Former pop star Jessica Simpson’s new memoir tells us why she stopped certain habits — ones we never knew she started — because she “hit rock bottom.”
She was lucky: Her rock bottom didn’t kill her. That same hard place is taking others’ lives.
In 2017, alcohol proved more deadly than illicit drugs, including opioids, according to a study from the National Institute on Alcohol Abuse and Alcoholism. Alcohol-related deaths had doubled between 1999 and 2017. Little wonder: Alcohol-related problems have increased dramatically in the last two decades across most U.S. population subgroups, including women, middle-aged and older adults, racial and ethnic minorities and the socioeconomically disadvantaged.
Each year, 88,000 Americans die from alcohol-related causes, making alcohol the third leading preventable cause of death in the United States, behind tobacco and poor diet/physical inactivity.
The number of deaths from alcohol is rising despite our improving understanding and acceptance of addiction. We know more about alcohol screening and treatment than ever before, but only 20 percent of those in need receive any form of treatment, and fewer than 10 percent get prescribed medications.
I think the reason for this is that they are waiting for a rock bottom. It provides another reason for people to delay treatment if they feel they haven’t hit that low. So many at-risk drinkers could use help and won’t get it because they haven’t yet crashed. It would be hard to imagine a scenario in which insulin is withheld until a diabetic’s vision loss is imminent, or anti-hypertensives denied until several strokes occurred.
As a clinician, my message to patients, families, friends and fellow clinicians is a simple one: Waiting kills. Alcohol is the most common problem encountered by primary care providers, yet the one they are least able to manage before their patients hit a crisis point.
The rock bottom myth convinces drinkers that they must become a form of irredeemable to get help. Suggesting that the only way to get better is to get worse doesn’t make sense in many ways. Moreover, a message tinged with that hopelessness has a lasting effect on our collective psyches.
The bottom made of rock doesn’t exist, at least not in an objective sense. “Rock bottom” is subjective to the individual. For some, the consequence may be financial — such as losing a job or recklessly spending. For others it’s an injury, perhaps after an accident caused by impaired driving. Jessica Simpson identified her rock bottom moment as being unable to dress her children on Halloween.
Let’s forget the bottom and take it from the top. Some may be surprised to discover that the prognosis for those who struggle with drinking is encouraging. No single treatment fits everyone, but research shows no matter how severe the problem, most people with an alcohol use disorder can benefit from some form of treatment. Non-habit-forming medications, therapies and mutual-help groups help offset changes in the brain caused by alcohol.
One-third of those treated for alcohol problems have no further symptoms one year later. Others substantially reduce drinking and alcohol-related problems. Treatment works without an all-but-unrecoverable crisis. As with many conditions in medicine and in life, events can best motivate us to change. And that change can happen at any time.
Gail Basch is an associate professor at Rush University Medical Center’s Department of Psychiatry and Behavioral Sciences in Chicago. This column was originally published by the Chicago Tribune.