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SAN ANTONIO
Risky
MEDICINE

Substance

By Arti Thangudu, MD

The coronavirus pandemic has turned our world upside down. More
time at home has had positive effects, like more time with our family and
perhaps more sleep. However, the stress of the pandemic along with find-
ing ways to unwind at home have led many people to reach for increasing
amounts of alcohol. Nielson reports increased alcohol purchasing in-store
and online during the pandemic and in a poll done on 2,200 adults; 19%
reported drinking more during the pandemic.
In my practice, I’ve had several patients report drinking much more than
usual early in the pandemic and now finding themselves trying to cut back,
realizing that their drinking was going to extremes and also realizing that
this quarantine is going to last much longer than any of us expected.

Many people may be drinking in excess without realizing it. That
gives us a great opportunity to educate ourselves and our patients
and screen for risky behaviors related to alcohol.

Per the National Institutes of Health (NIH), a standard drink is 12 fluid
ounces of regular beer, 8-9 fluid ounces of malt liquor, 5 fluid ounces of
table wine or 1.5 fluid ounces of distilled spirits.
As defined by the National Institute on Alcohol Abuse and Alcoholism
(NIAAA), low-risk drinking for women is no more than 3 drinks on any
single day and no more than 7 drinks per week. For men, it is defined as
no more than 4 drinks on any single day and no more than 14 drinks per
week. However, even within these limits, people can have problems if they
drink too quickly or if they have other health issues.
NIAAA defines binge drinking as drinking that brings blood alcohol
concentration to 0.08 grams per deciliter (0.08%) or higher, which typically
occurs after a woman consumes 4 drinks or a man consumes 5 drinks in a
2-hour time frame. At risk drinking includes drinking that exceeds the num-
ber of drinks per day any day of the week, binge drinking at least once per
month or drinking that increases the risk for problems even if no current
problems exist.
Alcohol Use Disorder Identification Tests (AUDIT) exist to help
providers with screening. There are multiple in-office behavioral interven-
tions and anti-relapse medications to help you and your patients in man-
aging alcohol abuse.
COVID-19 has put a magnifying lens on our healthcare system’s need
for increased dedication to preventative healthcare. Targeting risky behav-
iors with regard to substances and mental health are areas we all can work
on in our practices to improve the health of our community.

Arti Thangudu, MD, is the Founder of Complete Medicine and is a mem-
ber of the Bexar County Medical Society.
26 San Antonio Medicine • November 2020