Tagged Alcohol Abuse

How to Lower Your Child’s Risk for Addiction

A strong sense of self-efficacy is one of the most powerful protective factors parents can give their children.

In the decade that I was an active alcoholic, my focus was on protecting my right to drink the way I wanted to drink, and keeping my drinking a secret from my family. From the day I got sober in 2013, however, my focus shifted to protecting my two sons from the genetic and environmental risks of addiction I’d strewn in their path.

For five years, I felt great about my efforts. I was setting a good example by being sober, my husband modeled healthy moderation and we were raising our kids with the support of a proverbial village of families we’d known and trusted for years.

Then, in 2018, my husband had a job opportunity that required us to leave that community and move to another state: Vermont. Our older son was already in college, so the change didn’t affect him too much, but our younger son, Finn, who was about to transition from middle to high school, was devastated.

“You are ruining my life,” he said, when we told him about the move. There was no yelling, no wild gesticulations, just a calm statement of fact, which was much, much worse.

According to all the research on risk for substance use disorder, the move had the potential to be a disaster for Finn. We had voluntarily exposed our 14-year-old boy to a host of risk factors for substance abuse during a vulnerable period of cognitive development on top of the genetic risk he already faced. A stressful physical and emotional transition that was out of his control? Check. Living in a state with permissive marijuana laws? Check. Sever ties with a peer group we trust? Check. Replace those peers and their supportive, loving parents with families we have never met? Check.

Before we moved, Finn had plenty of protections heaped on the prevention side of his metaphorical substance abuse scale: physical, financial and emotional stability; lack of stress; and his friends’ parents looking out for him and providing healthy models for sobriety, support and coping. My job was to figure out what I could do to balance the weight of his risk by loading the other side of the scale with as much protection as possible.

I could not help him make new friends, let alone pick their parents, but I could help restore Finn’s sense of control, agency and hope by building his sense of self-efficacy.

Self-efficacy, as defined by the psychologist Albert Bandura, is one’s belief in one’s ability to succeed; to regulate one’s thoughts, emotions and life; and to cope with challenges in a positive way. Self-efficacy is also the foundation for so many other positive traits, including resilience, grit, fortitude and perseverance. Self-efficacy is what gives kids a sense of control, agency and hope, even when the world around them feels out of control.

People with a weak sense of self-efficacy, on the other hand, tend to be pessimistic, inflexible, quick to give up, have low self-esteem, exhibit learned helplessness, get depressed, and feel fatalistic and hopeless. Not coincidentally, people who exhibit these traits are more likely to turn to drugs and alcohol to alleviate these negative feelings.

I wanted Finn to be able to talk to me about all his fears and anxiety around the move, and I knew that self-efficacy could help with that, too. It promotes open parent-child communication while helping kids resist peer pressure both directly and indirectly. Research shows that when a child believes he has the ability to resist peer pressure, he will be a lot more likely to do so, and further, he will be more likely to talk to his parents about those episodes of peer pressure when they arise. On the other hand, kids who don’t feel as if they can resist peer pressure don’t tend to talk to their parents about the things they do outside the home.

Lack of self-efficacy is a risk factor for substance abuse and other negative health outcomes, but when converted into its opposite and equal force, a strong sense of self-efficacy, it can be one of the most powerful protective factors we can give our children. Here are some practical ways parents can boost kids’ perceptions of their own self-efficacy and help kids with low self-efficacy get back on the right path:

Start with yourself.

Model, model, model self-efficacy for your kids. Start questioning your own assertions of “I can’t” with “I can’t yet,” then turn that perspective outward, toward your children. That helps kids believe competence is not congenital, it is learned, and often hard-won.

Give kids skills.

Praise alone won’t give your child a sense of self-efficacy or competence; these things come from the actual experience of trying, doing, failing, trying again, and succeeding. Give kids age-appropriate tasks that help them stay engaged and challenged while granting opportunities to taste success. Teach them how to make dinner from start to finish and see what they create on their own. Encourage your teen to take the family car to the garage and have that rattle behind the dash fixed.

Project optimism.

Optimism is about more than seeing a glass as half full; it’s a mind-set that has a very real impact on physical and mental health. Optimistic children are better able to resist learned helplessness and depression, whereas pessimists are much more likely to give in to feelings of helplessness and are consequently at much higher risk of suffering from a wide range of negative mental and physical health outcomes. According to the psychologist Martin Seligman, author of “The Optimistic Child,” pessimistic kids see obstacles as permanent, pervasive, and their fault. Optimistic children, on the other hand, view setbacks as temporary, specific and attributable to behaviors that can be changed. As Dr. Seligman explains: “Children learn their pessimism, in part, from their parents and teachers, so it is very important that you model optimism for your children as a first step.”

Make failures specific, but generalize success.

Guide children toward optimism by framing their success as generally as possible. If your daughter has a good day in math class, help her globalize that success. Instead of “I did well in math class because I paid attention,” move toward “School

is going well because I am doing all my assignments on time.” Help her expand her success beyond the boundaries of one class or one day.

Be specific in your praise.

General praise, such as “Good job!” is useless when it comes to bolstering self-efficacy in kids because it has no real meaning. Aim for behavior-specific praise that reinforces practices you want to encourage, such as, “I’m so proud of you for sticking with that project even when you got frustrated.” Behavior-specific praise describes the desired behavior, is specific to the child, and offers a positive, clear, statement.

Don’t go overboard with your praise.

Experts on the use of behavior-specific praise in the classroom recommend a 3:1 or 4:1 ratio of praise to correction, a ratio I have tried to maintain with my own students and children. I teach and parent older teens, but this guideline is effective for kids of any age. Research shows it not only boosts good behavior, but also creates a sense of community and positivity that helps kids hear our constructive criticism when it inevitably comes.

A belief in self-efficacy, Dr. Bandura writes in his book “Self-Efficacy: The Exercise of Control,” is “the foundation of human motivation, well-being, and accomplishments.” That might have been what my son needed most to get started in a new school, and not just as a protection against substance abuse. It could help him set and achieve goals, view obstacles as surmountable, have a lower fear of failure and approach new challenges with the assumption that he could succeed.

While I can’t know which, if any, of the preventions I’ve heaped on Finn during his adolescence will inoculate him against developing a substance use disorder, I do know that boosting his self-efficacy has been essential to building up his sense of competence, well-being and happiness.

One year after the move, Finn and I hiked up to the top of the mountain behind our house to pick wild huckleberries. We’d spent an hour or so crawling around on our hands and knees talking about whatever drifted through our minds, when Finn sat back on his heels, dumped a handful of berries into his mouth and admitted to being happy. What’s more, he was looking forward to his second year of high school. As we sat together, eating huckleberries and looking out over the Vermont landscape, I felt the weight of his risk ease from my shoulders, at least for a while.

Jessica Lahey is a former teacher and the author, most recently, of “The Addiction Inoculation,” from which this article is adapted.

Teenage Brains May Be Especially Vulnerable to Marijuana and Other Drugs

Teenagers are more likely to get hooked on marijuana, stimulants and other recreational drugs than college-aged or older adults.

Adolescents and teenagers who experiment with marijuana and prescription drugs are more likely to get hooked on them than young people who try these drugs for the first time when they are college-aged or older, according to a new analysis of federal data.

The research suggests that young people may be particularly vulnerable to the intoxicating effects of certain drugs, and that early exposure might prime their brains to desire them. The findings have implications for public health policymakers, who in recent years have called for increased screening and preventive measures to reverse a sharp rise in marijuana vaping among teenagers.

