The true death toll of the COVID-19 pandemic extends beyond the millions of Americans dying of the virus. Numerous reports have been published showing Americans drank more alcohol to cope with the psychological, social and financial stressors of the pandemic, and the numbers in Wisconsin are disturbing. According to the Wisconsin Policy Forum, in 2020, alcohol-induced deaths in the state surged by 25%. This was the largest one-year increase in more than two decades. Injuries spiked too, with trauma centers at Wisconsin hospitals admitting more patients who screen positive for alcohol misuse. Social work teams and nurses are conducting more potentially lifesaving interventions and connecting more patients with alcohol addiction treatment resources. Around a quarter of the patients admitted to the Froedtert & the Medical College of Wisconsin adult Level I Trauma Center at Froedtert Hospital screened positive for alcohol misuse during the pandemic.
“Alcohol misuse is an important risk factor for injury,” said Terri deRoon-Cassini, PhD, MS, trauma psychologist at the adult Level I Trauma Center at Froedtert Hospital, MCW faculty member and executive director of the Medical College of Wisconsin Comprehensive Injury Center. “From motor vehicle crashes to assaults, alcohol plays a role in a number of trauma center mechanisms of injury.”
Alcohol Interventions at Trauma Centers Reduce Risk of Re-Injury
Alcohol is involved in 30% to 50% of all traumatic injuries, according to the American College of Surgeons (ACS). Research has shown that trauma patients are a subset of the population with a high risk of alcohol misuse. Alcohol interventions at trauma centers reduce a patient’s risk of re-injury, which is why trauma centers are required by the ACS to do an alcohol misuse screening on every patient.
“When trauma happens, a person’s life becomes reprioritized,” Dr. deRoon-Cassini said. “After injury, there is a critical window where a person realizes their mortality, called “mortality salience.” People see their goals and the problems that are in their way more clearly. Doing the intervention during this critical period is most effective, which is why the intervention happens during the hospital stay.”
Alcohol screening protocols vary by hospital. Measuring a patient’s blood alcohol level (BAL) is only standard at some trauma centers. The protocol for the adult Level I Trauma Center at Froedtert Hospital does not include a BAL. A bedside nurse will conduct an AUDIT-C (Alcohol Use Disorders Identification Test-Concise), a three-question verbal screening. If the AUDIT-C score indicates the patient is positive for alcohol misuse, a member of the social work team will do a brief intervention and refer the patient to appropriate treatment and resources.
“Patients who are able to make a connection between their alcohol consumption and impact to their lives are more likely to make a change in their habits,” said Anne Long, social work educator at Froedtert Hospital. “Our team is trained to help the patient identify how alcohol is affecting their health and relationships. This is when we can have a breakthrough in the conversation.”
The intervention’s purpose is to prevent potential future traumatic injuries, as well as non-injury-related medical conditions linked to alcohol overconsumption: such as high blood pressure, stroke, liver disease, heart disease and cancer. The American Cancer Society says alcohol use has been linked to seven types of cancer: mouth, throat, voice box, esophagus, liver, colon and rectum and breast cancer. Alcohol misuse is also linked to several mental disorders and suicide deaths.
“The intervention is the first step,” Long said. “Our goal is for the patient to have the motivation, support and resources they need upon discharge to have a plan to move forward with making a change in their alcohol consumption.”
Preventing Alcohol Misuse with Safe Drinking Habits
Alcohol misuse, or excessive alcohol consumption, is preventable with safe drinking habits. The Centers for Disease Control and Prevention (CDC) says the most common form of alcohol misuse is binge drinking. Binge drinking is defined by the CDC as consuming five or more drinks on an occasion for men and four or more drinks on an occasion for women, bringing a person’s BAL to 0.08 g/dl or more.
Wisconsinites binge drink at a higher rate than most, ranking third in the nation, behind the District of Columbia and New Hampshire, according to the CDC. The Wisconsin Department of Health Services (DHS) tracks state alcohol use trends. DHS data shows nearly a quarter of Wisconsinites engage in binge drinking.
“The binge drinking culture in the state of Wisconsin, combined with the accessibility of alcohol and the stress of the pandemic makes the drinking issue in our state particularly problematic,” Dr. deRoon-Cassini said.
Drinking alcohol in moderation can help prevent trauma-related injuries and other alcohol-associated health risks. Drinking in moderation is defined by the CDC as having two alcoholic drinks or less in a day for men and one alcoholic drink or less in a day for women. The CDC has a free online tool to check your drinking habits. The tool can also help you make a plan to drink less.
Here are some tips from the Wisconsin DHS to help you reduce your alcohol consumption:
- Set a drinking budget and stick to it by bringing exact cash or set a spending alert on your credit or debit card.
- Choose drinks that are lower in alcohol; lighter beers are around 4% alcohol by volume
- Plan social outings that aren’t centered around alcohol or that don’t involve alcohol
- Don’t say “yes” to a drink just because someone else is buying
- Wait for your evening meal to enjoy your alcoholic beverage
- Don’t drink out of boredom. Try a new hobby, exercise or go for a walk or busy yourself with a household chore.
Where to Get Treatment for Alcohol Misuse
If you or someone you know needs help with alcohol misuse, here are some resources to help you find treatment programs in your area:
- The Substance Abuse and Mental Health Services Administration’s (SAMHSA) treatment facility locator and the SAMHSA National Helpline: 1-800-622-HELP (4357)
- The National Institute on Alcohol Abuse and Alcoholism
- The Wisconsin Addiction Recovery Helpline: Call 211 or 833-944-4673 or text your zip code to 898211
- SmallTalksWI.org, aimed specifically at preventing underage drinking in Wisconsin.
For more information about Froedtert & MCW outpatient alcohol and drug treatment programs, visit: https://www.froedtert.com/behavioral-health/alcohol-drug-treatment