29.09.2020. The Kusnacht Practice Podcast #004: Interview with Dean Gustar on the rise in alcohol dependence during the COVID-19 crisis

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“It’s no surprise with the stress, global stress that we’re experiencing that people are turning to alcohol as a coping strategy.”- Dean Gustar, Senior Clinical Operations Manager at The Kusnacht Practice.

As the COVID-19 pandemic lingers on, the exponential rise in cases of anxiety and depression appear directly linked to the escalation in alcohol consumption.

In the fourth episode of our podcast series, we are talking with Dean Gustar, Senior Clinical Operations Manager about the dramatic increase in alcohol dependence during this difficult time. Dean explores the various ‘triggers’ that lead to consumption, the warning signs to look out for and the methods to adopt in order to avoid spiralling into dependency.


Presenter: Hello, welcome everybody this is The Kusnacht Practice podcast that you are listening to. We are here this morning with Dean Gustar, he’s the Senior Clinical Operations Manager here at The Kusnacht Practice. We are leaders in mental health treatments, and we’ll use this opportunity to talk about the questions regarding the rise in coronavirus-related alcohol addictions. Good morning Dean.

Dean Gustar: Good morning

Presenter: The first question this morning is the number of people drinking at high risk levels in the U-K has doubled to almost eight point five million since February, according to the Royal College of Psychiatrists. With the country facing a looming addiction crisis and millions turning to alcohol to cope with the pandemic, do these figures really surprise you?

DG: No, they don’t surprise me. I think that it’s been well documented that the stress on individuals and on communities caused by the coronavirus has led to people suffering from increased depression, increased anxiety, increased general stress levels; these are all triggers to increased alcohol use.

Some of the research papers in the Royal College of Psychiatrists report points to the correlation between coping with different kinds of mental health stresses and increased alcohol use. So it’s no surprise with the stress, global stress that we’re experiencing that people are turning to alcohol as a coping strategy.

Presenter: Right. And what signs should family members and friends look out for to spot alcohol dependency?

DG: I’m going to split this into two, two separate groups of warning signs. I’m going to talk about some warning signs if someone’s drinking too much and then some warning signs over full blown dependency. So if someone’s drinking too much, likely is they’re going to be suffering from a lot of hangovers in the morning. That’s something to spot.

They’ll probably be drinking pretty much every day, and sometimes drinking more than they set out to drink. So drinking more than they intended. It may be that they start to get a bit sick because of the alcohol consumption. Maybe they might experience some gaps in their memory, some cognitive deficits. They may be drinking alone. That’s a very sure sign that something’s not right. Neglecting their responsibilities, so they stop doing the things that they’re supposed to do; maybe they also stop doing the things that give them some pleasure in life as well. They may begin to experience some signs of withdrawal if they have a day with no alcohol. So those would be some usual signs that we could expect to see if someone’s drinking too much.

Now the signs of actual dependency. They’re fairly similar, but they’re more accelerated. So it would be a complete loss of control over their alcohol use, so pretty much every day they might be drinking more than they intended. There would be a distinct change in their behaviour, their behaviour may become more risky or aggressive. When I say risky, they may be doing some things that might impact on their personal health, or the health of their family. They start to neglect their personal appearance, so they’ll start to be a bit unclean, a bit sloppy in their appearance and personal hygiene.

They’ll drink more, so they’ll develop a tolerance; so they’ll be drinking progressively more and more to get the same effect. And for sure, if they will feel withdrawal symptoms if, for some reason they don’t have access to alcohol. These withdrawal symptoms can be quite severe. So they might be anything from sweating, shaking, nausea, loss of appetite, to even more dangerous withdrawal symptoms, which can ultimately be seizures. And they may continue to drink despite negative consequences happening all around them. So that might include stress or arguments in the family home. It may be harmful consequences to their own health. These would all be sure signs of someone falling into dependent use of alcohol.

Presenter: Very good. That’s, that’s actually something that we should keep an eye on. Definitely.

And what coping strategies do you think individuals employ to prevent themselves from falling into alcohol dependence?

DG: So there’s some fairly simple, proven strategies to help people manage and moderate their drinking better. To stop the slide into dependency. These are very straightforward. One of the most simple things people can do to change any behaviour is to record it. So to keep a drink diary with dates, and times, and amounts of alcohol consumed. This is a very, very good strategy to, a) to record how much you’re drinking so, so it’s measurable, so you can measure the risk. But also, when you start to record something and you, you start to see the patterns, we almost begin to moderate of our own accord, just when we see what the situation is like.

