Alcohol’s Harm to Others | Secondhand Drinking
Alcohol’s Harm to Others | Secondhand Drinking are two terms that identify the very real, health-harming, quality-of-life impacts that a person’s drinking has on others.
Secondhand Drinking is a term I coined in 2009 to raise awareness about the negative impacts a person’s drinking behaviors has on others. Drinking behaviors include: verbal, physical, emotional abuse; neglect; blackouts; unplanned/unwanted sex; breaking promises to stop or cut down; shaming, blaming, denying; unpredictable behaviors; and driving while impaired, to name a few.
Secondhand drinking directly affects an estimated 80 million Americans, including moms, dads, husbands, wives, children, brothers, sisters, grandparents, close friends, boyfriends, girlfriends. It indirectly affects tens of millions more, including co-workers, fellow-students, innocent bystanders – even the tax payers and citizens of a community. And this is just in America!
As such, it is likely most readers know someone or they are the someone who has personally experienced secondhand drinking. The tragedy is we hardly talk about the persons experiencing it.
Fortunately, that’s about to change, thanks to several recent studies being conducted around the world on Alcohol’s Harm to Others (AHTO), such as:
- One in New Zealand: “Recently researchers have started to focus on alcohol-related harms to people other than the drinker; described as the ‘collateral damage,’ ‘second-hand effects,’ or ‘negative externalities’ of drinking (Connor and Casswell 2012).”
- One in Australia: “…almost three-quarters of all adults in Australia were negatively affected over a one-year period by someone else’s drinking…. (Laslett et al 2010).”
- One in Five Indian States: “Approximately 83% of respondents reported at least one alcohol-related harm from having a heavy drinker in their lives across domains of physical, sexual, psychological, financial and social harm (Esser et al 2016).”
My hope is this AHTO research expands to incorporate the kinds of harm to others associated with toxic stress, which is the basis of my concept, secondhand drinking.
Secondhand Drinking and the Toxic Stress Connection
Toxic stress is caused by repeated activation of the brain’s fight-or-flight stress response system (FFSR), an instinctually wired system built into the human species that’s critical to survival. It is a system intended to kick into gear when a person is faced with physical danger. This was especially important back in caveman days when the primary danger humans faced was physical danger, as in, “Run or Fight,” but don’t just stand there!
Explaining the toxic stress connection to explain some of the impacts of Alcohol’s Harm to Others | Secondhand Drinking
The FFSR is designed to prepare the body to do just that, fight or run, or if necessary, freeze. And it’s a two-part system. One part is the activation — the part that gets the FFSR going fast and without thought. It’s called the Sympathetic Nervous System (SNS). The second part is the tamping down — returning to normal. This is called the Parasympathetic Nervous System (PNS).
In very GENERAL terms, it works as follows:
A cue, such as the danger-producing emotions, like fear, anxiety and anger, one experiences when coping with a loved one’s drinking behaviors, triggers the key stress hormones, adrenaline (epinephrine) and cortisol to activate the SNS. These stress hormones cause a number of things to happen to help us RUN or FIGHT.
They cause blood vessels to the skin to constrict to lessen blood loss if injured. They shut down the digestive system in order to conserve glucose needed for energy to run or fight. They cause muscles in the neck, shoulders and back to constrict. They dilate the bronchial tubes in the lungs in order to carry more oxygen to the muscles. And they increase heart rate to push blood flow to large muscles in order to react quickly, run fast, or come out fighting. It is truly astounding what the FFSR does in such a short period when triggered — often within mere milliseconds, which is how a person jumps out of the way of an oncoming car. This kind of stress is known as normal stress.
Today, however, a great deal of our stress is triggered by thoughts, emotions and memories of negative experiences — such as those associated with secondhand drinking — not by immediate physical danger. In other words, it might be anger at a spouse over the mean, horrible things they said when drinking or fear of how bad the fighting between parents over the drinking is going to be when a child gets home. Because we can have these stress-triggering emotions repeatedly throughout our day, a child/adult can repeatedly activate the FFSR.
There are two big problems with chronic activation of the FFSR if one does not have solid, self-soothing practices also mapped in their brains — practices they engage to stop the escalation of the SNS.
The first is that a child/adult rarely does the physical running or fighting these changes are meant to support. Instead, all of that “stuff,” like increased glucose, shutting down of the digestive system, increased heart rate, and high levels of stress hormones, “sits” and builds up in various body tissues until (or if) it is reabsorbed or used. In other words, it becomes toxic stress because the PNS never gets to fully do its part.
The Physical and Emotional Health Consequences of Toxic Stress Are Life Changing
How toxic stress – like that experienced with exposure to secondhand drinking – causes harm to the brain and body.
The physical health consequences of toxic stress are many. They include: upset stomach or other stomach problems (shutting down the digestive system over and over, it’s no wonder!), migraines/headaches/skin rashes/hair loss (constricting blood vessels to the skin over and over), racing heartbeat, back pain, muscle aches, sleep problems, changes in eating habits (causing obesity or weight loss), dizziness and the like.
The mental health consequences of toxic stress are equally troubling. These include: anxiety, depression, feelings of hopelessness or helplessness, difficulty concentrating or a desperate need to be in control.
