Are you sober curious?

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Welcome back to Sarah Has Questions. Today, we're talking sober

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curious. Have you ever done a dry January or sober October?

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I have. And did I feel better? I sure did.

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There are a lot of positive things it does to our bodies. Let's talk about

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it. I'm Sarah King, and I have a lot of questions.

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What exactly happens when you orgasm physically? Will popping a

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knuckle or a joint give us arthritis? What can we learn from our

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poop? The size of your body doesn't necessarily indicate your measure of health.

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Yes. And what are your thoughts on that? Cleansing. Do we need to do

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anything special to our nether regions?

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In this show, I get to ask all these questions to WakeMed doctors

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who happen to know everything about everything. Sarah

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Hess questions is a production of Capital Broadcasting Company and Mix

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101.5. It's presented by WakeMed.

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Today, I have doctor Christopher Thompson. He is an addiction

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medicine physician with Wake Med. Welcome. Thanks so much for coming in today. Thanks.

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I'm glad to be here. Sober October is something I keep hearing about and sober

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curious on my Instagram and, social media. I keep seeing

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all these, so these alcohol free liquors.

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Where do you think all this is coming from? Yeah. It started out,

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about 10 or 15 years ago out in the UK with dry January.

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So it's part of, like, New Year's resolution. It was, like, challenging, you know,

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your friends and your family Mhmm. You know, to kinda be, you know, alcohol

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free or to kinda live a different lifestyle Mhmm. And just

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being mindfulness of how much alcohol that they're using Mhmm. And

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how it's affecting their health and how it's affecting their well-being. And it's it feels

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like it's just grown exponentially. It has. Social media has really kind of

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pushed it, you know, out, to a wider audience. Uh-huh.

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And, of course, the new generation of folks are, you know, coming up.

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And, some of the, teenagers that are now, you know, legal

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drinking age are now realizing, some of the risks

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and and benefits of not using alcohol, is really important to

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them. And these online challenges, everybody's like, oh, dry

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January or, you know, sober February's. And, you know,

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every month has some sort of Moniker?

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Moniker and challenge. You can turn any of them into, you know, like,

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favorable February. Yeah. There's some books being written. You

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know, Sober Curiosity is is a big one that's out there, just

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being mindful and just a lifestyle change. A lot

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of new entrepreneurs are coming out with these mocktails and

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these, changing lifestyles where you don't need, you know, alcoholic

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beverages at every event, like weddings and Yeah. You know,

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open bars are not Yeah. Not as big of what they used

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to be in the past because people are being more conscious of their health and

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their finances, you know, going through. So Well, yeah, finances for sure. An open

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bar is a pretty big price tag. Is there any benefit from having a dry

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Mhmm. Whatever month you wanna put in there? What like, does it even

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help? Yeah. Oh, absolutely. People can see a big difference in their

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health, in just 30 days of being abstinent from

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alcohol. They improve sleep, improved

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memory. Weight loss is a big thing. Yeah. You'd be surprised how many

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calories are in, you know, an alcoholic beverage. Mhmm. And then,

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so cutting all that out, you can drop usually several pounds in in over a

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30 day period. But you sleep better. Why do

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you think that we that sleep is affected? What is it about alcohol that affects

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your sleep? Alcohol, it affects your REM sleep. It doesn't allow

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you to get that deep, sleep, that

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regenerates your body and helps with your memory and kind of processes, you

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know, what you did the day before, and then being refreshed the next

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day and being able to start your day off, in

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a very more relaxed way, not hungover, not

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having headaches. Right. So a lot of neurological effects as

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well. So what is it about alcohol that gets in the way of REM sleep?

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Do you do you know that answer? Okay. Can you tell me, doctor? Yes. We'll

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we'll we'll get a little scientific here. You know, this will be,

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that's a little bit. I'm curious. So, we have gabanglutamate in our

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body. That is our inhibitory and excitatory,

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part of our, nervous system and our way our body

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reacts. So when we drink alcohol, it's a depressant. Okay. Right.

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So it depolarizes our nerves and really relaxes everything. And we

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That's why people like drinking. Right. We get some those are the positive effects for

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alcohol. And if we use alcohol at lower amounts

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and and stick with our, you know, daily limits and our weekly

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limits, you know, there are some positive benefits to alcohol. The problem

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comes is when we use

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excessive amounts of alcohol, our body tries to compensate.