The new study, published in JAMA Pediatrics and led by a team of scientists at the National Institute on Drug Abuse, sought to gain a better understanding of how adolescent brains respond to a variety of recreational drugs. Previous research suggested that early exposure to marijuana, nicotine and alcohol might lead to faster development of substance use disorders. But the new analysis cast a wider net, looking at the effects of nine different drugs, including opioid painkillers, stimulants, marijuana, alcohol, cigarettes, cocaine, heroin, methamphetamine and tranquilizers.

The researchers used data from the government’s National Survey on Drug Use and Health, a closely watched annual study that tracks substance use and mental health issues among Americans. The new research focused on two age groups: adolescents between the ages of 12 and 17, and young adults aged 18 to 25. Alcohol was by far the most commonly used substance in both groups: A quarter of adolescents and 80 percent of young adults said they had used it. About half of young adults said they had tried cannabis or tobacco. But among adolescents, that number was smaller: Roughly 15 percent said they had experimented with cannabis, and 13 percent said they had tried tobacco.

Most troubling to the authors of the new study was how many people went on to develop a substance use disorder, indicating that their experimentation had spiraled into an addiction. The researchers found that within a year of first trying marijuana, 11 percent of adolescents had become addicted to it, compared to 6.4 percent of young adults. Even more striking was that within three years of first trying the drug, 20 percent of adolescents became dependent on it, almost double the number of young adults.

Adolescents who tried prescription drugs were also more likely to become addicted. About 14 percent of adolescents who took prescription stimulants for recreational use went on to develop a substance use disorder within one year, compared to just 4 percent of young adults. And while 7 percent of young adults who tried opioid painkillers became addicted soon after taking them, that figure rose to 11.2 percent among younger users.

For alcohol and tobacco, however, there was not much of a difference between the two age groups: Both older and younger youth had a similar rate of developing a substance use disorder. And for illicit drugs such as cocaine and heroin, the number of adolescents using them was too small for the researchers to draw any meaningful conclusions.

One possible explanation for the findings is that young people who have a greater predisposition to developing an addiction may be more likely to seek out illicit drugs at an earlier age. But Dr. Nora Volkow, a senior author of the new study and the director of NIDA, said it is known that cannabis and other drugs can have a potent effect on adolescent brains because they are still developing. Younger brains exhibit greater plasticity, or ability to change, than the relatively static brains of older individuals. As a result, drugs like cannabis are more likely to alter synaptic connections in younger brains, leading to stronger memories of pleasure and reward.

“It’s a learning process when you become addicted,” said Dr. Volkow. “It’s a type of memory that gets hard-wired into your brain. That occurs much faster in an adolescent brain.”

Studies show that regularly using marijuana can affect cognition in adolescents, leading to impairments in parts of the brain that are involved in learning, reasoning and paying attention. Yet in recent years the booming popularity of e-cigarettes has led to a sharp increase in the number of adolescents who vape nicotine and marijuana, a trend that has alarmed public health officials. Some studies suggest that adolescents may also be more likely to try marijuana as more and more states legalize its recreational use.

Dr. Volkow said that as states implement new marijuana regulations, policymakers should work on measures aimed at protecting adolescents. She stressed that pediatricians and dentists should screen for drug use in their young patients by asking them about it. And she cautioned parents not to dismiss marijuana use in teens and adolescents as something that is harmless.

“As it relates to marijuana, the drugs that were available when parents today were teenagers are very different from the drugs that are available now,” she said. “The content of THC is much higher, and the higher the THC content, the greater the risk of adverse effects.”

Are Some Foods Addictive

Are Addictive Foods Making Us Fat?

Food researchers debate whether highly processed foods like potato chips and ice cream are addictive, triggering our brains to overeat.

Credit…Richard A. Chance
Anahad O’Connor

  • Feb. 18, 2021, 5:00 a.m. ET

Five years ago, a group of nutrition scientists studied what Americans eat and reached a striking conclusion: More than half of all the calories that the average American consumes comes from ultra-processed foods, which they defined as “industrial formulations” that combine large amounts of sugar, salt, oils, fats and other additives.

Highly processed foods continue to dominate the American diet, despite being linked to obesity, heart disease, Type 2 diabetes and other health problems. They are cheap and convenient, and engineered to taste good. They are aggressively marketed by the food industry. But a growing number of scientists say another reason these foods are so heavily consumed is that for many people they are not just tempting but addictive, a notion that has sparked controversy among researchers.

Recently, the American Journal of Clinical Nutrition explored the science behind food addiction and whether ultra-processed foods might be contributing to overeating and obesity. It featured a debate between two of the leading experts on the subject, Ashley Gearhardt, associate professor in the psychology department at the University of Michigan, and Dr. Johannes Hebebrand, head of the department of child and adolescent psychiatry, psychosomatics and psychotherapy at the University of Duisburg-Essen in Germany.

Dr. Gearhardt, a clinical psychologist, helped develop the Yale Food Addiction Scale, a survey that is used to determine whether a person shows signs of addictive behavior toward food. In one study involving more than 500 people, she and her colleagues found that certain foods were especially likely to elicit “addictive-like” eating behaviors, such as intense cravings, a loss of control, and an inability to cut back despite experiencing harmful consequences and a strong desire to stop eating them.

At the top of the list were pizza, chocolate, potato chips, cookies, ice cream, French fries and cheeseburgers. Dr. Gearhardt has found in her research that these highly processed foods share much in common with addictive substances. Like cigarettes and cocaine, their ingredients are derived from naturally occurring plants and foods that are stripped of components that slow their absorption, such as fiber, water and protein. Then their most pleasurable ingredients are refined and processed into products that are rapidly absorbed into the bloodstream, enhancing their ability to light up regions of the brain that regulate reward, emotion and motivation.

Salt, thickeners, artificial flavors and other additives in highly processed foods strengthen their pull by enhancing properties like texture and mouth-feel, similar to the way that cigarettes contain an array of additives designed to increase their addictive potential, said Dr. Gearhardt. Menthol helps to mask the bitter flavor of nicotine, for example, while another ingredient used in some cigarettes, cocoa, dilates the airways and increases nicotine’s absorption.

A common denominator among the most irresistible ultra-processed foods is that they contain large amounts of fat and refined carbohydrates, a potent combination that is rarely seen in naturally occurring foods that humans evolved to eat, such as fruits, vegetables, meat, nuts, honey, beans and seeds, said Dr. Gearhardt. Many foods found in nature are rich in either fat or carbs, but typically they are not high in both.

“People don’t experience an addictive behavioral response to naturally occurring foods that are good for our health, like strawberries,” said Dr. Gearhardt, director of the Food and Addiction Science and Treatment lab at the University of Michigan. “It’s this subset of highly processed foods that are engineered in a way that’s so similar to how we create other addictive substances. These are the foods that can trigger a loss of control and compulsive, problematic behaviors that parallel what we see with alcohol and cigarettes.”

In one study, Dr. Gearhardt found that when people cut back on highly processed foods, they experienced symptoms that were comparable to the withdrawal seen in drug abusers, such as irritability, fatigue, feelings of sadness and cravings. Other researchers have found in brain imaging studies that people who frequently consume junk foods can develop a tolerance to them over time, leading them to require larger and larger amounts to get the same enjoyment.

In her clinical practice, Dr. Gearhardt has encountered patients — some obese and some not — who struggle in vain to control their intake of highly processed foods. Some attempt to eat them in moderation, only to find that they lose control and eat to the point of feeling ill and distraught. Many of her patients find that they cannot quit these foods despite struggling with uncontrolled diabetes, excessive weight gain and other health problems.

“The striking thing is that my clients are almost always acutely aware of the negative consequences of their highly processed food consumption, and they have typically tried dozens of strategies like crash diets and cleanses to try and get their relationship with these foods under control,” she said. “While these attempts might work for a short time, they almost always end up relapsing.”

