Episode Transcript
Simon Floss (Host):
Hello and welcome. You’re listening to the “Health and Wellness” podcast brought to you by Sanford Health. I’m your host, Simon Floss, with Sanford Health News.
Our conversation today is about sober curiosity and the rise of a sober generation. Our guests today are Anna Chock and Ashlea McMartin. Ashlea is the director of behavioral health at Sanford Health in Bemidji, Minnesota, and Anna is the behavioral health clinical manager at Sanford Health, also in Bemidji.
Thank you both for being here today.
Anna Chock:
Thank you.
Ashlea McMartin:
Thanks for having us, Simon.
Simon Floss:
So, this is something that it seems like it’s around us everywhere we go is alcohol. What are some trends in alcohol consumption? And for this first question, Anna, we’ll start with you.
Anna Chock:
Well, in general, I would say that the sober curious lifestyle or just sober curiosity in general is on the rise. Especially within that younger generation there’s a lot more exploration about what alcohol, how alcohol interacts with the individual, consumption in general. There’s a lot of different data, unfortunately we saw a large spike in alcohol consumption, especially during the COVID pandemic, and I do believe that we are still seeing a lot of the effects of that.
Simon Floss:
Yeah. Ashlea, that was exactly what I was going to ask you. So, as Anna said, it’s well documented rates increased for alcohol consumption and binge drinking during the pandemic. In your opinion, (based off) the things that you see every day, why is that?
Ashlea McMartin:
Yeah, so I want to point out in some of the numbers that I looked at in preparation for meeting today. One of the interesting pieces is that rates of sale of alcohol did increase substantially, but they did not necessarily out-trend the decrease in on-trade purchases. And so, we just saw movement from going out to eat and the bars and the restaurant sales, and we then saw an increase in buying from a liquor store or something like that.
As we’ve seen more data, we’ve seen this balancing act between those two. But in terms of when I think about how COVID may have impacted alcohol use and how alcohol use may have increased anxiety around COVID, did they exacerbate each other? Not in terms of I got sicker because I drank alcohol, but just the idea of anxiety around COVID and those different pieces.
But so again, we saw the off sale (off-site sale of alcohol) went up, but the rates within on-trade (on-site sale of alcohol) went down and they weren’t equal amounts or percentages. We’ve seen people return to going out and going to bars and restaurants like we had pre-COVID. In terms of the why of alcohol is often used, it’s an escapism. And so, during COVID, when we were in lockdown and we were forced to be together and in tight quarters, and not having an outlet, that might explain why people turned to alcohol to kind of escape the reality of what was going on.
Simon Floss:
And what would you say as far as post-COVID rates?
Ashlea McMartin:
That information is still coming out, so I’m not sure we have great data. I even questioned like, so what is post-COVID? What does that mean? When did COVID officially end? And what does statistically that mean for some of this information?
I will say, we offer substance use disorder services within our behavioral health here in Bemidji, and our rates of referrals and people seeking services voluntarily continues to rise and rise and rise. And so, whether that is greater awareness, like someone is aware that they have a substance use disorder issue, whether it’s just greater understanding by providers that this might hit that threshold and you might need as a patient, need a referral or whether it’s increased use, it’s hard to know based on providing the services.
Simon Floss:
That makes a lot of sense. So Anna, we’ll switch to you for this next question. We all know this because, I’m in Sioux Falls, South Dakota, part of the Midwest – it’s well known that binge drinking rates are very high in the Midwest. And obviously that’s within Sanford Health’s footprint. Binge drinking rates, as well, are very high in the Northeast, we should not fail to mention. Why is that?
Anna Chock:
I think that’s a really good question. I would say there’s some conversation going on, especially around those in their early adulthood. And this is also part of that sober curious conversation, but just some of the lack of entertainment options that happen in a more rural area can definitely contribute to that. And it can be normalized differently in rural areas than not.
People may have different models of what alcohol consumption looks like as they are maturing and growing into adulthood. Typically, the things that we hear of the most are lack of other entertainment options, and it being somewhat of the cultural norm to engage in alcohol consumption.
Simon Floss:
So, Ashlea, what is considered binge drinking for men and women?
Ashlea McMartin:
Yeah, so based on the Centers for Disease Control and Prevention, who does a lot of our research and sets some of our health standards, binge drinking for men is when someone consumes five or more drinks on one occasion. And more than four drinks for women.