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So the other side of that inhibitory part is the excitatory

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part in the, the, glutamate part of our

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body. And it's kinda, neurotransmitters in

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our body Mhmm. Receptors in our body that kinda upregulate

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to kinda help with kinda all that negative effects. So

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what does it do to upregulate? It just over time, it it produces new

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receptors, and we get more receptors, you know, on our

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on our neurons. Okay. That when we remove alcohol and we don't

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drink, that's what causes the withdrawal because we have this unopposed excitatory

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response Interesting. In our body. That which causes the really

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bad side effects of using alcohol, like seizures,

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you know, DTs, deuterium tremors Oh, yeah. You know, for folks that, you

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know, really excessively use alcohol Yeah. They have this really

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high upregulation of these receptors. So when you remove alcohol

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suddenly Yeah. You get really severe withdrawal. So if you were to remove

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alcohol, for, like, a extended period of time, do those

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receptors go away? They do. Yep. Where do they go? They just disappear. They just

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deregulate. That's what's so fascinating about our body. Fascinating. Our

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body doesn't like to be in that intoxicated state. So it really

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changes its structure Uh-huh. So that it you know, we

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still have the effects of alcohol. We're still intoxicated. It still, you know,

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decreases our, reflexes and our

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ability to to to perform. Sure. But it really

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tries to it doesn't like that, so it it upregulates. And then when alcohol is

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removed, even with that 30 days of a dry January, those receptors will start

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to to go back down and kinda get back into equilibrium. Interesting.

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When you're talking about these, these withdrawal

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effects. A hangover is withdrawal. Is it not? Yeah. I

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mean, we look at,

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a scale for withdrawals Okay. Called the CIWA scale. Okay. We

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can kinda measure, you know, what your kinda withdrawal symptoms

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are. Did you say CIWA or CIWA like Jojo CIWA?

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Yeah. I wonder if that's where she got her name from. I'm sorry. Go ahead.

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But we have that those scales that we can kinda look at the withdrawal settings.

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And, you know, the standard hangover of, you know, headache,

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fatigue, upset stomach Yeah.

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Sometimes some diarrhea. Those are, you know, kinda common withdrawal

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symptoms. You know, the more severe withdrawal symptoms would be

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seizures and, you know, more chronic

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liver disease and other, properties that kind of more of

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a chronic, effect on your

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health, that can lead to more severe withdrawals. And some of it

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is relative to how much alcohol we consume. Okay. But everybody's a little bit

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different. So some people can have those severe withdrawals, which is even having, you

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know, a little bit overdrafting. Maybe they have, like, more receptors just

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pop up quicker. I noticed you said using alcohol as opposed to drinking

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alcohol. Is that something We're trying to change the terminology,

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trying to change the stigma. Okay. We're really considering, you

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know, alcohol use disorder as a medical condition.

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So talk talk to more about that. So it used to be called alcoholism.

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Right? Now you're calling it alcohol use disorder. Why the

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change? Couple different reasons for the change, and and the biggest one is to kinda

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reduce the stigma so people can go get help and treatment, if they need

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it. But we look at alcohol as a chronic disease. When

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we get to the point where we, you know, use

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excessive alcohol Mhmm. And we form an

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addiction, that that is considered, you know, a chronic disease. And you need medical

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attention, to help, you know, reduce your alcohol and to,

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live a healthier lifestyle. We talk about there's genetic factors to

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to alcohol use disorder. Usually, somebody, if they have,

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an alcohol use disorder, they have a 50% chance that one of the first degree

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relatives also, you know, has addiction. Do we know why? There

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are some studies and genes and different alleles and the expression

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of our DNA, that lead folks, you know, into addiction

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and and alcohol use. And there's also some genes that actually protect people

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from, alcohol use disorder. Like and and what

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way would it would they protect it? Because if people, you know, get sick

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if they consume too much alcohol, some people can't process alcohol. They can't

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metabolize alcohol as much or as fast. Uh-huh. So

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the more they drink, usually, kind of the

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The worse they feel. The worse they feel. Yeah. Not just through the intoxication or

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through the withdrawal, but the actual consumption of alcohol. They get consumption of alcohol. They

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get they get flushed. You know, they get sick to their stomach. They just don't

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feel really, well, you know, when they consume alcohol. So they just tend to avoid

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alcohol because they don't get those positive effects that that many people do.