But Dr. Hebebrand disputes the notion that any food is addictive. While potato chips and pizza can seem irresistible to some, he argues that they do not cause an altered state of mind, a hallmark of addictive substances. Smoking a cigarette, drinking a glass of wine or taking a hit of heroin, for instance, causes an immediate sensation in the brain that foods do not, he says.

“You can take any addictive drug, and it’s always the same story that almost everyone will have an altered state of mind after ingesting it,” said Dr. Hebebrand. “That indicates that the substance is having an effect on your central nervous system. But we are all ingesting highly processed foods, and none of us is experiencing this altered state of mind because there’s no direct hit of a substance in the brain.”

In substance use disorders, people become dependent on a specific chemical that acts on the brain, like the nicotine in cigarettes or the ethanol in wine and liquor. They initially seek out this chemical to get a high, and then become dependent on it to alleviate depressed and negative emotions. But in highly processed foods, there is no one compound that can be singled out as addictive, Dr. Hebebrand said. In fact, evidence suggests that obese people who overeat tend to consume a wide range of foods with different textures, flavors and compositions. Dr. Hebebrand argued that overeating is driven in part by the food industry marketing more than 20,000 new products every year, giving people access to a seemingly endless variety of foods and beverages.

“It’s the diversity of foods that is so appealing and causing the problem, not a single substance in these foods,” he added.

Those who argue against food addiction also point out that most people consume highly processed foods on a daily basis without showing any signs of addiction. But Dr. Gearhardt notes that addictive substances do not hook everyone who consumes them. According to research, about two-thirds of people who smoke cigarettes go on to become addicted, while a third do not. Only about 21 percent of people who use cocaine in their lifetimes become addicted, while just 23 percent of people who drink alcohol develop a dependence on it. Studies suggests that a wide range of factors determine whether people become addicted, including their genetics, family histories, exposure to trauma, and environmental and socioeconomic backgrounds.

“Most people try addictive substances and they don’t become addicted,” Dr. Gearhardt said. “So if these foods are addictive, we wouldn’t expect that 100 percent of society is going to be addicted to them.”

For people who struggle with limiting their intake of highly processed foods, Dr. Gearhardt recommends keeping a journal of what you eat so you can identify the foods that have the most pull — the ones that cause intense cravings and that you can’t stop eating once you start. Keep those foods out of your home, while stocking your fridge and pantry with healthier alternatives that you enjoy, she said.

Keep track of the triggers that lead to cravings and binges. They could be emotions like stress, boredom and loneliness. Or it could be the Dunkin’ Donuts that you drive by three times a week. Make a plan to manage those triggers by a taking a different route home, for example, or by using nonfood activities to alleviate stress and boredom. And avoid skipping meals, because hunger can set off cravings that lead to regrettable decisions, she said.

“Making sure you are regularly fueling your body with nutritious, minimally processed foods that you enjoy can be important for helping you navigate a very challenging food environment,” said Dr. Gearhardt.

How to Reimagine Your Relationship to Alcohol

Reimagine Your Relationship to Alcohol

For many, January is a month to rethink how much they imbibe, whether they’re worried about heavy drinking or just looking for a reset.

Credit…Jordan Awan

  • Jan. 15, 2021, 2:47 p.m. ET

Seven years ago, Laura McKowen started a drinking journal. She knew alcohol was an issue for her — she knew it when her 4-year-old daughter helped her clean up the morning after a blackout, and she knew it the 10th time she drove to work hung over — but she needed to see it.

“Something very interesting happens when we put things on paper,” Ms. McKowen said, “because we have a lot of cognitive dissonance around drinking.” She couldn’t deflect around what she saw on the page, though: two bottles of wine a night. She got sober, and went on to help others do the same through coaching and teaching workshops.

Last January, Ms. McKowen published “We Are the Luckiest: The Surprising Magic of a Sober Life” and in March, she began hosting free sobriety support meetings on Zoom. By May, she had 12 employees and a company called The Luckiest Club, which offers classes and access to its community.

It’s no surprise Ms. McKowen found an eager client base. According to the 2019 National Survey on Drug Use and Health, more than 14 million American adults suffer from alcohol use disorder (A.U.D.), which is a term medical professionals prefer to alcoholism.

You don’t need an A.U.D. diagnosis to find your drinking problematic, though. Alcohol can impair sleep, cause weight gain, exacerbate anxiety, or subtly change your personality. A study conducted by the RAND Corporation in September suggests Americans are drinking 14 percent more often in response to pandemic-related stress, especially women, whose heavy drinking days increased by 41 percent in 2020.

When we go to work every day during non-pandemic times and don’t have an inordinate amount of stress, it’s fairly easy” to limit drinking to Friday nights, said James G. Murphy, a psychology professor and researcher at the University of Memphis who published a paper in November about alcohol and drug use during the pandemic. “When all of that structure is ripped away — when you’re worried about finances and your kids’ home-schooling and you don’t have to be anywhere in the morning, so no one will see if you’re hung over — alcohol can be way more difficult to manage.”

This is one reason you might be seeing more Dry January hashtags in your social media feeds this year. One month off from drinking can be an opportunity for the sober-curious to examine their alcohol use.

If any of this sounds familiar, here are some suggestions to help you navigate your relationship with alcohol or bring it to an end.

Get curious.

Take note of how much you’re drinking, as well as the pros and cons of that consumption. Are you opening that bottle of Riesling because it pairs well with your Chinese takeout, or are you hoping the third glass will drown out those voices in your head that are telling you you’re mediocre? Study your own habits — and be honest about them.

To give you some perspective, the federal government’s 2020-2025 U.S. Dietary Guidelines for Americans recommend no more than one drink per day for women or two for men (though some suggest fewer), and Dr. Murphy suggests the free alcohol screener at the website CheckUp & Choices. Take the questionnaire, which is used by health care providers, and use the score to assess your drinking. Similarly, Drinks Meter is an app with a daily calculator that helps put your own behavior into perspective using an anonymous database of over 6,000 people’s drinking habits worldwide.

“You don’t have to have things figured out, aside from wanting to make a change,” said Holly Whitaker, the author of “Quit Like a Woman: The Radical Choice to Not Drink in a Culture Obsessed with Alcohol” and creator of an online A.U.D. recovery program called Tempest. “You’re doing it right now, by being brave enough to read this article.”

Clear out the alcohol.

If you’ve decided alcohol is having a negative impact on your life, try distancing yourself from it for a while. Remove bottles from your physical spaces and booze-related content from your virtual ones. Cleanse your phone and computer of anything that might tempt you to drink.

It’s not about having a siloed existence or avoiding anything that creates an urge to drink, said Ms. McKowen, it’s about dismantling the myth that drinking is what makes life fun. “You want your online world to reflect the energy of where you’re going,” she said.

Then try not to drink for a month. Pick a date and stick with it. Experts say this is the best way to evaluate your alcohol use, and it’s a jump start on reducing your consumption, if that’s what you decide to do.

“Detoxification literally means removing the toxin,” said George F. Koob, director of the National Institute on Alcohol Abuse and Alcoholism. This can be done on your own unless you have moderate to severe A.U.D., in which case you should seek medical help. Untreated severe alcohol withdrawal can be fatal.

But fill the space with something else.

Alcohol does have positive effects: It squashes tension and lowers inhibitions. Remove it and you will miss it, at least initially.

So, identify other activities you love and increase them. Whether it’s exercise or spending time with friends, “we need another outlet to fill the void that alcohol leaves,” Dr. Murphy said.

Find your people.