I just want to point out we’re talking a standard-sized drink, so a standardized glass of wine, a shot, or a beer. And I think when we think about the supersize me size servings in America, there’s this perception that, “well, I only had like three beers,” but really the beers were “talls,” which would be considered near two standard drinks. And so, I just went from three drinks as a woman to six drinks, and I hit that threshold.
Simon Floss:
Anna, how does alcohol affect us emotionally?
Anna Chock:
I’d like to start by just saying that first, it can affect people differently. It does affect people differently. So generally, what we know and understand about alcohol is certain parts of the brain that it stimulates or impacts, one of those being our frontal lobe, (which is) where we make our wonderful decisions and have our critical thinking skills, judgment, things like that.
But it also stimulates the limbic system, which is responsible for our emotional responses to situations and things going on around us. Meaning people may feel happier, right? If that is stimulated, it doesn’t mean they will, but that is definitely a big draw to alcohol use. So, I would say it affects us differently.
But generally, across the board, we know that it does impact judgment, decision making, but also can bring on pleasurable feelings, which is why it sometimes is used as a coping mechanism for other things going on in people’s lives. And unfortunately, it’s fairly effective (laugh). So, that’s a part of alcohol that is hard to argue when people are using that as an effective coping mechanism for what’s going on.
Simon Floss:
Well, so you talk about coping mechanisms. What are the warning signs that someone might have a problem with alcohol, or are using alcohol too much as a coping mechanism?
Anna Chock:
I’m so glad you asked that question and used the word “problem,” because I think that’s a large part of the sober curious movement. When you think of alcohol first, it’s important to remember that it is a carcinogenic neurotoxin, meaning it’s going to affect us in some way. And, you know, as you mentioned earlier, Ashlea mentioned earlier why maybe we saw a spike in COVID or what that looks like.
We should have a problem with it to some extent because of what alcohol really is. When we think about tolerance, when we think about, “I don’t have a problem with alcohol,” if you change out the word “alcohol” with something else, like, “I don’t have a problem with methamphetamines,” it puts a different spin on it, right? But alcohol is as mood altering as any other type of substance.
Are you making good decisions, good judgments? Are you dependent or reliant on alcohol to cope? Do you find yourself craving alcohol? Do you find yourself seeking alcohol during specific situations or prior to or after something? Those are usually really relatively easy things for people to see about themselves and others is what are those patterns of alcohol use? I would say those are probably the most obvious that would be helpful for people to be aware of.
Simon Floss:
It makes a lot of sense. Can you maybe just quickly talk about how, and then Ashlea we’ll get to you, we haven’t forgotten about you, I swear. How hard is it to facilitate these conversations where, say you’re recognizing that in a loved one. How hard is it to bring that up? And what advice would you give to someone who’s seen this behavior and they’re concerned?
Anna Chock:
I always suggest leading with curiosity and care and concern for that person as a person. It’s easy to point out problems that you think other people have, much easier than going towards a situation with compassion and curiosity. But if you approach it in a curious way, hopefully that will keep that person’s mind open to exploring either in that conversation or with themselves. Simple questions like, “I’m noticing that you’re consuming alcohol more often. Have you noticed that?” Just general, kind of open-ended questions about if they notice things. How do they feel when they’re using alcohol? It just helps increase insight and also just start some thinking about, I wonder what this is really looking like in my life, and how and why I’m using it.
Simon Floss:
So, Ashlea, more and more people are living a sober or a sober curious lifestyle. Personally, I myself don’t drink and quite a few of my friends are leaning more into some of the many nonalcoholic options for beverages out that are. So, what lifestyle tips do you have for those who are sober curious or, maybe would even like to be fully sober?
Ashlea McMartin:
Yeah, I think especially in the Midwest, Anna had shared how use really transpires sometimes out of boredom and out of not a lot of things to do. So, my number one suggestion always to people is find your people, find your support system, (find) those other individuals that might be equally as sober curious, and willing to try different and new things together. And that your equation that works out for balanced life for you is not going to be the same equation that works for someone else. And so, knowing that about yourself and as you meet people who might be on their own either recovery journey or just sober curious journey.
And then I think the last thing probably, and I’ve gone through periods of this because my alcohol consumption looks different than my family systems, is you don’t have to justify or explain your lifestyle in why you’re choosing to be sober or why you’re exploring that.
