Barts-MS rose-tinted-odometer: ★
She recently turned 32 and has had multiple sclerosis for just shy of 4 years. She previously described herself as a moderate drinker having 2 to 3 glasses of wine per day in the week and maybe a bottle of wine per day on weekends. She would have typically her first drink of the day in the early evening when she got home from work. However, with COVID-19 and being forced to work from home she started drinking earlier, typically midafternoon. She has started drinking wine out of a mug to disguise it from her work colleagues on her zoom calls.
Now in the second lockdown, she has her first glass of wine with lunch. Her wine consumption has increased to more than a bottle per day. She admits to being unable to stop drinking and feels hungover on most mornings. She admits that her drinking has become a crutch. She feels lonely as she lives on her own and has not been able to visit family and friends, which is one of the reasons she is now drinking so heavily.
Does this scenario sound familiar? Alcohol consumption data during COVID-19 is worrying; recent studies have shown a large increase in alcohol purchases and consumption.
Alcohol is an anxiolytic and is probably the most used drug on the planet. Its adverse event profile is well described and long-term chronic use is associated with neurological and systemic toxicity. Neuroscientists now say there is no safe level of alcohol consumption when it comes to your brain health.
There is limited data showing that alcohol and drug misuse is higher in people with MS (pwMS) than the general population. The latter is not surprising given anxiety is so common in pwMS. Similarly, social isolation and loneliness, which are strongly associated with alcohol misuse, are endemic in pwMS. A recent survey by the MS Society indicates that 3 out of 5 pwMS describe themselves as lonely.
If you are reading this and feel your alcohol consumption has got out of hand as a result of COVID-19 please contact your HCPs and let them know. There are things that can be done remotely to help you. Don’t be ashamed to admit you have a problem; HCPs are trained to be non-judgemental and understand the issues.
As part of the holistic or marginal gains approach to the management of MS reducing alcohol consumption is one of the lifestyle interventions we promote. I am aware that it is easier said than done, but unless you try you won’t optimise your potential longterm outcome.
If you have any personal experiences you want to share with us about alcohol and how it has affected your MS, we would appreciate hearing about them. Your stories may help your fellow readers.
Bombardier et al. Alcohol and drug abuse among persons with multiple sclerosis. Mult Scler. 2004 Feb;10(1):35-40.
Objective: To examine the one-month prevalence and impact of substance abuse in a large community sample of persons with multiple sclerosis (MS).
Method: Members of the Multiple Sclerosis Society of King County were surveyed by mail. This multifaceted health survey included questions pertaining to substance abuse. Seven hundred and thirty-nine out of 1374 potential participants (54%) returned the survey, while 708 reported a medically confirmed diagnosis of MS and provided sufficient data.
Results: Fourteen per cent of the sample screened positive for possible alcohol abuse or dependence, and 7.4% reported misusing illicit drugs or prescription medications within the previous month. Possible alcohol abuse and drug misuse were associated with younger age, less severe MS-related disability and being employed, as well as greater self-reported depressive symptomatology. Most persons with alcohol problems indicated an interest in learning more about ways to stop or cut down.
Conclusions: Substance abuse may be present in up to 19% of this sample and contribute to high rates of depression. There may be greater risk of harm due to substance abuse in people with MS because of the potential magnification of motor and cognitive impairments. Comprehensive MS care should include substance abuse screening and advice to cut down or abstain.