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So

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So what I'm hearing you saying about, the receptor, the receptors I found very interesting.

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I'm glad we got in the weeds. Yeah. Yeah. Very nice. So how do you

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know you have an addiction? So there's a lot of different ways that we can

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kinda go about it. A lot of it is just kind of, if it is

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affecting your overall health, you know, and lifestyle. So we know what daily

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limits are. We know what kind of the recommended limits are for alcohol. Mhmm. And,

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you know, the first thing we need to look at is kinda what a standard

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drink is because people don't even know what a standard drink is. That's defined when

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we talk about how many drinks we can have in a day. Mhmm. And it's

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a really small amount. I bet. So yeah. What is it? So it's

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12 ounces of beer. Okay. One can. One can and traditional

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beer between 4 5% alcohol. Not a craft beer at

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9.5%. Correct. And those and those craft beers are really becoming more

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popular, especially in this area. And we have to be aware that they do

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contain a lot more alcohol. Mhmm. And they don't come in 12 ounce cans anymore.

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Oh, no. They're big. They're big. You can get them 24, 25 ounce cans. Yeah.

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Sometimes I say it's not a drink. It's a challenge. Correct. Yeah. And, like, 40

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40 ounces. Oh, yeah. Yeah. There's a lot of different sizes of beer out

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there, but the standard, size for a can of beer

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is 12 ounces. Okay. For wine for normal table wine, about 12%

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alcohol, it's only 5 ounces. Well, I used to work in restaurants

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Mhmm. For a long time, and I couldn't tell you how many times I we

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were we were, taught to pour a 5 ounce pour. Yep.

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And people would get so upset with us because they're like, you didn't fill our

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glass. I'm like, that's actually a serving of alcohol because you have to price it

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out. Yeah. So, yeah, it is. It's real small compared to what you norm like,

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the grandma pour most people give themselves on Friday night. Yeah. And then you look

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at liquor, and it's only an ounce and a half. Not even 2 ounces, which

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is the full jigger whenever you're making cocktails. Correct. Yeah. So it's an ounce and

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a half of 80 proof Oh, yeah. Spirits or or

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liquor. And, you know, even a an airplane bottle is,

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1.7 ounces. So it's more than So it's more than Oh, interesting.

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Dinner time. Yeah. Well and I know a trick to find out, what

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the what the proof is. And that is, like, whenever you're looking at a

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bottle of of alcohol and it says, you know, 40% alcohol,

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you just double that, and that's the proof of the alcohol. So there are some.

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I know there's one bourbon called JR Hirsch that I think is, like, a

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100 and something proof. Yeah. Just like we talked about craft beers, you know,

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liquor is also getting higher proof. You know, wild turkey 101

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Oh, yeah. And all the other bourbons are, you know, higher proof, and those are

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the ones that are sought after. Okay. Right? So now you're looking at maybe less

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than an ounce is considered a serving. Okay. Well, I think

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that a lot of people are overserving themselves. I can tell you right now in

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this conversation, I definitely have 2 servings of wine and one

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glass most often. Yeah. So you really have to define what that is to patients

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because they don't really know how much they are consuming, because they don't

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understand what that kinda So where do these serving sizes come from?

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So the servings that comes from, you know, federal government regulations

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of what, you know, healthy consumption of alcohol Okay. Can

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be, and not just so now that we define what a standard, you know,

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drink is, then we also have to define how much we can consume. So

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just to where to measure it. Yeah. So for women and

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men older than 65 Mhmm. It's it's no more than

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one drink per day and less than 7, you know,

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drinks per week. Mhmm. And then for men, under the age of

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65, it's no more than 2 per day

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and, no more than 14. Okay. Oh, interesting.

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Okay. So binge drinking. Yeah. Binge drinking. And so anything over those

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limits, is this considered binge drinking? Yeah. So binge drinking for

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men, it's, more than 5.