I would suggest to have at least two or three days alcohol free per week. As we talked before, about dependent drinking, dependent drinkers usually drink every day. So giving yourself two to three days with no alcohol, a set target is a, it’s a good way to moderate your drinking. The other thing you can do is to set yourself some achievable goals around your alcohol consumption, and let your family know. Your family can support you with your goals, so it’s good to tell them what the goals are and give them permission to support you; and that may include permission to challenge you a little bit if they see you stepping outside of your goals. A family can be a great support if you allow them to be.

Think about the alcohol level, the strength of alcohol in the drinks that you’re consuming and consider changing to lower strength drinks. So if you’re drinking a high alcohol content lager, if you’re drinking a lot of spirits like, I don’t know, vodka or whiskey, consider moving from the spirits to wine, or consider an alcohol of a lager that’s got a lower content of alcohol. Maintain your patterns of self-care. And that includes eating regularly and healthily, and making sure you’re hydrated and you’ve got enough water, you’re drinking enough water per day.

It’s good to understand the situations that trigger your drinking. Whatever they may be.

You may be able to build up some awareness of this with keeping a drink diary. It may give you some indicator around what’s happening that means you’re drinking. Once you understand what your triggers are it’s good to develop some better coping strategies. Try and exercise. Exercise is a very good antidepressant, and in times of stress and anxiety and depression, maybe exercise can help keep us balanced and keep us concentrating on our self-care. And of course, it has an impact on the brain, so it helps us cope better with life if we have a solid exercise regime.

I mean, the last thing I would say in this list, which is COVID-19 specific, but actually not a bad idea for, the whole time, is to cut down on news consumption. There’s a lot of news around at the moment. It’s usually full of stress. So they’re telling us how bad the situation is. They’re talking about the economic cost of COVID-19, they’re talking about second waves. It’s on a loop, it’s on every channel. It bombards us. And, you know it’s the reality of media coverage of any event; like this, they rarely give you the good news stories because they don’t really sell newspapers, so we’re just bombarded with bad news. And this will increase levels of depression and anxiety, and we don’t need to see it all day. I’m not saying don’t watch the news, but don’t watch it all day long. Just watch one news programme a day and leave it at that. So that would, I would say that, that’s just some simple coping strategies for people to be able to manage their alcohol intake a little bit better during these difficult times.

Presenter: Well thank you for this Dean. This is really down to earth, easy to follow. Obviously quite difficult in these times of anxiety, as you said. So you expect, basically the figures to rise further as the stresses increase, and with the continuing job losses and new waves of the virus, right? What sort of treatments do you recommend for those suffering with alcohol dependency then?

DG: Well, for people with alcohol dependency it seems highly likely that they have to change their relationship with alcohol. So usually this would mean some kind of medically supervised detox; and if their overall aim is to stop drinking, then I would suggest that they come in to some form of residential treatment. At the moment this may be difficult for some people, so I have to bear that in mind when I’m giving these kind of suggestions.

There’s a lot people can do online. So there’s a lot of counsellors and treatment centres that are providing services online for people. That’s been going from the very start of the pandemic in February and it’s still going now. Also, most treatment centres are open, and have been open throughout the pandemic; so the COVID-19 has not stopped people accessing residential treatment services around the world.

The Kusnacht Practice remained open, and lots of treatment centres across the world remained open and took clients in. But if someone doesn’t feel comfortable leaving their country, or leaving their set-up then they can access online services. Online mutual aid groups, online individual counselling, maybe in their local communities there may be services that they can access just to, just to help them in their initial phases. For sure if they’re thinking of stopping drinking they need some medical supervision.

Presenter: Good. Well this basically concludes our, our exchange today. Thank you very much Dean for your thoughts and for your advice to our listeners. We are here at The Kusnacht Practice as the global leaders in innovative care services. My role today was to bring close to you the kind of problems that we see increasing with the COVID-19 crisis, and trying to bring this to what we can propose in terms of treatments. We offer a unique combination of medical expertise to address your mind and body challenges. Dean, thank you very much.

DG: Thank you.