Today’s thing is about the increase in alcohol related deaths during the pandemic. But first I was reminded yesterday by Mary about the talk that we had about a year ago concerning the high cost of living with epilepsy in America with or without insurance.
I just went back and read it and it remains infuriating. Check it out here if you never read it.
Having suffered from seizures since she was very young Mary von Aue has become all too familiar with the cruelty of the American healthcare system. Sometimes almost as scary as the seizures themselves are the medical bills that follow soon after. The first thought she has now when she wakes up is relief at still being alive. The second thought is about how much having lived is going to cost her.
“I’m paying $450 a month for health insurance, and I’m still waking up from seizures thinking that if I didn’t hit my head that hard I’ll just risk it and not go in at all,” she told me. “Or if I did hit my head hard, fine, I’ll go, but I’m taking an Uber.”
She’s learned that lesson the hard way all too many times over the years considering how expensive it can be to have your life saved in America: a $15,000 bill in D.C. years ago, a $6,000 ambulance bill in Massachusetts, and to further highlight how insane our system here is, an experience receiving top notch medical care after a seizure in Turkey that set her back a grand total of $145.
More recently she found herself on the hook for $300 for a hospital visit in New York. Not terrible relatively speaking unless you consider that while there she received zero care whatsoever. After refusing to pay for nothing she started to get hounded by bill collectors.
Also a reminder to read Paul Bowers on the death penalty from the other day.
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The number of deaths in America in which alcohol was a contributing factor rose by 25.5% from 2019 to 2020 according to a just published study in the Journal of the American Medical Association. You may remember 2020 as the first year of the pandemic which thankfully is now over and we don’t have to think about anymore.
In raw numbers that meant a jump from 78,927 to 99,017 people gone.
An increase in alcohol related deaths had been observed every year between 1999 and 2017 they reported but it was at a much less stark 2.2% per year.
While rates increased across all age groups the biggest rise in death was among adults aged 35-44 — going from 22.9 to 32 per 100,000 (39.7%) — and those aged 25 to 34 — going from 11.8 to 16.1 per 100,000 (37.0%).
Thankfully I will not be in any of those age groups for much longer so at least I have that to protect me.
“Deaths involving alcohol reflect hidden tolls of the pandemic. Increased drinking to cope with pandemic-related stressors, shifting alcohol policies, and disrupted treatment access are all possible contributing factors,” the researchers from the National Institute on Alcohol Abuse and Alcoholism wrote. “Whether alcohol-related deaths will decline as the pandemic wanes, and whether policy changes could help reduce such deaths, warrants consideration.”
“The assumption is that there were lots of people who were in recovery and had reduced access to support that spring and relapsed,” Aaron White one of the authors of the report said.
“Stress is the primary factor in relapse, and there is no question there was a big increase in self-reported stress, and big increases in anxiety and depression, and planet-wide uncertainty about what was coming next,” he said. “That’s a lot of pressure on people who are trying to maintain recovery.”
I’ve already seen a lot of people use this study to retroactively confirm their priors about how we handled Covid. See!? I told you we shouldn’t have had such draconian restrictions etc.
We did not in fact have very many draconian restrictions.
I have no doubt that so many of us spending so much more time isolated and away from our normal routines had a very bad effect on our mental health — it certainly has on mine — but on the other hand there was actually a very deadly pandemic raging throughout the world from which over a million people died in this country alone so I’m not sure a fuck it do whatever policy would have made things any better in terms of lives saved.
I guess we’re going to find out since fuck it do whatever seems to be where we’re at now as far as the government is concerned about Covid funding.
Either way we’ve lost way too many people. Both of the famous and talented variety and regular assholes like you and me. The news about Taylor Hawkins’ death this weekend has fucked a lot of people up pretty good as did the passing of Mark Lanegan a few weeks ago for me which I wrote about at length here.
Two years ago this week almost absurdly early into the pandemic when we knew nothing about anything I did a piece in here in which I asked readers to write in with how they were handling the first two weeks of stress and increased isolation in terms of their substance use. A lot of us including myself made the decision at the time to let it fucking rip vis a vis drinking. I wish I hadn’t done that.
In light of the new study about the fall out of that sort of behavior I wanted to pose the same question again with a couple of years of perspective.
(To be clear here I don’t want to die and I don’t want any of you to die either so please know that there is help available for you out there when you are ready for it although I’m probably not the best person to be delivering that advice at this time. If you’d like to read a newsletter with a much healthier outlook on recovery please check out one of my favorites The Small Bow.)
Here’s what people told me about how the first two years of Covid changed their drinking habits for better or worse.