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Drinks a day? Drink drinks into one sitting and One one one. Sitting. Yep. Okay.

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And then for women, it's 4. Does that is that, irrelevant

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of the length of time? Typically, they say in one day in

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a 24 hour period. Okay. Typically, it is in a short period of time

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Yeah. In the evening or in one sitting. Okay. Well, that that's

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the thing. Like, if if sometimes you can have, like, one drink an hour.

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Say Say you're at a wedding. It's like a 6 hour event. Yep. And you're

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having and I've heard in the past that you can your

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body will digest essentially a one

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serving of alcohol an hour. So if you were to have one drink an hour

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for 6 hours, that's still considered a binge drinking session. And your body's

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really working overtime. And, you know, everybody metabolizes

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alcohol at a different rate. Okay. Women a little less than men. That's why those

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limits are lower. Thing that we just gotta put up with being women.

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Yep. But, you know, we tend to metabolize. It's approximately

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one drink per hour. Okay. So but, again, if you drink that

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first one, your body's still metabolizing that first one as you're consuming that

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second one within that first hour. So you're basically stacking. Sure. And

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that's what causes the intoxication and those higher levels of alcohol in our

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body, which can be, you know, toxic to our GI tract and to

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our pancreas and to our liver and, can really have

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more effects. Plus, we really talk about risky behavior when someone

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consumes that much alcohol. Oh, yeah. Most certainly. When we're saying

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addiction, is that just trying to get back to,

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like, getting those receptors met and then not having seizures and

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terrible things. Is that, like, the definition of addiction? Like, what

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exactly is addiction? So, you know, you have these,

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social drinkers where there's social alcohol use where they kinda, you know, on

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the weekends, weekend warriors, you know, as long as they kinda stay below those

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binge, we didn't talk about We're getting there next. We're getting there next. But if

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they're kinda just using, alcohol socially, that's fine. Using it

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for those positive, feelings and those, you know, help relax and

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reduce stress, you know, can be, you know, beneficial for

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folks too. The problem is is when you do exceed those

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limits, you know, and you do build up those receptors Mhmm. What happens is then

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you start sometimes consuming alcohol all day or early in

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the morning Mhmm. Call it an eye opener Uh-huh. Because you're trying

250
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to prevent those withdrawal symptoms. Your body builds this physical dependence

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on alcohol, and if it's not there is when you get those severe withdrawals. And

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that physical dependence are those receptors? Correct. Yep. And then they

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have to use alcohol so that they don't go into those severe

254
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withdrawals. And you get into this that's when you need medical treatment.

255
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It's really when you get to the to that severity of alcohol use.

256
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Mhmm. You can't stop alcohol. Severe alcohol withdrawals

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can be fatal. Why would it be fatal? Because of the seizures,

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because of that unopposed excitatory DTs. It

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really has an effect on our, on our body,

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again, through those mechanisms that we talked about Mhmm. To

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actually lead to to death. So if you're if

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you're an addict Mhmm. And you've gone a couple of

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months without addict without any a drink, and then you're you're like, I'm in a

264
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hotel room. I'm doing this. I'm gonna drink a lot. Why would

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that relapse? Most often, I find that, like, Amy Winehouse comes to

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mind. She had been sober for, like, a year, and then she had she had

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a relapse and she died from it. Why is the relapse so dangerous?

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You have memories. You know? Again, people use alcohol

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for those positive effects, and those positive effects make you feel good.

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And if you have those pathways that are built in your brain Mhmm. Or

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something, again, more in the weeds. We have neuroplasticity of our brain. So

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when we use alcohol, you know, the mid part of our brain or the limbic

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system of our brain forms memories of using alcohol. Oh. And

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their bodies like alcohol. So even if you're in recovery Uh-huh. And it

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again, we talked we talked earlier about it. It's a chronic disease. It

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never leaves you. Right. Right. So always gonna want to somewhere. Yeah. You're always

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gonna have those thoughts, feelings, and memories of those positive effects of

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alcohol. Gotcha. So even if you're sober for

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months, years, decades, right, a lot of times it

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doesn't start with, hey. I'm gonna rent a hotel room and just Drink myself. Drink.

