According to the CDC, deaths from alcohol abuse in the general population have risen over 26% since the onset of the COVID pandemic. The highest mortality was among middle-aged men (55 to 64). For physicians, the data is less clear. A systematic study published in JAMA Network Open in late 2022 suggests that “problematic alcohol use” among physicians increased from 16.3% to 26.8% during the 2010 to 2020 period. However, because the research relied on self-report surveys, it’s unclear if this uptick resulted from higher incidence or greater transparency in the study sample. Nonetheless, given the overall increase in the general population, physician use has likely risen as well.
“Problematic alcohol use” is defined by its impacts on behavior, health and relationships. While many evaluate abuse by how much and how often someone consumes alcohol, some moderate to heavy users remain high functioning, at least early on. Consequently, defining problematic use involves assessing the impacts of alcohol consumption on one’s job performance, relationships (work and personal), physical health, finances, emotional well-being and legal status. In other words, use becomes problematic when negative consequences emerge in one’s life functioning.
A slew of studies, some with competing conclusions, examined the impacts of alcohol use on overall health. A 2022 cohort study by the National Institutes of Health found alcohol has deleterious effects on brain, liver and cardiovascular health even at low doses, refuting earlier research suggesting limited benefits. It is believed, but not firmly established, that alcohol damages DNA, which may account for its connection to increased rates of certain cancers. The data indicate harmful effects are dose dependent but do not disappear altogether short of abstinence.
Factors increasing the risk of problematic alcohol use among physicians include:
- Emotional distress: Since the onset of the COVID pandemic, rates of anxiety and depression increased by over 25% (World Health Organization, 2022), elevating the risk of self-medicating with alcohol and other psychoactive substances.
- Burnout: The prevalence of physician burnout approaches 50% (Medscape, 2022), with over half of those affected reporting strong to severe impacts, particularly on relationships. About 25% indicated using alcohol to cope.
- Compassion fatigue: Prolonged exposure to suffering in others causes this condition, as well as complex post-traumatic stress. This is particularly true among “highly sensitive persons” (common in healthcare professionals) due to their heightened empathic response to others in distress.
- Consequences: Fearing impacts on licensure and livelihood, many physicians are reticent to disclose alcohol misuse in earlier stages when treatment proves most effective.
- Family: A family history of alcohol abuse remains among the highest predictors of risk (NIH, 2016).
