#MSCOVID19: alcohol

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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.

CoI: multiple

Twitter: @gavinGiovannoni                                      Medium: @gavin_24211

About the author

Prof G

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

17 comments

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  • I’m doing Dry January for I think the third year in a row. I’ve always said I can easily go without alcohol and sometimes I might go days or weeks without drinking. In fact it’s in my notes so I am periodically reminded of saying that at my annual appointments! I’ve got to say this Dry January has been tougher. And there’s an open bottle of mulled wine in the fridge that I didn’t finish in December… Part of me wants to carry this on though. I’m losing weight and feeling good.

  • I’m sure I read somewhere small doses of alcohol is neuroprotective..Now now let me finish this glass and read those papers again…

  • Rule of thumb:- I put nothing into my body that is known to be harmful, so no over the counter meds or supps, except Vit D3. Currently no prescription meds, though I am not stiff necked about them. If I need ’em I take ’em. I drink occasionally, but it’s like analgesics; I don’t like the feeling I get after a second glass, or the feeling I would get after 1000mg Paracetamol. If I feel ill I see the GP. If I have pain, I drink more H2O.
    Now if I were offered a glass of Petrus or Romanie Contie, would I accept. Absolutely I would. As it is I do have the odd tot of a single malt. After all, it was Burns Night on Monday and who wouldn’t want to celebrate a great poet, even if I don’t always know what he’s saying. To paraphrase, “A woman’s a woman for a’ that”.

  • I don’t follow OMS at all but I do like to cherry pick Jelinek who says in OMS health outcomes for pwMS who consumed alcohol in moderate amounts had better health outcomes! Is that now moot?
    But yeah.. I would say before Covid I wasn’t a home drinker much, then it was a drink every time Boris came on TV at 5pm for his speech.. now I think I drink more often (more days) than I would have done before, it’s mainly to separate the day from the night…but perhaps less in volume overall as is there is no nights out with friends work etc

  • NO safe amount at all? Once a week, once a month?

    I’ve never been someone to drink every day – mostly socially, on the weekends. Maybe three or four days in an average month. This is reduced with COVID since I don’t meet anyone anymore. Now I’m wondering if I should cut out even that minimal drinking to protect my brain?

    • All work and no play makes Jack a dull boy….You will e interested that there are papers showing that alcohol consumption has gone up in UK and US.

    • I enjoy wine too much and it improves the quality and enjoyment of a meal. My attitude is to wine and alcohol is similar to food and diet. It is important to understand the social aspects of alcohol consumption, which is why I couldn’t really imagine a life, in particular meals and feasts, without drinking wine again. My advice is to be mindful to why you are drinking; mindless/habitual drinking is to be avoided.

  • “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.”

    Once again, the focus is on the consequences of having a neurodegenerative disease / the collateral damage from having to see ones’s hopes and dreams diminish and not the disease itself. A therapy or cocktail of therapies which would allow a neuro to tell their MS patient that their disease has been halted / worsening disability would stop would have the greatest impact on helping MS patients reduce their level of anxiety, reduce their dependency on drugs and alcohol, increase their motivation to exercise and socialise…. Money spent on studies which conclude that MSers are more likely to drink more alcohol, take more drugs, experience more anxiety could be better spent ie on research into addressing smouldering MS.

  • I have been teetotal since my early twenties and never understood why people drink alcohol at all anyway, as it never had any effect on me other than dulling my senses. Now, with PPMS, that’s the last thing I need.

  • Could you please do a post on caffeine as well? I had a little coffee (unusual for me) recently, and my fatigue evaporated, I was practically bouncing off the ceiling. I felt so alert too.

  • Strikes somewhat close to home. I’m working on my masters and have been socially distancing since march last year.. I’m in my mid twenties and have had MS for three years. The combined effect on my mood of spending most hours of the day struggling with the dissertation and not getting to see people has certainly made drinking more regular. Sad to say i feel like it’s actually quite important for my life-quality right now: it’s something to look forward to. I do, however, closely monitor my habits and ”only” allow 2-3 beers on the wednesday and 4 on the saturday. Still though, I’ve certainly been worrying about the fact that this is not good for my MS.

  • Actually reduced my drinking. Partially because I started getting worse hang overs, partially because I don’t want to mix it with the muscle relaxants I now occasionally use…

  • Everyone describes themselves as moderate – in politics, socioeconomically and now in drinking habits. It seems most people like to be a part of the large cohort and not on the fringes. It probably is comforting to fit in with the general population. Personally in the early years of MS alcohol had a beneficial affect. I would feel less muscle spasticity after alcohol intake. But as I transitioned to progressive MS I noticed less benefit . Also, add on bladder issues and intake of alcohol has become < 1 per week.

  • I love wine and my partner’s studying wine as a hobby. Between March and July, we got into the habit of having a glass of wine on the balcony to mark the end of the work day, followed by wine with dinner and wine after dinner. By August, our clothes were tight, we knew anyway that we were drinking too much, and that life wasn’t going back to normal anytime soon. This coincided with discovering in August that I had my first new lesions since being diagnosed 7 years ago. Could be coincidence, or could be stress, less exercise and a less healthy lifestyle. In any case, it was a wake-up call and now I have 4 alcohol-free days a week. And I changed to Mavenclad.

By Prof G

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