The second big problem is that toxic stress changes a child/adult’s routine thoughts, feelings, and behaviors because of the way the brain creates brain maps of what it’s been “taught.” In this manner, the brain engages this FFSR when confronted with stress producing emotions, thoughts or memories, related and unrelated to the original cause, which in this example is secondhand drinking. This means that when a child/adult is confronted by anything that triggers their secondhand drinking toxic stress-related, danger-producing emotions, such as anger, fear, or anxiety, their embedded maps of secondhand drinking-related “reactionary” coping skills and behaviors kick in because the brain has mapped the reaction as critical to survival. Thus their brains/bodies are once again overrun by the FFSR. Examples of fight, flight, freeze reactionary coping skills, include:
- Yelling, crying, physically lashing out. This is especially true for children – they’re mad and don’t have an understanding, let alone words, to understand/explain why so they come out fighting – a natural outcome of activating the FFSR. (Fight)
- Shutting down emotionally when in conflict or facing an angry person. The person learned that not reacting or engaging or confronting an angry person – the source of their secondhand drinking, for example – kept them safe. (Freeze)
Living with a brain “governed” by its FFSR is no way to live. Thus, it’s important AHTO research include study of this secondhand drinking-toxic stress connection in order to improve the health and wellbeing of those harmed by a person’s drinking behaviors. Fortunately, we have a great success model to follow.
Secondhand Smoking Awareness and Prevention Model
The term, secondhand drinking, plays off the concept of secondhand smoking. Scientific research found that another person’s cigarette smoke could cause severe asthma attacks, respiratory infections, ear infections, heart disease, or lung cancer for those in the sphere of that person’s cigarette smoke. With this new research, the focus was not just on trying to get the smoker to quit for their health’s sake but also on how to help those exposed to secondhand smoking take care of their own health regardless of whether the smoker ever quit.
Similarly, new scientific research is helping us understand that coping with drinking behaviors and the fallout thereof causes toxic stress, and that toxic stress causes a number of physical and emotional health ailments, as well as quality of life consequences. Examples like those I shared above include: sleep difficulties, migraines, obesity, headaches, skin problems (psoriasis, rosacea, eczema, acne), hair loss, vertigo, distracted “thinking,” depression, anxiety, memory impairment, and heart disease.
With these new scientific understandings, we can now follow the successful secondhand smoking awareness and prevention model. We can take the focus off just trying to get the drinker to quit for their health’s sake and move towards helping those coping with drinking behaviors – secondhand drinking – take care of their own health and well-being, regardless of whether the drinker ever stops or cuts down.
For an example of how following this model might work, check out my post, “Alcohol Abuse Going on in the Family? If Only My Doctor Had Asked.”
Alcohol’s Harm to Others | Secondhand Drinking Research – It’s Time
Regardless of the term — Alcohol’s Harm to Others or Secondhand Drinking — it’s time for wide-ranging scientific study on the health ramifications of secondhand drinking | alcohol’s harm to others related toxic stress. When we heal and strengthen the person on the receiving end of drinking behaviors by helping them get the information, education, and much-needed toxic stress treatment and recovery options they need, we can change their lives. When we change their lives, we empower them to stand up to secondhand drinking in productive ways, which in turn reduces the number of people who drink too much — similar to the way secondhand smoking prevention programs reduced the number of cigarette smokers, overall.
It’s time.
Research On Alcohol’s Harm to Others
The following is a sampling of new and/or ongoing research on alcohol’s harm to others (AHTO) — none of which ties with the toxic stress – secondhand drinking connection I outlined above. That is a level of research study that will require much study in how to even conduct/construct the study. Nonetheless, what I’m sharing here points to a very real, very significant emerging awareness of the importance of studying alcohol’s harm to others because of the depth and breadth of its impacts on families, workplaces, schools, and communities.
- Connor J., & Casswell, S. “Alcohol-related harm to to others in New Zealand: evidence of the burden and gaps in knowledge,” August 24, 2012, The New Zealand Medical Journal, Volume 125, Number 1360, https://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2012/vol-125-no-1360/article-connor (accessed 7/28/18).
- “Harms to Adults from Others’ Heavy Drinking in Five Indian States,” Alcohol and Alcoholism, Volume 51, Issue 2, 1 March 2016, Pages 177–185, https://doi.org/10.1093/alcalc/agv078 (accessed 7/28/18).
- Greenfield, T. and Karriker-Jafee, K., “Alcohol’s Harms to Others among US Adults: Individual and Contextual Effects,” Pacific Health Institute, Oakland, CA, 2014-2018. http://grantome.com/grant/NIH/R01-AA022791-01 (accessed 7/30/18).
- Kaplan, L., Nayak, M., Greenfield, T., & Karriker-Jaffe, K. “Alcohol’s Harm to Children: Findings from the 2015 United States National Alcohol’s Harm to Others Survey, Journal of Pediatrics, Volume 184, pages 186-192, May 2017 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5403548/ (accessed 7/28/18).
- Karriker-Jaffe, K., Room, R., Giesbrecht, N., & Greenfield, T., “Alcohol’s Harm to Others: Opportunities and Challenges in a Public Health Framework,” Journal of Studies on Alcohol and Drugs, 79(2), 239-243, (2018) https://www.jsad.com/doi/pdf/10.15288/jsad.2018.79.239 (accessed 7/28/18).
- Laslett, A., Catalano, P., Chikritzhs, T., Dale, C., Doran, C., Ferris, J., Jainullabudeen, T. , Livingston, M., Matthews, S., Mugavin, J., Room R., Schlotterlein, M. & Wilkinson, C. “The Range and Magnitude of Alcohol’s Harm to Others,” Alcohol Education and Rehabilitation Foundation, 2010 http://fare.org.au/wp-content/uploads/The-Range-and-Magnitude-of-Alcohols-Harm-to-Others.pdf (accessed 7/31/18).
Lisa Frederiksen
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