Just know as you find your people, they’ll be supportive, or if you find the right supports, I should say, they will be caring and compassionate and curious along with you. Now whether that means they drink or not is kind of up to them in their equation of things, but if you’re finding yourself having to justify it might not be the right group and setting for you to continue to interact with and engage with.
Simon Floss:
Yeah, I’m very glad you said that. My grandma, when she was around, would say things like “show me your friends and I’ll show you who you are,” things like that. So, it’s just to that point of, who you hang around is everything.
So, Ashlea, let’s say someone’s listening to this and they’re wondering if they maybe have a problem with alcohol. (Let’s say) they’ve been drinking too much and are feeling some sense of shame about that. What would you say to them?
Ashlea McMartin:
Well, I think we are all doing the best that we can. And so, I usually start at that place of someone coming to me and saying, “I think I might have a drinking problem.” They are doing the best that they can with the resources that they have in that moment. And if they want to change those circumstances or resources, that’s fantastic. And if they don’t, that’s equally as fantastic. It’s getting them through what they’re going through in life.
But I think the other piece too is knowing how to access resources. It can be really difficult if you’re in an environment where alcohol is the culture. And so, figuring out what are the other options that people have and connecting with people that have maybe walked that same pathway, because shame hides in secrecy. That’s how it survives.
And when we start to expose and shed light on what those maybe secrets or shameful things are, we oftentimes find people that have either walked a similar pathway or can look at us genuinely and say, “Wow, that’s incredible that you want to do something different, that you want to try to do this coping skill in that instead of drinking” or “You are going to treatment for the 12th time. Wow. Some people would give up after 11 and instead you’re going back for a 12th time. That’s incredible.”
And so, one of the huge resources that pushed out in 2022 was the 988, which is a suicide prevention hotline, but it’s also a great resource for people dealing with any kind of substance use or mental health need. And so, you can see how it’s parallel to 911 in the event that someone is in a medical crisis and really accessing your local resources through that phone number to see what is there. Maybe there’s an online group that you can join.
We were just joking about as before we jumped on the podcast, right? Like, computers and technology are great until they’re not (laugh). But one of the great things with COVID that has developed is this massive network of online supports that we’ve never seen in the past in terms of substance use, harm reduction, alcoholics anonymous, (and) narcotics anonymous. If you grew up as a child of a parent who was an alcoholic, all of those groups now have a virtual place as well to meet, which makes it incredibly easier to connect in some ways than it would’ve been in the past when you were trying to find the one sheet of paper that had the phone number for the one meeting that happened on Tuesdays at 10:00 a.m. Now there’s a whole virtual world of connecting with people.
Simon Floss:
So now Anna, a lot of times there’s, I don’t know if “challenges” is the right word, but there’s movements, if you will, where there’s things like Dry January or Sober October. Those are gaining some popularity. I guess it’s kind of an open-ended question, but how do you feel about those challenges or lifestyle decisions, even if they’re temporary for a period of time? How can those positively impact people?
Anna Chock:
I think it can be helpful in, first of all, just awareness that there are other people who are attempting to perhaps reduce their alcohol consumption for a period of time. I can’t say it enough that alcohol does alter how we feel and how we think, as do other substances. So, I think things like Dry January, Sober October can shed light to the fact that other people can have challenges with tolerating alcohol as we all have challenges with it, right?
The part that I think is important for people to understand is that maybe we call it a challenge or some sort of event for a month of not using alcohol. That can be great, and it can work for some people. But one thing I really enjoy about the sober curious lifestyle is that it isn’t calling you to stop completely.
If that’s not of interest, it’s actually calling people to explore their relationship with alcohol to try other things without alcohol. And to just kind of get more curious with it, and friendly with the idea of perhaps not consuming alcohol. But it isn’t a fixed amount of time. There aren’t rigid boundaries around it that can make it seem impossible. For some people, if you were to say, “Don’t drink for a month,” that would be extremely hard. But if you were to tell somebody, “I wonder if we try going to a movie without alcohol beforehand. Let’s just see what it’s like.” That probably seems more doable than quitting alcohol for an entire month.
Simon Floss:
It’s kind of like the pendulum swings in lifestyle, you know? But anyway, continue. My fault.
Anna Chock:
No, I was just going to say if an entire monthlong challenge seems like something that would really inspire people, go for it. But if it’s something that seems like, oh my gosh, that’d be really hard, sober curiosity can be done day to day. It doesn’t have to be all or nothing.
