Suicide -Shocking News……Even Ice Cream Has a Substance Use Problem
By Lynn Patton Matthew Patton Foundation
Shocking News……Even Ice Cream Has a Substance Use Problem
This article is fifth in a series about stigma and mental health, the goal of which is to talk about these problems as easily as we talk about ice cream.
Since illicit drug use in the military is comparatively low and increased narcotic drug use is managed with polypharmacy policies, I will focus on alcohol misuse since it is the most used and readily available substance. Alcohol Use Disorder (AUD) is the overuse of alcohol that increases risk of accidents, health problems, risk-taking behaviors, vastly higher suicide risk, and potential death from aspiration and alcohol poisoning. Two dangerous misuses of alcohol are binge drinking, which is drinking five or more drinks in two hours for at least one day in the past 30 days and heavy drinking, which is five or more drinks on the same occasion for five or more days in a row in the past 30 days. An AUD diagnosis must meet specific diagnostic criteria, the number of which determine AUD severity—mild, moderate, or severe.
Alcohol misuse has been a long-term problem for the military at consistently higher rates than the civilian population. Those aged 18-25 heavily misuse alcohol (26% military/16% civilian). The gap closes as age increases; at age 46-64 more civilians heavily misuse alcohol. The Army’s Confidential Alcohol Treatment and Education Pilot study states alcohol use has increased in recent years; 43% of active-duty Soldiers admitted to binge drinking, with 67% in the 17 to 25 year-old range. Research from the Institute of Medicine (IOM) supports these numbers in active-duty Service members (military-wide), calling it a “public health crisis”.
Not everyone who takes a drink; however, will develop a problem. Can AUD start with that first drink? Yes, because for some drinking becomes compulsive as their ability to choose whether or not to use becomes compromised. Prolonged use of alcohol on the brain affects multiple circuits involved in learning, memory, reward and motivation, and inhibitory control over behavior. AUD is detrimental to discipline, levels of performance, military and family readiness, psychological health and fitness, and the safety of users and everyone around them. AUD is considered a chronic disorder, therefore, the goal of treatment is sustained abstinence and recovery. IMPORTANT: If you suffer from comorbid conditions (PTSD, TBI, depression), you must advocate for yourself and receive treatment for them at the same time in order for you to fully recover. Evidence-based medicine is very clear on this!
In past articles I have used ice cream flavors to provide an analogy to help you better understand complicated disorders, but in this case ice cream is drunk, too. Alcohol has become so pervasive in society that there are multiple companies that make ice cream using beer, wine, and hard liquor with alcohol by volume content so high (2.1% to 8%) only those 21 and over can purchase and consume it. They straight out advertise that you can enjoy “a buzz along with your brain freeze”. There are so many flavors I cannot list them all, but I can tell you what Matthew would have picked—Dark Chocolate Whisky Salted Caramel Ice Cream— since he literally chugged Jack Daniels straight from a 750 ml bottle. So, now we can all develop liver damage, cardiovascular disease from saturated fat AND financial problems because of the hefty cost—four pints for $99 or six pints for $119 depending on flavor. WOW, is all is I can say.
Barriers to treatment exist such that 78.1% of those with AUD remain untreated. Why? Our good “friend” stigma tops the list. Users fear looking “weak” because they cannot stop drinking and they experience disconcerting attitudes of others toward them. Other fears include effects on their careers and lack of confidentiality because command is involved in the treatment plan. Many fear living life without the numbness alcohol use brings, which is why treatment of comorbid conditions is vitally important.
So what can the military do to decrease AUD? The DOD should use the Army’s Confidential Alcohol Treatment and Education Pilot military-wide because it was a resounding success. When Soldiers were given the opportunity to seek treatment through self-referral with guaranteed confidentiality and no disciplinary action, THEY DID. This promoted better care affecting multiple facets of Soldiers lives, improved troop resiliency, and encouraged Soldiers to stop hiding the problem. Low and behold? Stigma decreased as well. See http://www.army.mil/article/26350/pilot-program-allows-soldier-self-referral-for-alcohol-treatment/ for more information.
Until then, help each other. Please remember it is hard admitting to and getting help for AUD, so providing support to those who have reached this point is important, particularly if there have been significant consequences as a result of their AUD. Use empathy and respect to help; simply saying, “You do not have to do this alone” helps. This lets those with AUD know they are heard, respected, and accepted. It may also save their life. Next month I will talk about Matthew’s death by suicide and how alcohol ultimately helped him pull that trigger.
You can find more in-depth information about AUD along with credible resources at matthewpattonfoundation.org under the facts tab.