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Yeah. Drink, you know, bottles and bottles of wine beer. Starts

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with one one sip. You know, if you're at a

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wedding and you have that champagne toast and you get that taste, all those

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memories flood back into you about all those positive effects, about all that

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addiction. And sometimes it just takes one sip, and they can't stop. And

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so then they go and they they just drink all night long. Yep. And then

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Or it just starts with a sip, and then the next day, they just have,

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oh, that was really good last night. I'm gonna have 2 tonight. I can handle

289
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it. I can handle it. And then it many times, will

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get out of control very quickly again for someone recovered. And and is it

291
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like the damage you had done to your body before, like, your body just can't

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handle it again kind of thing? Is that why they die? It's I mean, I've

293
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always wondered this, why relapses seem so dangerous. You do build a little

294
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tolerance, again, with those up regulation of receptors

295
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with, you know, your enzymes in your liver, and you kinda can process

296
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alcohol a little bit better when you are chronically using alcohol

297
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or you kinda return to use quickly. Mhmm.

298
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Your body is not able to process as much as

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fast as as quickly. So you, you know, get intoxicated,

300
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faster. I see. Right? But a lot of times, there is

301
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some health, you know, liver cirrhosis and some other things if you're real

302
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heavy Yeah. User of alcohol prior to. But it's really

303
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just kinda that those same effects that have, it just kinda comes back, you know,

304
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in full force. Gotcha. So we talked a lot about early on is,

305
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you know, the receptors and and, you know, there's medications that we can use

306
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for alcohol use disorder. Mhmm. Yep. So there's 3 FDA approved

307
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medications that we can use for alcohol use disorder,

308
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that can be used to to either, limit the cravings for alcohol

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use, you know, to kinda help with some of those receptors.

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Then, you know, there's 1, disulfiram that'll actually make

311
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you ill if you consume alcohol. Oh, okay. Like, a

312
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Pavlovian effect. Yep. Yep. A lot of people know that one, the

313
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disulfiram. It's an older medication, that you take it every day.

314
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It's a pill. And then if you consume alcohol, it just makes you really sick.

315
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Okay. But, again, we don't use that as much

316
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anymore because it does make folks ill. You know? Sounds miserable. It it

317
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does. If someone has some comorbidities, it can lead to to more

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health, effects if they have heart disease or

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So it's a little dangerous. It can be. You know, it they have to be

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under medical supervision if they're if they're gonna use that kind of medication. What are

321
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the other ones? Yep. So one is, acamprosate. Mhmm.

322
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Acamprosate kinda works, you know, on the that GABA receptor

323
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system Okay. And glutamate receptors that we talked

324
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about to kinda help kinda regulate those cravings and urges,

325
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to use. Okay. So those are some big ones. And then kind of the

326
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the gold standard, is naltrexone.

327
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Okay. So naltrexone comes in a pill and also an injectable

328
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form. Mhmm. The injectable form is called VIVITROL.

329
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Mhmm. And that tends to be the gold standard now, for

330
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alcohol use disorder. I see. So that kinda helps

331
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reduce those kinda positive feelings, you know, when you consume alcohol. So you

332
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just lose the the taste. You don't feel good? No. It's you just

333
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lose the kinda the taste for it. You just when you use alcohol, it

334
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doesn't give you those positive kind of reinforcements.

335
00:20:37.160 --> 00:20:41.000
Okay. And, you know, you're just like, I I can stay away from

336
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it. It it doesn't do what it used to do. The the the thrill is

337
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gone. The thrill is gone. That's a good way to put it. Yes. Yeah. Okay.

338
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I I have a couple of friends in my life who are in in recovery.

339
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And one went through AA Yeah. And one went through smart recovery. And the

340
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smart recovery person believes that addiction is something that you can mind

341
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your way out of. What are your thoughts on that?