You’re more likely to successfully abstain from alcohol if you have support. “Tell as many of your friends and family members who feel safe as you can about this,” Dr. Murphy said.

It also helps to connect with others who share your goal. In-person support meetings have become difficult to access in the pandemic, but help has proliferated online. Free sobriety support communities with virtual meetings include Alcoholics Anonymous, SMART Recovery, SheRecovers, In the Rooms, Eight Step Recovery, Refuge Recovery, Recovery Dharma, and LifeRing, among others. Neither good lighting nor charisma is required or expected; join from your phone while walking in a park or sitting in your car.

“I go to two meetings a day now,” said Braunwyn Windham-Burke, a reality TV star whose sobriety journey is currently playing out on season 15 of “The Real Housewives of Orange County.” “It’s so easy, because it’s in my bedroom.”

One Tempest member, Valentine Darling, 32, of Olympia, Wash., finds virtual meetings to be more L.G.B.T.Q.-friendly as well. “I feel safe sitting next to my house plants, so I’m more fully present and I’m also more authentically me: I wear dresses and express my gender queerness without worrying that anyone will follow me home.”

Many organizations have meetings specifically for people of color, certain age groups or even professions. Ben’s Friends is a sobriety support group geared toward restaurant workers. “We speak a common language in restaurants,” said co-founder Steve Palmer. “You find out that, ‘OK, he’s a line cook. She’s a bartender. These are my people.’”

Understand what recovery means for you.

If your month of sobriety was relatively easy to accomplish, then simply consider it a reset. But if you’re having trouble sticking to your plan, you might need more than group meetings. You may have A.U.D., which is a disease, not a moral failing, and it requires treatment like any illness. The most effective form of recovery usually involves long-term behavioral therapies and community support as well as medication, if needed.

The N.I.A.A.A. navigator can help you find the right treatment for you. The Substance Abuse and Mental Health Services Administration at the Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) also has an online treatment locator.

Be flexible.

If you decide you want to maintain your sobriety long-term, understand that treatment plans may vary over time. “The same practices that helped you quit drinking might not keep you sober later on,” Ms. Whitaker said. Maybe you’ve unlocked a trauma along the way, maybe you’re going through a divorce or maybe you’re living in the midst of a pandemic.

You haven’t done anything wrong; you just need a fresh set of tools.

Dr. Murphy recommends continuing to keep a log of alcohol use. Apps like Drink Control and Drinks Meter can help, but even using a pen and paper, make note of any benefits you see, to keep your momentum going. When you backslide, make note of that — and how you feel about it.

It probably took a long time to develop your current relationship with alcohol. Changing that relationship, then, will require sustained effort — and it might take several attempts. If the first one doesn’t last, Dr. Koob said, don’t judge yourself harshly. Just try again.

Well, So Much for Dry January


So Much for Dry January?

It’s been an intense and distressing month in America.

This you?
This you?Credit…Getty Images
Alex Williams

  • Jan. 12, 2021, 5:00 a.m. ET

Well, that was quick.

Dry January, the social-media fueled month of voluntary sobriety, became Damp January in under a week for many temporary teetotalers. Many were horrified enough by the assault on the U.S. Capitol and the ensuing protracted situation to break their vow and reach for the bottle, as evidenced by jokes, confessions and memes ricocheting around Twitter and Instagram.

Among bandwagoneers, the should-I-or-shouldn’t-I conversation was happening offline, too, as many attempting four weeks as non-tipplers decided that a national crisis was bigger than a 31-day health kick.

Dry January at least seemed like a sensible way to start fresh in 2021, said Nina McConigley, an assistant honors professor at the University of Wyoming in Laramie who swore off her extended pandemic cocktail kick.

But as she and her husband watched the tragedy unfold on television, feeling “sad and useless,” a nice dinner and a bottle of tempranillo seemed like the only balm, Ms. McConigley, 45, said: “I am of color, watching the Confederate flag being paraded in the Capitol, it was the worst. The act of a hot warm dinner and nice wine, it felt self-preserving.”

After five days of lemon detox tea, for example, Emily Titelman, an event producer in Los Angeles, detoured to tequila and orange juice on Wednesday, to ease her nerves after witnessing a mob send elected officials, their staff and media into hiding for their lives.

“As someone who is very politically engaged, I felt morally obligated to return to the news,” Ms. Titelman, 35, said. The drink, she added, “absolutely took the edge off my very real anger.”

People surround the U.S. Capitol on Jan. 6.
People surround the U.S. Capitol on Jan. 6.Credit…Jason Andrew for The New York Times

A year of quarantine had converted Adam Roberts, 41, the creator of Amateur Gourmet, a food blog, from social drinker to a regular home drinker, he said. It got to the point that he had vowed that very day, on a walk with his husband, the film director Craig Johnson, and their dog in the Atwater Village neighborhood of Los Angeles, to cut out drinking on weekdays during January.

“But when we got home and saw the images of a guy in a Camp Auschwitz sweatshirt storming the U.S. Capitol, I said, ‘I changed my mind. Make me a Oaxacanite,” he said.

Others who had pledged a month of sobriety managed to stay dry through the crisis, if barely.

Hitha Palepu, a pharmaceuticals executive in New York, leaned on more than 20 Dry January accountability groups she had started on Instagram to convince her to to boil a kettle for tea (albeit, with a drop or two of CBD,) rather than uncork a bottle of pinot noir.

“I had spent the past four years numbing the feelings that the news brought me with wine,” Ms. Palepu, 36, said. “This time, I chose to fully feel these feelings and find a new way to process them. It was my own little act of resistance for my present and future self, against my past self.”

The vision of the president of the United States goading his supporters against Congress, the Senate and his own vice president proved to be a shocking test for Frauke Weston, who is German and a marketing manager in Brooklyn. She was wondering if she could stick with her alcohol-free month she began, as she awaits her final interview to gain citizenship later this month.

“I keep getting messages from German and American friends alike, jokingly asking ‘Are you sure you want to sign up for this?’” Ms. Weston said.

For those who signed on to Dry January as a wellness experiment, like a juice cleanse, it seemed all in good fun to ditch their resolve after a few days and post jokey memes on Twitter, like the oft-quoted line from the 1980 comedy film “Airplane” — “Looks like I picked the wrong week to stop sniffing glue.”

But for many with addiction issues, the crisis of Jan. 6 was a graver matter, particularly after a wearying 2020 that seemed like a stress-ridden version of the movie “Groundhog Day,” said Dr. Joseph Lee, the medical director of Hazelden Betty Ford Foundation in Minneapolis.

“You’re seeing the intersection of pandemic stress, economic stress, political and social strife, and all those things have added together and predictably have increased the consumption of various substances by high-risk people,” Dr. Lee said in an email.

A lot of people, he said, were posting messages on social media like, “‘We made it five days, then everything went dumpster-fire-emoji,’” he said. “But on a serious level, when people are isolated and already over-interpreting the news, worrying too much, and losing confidence in our sense of democracy, all these things can be tipping points for people at risk.”

For those with the luxury of experimenting with sobriety by choice, however, the evenings of hot tea with lemon will last only through a month, even if the political chaos does not.

A day after breaking her Dry January vow, Ms. McConigley was back on the wagon, intent to last through the month. Well, most of the month, anyway.

“My one exception for the month has always been Jan 20,” she said. “We have a special bottle of champagne we are saving for Inauguration Day.”

Juggling My Children, Their Alcoholic Sitter and My Own Sobriety


Juggling My Children, Their Alcoholic Sitter and My Own Sobriety

The babysitter says she has nine days sober, but we all lie, every addict, every alcoholic.

Credit…Lucy Jones

  • Jan. 8, 2021, 5:00 a.m. ET

Tonight I left my children with our longtime babysitter, who claims she is nine days sober, but is possibly drunk or high.