For me it was like that scene in the Simpsons where Marge has nothing to do and sees a pack of smokes and thinks “Well, I suppose I could have a cigarette...” I was home, the beer was home, there was nowhere to go, I drank. I was never one to shy away from booze to begin with, but this wasn't a six pack at band rehearsal or “Oh shit, lol I've had 1,2,3...8 and it's only the third quarter!” This was abandon. Even if I didn't fully realize it, every beer was a fuck drained. It probably took until April? May? Around the time that this new reality had settled in, so had my new hobby.
Anyway, it lasted a while. It helped that I was “essential” and could keep relatively busy — and there was never any driving or working drunk — but my off time was just hazed up. I figured the memories were going to be cloudy anyway, I guess.
I've stopped now, the frequency, but it's still a different game. I had one of those “before we knew” cases in Jan/Feb 2020, and have been in and out of doctor's offices with “long covid” since, but this is my biggest scar. Fucked.
Our household essentially gave up drinking at-home a while before the pandemic, which is fortunate. Instead, we went from casual weed smokers to blowing through probably $100 of edibles a week, plus an eighth or so of flower a fortnight. It has been... surprisingly good, honestly. Has it affected my ability to do my job day in and day out? Maybe, probably, but given everything else going on in the world, I don't know that you can blame just the weed for that. (I don't go to work high and I don't use on the job, strictly off-the-clock because I'm a good boy who enjoys having gainful employment and the health insurance that comes with it.) On the other hand, it has absolutely made our marriage better in some ways; we're more open with one another about lots of stuff, we have essentially a nightly hour-plus window where we're just talking to each other and blazing it, and of course it's taken the edge off of the horror of continued existence in late capitalism. I'm really fucking lucky in that regard, and I do not envy you the task of reading the emails from people who were not so lucky.
I didn't think I was going to become A Weed Guy but I don't think any of us really had any sense of what we were about to be in for, much less what we'd be like two years later. If you can get it cheaply and legally where you are, I strongly encourage it over alcohol, but also I am not an addiction counselor or anything like that, just a dude who felt like shit when he drank a lot and feels less like shit when he smokes out.
I used to be pretty good with self imposed rules to moderate. I would limit myself to beers on the weekend with only a lapse here and there if there was a game or show or occasion mid-week. During Covid it all went out the window and I spent most of the first 18 months drinking 5-6 nights a week. That led to me building a big tolerance. I'm just now since the first of the year starting to get back to cutting down, but it's not nearly as limited as it used to be, and I find excuses to bend my rules much easier. I have also developed anxiety and a slight tremor on those days when I do abstain. So far the withdrawal effects themselves haven't been a reason to bend the rules. If I get to that point I really will be worried. On the positive side I really am doing better than I was six months ago. I really can't believe I got to this point though where it actually feels like I don't have 100% control of myself. I don't think I would be here if not for the last two years.
- I effectively quit drinking in December 2020. I was already drinking less than usual during the first six months of the pandemic and the idea of non-social drinking became less and less appealing with every passing day at home. Add in the layer of sedentary malaise Covid wrought and it was an easy decision. I don't think I'll go back.
Towards the start of Covid lockdowns I honestly thought I was going to drink myself to death. Not on purpose, but I hit this stretch of like nine or ten straight days in April 2020 where it seemed like maybe I'd beat Covid to the punch. Then I got violently ill, my body just gave out, and I couldn't drink for a while, which started a push-and-pull/invasion-and-repulsion/on-off dynamic that crested in August 2021 with a real bad time with my wife and kids that was all my fault.
Since then I've focused on finding other ways and outlets, which has worked really well for overcoming my impulse towards self-destruction. Microdosing, kratom, kombucha, constructive therapy sessions (i.e. not just bitching about everything), going to live shows, new writing projects. Mostly just awareness, though, and cutting myself some slack for not being perfect and the multitude of ways I'm fucked up has gone a long way the last six months to getting myself together.
Having grace, too, for everyone, and what we've all been going through. It's so difficult just to be here now, whether someone can admit that or not. All the death and destruction, violence physical and psychological, disregard and ignorance. As far as I can tell, grace and kindness are the best we can do for one another. Drinking too much too often takes that away from me, and without it I can't manage. So, I pay attention now, and do my best. I can't believe where I've wound up after all this, but I'm glad I'm still above ground, and am glad that you are, too.
When the pandemic started I was already trying to get sober “my way,” i.e. not very hard or successfully. Pandemic started and I gave up trying. It got worse, I got laid off, then it got worse, and I couldn't hide it like I had before. My wife and I were now home all the time. Then my wife got fed up and asked me to take the kids and leave, to go and move in with my brother and his wife. I was there about three weeks. It shook me up and I got sober. Not strong sobriety, and I relapsed after four months. Three months after that relapse I went to rehab. I’ve been sober over a year since, one day at a time, thank god.
