Practice Tip of the Week | Alcohol Use Disorder Awareness and the Normalization of Drinking Culture

By Brittney Majefski, MSN, RN, PMH-BC

If anyone reading this article had the radio on recently, they heard a variety of songs glorifying attributes of drinking alcohol, misusing drugs, and highlighting other painful experiences. From happy hours to decompression, taking the edge off the day to partying it up on vacation, glorifying heavy alcohol use has become increasingly accepted. While alcohol use may be safe for many in moderation, it is important that we have an understanding of the adverse effects that alcohol can have.

The Problem

According to the National Institute on Alcohol Abuse and Alcoholism (2024), there are over “178,000 alcohol-related deaths annually, making alcohol a leading preventable cause of death.”

Many studies are showing that since COVID-19, alcohol use has increased among both the general population as well as healthcare providers (Rathburn, 2022). It is vital now, more than ever, as nurses we have a good understanding of alcohol use disorder, how to prevent it, recognize it and know where there are resources for those in need of help.

According to the NIAAA, below is the definition of a standard drink as well as what constitutes “heavy drinking,” and it may be surprising:

Heavy Drinking:

For women—4 or more drinks on any day or 8 or more per week

For men—5 or more drinks on any day or 15 or more per week

A standard drink is equivalent to 12 oz. of beer, 5 oz of wine, or 1.5 oz of distilled spirits.

The risk of developing Alcohol Use Disorder (AUD) goes up exponentially with frequent heavy use. Alcohol can be damaging to multiple different organs in the human body and is even associated with the development of several different kinds of cancer.

Tools for personal use and clinical practice:

Rethinking Drinking: (interactive calculators, tips, strategies to cut down/quit drinking)

Alcohol Treatment Navigator

Healthcare Professionals Core Resource on Alcohol

Recognizing S&S:

While society normalizes drinking alcohol, there is unfortunately still a heavy amount of stigma on those that suffer from alcohol use disorder, even amongst healthcare professionals. This prevents people from seeking help in fear of retaliation. Alcohol is being used at an alarmingly high rate amongst healthcare workers, often under the guise of self-care. Unfortunately for many, what starts out as a social activity can soon become a dependency that can lead to devastating results if not properly addressed.

It is imperative for nurses to understand that AUD is a “treatable (disease) that affects a person’s brain and behavior,” much like other chronic illnesses we address without stigmatizing the individual suffering from the illness (NIMH, 2024). Nurses can help decrease the stigma and fear by educating themselves on how to identify this as a problem, assist with effective interventions and treatment options in a compassionate, non-punitive way (Molloy, 2024).

Common signs and symptoms of an individual that may be suffering from alcohol use disorder include but are not limited to:

• Abnormal Weight changes

• Nausea, vomiting, or diarrhea a

• Tremors

• Slurred Speech

• Unsteady gait

• Hygiene concerns

• Labile mood

• Smell of alcohol on person

Specific things to monitor for amongst peers while at work include:

• Frequent trips to the bathroom

• Difficulty completing daily tasks

• Tardiness or absenteeism

• Falling asleep

• Long unaccounted for breaks with mood changes

• Illogical or illegible charting or other mistakes in EMR, poor performance or judgement

• Frequent mistakes

Solutions

The good news is that there is help available. There are several things according to Rathburn (2022), that can be done to help increase awareness and decrease stigma associated with AUD including:

• Collegiate and Workplace education

• Extended research (that is specific to how this disease is affecting nurses)

• Shame-free national alternative to discipline policies

• Securing funding to help cover cost associated with treatment

• (Wellness) Educational Programs

• National campaigns to reduce AUD stigma

We can all make a difference in outcomes by standing together against stigma and helping those that have lost their voice find it, in the fight against alcohol use disorder. To find out more information or identify resources here in the state of Texas, contact TPAPN for information on how Texas Peer Assistance Program for Nurses is here to help.

As a reminder, it is always best to self-report to TPAPN when you feel like you are having issues that could impair your practice. This is the best way to get help quickly and remains confidential. For more information, visit tpapn.org.

References:

Molloy, P. (2024). Nurses and nursing students with substance use disorders. Journal of

Addictions Nursing. 35(1),15-21.

National Institute of Mental Health. (2024). Substance use and co-occurring mental disorders.

U.S. Department of Health and Human Services, National Institutes of Health.

https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health

Nation Institute on Alcohol Abuse and Alcoholism. (2024). April is alcohol awareness month.

U.S. Department of Health and Human Services, National Institutes of Health.

https://www.niaaa.nih.gov/news-events/announcement/april-alcohol- awareness-month

Rathburn, J.(2022). Destigmatizing alcohol use disorder among nurses. Nursing. 52(7),23-29.

doi: 10.1097/01.NURSE.0000832364.28141.12. PMID: 35752904; PMCID:

PMC9208743.