At the very least, she is exhausted — the kind of exhausted that seeps into your bones and calcifies. I am leaving my children with her because I trust her. Four years, she has cared for my children. She has made them paper crowns and cardboard castles, bathed them and sung them to sleep. She and I have lunched and sipped tea. Together, we have summited mountains of paperwork to secure her health insurance, a new car, a new apartment.

I know her, I trust her. This is the mantra I repeat to myself from my office upstairs, where I am listening to every thump and bump and giggle below.

I am in the house. I didn’t leave. It’s the middle of a pandemic; no one leaves anymore. That’s how I know my children will be alive when I finish working. But as the night goes on, I start checking the baby monitor, because my children are not in bed and it is after 8 o’clock, after bedtime, late and getting later. When they finally appear — my 5-year-old daughter doing a cartwheel, my 3-year-old son dragging his blankies, the babysitter, alert and smiling — I release a breath I had not realized I was holding.

How many days of sobriety do you need to babysit? To be trustworthy? Seven days? Thirty days? Ninety days? Conventional wisdom holds that the physical symptoms of alcohol withdrawal — the nausea and sweating, the shaking and disorientation — usually subside in three to five days.

The babysitter says she has nine days sober, but we all lie, every addict, every alcoholic. I detoxed in the hospital’s drunk tank. On day two of sobriety, I had a seizure. On day six, I had a panic attack. On day nine, I could put on my own pants, barely.

But the struggle doesn’t end with the physical. It’s mental. The misery of protracted withdrawal — dysphoria, depression, irritability — can drag on for weeks. Twelve-step programs refer to this as “the monkey on your back,” because the cravings weigh on you, pick at you, natter in your ear about how much more bearable this conference call, this meal, this round of hide-and-seek might be with a drink. My first sponsor insisted I find a job and keep busy, which I did, and I stayed sober.

Tonight, I’m paying it forward. I am giving the babysitter a job. I am keeping her busy. I am hoping she stays sober.

But what if I weren’t an alcoholic? Would I have asked her to leave? Would I have said I’m not comfortable, and sent her away? This babysitter has become something more akin to family. She has told me stories of being dragged through her childhood like a fiberglass boat through the shallows: a father who left, a mother who did her best, a grim foster care placement, and the briny scrape of countless other dangers, both visible and not. This babysitter — whose heart is miraculously intact despite the damage it has endured, including a recent brush with death and viral cardiomyopathy — could I have asked her to leave?

The Big Book of Alcoholics Anonymous says she should stay. Being of use is important, it says. The fellowship of another alcoholic is crucial, it says. Still, I wish she hadn’t confessed. I wish she hadn’t told me over the kitchen island, in front of the children as they were eating spaghetti, as they were eating her every word, saving their questions for the morning when I know they will ask me, What is drinking? What is sober? Why is her face so fluffy?

They do not know what it is to be bloated. They do not understand edema or addiction. They have never seen me drink alcohol, not once, not ever. I will have to explain it to them. They share my blood, so it’s possible that this thing, this alcoholic affliction may be metastasizing in them, even now, as they lie in their beds, chattering back and forth. I will have to explain at least part of it to them in the morning.

Someday they will want to know all of it. How I stopped drinking. How I writhed as the alcohol and dope leached out of my system. How I was dry. For years I was dry, like a desert, like the air in winter, like a pile of ash. Angry. Pimpled. Thirsty. That first year, I locked myself away in a halfway house where I learned how to shower, how to clean a toilet, how to cook spaghetti, how to wash a dish, how to make a bed, why you should care about making your bed. And AA meetings every day. For three years, every day. I had the Big Book nearly memorized — the acceptance passage, the serenity prayer, How It Works, the steps and traditions. I remember so little now.

I’ve been sober 18 years, so long I don’t even think about drinking and drugs anymore. Not really, anyway. Not often. Definitely not every day. But once in a while, maybe out at dinner with friends, when someone orders a red wine, or a beer, or a vodka tonic.

Vodka. I’d like seven vodka tonics. I’d like to slip inside a bottle of vodka, to bathe in it, to slosh, just for the night, just for a little while.

That’s how I know my addiction is still there, still lurking, still hungry. After 18 years it’s probably ravenous, but it’s not starving. Starvation is something you die of, and addiction cannot be killed. You can’t excise or eradicate it. You have to contain it. Dam it. Barricade it. Even then, it whispers. Through whatever levees you erect, it gurgles. It splashes out a Morse code of desire. You become a certain kind of deaf, a certain level of numb, all the time, every day. That’s the work. That is how you progress from drunk, to dry drunk, to sober human. You’ll never be just human. You’ll always be a sober human — a person almost, but not quite.

My babysitter has nine days sober. When she tells me, she says how proud she is. I have given her my children for the night. When I go downstairs, they will be asleep, or will be in bed contemplating going to sleep. She and I will talk. I will tell her what it was like, what happened, what it’s like today. I will tell her half-truths — not even. She will tell me what it is like for her right now, today, with her nine days sober. I will believe half of what she says — not even.

Tomorrow night, she will watch my children again. She will hold them, and her soon-to-be 10 days, as tightly as she is able. I know her, I trust her. She will keep the children as safe as she knows how. I pray their laughter and shrieks and glee will keep her safe in return. These are the things alcoholics do for each other. These are the things that keep us sober. These are the things I hope someone would do for my children, should they need it.

Sarah Twombly is a writer and mother to two young children.

‘Vodka in Your Coffee Cup’: When Pandemic Drinking Goes Too Far

‘Vodka in Your Coffee Cup’: When Pandemic Drinking Goes Too Far

Some women are seeking to regain control over their alcohol habits after months of laissez-faire consumption.

Martha Duke has been surprised at how many women have recently sought her advice on cutting down on drinking. She is part of the Sober Mom Squad, a support group created during the pandemic.
Martha Duke has been surprised at how many women have recently sought her advice on cutting down on drinking. She is part of the Sober Mom Squad, a support group created during the pandemic.Credit…Celeste Sloman for The New York Times

  • Dec. 25, 2020, 5:00 a.m. ET

Martha Duke, who has been sober since Jan. 1, 2018, didn’t set out to become an abstinence guru during the “what does it matter anyway” drinking frenzy of 2020.

Until it started to matter.

All of a sudden, Ms. Duke, a vocal critic of “mommy wine culture” and a member of the Sober Mom Squad, a virtual community created during the pandemic, was fielding questions about alcohol from friends and acquaintances. Was two bottles of wine a night a bit over the top? How much was too much? Many of the women seeking her out were high school connections she hadn’t spoken with in years, and with whom she mostly communicated through social media.

“No one is talking about glasses of wine anymore,” said Ms. Duke, who works for a dog grooming app and lives in Manhattan with her two teenage sons. “People are measuring by the bottle,” she continued. “That scares me. I know too many women who went from one or two glasses to two bottles of wine to vodka in your coffee cup.”

During the pandemic, alcohol has become an easy way to self-medicate, aided by the fact that liquor and wine stores were deemed essential services from the start. Many even offer delivery, with apps like MiniBar filling in the gaps. New Yorkers who ache for fresh air and company have been able to order cocktails to go from restaurants and enjoy them on the sidewalk.

But as a new year approaches, many New Yorkers are re-evaluating their relationship with alcohol, whether it’s by cutting down, joining support groups or stopping completely.

Loosid, a sober social and dating network, saw more than a 3,000 percent increase in messages and posts this year, rising from about 500 in February to over 16,000 in November. Its hotline has been just as active. In February, the hotline received 84 messages. Last month, it received 3,205.