In a sense [having to spend so much time at home was a blessing in disguise]. It brought the bottom on a lot faster: confrontations with my wife, not being able to hide it and continue half-assing my way through AA, etc. Wanting to save my marriage saved my life. I have no idea if in an alternative universe I would have gotten sober without rehab. I never in a million years would have gone if she didn't make it absolutely clear that I needed it (to her credit, she never said "go to rehab or I'm out" she wanted me to make the choice. But I wouldn't have gone without her, and she wouldn't have said that if we weren't both home all the time).
It's a little hard to get my mind around the idea of it being a blessing in disguise, because it was such a hard year plus, and I haven't really thought of it that way before. But yeah, if things had just been going along like before, no pandemic, it's really unlikely I'd be in as good of a place as I am now. Just sucked getting here. Thank goodness I had/have the support to have made it through.
- Pre-Covid I was in a bad work situation in higher ed. I would typically go through a four-pack or two of Hazy IPA tallboys in a week, so, a decent amount. When things hit the fan I started working from home for a few months, and I was furloughed in May for the summer. I was able to get cases of craft beer shipped directly to my house, so of course I did that. I would go through several four-packs a week during that time, with not much else to do and nowhere to go. Then, seeing the writing on the wall with a shitty supervisor who I clashed with regularly, I assumed I would be jettisoned, so I started looking for a new job mid-pandemic. Luckily, I found one, but it was with a brewery! Now I had basically unlimited free beer at my disposal, so I started housing multiple four-packs a night. Needless to say this has not had healthy benefits. I've gained weight, worsened my GERD, developed (or hastened) apnea, and my blood pressure is that of a much unhealthier person than previously. My mental health was shit so I'm (finally) now on antidepressants, and the alcohol helps none of this.
I'm a schoolteacher and during the first couple weeks of quarantine when school was fully shut down I took the time to work out more and generally practice a lot of the “self care” bullshit that gets pushed in every staff meeting and across every social media platform. Over time though the quarantine didn't lift and all I was asked to do was upload a lesson once per week and otherwise stay indoors, so I found myself doing a lot more drawing.
Ideas come to me easier when I drink usually. So quarantine turned into a lot of day drinking. Then day drinking bled over into evening drinking because “Look, we're all stressed out. I need to unwind.”
I'm lucky that I live with my fiance who kind of made me pull my head out of my ass. Being faced with the wall-to-wall failures of our major institutions to address Covid made me sink pretty low. I pulled it together over the summer before the following school year. We had to be on Zoom with the kids and I realized I couldn't run classes hung over on camera all day.
My fiance and I are both teachers so there was a lot of psychic damage being taken. The early pandemic hero worship turned into “let them back in the building you monsters” real fast.
- March/April 2020 probably featured the highest percentage of days that I consumed alcohol in my entire life. I was going on so many Zoom dates. Multiple dates every night at times. I am someone who only drank like once a month in college for context. The combination of it being a rare period of my life being single and probably being holed up in an apartment by myself every day were likely the main sources. I often find myself thinking, "I responded really well to early quarantine compared to most people in my life" before remembering oh right the initial month or so was spent drinking with strangers on Zoom who were also losing their minds. Eventually I started seeing someone exclusively from one of these meetings (we're engaged now!) and instantly my desire to drink resumed its normal, mostly non-existent levels. Drinking historically is just really something I do to take the edge off in social situations to cope with social anxiety.
I was drinking heavily before the pandemic. I was working then. When I say drinking heavily I mean drinking hard liquor at home by myself. I lost my job shortly before the pandemic. This would have been around February of 2020. By then I realized that I couldn't keep doing what I was doing. I quit and I haven't taken a drink since. I'm much better off.
If I had continued to drink like that during lockdown who knows what would have happened. It's very easy to see why so many people are dead now from substance abuse. Booze is a fucked up lethal narcotic that society treats as a joke.
This period got a lot of people. Quitting booze was much harder than quitting hard narcotics. You have a liquor store on every corner and social life revolves around drinking. American drinking culture is disgusting. It's not healthy at all.
There is a very good book called Smashing the Liquor Machine about alcohol prohibition movements. It goes without saying that alcohol prohibition is as bad as drug or gambling prohibition, but the repulsive way that the government allows Big Alcohol to addict and exploit the population is a strategy of suppressing the population. It always has been.
It's not unique to any one country. With weed legalization finally we have a healthier alternative but a huge deal more needs to be done to protect people.
