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Pandemic drinking is on the rise. Here's how to set healthy limits

Research shows that Americans are drinking more during the pandemic. Here's why that's troubling — and what experts suggest to avoid overdoing it.

Have you found yourself drinking more during the pandemic? If the answer is "Cheers!," you're not alone. Adults across the country reported imbibing 14% more often in spring 2020 than the same time the previous year, according to a report in JAMA Network Open that focused on a survey of more than 1,500 people.

This is no surprise, considering that when hand sanitizer and toilet paper were flying off the shelves in last year, so too was alcohol. As more people began sheltering in their homes to help curb the spread of COVID-19, retail alcohol sales in the U.S. started to rise along with sales of cleaning products, TP, and food, showing just how important our drinking rituals are even (and maybe especially) in a crisis.

But even before the pandemic started, alcohol-related deaths were already on the rise in the U.S., according to a report by the Centers for Disease Control and Prevention, which found that from 2006 to 2018, deaths from alcohol use increased by 43%. Researchers noted that though the rates each year were higher for men than women, the increases in the rates among women were more dramatic, especially for those living in rural areas. The National Institute on Alcohol Abuse and Alcoholism estimates that more than 88,000 people die from alcohol-related causes annually.

Vicky Nguyen, NBC News consumer and investigative reporter, spoke to Kelly White, a mother of three whose office job was put on pause in March 2020. As a way to pass the time, she started drinking more than usual. White estimates that her alcohol intake doubled or tripled on some days. By July, unable to drink and suffering from nausea, she ended up in the hospital. Doctors told her she had alcohol-associated hepatitis and that her liver was scarred and dangerously swollen. “They just said, if you have one drink, you'll die," White explained.

Dr. Haripriya Maddur, a hepatologist and assistant professor at Northwestern University's Feinberg School of Medicine told TODAY that women in particular are at risk right now. "They're developing much, much more liver disease at younger ages. And so it's really, really frightening. It's actually alarming as a hepatologist.”

The problem with alcohol and catastrophic events

Wendy McClary, a licensed marriage and family therapist, said that the rise in alcohol consumption is something to watch very carefully.

It can be tempting to self-medicate with alcohol. “In small quantities,” said McClary, “alcohol can help reduce anxiety, but it’s mainly a depressant.” With the threat of the deadly coronavirus and all the havoc it’s wreaking, people have felt anxious. Their typical routines have also been disrupted. This, she said, can create a scenario where the usual rules no longer apply.

Under normal circumstances, explained McClary, “most adults who drink are able to do so within responsible limits.” But studies show that catastrophic events can trigger increased substance use. “In the aftermath of 9/11,” she explained, “there was significantly increased use of alcohol, marijuana and cigarettes among New York City residents. In particular, there was a major increase of use in individuals — such as social drinkers — who’d used the substances previously.”

Excessive drinking can also weaken your immune response, which can increase your risk for respiratory illnesses and other conditions, says Samantha Cassetty, a New York City-based registered dietitian. “Many people are surprised to learn that heavy drinking is considered eight drinks per week for women and 15 drinks for men.”

Too much alcohol can lead to feelings of depression, anger, hopelessness and powerlessness — and domestic violence, which McClary said is a real concern at a time when many families are cooped up together under stressful circumstances.

And in cases like White's, excessive alcohol consumption can have grave physical effects. “You could have problems with thinking, you could have problems with being more susceptible to bleeding and developing fluid around your belly and around your legs. And then other organs are at risk of shutting down,” Maddur cautioned.

How to keep drinking in check

“As long as you’re healthy,” explained Cassetty, “it’s OK to have a drink a day for women or two for men.” TODAY asked Maddur to break down what one drink really looks like: "So no more than 5 ounces of wine, and no more than an ounce and a half of hard liquor. That’s also equivalent to 12 ounces of beer." Here are five ways to enjoy the occasional tipple — without overdoing it.

1. Set limits on how much you’re drinking

The serving size for a glass of wine is 5 ounces, says Cassetty. But if you’re using a large wine glass, you could be pouring much more than that. “So even if you’re sticking with one glass,” she says, “you might be having nearly two drinks.”

2. Limit sugary cocktails

“We’ve seen that people with underlying conditions, like heart disease and diabetes, are at greater risk for serious illness from COVID-19,” said Cassetty. “Excess added sugar in the diet has been linked with these conditions, along with other things, like inadequate sleep, which also impacts your immune functioning.” Keep it simple and opt for a spritz over cocktails made with sugary mixers or simple syrups.

3. Consider low- or no-alcohol drinks

Add lower ABV wines (12% or 13% max), spritzes and spirit-free cocktails into your drinks rotation. If you’re having trouble maintaining alcohol limits, said Cassetty, it may help to avoid activities that involve drinking (including mocktails, which mimic drinking), and focus on self-care strategies, like meditation or a hobby, instead.

4. Be careful about relaxing your own rules

“Increased use tends to begin with relaxing the typical ‘rules’ around alcohol,” said McClary. “The challenge is to be mindful of what the usual rules would’ve been, and to try to stick with them.” If you typically have a glass of wine with dinner, it makes sense to stick with that — don’t go for a second glass. Similarly, she says, “if you never would’ve previously considered drinking before 5 p.m., don't start now.”

5. Adjust your focus

Even if the cocktail you made is a masterpiece, the real focus of the evening, said McClary, should be on the people who are there with you and the personal connections you’re making. There are many downsides to the way the pandemic is affecting our lives. One upside, she says, is more time to reconnect with family and friends, whether remotely or in person. “We’ll all benefit from connecting with others.”

Kelly White hasn't had a drink since July — and now she's encouraging people to seek help if they have a problem. “I am proud of myself. I'm sober and I'm recovering … I really just enjoy life a lot more now,” she said.

If you’re struggling to cope with stress or worried about how much you're drinking, reach out to your doctor or a licensed therapist. Therapy can be a valuable tool for managing pandemic-related stress, but just as importantly, said Cassetty, “it’ll help you down the line, too.”