Women in particular have been vocal about curbing their heavy drinking, the frequency of which increased by 41 percent this year, versus 7 percent for men, according to a RAND Corporation study published in September.

“It’s been understood that women are more likely to drink to cope with isolation issues or problems with relationships,” said Sharon Wilsnack, a retired professor of psychiatry and behavioral science at the University of North Dakota School of Medicine. “The pandemic prevented us from connecting with others. If we’re deprived of these relationships, which causes more stress, it might make women turn to drinking as a way to deal with that deprivation.”

This might be one reason Wellbridge Addiction Treatment and Research in Calverton, N.Y., on Long Island, has already seen a surprisingly large number of women seeking treatment since opening in May. Dr. Harshal Kirane, the medical director, said that in his experience, only around 15 percent of addiction patients are women in their 40s and 50s. Yet three months into the pandemic, 70 percent of those admitted to Wellbridge came from this demographic.

These days, there is a general, distorted sense of what healthy and acceptable drinking is, Dr. Kirane said. “Responsible drinking is reinforced by structure in people’s lives — going to work, taking their kids to school, interacting and maintaining a home,” he explained. “The pandemic has turned such boundaries on their head and created more space for alcohol.”

That’s what happened to Natalie Silverstein, a marketing manager in media, who is planning an alcohol-free January. Before the pandemic, she was a self-described social drinker, who mostly had a glass of wine on a date or on the weekend. But this year, she started drinking every day.

“Being inside all these months was extremely confining,” said Ms. Silverstein, who lives in the East Village. “I needed something to relax. I looked forward to drinking because it broke the barrier.”

For her, a glass of wine signaled the end of the day. Anxious, tired and stressed, it helped her sleep. It also helped her socialize and connect.

“In New York, drinking was an activity. In isolation it helped us gather,” she said. “My team would do Zoom happy hours, and everyone had wine or a cocktail. That became habitual. It felt like drinking was the one thing holding us up.”

For Andrea Morgan of Long Island, a publicist and mother of two children who have been in remote school this year, drinking helped ease boredom. She knew it was becoming an issue, so she stopped drinking for November, as did her husband. “No one wants to teach their kids virtually with a drink in their hand,” she said. Now Ms. Morgan is considering doing a dry January. “It was great to have the discipline during this time, when so much is out of my control, to prove to myself I can control this.”

For her own dry January Ms. Silverstein is thinking up ways to continue the ritual of pouring a drink at the end of the day, just one without alcohol. “That’s easier than removing the habit,” she said. “I’m excited to try alternatives. I want to develop positive behaviors.”

For some, the solution to stop self-medicating with alcohol is actual medication.

“I was never a big drinker — I had one or two glasses of wine at dinner — then I became a pandemic drinker, having three to four glasses of wine a day,” said Jennifer Rubenstein, an annual fund manager at a synagogue who lives in Stuyvesant Town on the East Side of Manhattan. “I was depressed and anxious. I missed my colleagues. I started drinking nightly, then it was drinking at 5, and before you know it was a Bloody Mary at 10 a.m. I was having hangovers and little blackouts.”

Women, especially, began drinking more after the coronavirus struck. “I was depressed and anxious,” Jennifer Rubenstein of Manhattan said. “I missed my colleagues.”
Women, especially, began drinking more after the coronavirus struck. “I was depressed and anxious,” Jennifer Rubenstein of Manhattan said. “I missed my colleagues.”Credit…Celeste Sloman for The New York Times

In September Ms. Rubenstein asked her therapist for help.

“I started Naltrexone, which reduces alcohol cravings, in an effort to severely cut back on my drinking, which I’m taking in tandem with an antidepressant,” she said. “The effects were immediate. It’s made a profound difference. My head feels clear in the morning. Now I only have four ounces of red wine at night. The craving for more is gone.”

Hilary Sheinbaum of Queens, the author of “The Dry Challenge: How to Lose the Booze for Dry January, Sober October, and Any Other Alcohol-Free Month,” offered a few practical suggestions on how to cut back or stop completely. “Remove it from your home by giving it to a neighbor or friend to hold,” she said. “Or pour it down the drain.”

She also emphasized the importance of a support network when quitting alcohol, and of speaking honestly with friends and family about the process: “The ones who care about you will support your efforts.”

A.A. to Zoom, Substance Abuse Treatment Goes Online

Until the coronavirus pandemic, their meetings took place quietly, every day, discreet gatherings in the basements of churches, a spare room at the YMCA, the back of a cafe. But members of Alcoholics Anonymous and other groups of recovering substance abusers found the doors quickly shut this spring, to prevent the spread of Covid-19.

What happened next is one of those creative cascades the virus has indirectly set off. Rehabilitation moved online, almost overnight, with zeal. Not only are thousands of A.A. meetings taking place on Zoom and other digital hangouts, but other major players in the rehabilitation industry have leapt in, transforming a daily ritual that many credit with saving their lives.

“A.A. members I speak to are well beyond the initial fascination with the idea that they are looking at a screen of Hollywood squares,” said Dr. Lynn Hankes, 84, who has been in recovery for 43 years and is a retired physician in Florida with three decades of experience treating addiction. “They thank Zoom for their very survival.”

Though online rehab rose as an emergency stopgap measure, people in the field say it is likely to become a permanent part of the way substance abuse is treated. Being able to find a meeting to log into 24/7 has welcome advantages for people who lack transportation, are ill, juggling parenting or work challenges that make an in-person meeting tough on a given day and may help keep them more seamlessly connected to a support network. Online meetings can also be a good steppingstone for people just starting rehab.

“There are so many positives — people don’t need to travel. It saves time,” said Dr. Andrew Saxon, an addiction expert and professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine. “The potential for people who wouldn’t have access to treatment easily to get it is a big bonus.”

Participants of the combined virtual and in-person therapy group at Ottagan. While the convenience and ease of telehealth is undeniable, some say they crave the intensity of physical presence.
Participants of the combined virtual and in-person therapy group at Ottagan. While the convenience and ease of telehealth is undeniable, some say they crave the intensity of physical presence.Credit…Emily Rose Bennett for The New York Times

Todd Holland lives in northern Utah, and he marvels at the availability of virtual meetings of Narcotics Anonymous around the clock. He recently checked out one in Pakistan that he heard had a good speaker, but had trouble with some delay in the video and in understanding the speaker’s accent.

Some participants say the online experience can have a surprisingly intimate feel to it.

“You get more a feel for total strangers, like when a cat jumps on their lap or a kid might run around in the background,” said a 58-year-old A.A. member in early recovery in Portland, Ore., who declined to give his name, citing the organization’s recommendations not to seek personal publicity. Plus, he added, there are no physical logistics to attending online. “You don’t go into a stinky basement and walk past smokers and don’t have to drive.”

At the same time, he and others say they crave the raw intensity of physical presence.

“I really miss hugging people,” he said. “The first time I can go back to the church on the corner for a meeting, I will, but I’ll still do meetings online.”

Mr. Holland, who for decades abused drugs until Narcotics Anonymous helped him stay sober for eight years, said the online meetings can “lack the feeling of emotion and the way the spirits and principles get expressed.”

It is too early for data on the effectiveness of online rehabilitation compared to in-person sessions. There has been some recent research validating the use of the technology for related areas of treatment, like PTSD and depression that suggests hope for the approach, some experts in the field said.

Even those people who say in-person therapy will remain superior also said the development has proved a huge benefit for many who would otherwise have otherwise faced one of the biggest threats to recovery: isolation.

The implications extend well beyond the pandemic. That’s because the entire system of rehabilitation has been grappling for years with practices some see as both dogmatic and insufficiently effective given high rates of relapse.