Simon Floss:
A couple more questions here, Anna and Ashlea, before we get you out on your way. High school students, college students, they’re obviously looking to experience new things. It’s a very developmental time for those individuals’ lives. So, what are a few things to look for in someone that may be going through changes and experiencing changes with alcohol in a harmful way that they may not have previously? And how can a person be of help, you know, talking about the risks of binge drinking and tailgates and things like that? So, Ashlea, I’ll let you take that one.
Ashlea McMartin:
Sure. We saw, gosh, probably in the ‘90s and 2000s this huge push to educate around binge drinking, especially as it pertained to like frats and sororities because we saw alcohol-induced deaths. And so, we come to kind of this time of year and anyone that lived through that era of things probably has that on their mind at times of, “Oh gosh, we’re starting the initiation of a new school year in another new round,” or, we have young kids that were socially isolated for three years during COVID coming back to their first bonfires, their first post-dance, first post-football game pieces of things. And I think some of the important things to maybe educate parents and friends, loved ones around is, you kind of hit earlier, Simon, the idea of shame.
And not that we want to promote alcohol use by people, but we also want to make it a safe place to be a reach out to as it relates to driving safely. Or if you feel like you’re in a tight spot you can call me. Parents establishing guidelines around what happens if your kid ends up at a party and doesn’t feel safe and does call you? Are there repercussions for that? Do you get punished for that? Or are there safe zones where it’s kind of like, “Hey, I’d rather have you home alive. We can talk about this afterwards, but we’re going to get you feeling better, and then we’ll talk about what happened” type of a thing.
So, I think that’s kind of number one, is starting the conversations with your teenager, with your adult, your early adult child of you’re probably not telling them anything they haven’t ever seen on TV, witnessed at a ballgame, or seen or heard from their friends. And so just kind of laying the groundwork of, “We’re willing to talk about this. We’re willing to entertain this conversation” is important.
And then the other thing is watch out for your friends. Take care of each other. We’re not responsible for how much other people drink, but we can certainly just keep an eye out. If I’m out with Anna, maybe we are each other’s buddies and we’re watching each other for the night, and we’re going to look out for each other if we’ve had too much, or if we both have our threshold where we’re going into the night saying, “I’m going to have two drinks. How many drinks are you going to have? How are we going to address this if either one of us feels like having more?”
That is really bringing intentionality to the space and the experience. I think that’s really what the sober curious generation and lifestyle is about, is the curiosity, intentionality behind how do we want to live this out? How do we want to be in this moment, in this environment together? And so, we can really get to that space together by talking about those pieces.
Simon Floss:
I think it needs to be said a lot of behavior is learned. And so, when it comes to changes in your lifestyle, it can obviously be incredibly overwhelming because you’re not only changing a lifestyle, but maybe it’s something that, it’s the only thing that someone’s ever known. So lastly, Anna, what resources does Sanford Health have?
Anna Chock:
Specific to Sanford Health Bemidji, we do have an outpatient SUD (substance use disorders) team and we provide outpatient treatment and peer recovery options for people who are interested in treatment for substance use. We use a harm reduction model, so as Ashlea mentioned, it’s not always about complete abstinence. It’s about how can we do this in a safer way, how can we be more aware of our use? This team has co-occurring clinicians, meaning they can navigate the mental health and substance component of that patient seeking care.
Ashlea McMartin:
I think again, as we get out of the post-COVID kind of fog of things, I think service providers are looking for opportunities to support individuals in knowing that substances are effective for coping. And at some point, they might become ineffective, and they might become harmful.
And so how do we really meet the person where they’re at and provide holistic care around that, whether that’s going to your primary care or whether it’s seeking mental health services. And I think Sanford is interested in learning more about how we can better support people in that way.
Simon Floss:
Awesome. Well, thank you both so much for taking the time and talk about this very important topic here today.
Anna Chock:
Thank you.
Ashlea McMartin:
Thank you, Simon.
Simon Floss:
Sanford Health offers substance use disorder care at many locations throughout the footprint. For more information on what care is available near you, call your provider, clinic, or visit sanfordhealth.org to learn more.
This episode is part of the “Health and Wellness” series by Sanford Health. For additional podcast series by Sanford Health, you can find us on Apple, Spotify, and news.sanfordhealth.org. Thanks for listening. I’m Simon Floss.
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Posted In Back to School, Behavioral Health, Chemical Dependency, Children's, Family Medicine, Health Information, Rural Health