342
00:21:02.120 --> 00:21:05.320
So all of those, peer run groups that are out there

343
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Great support systems. Awesome. Vital. Yep. So do you think that someone

344
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who's just a a big alcoholic can will their way out of

345
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it? So, again, those medications kinda help on that kind

346
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of midbrain, that limbic system, all that stuff, but a lot of our,

347
00:21:21.095 --> 00:21:24.855
judgment comes from our frontal lobe or our executive decision making of

348
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our brain. That that's where folks kinda make that decision to to continue

349
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to use alcohol or, you know, know if you talk to folks

350
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that use a lot of alcohol, they know it's harmful for them, but that they

351
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keep using. Right? And they keep drinking and they keep, you know, putting themselves at

352
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risk even if they have health problems. They just can't

353
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stop. Yeah. And part of that's that executive. So everybody

354
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has triggers, to use alcohol, and they

355
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need coping skills. They need better coping skills than reaching for a bottle or reaching

356
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for a drink. Yeah. And that's where our therapy comes in. So there's

357
00:21:58.210 --> 00:22:01.889
many different types of therapies. You can have therapies from a

358
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therapist and a provider run either individual therapy or

359
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group therapy. Uh-huh. I I'm a therapy proponent. I love therapy.

360
00:22:09.330 --> 00:22:12.655
It's the best thing ever. Who doesn't wanna talk about themselves for an hour? Mhmm.

361
00:22:12.655 --> 00:22:16.015
Right. And it really helps get down to the kind of the root cause about

362
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why you started using alcohol, you know, find what

363
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your triggers to use alcohol are. Mhmm. Figure out coping

364
00:22:23.215 --> 00:22:27.000
mechanisms. You know, when you're thinking about alcohol or thinking about picking up that

365
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bottle, what else can we do? We'll be right back because you know I

366
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have more questions.

367
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From what I understand, this is a 4 question quiz. And if you get more

368
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than 2 yeses, 2 or more yeses can indicate alcohol use

369
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disorder. I'm nervous, but I'm willing to take it. So I'm sure you

370
00:22:49.135 --> 00:22:51.880
do have you don't have them written down. There are only 4 questions. I probably

371
00:22:51.880 --> 00:22:54.760
do, but I I You've got them. And yeah. You this is what you do.

372
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So I I I think what you're referring to is what we call the cage

373
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questionnaire. Okay. C a g e. So have you ever tried to cut

374
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down, unsuccessfully with your alcohol use? That's the

375
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first question. That's the first question. Okay. Have I ever? An

376
00:23:09.005 --> 00:23:12.525
yeah. I guess, yes. Is that yeah. Yeah. Alright. And then, you know, the a

377
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is, you know, do you ever get annoyed when someone kinda comments about your alcohol

378
00:23:16.365 --> 00:23:20.125
use or maybe tells you that you probably need to to stop using

379
00:23:20.125 --> 00:23:23.950
as much alcohol? I haven't had that Okay. Told to me. Okay. Do you ever

380
00:23:23.950 --> 00:23:27.630
feel guilty about your alcohol use? That's a trick question. I grew up

381
00:23:27.630 --> 00:23:31.090
Catholic. Mhmm. Yeah. So I feel guilty about everything.

382
00:23:31.550 --> 00:23:34.605
So yes is the answer, but I also feel guilty when I eat a cookie.

383
00:23:34.605 --> 00:23:37.725
So you know? That's hard. Okay. And then e is for eye opener. Like, we

384
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talked about, you know, using alcohol early in the morning to help with withdrawal symptoms

385
00:23:41.485 --> 00:23:44.845
or help with hangovers. I've never had a hair of the dog. Yep. I've I've

386
00:23:44.845 --> 00:23:48.045
tried it once. It was the grossest thing ever. I'll never do that again. Yep.

387
00:23:48.045 --> 00:23:51.700
So that's your 4 questions. That's the easy screening question, and that's where most, like,

388
00:23:51.700 --> 00:23:55.540
your primary care doctors will kinda ask you before going in. So you

389
00:23:55.540 --> 00:23:59.300
had 1, maybe 1 and a half. You know? But it's something to consider

390
00:23:59.300 --> 00:24:02.945
and something to think about, when you, you know, especially when

391
00:24:02.945 --> 00:24:06.384
you've tried to cut back, you know, maybe that internally you think, you know, you

392
00:24:06.384 --> 00:24:09.825
may be, you know, using too much alcohol Yeah. And that you need to kinda

393
00:24:09.825 --> 00:24:13.585
think about kinda cutting back a little bit and cutting down. And

394
00:24:13.585 --> 00:24:17.429
then you try doing that, you know, through your you know, through