A worksheet to help patients clarify their thoughts and behaviors during the Ottagan group session.Credit…Emily Rose Bennett for The New York Times

“It’s both challenging our preconceived concerns about what is necessary for treatment and recovery but also validating the need for connection with a peer group and the need for immediate access,” said Samantha Pauley, national director of virtual services for the Hazelden Betty Ford Foundation, an addiction treatment and advocacy organization, with clinics around the country.

In 2019, Hazelden Betty Ford first tried online group therapy with patients in San Diego attending intensive outpatient sessions (three-to-four hours a day, three -to-four hours a week). When the pandemic hit, the organization rolled out the concept in seven states, California, Washington, Minnesota, Florida, New York, Illinois and Oregon — where Ms. Pauley works — and has since expanded to New Jersey, Missouri, Colorado and Wisconsin.

Ms. Pauley said 4,300 people have participated in such intensive therapy — which entails logging into group or individual sessions using a platform called Mend that is like Zoom. Preliminary results, she said, show the treatment is as effective as in-person meetings at reducing cravings and other symptoms. An additional 2,500 people have participated in support groups for family members.

If not for Covid, Ms. Pauley said, the “creative exploration” of online meetings would still have happened but much more slowly.

One hurdle to intensive online rehab involves drug testing of patients, who would ordinarily give saliva or urine samples under in-person supervision. A handful of alternatives have emerged, including one in which people spit into a testing cup while being observed onscreen by a provider who verifies the person’s identity. The sample then gets dropped at a clinic or mailed in, though the risk of trickery always remains. In other cases, patients can visit a lab for a drug test.

Kim Villanueva, of Muskegon, Mich., shared a story during the group therapy session at Ottagan.Credit…Emily Rose Bennett for The New York Times

Additionally, some clinical signs of duress can’t be as easily diagnosed over a screen.

“You can’t see the perspiration that might indicate the person suffering mild withdrawal. There are limitations,” said Dr. Christopher Bundy, president of the Federation of State Physician Health Programs, a group representing 48 state physician health programs that serve doctors in recovery. He said that hundreds of physicians in these programs are attending regular virtual professionally monitoring meetings in which they meet with a handful of specialists for peer support and to assess their progress.

“This sort of thing has challenged our assumptions,” he said of the pandemic and the use of the internet for these therapies. “There’s a sense it’s not the same, but it’s close enough.”

Other participants in drug rehab and leaders in the field say that while online has been a good stopgap measure, they also hope that in-person meetings will return soon.

“It’s been a mixed blessing,” said David Teater, who wears two hats: he’s in recovery himself since the 1980s, and he’s executive director of Ottagan Addictions Recovery, a residential and outpatient treatment center serving low-income patients in western Michigan whose therapy typical gets paid through Medicaid.

In that capacity, he said online tools have been a godsend because, simply, they allowed service to continue. Through $25,000 in grants, the center got new computers and other technology that allowed it to do telemedicine, and set up a “Zoom room.” It includes a 55-inch monitor so that people who are Zooming in can see the counselor as well as the people who feel comfortable enough to come in-person and sit at a social distance wearing masks.

“We think it works equally well, we really do,” Mr. Teater said.

Overcoming the Shame of a Suicide Attempt


Credit Jordin Isip

I don’t remember much about the first time I tried to kill myself, 21 years ago, because any time the memory popped up I deleted it from my mind like an unflattering photo on Facebook. Despite being open and public about my second attempt, in 2006, which I revealed in a memoir about my alcoholism, I’ve never told anyone else about that first one – not my partner of 25 years, my therapist of 10 years, family, nor friends – until now.

Here’s what I remember about that first time, in 1995. I felt hopeless, that my 27 years of life were done (27!). I’d come home drunk from a glamorous Manhattan book event, which I had organized as the publicist. The wattage of successful artists in literature, fashion and theater was blinding. I felt like a failure, that I would never be more than the hired help, that my own dreams were just thin air. When I came home and poured another drink and remembered the leftover painkillers in my medicine cabinet – prescribed for a sprained ankle earned by a drunken fall — I thought, “Why not?”

My attempt was impulsive, not premeditated. Had it been successful, I’d classify it as suicidal manslaughter. I climbed into the antique wrought iron bed I shared with my partner and passed out. The next morning, I woke up next to him and he was none the wiser. I got up in a daze and went to work feeling like I was moving under water, so heavy was my triple hangover from booze, pills and shame. I kept moving, kept drinking (I was blind then to the cause and effect of booze and depression) and kept silent.

My silence nearly killed me. Eleven years later, I tried again. I had been fantasizing about suicide every day for months. I was more hopeless. I was drunker. That time I did it with sleeping pills I’d been taking to prevent me from drinking as much at night. Booze, pills, suicide attempts: it was all one big happy “Valley of the Dolls” family. That time I took the pills in the morning after my partner left for work, and I didn’t wake up on my own. My partner found me in that antique bed when he came home from work. The jig was up, and my winding path to recovery began.

Why bother talking about the first one? Now that I’ve been sober for almost eight years and my artistic dreams are coming true, the secret made me feel like a house rebuilt on a foundation still riddled with termites. I knew I would have to own the attempt eventually, so when the Centers for Disease Control and Prevention recently released a report that suicides had surged to the highest levels in 30 years, I knew it was time for me to come clean. With two attempts on my score card, I forever remain in a suicide high risk group. According to the Harvard T.H. Chan School of Public Health, a history of suicide attempt is one of the strongest risk factors for suicide, and the American Foundation for Suicide Prevention reports that approximately 40 percent of those who have died by suicide have made a previous suicide attempt at some point in their lives. I don’t want the third time to be the charm.

The further away from that first attempt, the deeper the secret grew and the less real it became. I didn’t really do that. I didn’t think a few painkillers would kill me. I didn’t mean it. But I did do it and I did mean it. I’m mortified by that. It was reckless, rash, stupid, selfish, pathetic.

As a recovering alcoholic I know that admitting to my behavior and owning my story is the only way it can no longer own me. I’m not ashamed of being an alcoholic, but I’m still ashamed of trying to kill myself, even though I know I did it under the temporary insanity of alcohol. According to the A.F.S.P., approximately 30 percent of those who die by suicide have blood alcohol levels in the range of intoxication at the time of their deaths.

After my second attempt, I went to rehab and then to sober meetings. The focus quickly shifted from my suicide attempt to my alcoholism, and rightfully so. Once my alcoholism was treated, the depression lifted. It was alcohol that brought on my depression and thoughts of suicide, and ultimately twice gave me the courage to try it. Since I’ve been sober, I no longer suffer from depression, do not take antidepressants and no longer think about killing myself.

I’m fortunate to live in New York City, where there are almost as many sober meetings as there are bars. These are peer-led meetings of alcoholics helping other alcoholics, free of judgment and condescension. These meetings keep me sober, hence nonsuicidal.

But what about the nonalcoholics and nonaddicts who’ve attempted suicide? Where are their meetings? I could find only a few peer-led suicide attempt survivor support groups via Google, and none in New York City. When I called the National Suicide Hotline requesting local suicide attempt survivor support groups, the operator suggested just one option: a Safe Place Meeting hosted by the Samaritans, a suicide prevention network. But those meetings are for those who have lost loved ones to suicide, and they have no meetings for attempt survivors.

I admitted my second suicide attempt because I was found out, and had to. But shame kept me quiet about my first attempt. I admit it now, and I throw out a call for other closeted suicide attempt survivors to do the same: Own it, and find – or create — a safe group where you can talk about it.

Today I own my story, so that my story doesn’t kill me.

Jamie Brickhouse is the author of “Dangerous When Wet: A Memoir of Booze, Sex, and My Mother.