Nothing too dramatic for me, but maybe a data point. I was doing pretty well for a few years of not drinking during the week for general New Years Resolution-y reasons. After a couple weeks of lockdown, I was kind of like, “fuck it, it’s a pandemic” and started having a beer or a cocktail before bed. Sometimes less, sometimes more. I don’t think it’s had any really negative effects beyond undoing any good that my not drinking had previously done. Then again, I’ve seen a pretty stark deterioration in my mental health and resilience over the past two years, so who knows what effect any individual factor has had. I dunno. Everything kinda sucks.
Rough seas over here, but still plugging along five and a half years sober. Four people in my life have drank themselves to death since the start of the pandemic. A friend of my ex wife's, a female co-worker, my own maternal uncle and the brother of one of my best college friends. They're all white working class. That's the common thread between them. Varied in age, gender, etc.
The co-worker, she spent weeks in the hospital, and they told her if she didn't stop drinking she would die, and she fucking died, man. Didn't stop drinking until her fucking organs gave out.
[Looking at the picture in her obituary] This is rough but she looked nothing like that. So thin, skin barely hanging on, hair falling out. We all wanted to just shake her and say stop but wtf do we know?
My uncle hanged himself in his backyard after being unable to quit. He was in and out of psych wards his last few months. My mom and her sisters were devastated but they all saw it coming and couldn't push him off the track. It's crazy how common this is becoming
Covid definitely altered/increased my and my wife's drinking habits. We used to go out and get hammered twice, maybe three times a week. With Covid that eventually turned into every day. Not hammered, but definitely higher overall consumption week over week.
It's kinda taken the fun out of it. It's just something to do because for so long there was nothing else to break up the monotony of wake up, work computer job, make and eat dinner, sit on the same couch watching the same TV.
For a while either the wife or I could convince the other to take a night off here and there, and of course last spring/summer with the vax we felt a lot safer going out. But the fall/omicron put the kibosh on that.
I’m pretty much resigned to the idea of having drinks every night, but on the plus side I've learned to drastically reign in how many I have on a given night and that's helped.
My husband, never a big drinker, has continued not to be a big drinker. By which I mean he buys a six-pack of hard cider or pilsner or whatever and drinks one a week until it's done, just like he's always done since we first moved in together. Which is to say the pandemic fucked him up just like the rest of us, but not in the alcohol-dependency category.
I don't think I was ever a “problem drinker,” but the pandemic and all these people bent on destroying the planet/marginalized peoples/themselves got me really depressed and anxious, and lately I've been wondering if I'm losing my grip on reality? But I am more terrified of the cost of a “hey don't harm yourself or others and maybe lay off the crying until you hyperventilate” 48-hour hospital “visit” than of anything I might do to myself. We are so broke and what if my legacy to him was a massive hospital bill? Anyway, however reasonable a drinker I'd been before, with the panoply of meds I take now I can't even have half a glass of a low-ABV beer. It makes me immediately pass-out-standing sleepy or fully hungover. So cool, I love it, my medication regimen is definitely working and I don't stay up nights crying about the kids we won't have and the climate disasters we can't stop and all the senseless deaths.
The best (“best”) part is my psychiatrist isn't just open to suggestions, he makes them himself, so after going through some real fucked-up stuff in 2016-2017 and being put on klonopin for the anxiety, I'd been responsibly and carefully tapering the dose till I was at 0.25mg a few times a week by the end of 2019. Now I'm back up to 2mg a day just so I don't claw my skin off. I wonder how many other people have benzo addictions now due to “getting help” for their pandemic etc anxiety. I wish I could just have a whiskey soda again.
I was always a big drinker. I only drink beer. Liquor is too unpredictable and wine makes my guts sour. I come from a long line of big drinkers. In November 2019 a high school buddy of mine flew up from Missouri to Worcester so we could go see The Cherry Poppin Daddies in concert (don't laugh, they slapped 25 years ago when we were in high school). And it was like... he's my oldest buddy and he has a wife and kids and a shitty job and car payments and is like a normal dude. After he visited I was convinced it was time for me to go straight, stop smoking, drink less, maybe lose some weight, get in the market for a couple of kids and a white picket fence and all that. I was going to turn my shit around. I kept it up until mid-March. Then with the pandemic... I mean I started drinking heavy again because there was nothing to do. In the literal sense, I couldn't go out any place, but also in the figurative sense, we live in this shithole nightmare society and there's nothing to do about it, what's the goddamn point, I might as well get bladdered on the couch every night if it passes the time.
So anyway it's been a little over two years and there's not a single day I haven't drank less than a six pack every night and the hope inside me that things will ever be any different is dead. I don't mean that like a sob story boo hoo I got problems or anything like that, it would just be nice to know that not being this way is an option even if I keep being this way but it's not so here we are.
Oh, P.S., I know six beers a night is not like, hardcore. I don't even have the guts to hit full Bukowski or whatever but still it'd be nice to take a solid dump now and then.
See you later.