Dr. Sarah Wakeman
speaker
484 appearances
2 recordings
2 series
first heard Jan 2025
last heard May 2025
Dr. Sarah Wakeman’s voice in public audio — every appearance, attributed to the second.
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My opinion is that we shouldn't be thinking of it as a health benefit. So I would never, as a doctor, say to a patient, I think you should start drinking a glass of wine a day for your health. We used to people used to say that, you know, again, this idea of a glass of red wine is healthy. I think that framing is wrong.
I think that doesn't mean that you can't drink any alcohol and we should talk through that. But thinking of it as a health promoting behavior is probably not the best way to frame it. Now, there are many things we do in life that the safest thing would be to do none of it.
So if your goal is to have zero risk, you should probably never drive your car, never go skiing, never fly in an airplane, never eat bacon, never go out in the sun. And people aren't going to live that way. So I think it's really important to understand what are the risks? How does this fit into my overall life? And when should I be concerned?
And how can I actually make changes to decrease those risks? So if you're finding that you are really stressed in your life and you're reaching alcohol as a stress reliever, it's probably not going to be a healthy way of coping with that and may lead to longer term problems.
And especially if you're trying to live a life where you're being more mindful or more present or present for your kids or your partner or you're trying to get in shape and you want to wake up in the morning to exercise. If you're drinking every night, you're probably going to feel not refreshed in the morning. You're going to notice that you don't have the same exercise capacity.
So I think just figuring out sort of how this ritual, alcohol, what role it plays in your life. And it doesn't have to be that you stop drinking entirely. And I think that's a really important message because that may not be the goal for people.
But if you are feeling like maybe this is causing some problems to me, maybe this is actually counterproductive to my other health goals, making some changes, cutting back, taking a break. Those are all really healthy ways that you can start to really explore your relationship with alcohol.
Yeah. So from a research standpoint, high risk drinking would be if you're having more than 10 ounces of hard alcohol a week or 35 ounces of wine in a week for a woman or for anyone over 65. So above that, we start seeing health risks like increased risk of dementia, impact on your liver, your digestive tract and other serious conditions.
Yeah, and I think there's so many important points buried in that. So first, we all lie. I tell my dentist I floss every day. I don't. We want people to like us and approve of us. So I sort of expect people will lie to me, especially if they don't know me. And for most people, because of the tremendous stigma around substance use disorder, there's a lot of shame and worry.
For many people, their experience has not been that good things happen to them when they share that they're having a problem with alcohol or other drugs. And so as a doctor, I feel like it's on me to earn someone's trust and also to educate them.
I mean, there's nothing more heartbreaking to me than when I see someone in the terminal stages of liver failure, for example, from alcohol, and no one has told them beforehand what the risks are, that this could happen, what sort of lower risk drinking looks like.
they've often never had that conversation so we'll see people in their 30s come in they literally die during that hospital admission and you look back and they had touch points with doctors they maybe were drinking heavily and no one stopped to sort of talk to them about it and i think that is a real testament to how in the medical system for so long we have seen substance use and addiction as something separate from the rest of health care is sort of not our job or a behavioral issue or a moral issue or a willpower issue
But this is a health condition like any other. And I think the medical system and doctors need to get comfortable talking to patients about it, asking them the right questions, giving them the right education and partnering with people around making healthy changes.
that you would say these are all indications that this could be a problem yeah that's a great question so i'll run through kind of the checklist that i'm thinking when i'm talking to someone about alcohol so first um you know understanding how much they're drinking just the general quantity and how frequently is important as sort of a proxy for what their risk might be but then the really important questions are um are they drinking more than they want to so are they
They may have set an intention for themselves and they're finding they're actually always drinking more or spending more time on drinking or recovering from drinking than they intended. Have they tried to make changes and not been able to? So if you tried to cut back or tried to stop and you actually weren't able to, that's a really important sign that you may have lost control of your drinking.
Are you drinking despite the fact that people in your life are worried about it or your spouse has expressed concern or it's impacting your work or your ability to function in roles that matter to you? Are you drinking despite the fact that it actually makes you more anxious or it's worsening your mental or physical health in some way? And then we often think about
craving, which is sort of a strong psychological urge to want to drink. So like you can't get the idea of having a drink out of your mind. That's something that we can see with alcohol use disorder. And then there are two physical symptoms, which is that idea of like, do you need to drink more to get the same effects?
Do you need to drink four drinks now, whereas before one or two would give you that effect? And do you feel sick if you stop drinking? So that's sort of the checklist we run through and I think really gets at those kind of general areas of losing control, using compulsively, using despite consequences and then craving.
Yeah, it's a great question. So one really common thing is worsened acid reflux. So if you have heartburn, that's strongly associated with alcohol, which actually relaxes the part of your esophagus that allows acid to come back up. So oftentimes people who are struggling with terrible heartburn and they don't realize that those two glasses of wine are probably having a direct impact on that.
Other things we know that alcohol can make you dehydrated. So you may notice that your skin changes. It impacts how you sleep. So you may feel less rested when you wake up in the morning or wake up in the middle of the night and not be able to fall back asleep. So lots of little sort of day-to-day ways that alcohol may be impacting your health and your experience.
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