Do Children in France Have a Healthier Relationship With Alcohol?


Credit Tony Cenicola/The New York Times

The Italian Senator Dario Stefàno proposed a bill last month that would require schools in Italy to teach one hour of wine culture a week to students starting at age 6. Mr. Stefàno clarified that the intention was to teach children about the cultural importance of wine in Italy, rather than to teach them to drink. But the idea of wine education for children would seem very foreign to most American parents.

Still, whether parents in the United States or elsewhere realize it or not, most children are already getting an informal education in alcohol consumption. From infancy, children are learning about their worlds – the rituals, practices, and languages that make their culture thrive. What adults eat – and drink – is a major part of this cultural fabric. Food selection is learned early in life, and it is social from the get-go.

One of us, Katherine Kinzler, was part of a team of researchers that found that by 12 months, babies are learning what foods are eaten in their culture. In the study, American babies were given two foods to try. One of the foods was offered by a native English speaker, who tried the food first and expressed appreciation for it. The other was tried and offered by a French speaker.

Babies tried both foods with glee – remember, babies of this age love to put things in their mouths, including dirt and dog toys. But when babies were given the choice of the two foods a second time – when they had to pick between the two foods that they had just tried and enjoyed – they picked the native speaker’s food. This is evidence of cultural learning: Babies are figuring out not just what tastes good, but also who eats which kind of food.

Even if a child has yet to have his or her first sip of wine, children are also witnessing how people drink alcohol. They are observing and learning whether alcohol is drunk with food, whether it is imbibed in groups or alone, if it makes people feel happy or sad.

How children learn about wine and alcohol consumption sets the stage for drinking habits across the lifespan. Differences in learning become readily apparent when comparing drinking behaviors of young adults in countries with a rich wine culture to those without one.

Though some studies have suggested that offering children small tastes of alcohol is associated with problem drinking, countries where drinking wine at meals is standard, including Italy, France and Spain, rank among the least risky in a World Health Organization report on alcohol. Can cultural attitudes toward wine affect our propensity for problem drinking?

By most accounts, binge drinking by young adults – particularly on college campuses – is an increasing problem worldwide. Yet, not all countries are equally affected by this rise in excessive alcohol consumption. The amount of binge drinking by students on college campuses in France is reported to be considerably lower than in the United States.

The French consume about four times per capita the amount of wine we consume in the United States, and more alcohol over all per capita as well. In France, drinking wine – particularly with a meal – is commonplace. Drinking wine to excess is not.

If children see adults appreciating wine – smelling, tasting, discussing and consuming it with meals and in moderation – it may bode well for their drinking habits in college. American college students tend to drink wine to excess much less frequently than other drinks. And anecdotally, one of us, Justine Vanden Heuvel, hears from students in her wine classes at Cornell University that as they learn to appreciate wine, they become pickier about the alcohol they consume, which may reduce their consumption at parties.

The recent proposal by the Italian senator seeks to capitalize on this early cultural learning in public schools. But children don’t need to go to school to learn the basics of alcohol consumption; this they get free – for better or worse – at home.

Katherine Kinzler is an associate professor of psychology and human development at Cornell University and Justine Vanden Heuvel is an associate professor in the viticulture and enology program there.


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Offering Kids a Taste of Alcohol


Credit Anna Parini

I discovered a new category for myself as a parent when I read a study published in March in the journal Pediatrics called “Parents Who Supply Sips of Alcohol in Early Adolescence: A Prospective Study of Risk Factors.” I confess I bridled a bit at the idea that the investigators might mean me: A ceremonial drop of Champagne on New Year’s Eve? A token “sip” of wine at Passover? Doesn’t this sound a little, well, puritanical?

It turns out that there is a growing body of research, much of it in specialized journals on alcohol use, on parents’ providing small tastes of alcohol to relatively young children in the context of family events, and trying to tease out what it does or doesn’t mean in terms of children’s later relationship with alcohol. Mind you, the sipping children aren’t high school students; we’re reaching back earlier than that. And the research came about because it is so common for parents to offer those sips at home, before children have had other tastes of alcohol.

“The whole issue of sipping came as a surprise,” said Dr. Monika Wadolowski, an epidemiologist who is a postdoctoral research fellow at the University of New South Wales Australia and the lead author on the study, which looked at 1,729 Australian seventh graders. She was drawn to the topic, she said, because some statistics were identifying high rates of early alcohol use in adolescents, but they weren’t distinguishing between the kids who had “sipped” and the kids who had had whole drinks.

Some researchers are trying to get at a child’s very first experience with drinking, “the earliest transition in the youngest population, specifically, from abstention into sipping or tasting alcohol among children,” according to a study published in 2014 in the journal Alcoholism: Clinical and Experimental Research. And that can mean going back pretty early. Researchers looked at 452 children in Pennsylvania to see what factors might predict which ones would start tasting alcohol from ages 10 to 12. Sipping wasn’t associated with the kinds of behavior problems that have predicted problem drinking in other studies. Instead, it was connected to whether parents approved of the sipping and to children’s perceptions of those attitudes.

The lead author, John E. Donovan, a professor of psychiatry at the University of Pittsburgh, recently wrote to me in an email that based on the cumulative research: “Child sipping is related to earlier initiation of drinking, which is a risk factor for a lot of other problem behaviors,” and related to binge drinking and drug use. His conclusion: “Parents should not be providing alcohol to their kids.”

That connection between early sipping and more serious drinking was explored in 2015 study, again published in a specialized journal, the Journal of Studies on Alcohol and Drugs, which followed a group of children from the beginning of sixth grade to the beginning of ninth grade to look at whether early sipping behavior was associated with patterns of early alcohol use. They excluded alcohol in the context of religious services. The children who had tried alcohol before sixth grade — mostly at home, mostly beer and wine, mostly given by a parent — were more likely to have had full drinks or gotten drunk by the beginning of ninth grade.

The researchers controlled for a variety of risk factors, including child behavior problems, parents with a history of alcoholism, and parental drinking. Even so, they found that early sipping was strongly associated with more serious alcohol use by ninth grade.

What does that early sipping do, the researchers wondered. Does it change a child’s sense of what is normal behavior? Of how available alcohol is or should be? Is it possible that the taste — or the effects — of even small sips of alcohol may reinforce drinking behavior in young children?

Parents may think that by providing sips of alcohol to children, we are actually protecting them against problem drinking. We may think that we are modeling — at family occasions or on religious holidays — a healthy, festive attitude toward alcohol, consumed in moderation and in celebration. As a mother who supplied occasional sips, I want to ask about parental motivation, cultural patterns, community context, and about conversations between parents and children.

In Dr. Wadolowski’s study, the most powerful association was that parents who perceived that their child’s peers were using drugs or alcohol were more likely to be providing those sips at home; there were also associations with increased home access to alcohol and lenient rules about alcohol.

“What was really interesting,” she said, “was to find the parents who were supplying alcohol to their children, they had good parenting practices, they had strict rules, they monitored their children’s relationships.” What correlated with their decision to offer those sips? “The biggest predictors were whether they thought their children’s friends were drinking,” she said. So perhaps they were deliberately trying to offer an alternative model.

Dr. Wadolowski is concluding another study that looked at how the seventh graders who had had sips of alcohol behaved over the next year. It found that those who progressed to drinking whole drinks were more likely to have problem behaviors, friends who drank, and less parental monitoring; these factors were more important than the history of sipping. And the risk factors are interrelated.

Because it is so widespread, “we really do need to understand what the long-term effects are and whether it really does relate to binge drinking,” Dr. Wadolowski told me. “The research is so young.”

And so, of course, are the children.



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