 daughters and had numerous pets. They have lived in the same house for the last 35 years.
Man or bear explained: Online debate has women talking about safety
Man is scary," one of the women responds. A number of women echoed the responses given in the original video, writing in the comments that they, too, would pick a bear over a man. The hypothetical ...
NIOSH Science Blog: The Problem of Falls from Elevation in Construction
Attendees will learn more about identifying a competent person to lead fall prevention and rescue planning, incorporating key components of a rescue plan into the pre-job planning process, and using FREE resources and templates to tailor your plans to each unique jobsite. ... Ph.D. is a Senior Biomechanical Research Engineer in the Division of ...
Should You Exercise in the Morning or the Evening ...
Last year, a study published in the journal Obesity found that people who exercised between the hours of 7 a.m. and 9 a.m. had a lower body mass index than counterparts who exercised in the ...
Alcohol-induced blackouts: A review of recent clinical research with
According to a study of amnesia in people arrested for alcohol-related offenses (Perry et al., 2006), the probability of a fragmentary or an en bloc blackout was 50/50 at a BrAC of 0.22 g/dl and the probability of an en bloc blackout was 50/50 at a BrAC of 0.31 g/dl. As such, blackouts typically occur during binge or excessive drinking episodes.
Role of purchasing arrangements for quality chronic disease care: WHO
WHO's new publication "The role of purchasing arrangements for quality chronic care: a scoping review" examines how different methods of payment to health care providers impact quality of care for chronic diseases. By analyzing a range of approaches used globally, the publication highlights the effectiveness and challenges of these methods and underscores the critical need to invest in new ...