America's Alcohol Crisis Has Hit 'Rock Bottom'
Nearly one in five Americans drinks heavily. That's the takeaway from a new Harris poll, which defines "heavy drinking" as women having four or more drinks in a sitting, and men five or more, at least twice a week.
The consequences of heavy drinking can be severe. Roughly 15 million Americans struggle with alcohol use disorder, or AUD -- the medical community's official name for an inability to control alcohol consumption despite adverse social, occupational, or health consequences.
I was one of them. I tried Alcoholics Anonymous, therapy, even emergency detox. But it was a pill that helped me change my relationship with alcohol -- and learn to consume it in moderation.
Expanding access to this kind of medication could save the lives of the tens of thousands of Americans who die from alcohol-related causes each year -- and help millions more drink responsibly.
Non-medical interventions -- things like Alcoholics Anonymous -- have helped millions of people get sober. But they don't work for everyone, as I know all too well. And I'm hardly an outlier.
Alcohol-related deaths doubled between 1999 and 2017 -- a sure sign that the prevailing "mind-over-matter" approach to tackling alcohol use disorder isn't working as intended.
Many people who struggle with alcohol have no idea medication may be able to curb their dependence. According to that Harris poll, only one-third of heavy drinkers were aware that prescription drugs were a potential treatment option.
Doctors also tend to be hesitant about prescribing drugs to patients with AUD. Even those who regularly see a physician are unlikely to get treatment, according to a new analysis from Washington University School of Medicine in St. Louis.
Cost is not the reason people lack access to these medications. The three that have been approved by the Food and Drug Administration to treat alcohol problems have been around for decades and are manufactured generically. That makes them affordable for nearly everyone.
The failure to embrace medication as a viable means of treating alcohol use disorder is largely a function of our culture, which continues to tell us that addiction is a personal failing, willpower is the route to salvation, and anti-addiction meds amount to "replacing one drug with another."
We don't tell people with diabetes to forego insulin if they need it, or demand that people with clinical depression simply "feel better." It's just as nonsensical to demand that people with alcohol use disorder forego medication if it can help them.
To change and even save lives, we'll need to break down barriers to medication-assisted treatment. Telemedicine can help.
For starters, it can help someone struggling with alcohol get around the shame they may feel. People are likely to be far more willing to seek help online from the privacy of their own homes than they would be to travel to a physician's office at some later date to open up about their drinking habits in person.
Telemedicine visits are also quicker and cheaper than in-person consultations. That makes them more accessible and ensures that patients can afford follow-up check-ins that boost their chances of successfully controlling their drinking. This added convenience is particularly important now, since heavy drinking has increased markedly since the start of the pandemic, according to a recent RAND Corporation study.
I've seen the benefits of combining telemedicine and AUD medication firsthand. After my experience with alcohol addiction, I founded Oar Health, a company that connects people struggling with alcohol use disorder with medical providers online.
After completing an assessment, patients receive a customized treatment plan from their provider -- which may include a prescription for naltrexone, a non-addictive, FDA-approved drug recommended by leading experts as a frontline treatment for patients with moderate-to-severe alcohol use disorder. Naltrexone disrupts alcohol's grip on the brain's reward pathways, helping patients like me take control of their drinking.
Treatments for AUD aren't one-size-fits-all. What works for one patient may fail for another. But realizing that there are multiple options in the first place -- and making those options accessible -- are necessary steps toward loosening alcohol's hold on millions of Americans.
Jonathan Hunt-Glassman is founder and CEO of Oar Health (www.oarhealth.com).
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