When do coping strategies become harmful for veterinary care providers?

We’ve all been there. Nearing the end of a horrible shift with not an ounce of energy left; all we can think about is getting home to our couch, favourite TV show, and large glass (or bottle) of wine. And if you don’t drink alcohol, I would venture to guess that you have heard someone else you work with say “you deserve a glass of wine after this” or “I need a glass of wine after that”. 

I’m not here to tell you that drinking wine is a bad thing or that a person should never unwind after a difficult day with some sort of alcoholic beverage. However, I’m going to remind you that drinking alcohol is a coping strategy, not a form of self-care. 

You’ve probably heard me harp on this before, but it’s so important that I’ll do it again. Coping strategies are reactive, short-term ways of dealing with stress, and most of the ones we choose are not health-promoting (case in point, wine). 

Conversely, self-care strategies are proactive, long-term means of building up our reserves so we can deal with stress productively when it arises. To do this, self-care strategies must be health-promoting, even though they might not always be fun or easy (think having an appointment with your therapist). 

So often I’m seeing colleagues, team members, and friends use alcohol to cope with the long and stressful shifts we are all currently experiencing in veterinary medicine. So much so that some have confided in me that they don’t know if their alcohol intake is a problem. 

How does a person know if their alcohol intake is appropriate?

Alcohol is one of the most widely used substances, but it can be difficult to determine how much is “too much”. 

Experts say that substance use disorder occurs when a person continues to use substances (e.g., alcohol, nicotine, prescription or OTC drugs, caffeine, or illicit drugs) despite negative consequences. Those consequences might include failing to meet obligations at work or at home, using substances in situations where it is physically hazardous, or facing substance-related legal problems.

However, people can experience “problem drinking” before they progress to demonstrating signs of a substance use disorder. An alcohol screening test known as CAGE, asks four questions to assess alcohol use: 

1. “Have you ever felt you should cut down on your drinking?”
2. “Have people annoyed you by criticizing your drinking?”
3. “Have you ever felt bad or guilty about your drinking?”
4. “Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?”

Answering yes to two or more of these questions is an indicator of problem drinking. 

What is the incidence of high-risk alcohol consumption among veterinarians? 

One of the few studies investigating alcohol use by veterinarians surveyed 1,060 European veterinarians more than 10 years ago. High risk alcohol consumption was considered > 10 g of alcohol per day for women and > 20 g of alcohol per day for men. To put this into perspective, 10 g of alcohol is equivalent to 10 oz (1 can) of beer, 3 oz (90 mL) of wine, or 1 oz (30 mL) of spirits. Binge-drinking was considered consumption of 5 or more alcoholic beverages drank during a single occasion. 

The study revealed that nearly one-third of veterinarians engaged in high-risk alcohol consumption, which was more common among women compared to men, and practice owners compared to practice employees. Additionally, 22% of veterinarians engaged in binge-drinking at least once during the previous 30 days, which was more common among men compared to women, and those with psychological distress compared to those without. Overall, alcohol consumption among veterinarians exceeded that of the general population. 

What is considered moderate drinking for adults?

Each country’s recommendations differ slightly, but the Centers for Disease Control and Prevention advise to choose not to drink, or to drink in moderation (≤ 2 drinks per day for men, ≤ 1 drink per day for women), and avoid heavy drinking (≥ 15 drinks per week for men, ≥ 8 drinks per week for women), or binge drinking (≥ 5 drinks during a single occasion for men, ≥ 4 drinks during a single occasion for women). 

Another helpful guideline to follow is to not consume alcohol at least 1 (if not 2) days during the week. Some jurisdictions have promoted this guideline to curb excess alcohol intake during stressful times (e.g., pandemic lock down). 

Whatever you decide, try to be intentional when it comes to your daily and weekly alcohol intake. Know that people who drink excessively do not necessarily have a substance use disorder, but the tendency can lead to short- and long-term health risks. Also remember that while opening that bottle of wine may feel good in the moment, it is a short-term coping strategy, not a form of self-care.