395
00:24:17.730 --> 00:24:21.570
kind of self motivation. Yeah. Right? We talk a lot about motivational interviewing and

396
00:24:21.570 --> 00:24:25.169
what's important to you and health and finances. So if that's

397
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something that's important to you, and that's where those kinda dry

398
00:24:28.785 --> 00:24:32.385
January's and and other, you know, challenges come in as you'll kinda start to see

399
00:24:32.385 --> 00:24:35.665
if, hey. I can cut down. Hey. It does help my, you know,

400
00:24:36.225 --> 00:24:39.665
overall health and well-being. Right. And that's gonna be more

401
00:24:39.665 --> 00:24:43.049
motivation to to not use as much alcohol in nature. Yeah. I

402
00:24:43.049 --> 00:24:46.330
I find whenever I have tried to cut down, the hardest part is the social

403
00:24:46.330 --> 00:24:50.009
aspect. Because everywhere you go It's everywhere. Yep. It's everywhere. Yep. And then every

404
00:24:50.009 --> 00:24:53.769
restaurant you go to has that specialty drink that's amazing. Right? Oh, yeah. Yeah.

405
00:24:53.769 --> 00:24:57.245
But, again, now margaritas come in this, like, fishbowl, you know,

406
00:24:57.245 --> 00:25:00.685
24 ounce margaritas. I think those are meant to share at least. Yeah. I hope

407
00:25:00.685 --> 00:25:04.445
so. Mhmm. Alright. I have a couple of, I have a couple of listener

408
00:25:04.445 --> 00:25:07.830
questions. K. Okay. Let's see. A bunch of kids at my

409
00:25:07.830 --> 00:25:11.669
college drink Borg's. Have you heard of this? I have not. Oh, lord.

410
00:25:11.669 --> 00:25:15.190
Well, let's learn together. This is where they take a gallon of water

411
00:25:15.510 --> 00:25:19.350
Mhmm. Like a physical gallon of water, dump some out, and then put a

412
00:25:19.350 --> 00:25:23.174
5th of liquor, typically vodka, into the mix with, like, some kind of

413
00:25:23.174 --> 00:25:26.934
flavoring packet. Most don't finish their gallon, but what

414
00:25:26.934 --> 00:25:30.695
are your thoughts? Is this safer in any way? It is. I Right. You don't

415
00:25:30.695 --> 00:25:34.135
think so? No. We talked about those dealing with 5th of vodka. We used we

416
00:25:34.135 --> 00:25:37.735
used to mix all kinds of cocktails in 5 gallon buckets and, you know,

417
00:25:37.735 --> 00:25:41.310
and When you were in college? College and Purple

418
00:25:41.310 --> 00:25:44.350
Jesus is what we did around here. Exactly. Yep. Purple Haze. We had them we

419
00:25:44.350 --> 00:25:47.950
had them all. Yeah. And, yes, they're very unsafe. A lot of times, they have

420
00:25:47.950 --> 00:25:51.695
grain alcohol in them. A lot of times, they'll have several bottles,

421
00:25:51.995 --> 00:25:53.695
you know Yeah. Yeah. Different,

422
00:25:56.635 --> 00:25:59.855
mixology, portions of it, you know, and they're really,

423
00:26:00.154 --> 00:26:03.434
harmful to you. Again, you don't know how much you're consuming. It's mixed in a

424
00:26:03.434 --> 00:26:06.460
in a gallon jug. You don't know how much you're pulling out of it. Yeah.

425
00:26:06.460 --> 00:26:10.300
Exactly. And, again, if you're drinking and consuming just that much, you know Bad

426
00:26:10.300 --> 00:26:14.140
news bears right there. Exactly. What about drinking water in between drinks?

427
00:26:14.140 --> 00:26:17.955
Is that at all, you know, have an advantage? So some folks do

428
00:26:17.955 --> 00:26:21.395
get dehydrated. And when you drink alcohol, it is a diuretic. It does cause you

429
00:26:21.395 --> 00:26:25.155
to urinate. Yeah. Water does help keep you hydrated, but it doesn't

430
00:26:25.155 --> 00:26:28.835
help metabolize alcohol any faster. Mhmm. What it does

431
00:26:28.835 --> 00:26:32.550
do, it takes longer to kinda drink a glass of water, and it's just

432
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time that can sober you. Gotcha. Okay. Alright. The the last one, just

433
00:26:36.390 --> 00:26:40.150
2. My parents were both alcoholics. Does

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that put me kinda covered this earlier. Does that put me at a higher risk

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for alcohol abuse? It does. Is it only

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I'm I'm gonna add on. Is it because it like, you're gonna socially see them

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drinking or, like, physically see them drinking as opposed to

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physiologically or both? Both. So, genetically, you're you have a

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genetic disposition for alcohol use, especially with 2 first degree relatives

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having alcohol use disorder. So, again, you kinda have that that genetic

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component and those genes can be expressed when you're exposed

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to to alcohol. There's a lot of studies out there Mhmm.

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On the genetic components of it. But if she never

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uses alcohol, then her brain will never be exposed to it and maybe

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never become addicted to alcohol. So maybe if you have alcoholics in your family, the

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best thing to do is never touch a drink. Correct. Yep. It's absolutely correct. So

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there's mom and dad. Yeah. There there is, you know, nature versus

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nurture. We hear those terms a lot when we come to addiction,

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and that, you know, part of it is what we see our parents do, you

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know, socially. And we find that socially acceptable, and we,

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know, do that as we as we get older. That makes sense. But also, you

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know, once we do get exposed, you know, to those substances, if we have

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those genetic dispositions, those that that switch flips

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in our brain Mhmm. And then, you know, we, you know, have a a very

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high risk of of substance use and for, alcohol use

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disorder. Okay. So if for anyone who has any inkling

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that they might need help, where should they go? It's always best to start, you

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know, with your primary care physician. Most family practice and

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internal med, doctors outpatient, can provide

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support for alcohol use disorder Mhmm. And and prescribe those 3

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medicines that we talked about. Many psychiatry and mental

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health and well-being providers will also do,

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alcohol, you know, management. A lot of times, they have more

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resources as far as the therapy aspect goes. But, again, if you

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start with your primary care, a lot of times, they'll refer you and vice versa

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if you have medical conditions from your alcohol use.

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If you have severe alcohol use disorder and maybe

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struggle with those withdrawal symptoms that we mentioned, sometimes

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you need kind of more acute care. And, you know, a hospital is

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not a bad place to to to start if you really have, you know, severe

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alcohol or you have a history of, like, withdrawal seizures, and it's something that you

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can't necessarily stop just in the outpatient. Even if they don't have a rehab center,

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if you're not sure that they have a rehab center in that hospital, just go

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to the hospital. That's true. Yeah. And then there's our, in this area,

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there's Holly Hill, there's Triangle Springs, and there's some other kind of places you can

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kind of self report to. Okay. So you can go to those locations. You

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can, you know, Google search, and there's lots of different

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alcohol rehab centers, that you can just go and self report, and they'll do

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an assessment to you. And if you are medically stable enough to be admitted,

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they can admit you there. And if not, they feel you might need more higher

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level of care. They'll send you to the hospital. Okay. Well, what I hear from

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you is that there's hope, and I love that. Like, it it may seem like

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it's the hardest thing, and it may be very hard to get through. But at

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the end of the day, you can do this. And if you have any ink

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inkling that you might have issue with alcohol, wanna get dealt with,

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do it. It's gonna be worth the worth all the work you put into it.

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Thank you so much. Thank you so much for having me. Of course. I find

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it so interesting that even a short break from drinking can make a big difference

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in our mental clarity and how we feel. Remember, the recommended

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daily limits. One drink for women and anyone who's over

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65 and 2 for men under 65.

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And one drink is 5 ounces of wine, 12 ounces of beer, or 1

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and a half ounces of liquor. It's not that much. Doctor Christopher

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Thompson was my guest today. You can find him at wake med dot org. There's

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a link to his quiz and an article he wrote about the sober curious

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movement in our show notes. If you have any thoughts in this episode, please share

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them with us. We'd love to hear from you. Go to wralfm.com/sarahhasquestions.

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Thanks for listening, watching, and most important, sharing this show with all your

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friends. See you next time.