According to an article in the journal JAMA Network Open, American adults report they are drinking 14% more often during the COVID-19 pandemic. While the research didn't determine why drinking frequency has increased, health experts worry that people are turning to alcohol to cope with the stress, anxiety, and isolation caused by the pandemic.

On the Mayo Clinic Q&A podcast, Dr. Victor Karpyak, a Mayo Clinic psychiatrist and addiction researcher, discusses alcohol use and the warning signs that drinking may be a problem.

Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date.  

For more information and all your COVID-19 coverage, go to the Mayo Clinic News Network and mayoclinic.org.

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Dr. Victor Karpyak, a Mayo Clinic psychiatrist and addiction researcher, says using alcohol to celebrate or relieve stress is an age-old human trait, but overusing alcohol as a coping mechanism during these difficult times has consequences. 

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (0:59) is in the downloads at the end of this post.  Please courtesy "Victor Karpyak, M.D./ Psychiatry/ Mayo Clinic." Read the script.

If you are closing your computer at the end of a work day and reaching for the liquor cabinet, chances are you're not alone.

How much is too much though?

Current recommendations are no more than 14 drinks per week and no more than four drinks per occasion for men, and, for women, no more than seven drinks per week and no more than three drinks per occasion.

"If it becomes three or four drinks today and it is again three or four drinks tomorrow, then very easily we start to hit above the weeklong threshold, and this is what needs to be an alarming sign," says Dr. Karpyak.

An escalating pattern of drinking may be a potential sign of alcohol abuse and development of addiction, which affects relationships as well as the body.

"There is no organ or system which is not impacted by chronic and significant alcohol use."

Alcohol-related liver disease is perhaps the most familiar problem, along with acute and chronic pancreatic disease and heart-related damage.

"And, as a psychiatrist, I can tell you that there is a lot of negative impact that long-term significant alcohol use has on brain tissue."

Next time you want to reach for a cold one, consider reaching out to a friend to help ease the stress of the day.

Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date. 

Check the CDC website for additional updates on COVID-19. For more information and all your COVID-19 coverage, go to the Mayo Clinic News Network and mayoclinic.org.

The post Mayo Clinic Minute: How COVID-19 has changed alcohol use appeared first on Mayo Clinic News Network.

On the Mayo Clinic Radio podcast, Dr. Christopher Aakre, an internal medicine specialist in Mayo Clinic's Fibromyalgia and Chronic Fatigue Clinic, discusses diagnosing and managing fibromyalgia. Also on the podcast, Dr. Andrew Bentall, a Mayo Clinic nephrologist, explains what can be done to help sensitized transplant patients who can be difficult to match with organ donors. And Dr. Victor Karpyak, a Mayo Clinic psychiatrist, shares research on how your genetics can affect your response to treatment for alcohol use disorder. This research is funded by the National Institute on Alcohol Abuse and Alcoholism.

The post #MayoClinicRadio podcast: 3/23/19 appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Dr. Christopher Aakre, an internal medicine specialist in Mayo Clinic's Fibromyalgia and Chronic Fatigue Clinic, will discuss diagnosing and managing fibromyalgia. Also on the program, Dr. Andrew Bentall, a Mayo Clinic nephrologist, will explain what can be done to help sensitized transplant patients who can be difficult to match with organ donors. And Dr. Victor Karpyak, a Mayo Clinic psychiatrist, will share research on how your genetics can affect your response to treatment for alcohol use disorder.

Here's your Mayo Clinic Radio podcast.

The post Fibromyalgia / sensitized transplant patients / genetics and treatment for alcohol use disorder: Mayo Clinic Radio appeared first on Mayo Clinic News Network.

The post Mayo Clinic Radio: Fibromyalgia appeared first on Mayo Clinic News Network.

Fibromyalgia is a disorder that causes pain all over the body, sleep problems, fatigue, and often emotional and mental distress. Fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals, meaning people with fibromyalgia are more sensitive to pain than those without the disorder. According to the Centers for Disease Control and Prevention, fibromyalgia affects around 4 million U.S. adults, or about 2 percent of the adult population.

On the next Mayo Clinic Radio program, Dr. Christopher Aakre, an internal medicine specialist in Mayo Clinic's Fibromyalgia and Chronic Fatigue Clinic, will discuss diagnosing and managing fibromyalgia. Also on the program, Dr. Andrew Bentall, a Mayo Clinic nephrologist, will explain what can be done to help sensitized transplant patients who can be difficult to match with organ donors. And Dr. Victor Karpyak, a Mayo Clinic psychiatrist, will share research on how your genetics can affect your response to treatment for alcohol use disorder.

The post Mayo Clinic Radio: Fibromyalgia / sensitized transplant patients / genetics and treatment for alcohol use disorder appeared first on Mayo Clinic News Network.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video pkg (0:59) is in the downloads at the end of the post.
Please ‘Courtesy: Mayo Clinic News Network.’ Read the script.

Roughly 3 in 10 Americans meet the criteria to be diagnosed with alcohol use disorder. And many of those people are related to others with similar problems.

"We know that people who have alcohol use disorder tend to have relatives with alcohol use disorder or relatives who are suffering from other substance use disorders," says Dr. Victor Karpyak, who oversees Addiction Services at Mayo Clinic.

Dr. Karpyak says about half of those with alcohol use disorder inherit it because of their genetics. But genetic markers also may help improve treatment of alcohol use disorder.

In addition to behavior modification, many people are able to overcome their alcohol use disorder with one of three approved drugs. Dr. Karpyak says new research in genetic factors is helping pinpoint which of those drugs each patient is most likely to respond well to.

"I'm trying to find the right tools, which will meet the need of the particular patient, and we work with together with the patient," Dr. Karpyak says. "And [we] give the patient a lead to guide us and show us which of the selected approaches are actually helpful."

So while there may never be a magic bullet to cure alcoholism, Dr. Karpyak says genetic research is making it easier for health care providers to give the most effective treatment possible to each patient.

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research is bringing together knowledge of psychiatry, genetics, metabolomics, pharmacogenomics and artificial intelligence to seek biological markers associated with alcohol use disorder and treatment response. Finding the molecular drivers of alcohol use disorder commonly known as alcoholism, could help predict who is most likely to develop this disorder and who might respond to medications approved for treatment. It might also reveal insights into new medications when standard drugs don’t work and could guide health care providers to precise treatments.

“Alcohol use disorder is one of the most prominent mental health problems in the world, second only to depression in terms of burden of disease,” says Victor Karpyak, M.D., Ph.D., a Mayo Clinic psychiatrist, co-principal investigator and leader of the integrated study team. “Only about 10 percent of those with alcohol use disorder seek therapeutic help. We believe that’s because people don’t expect medications to be efficient and helpful in treatment, which is unfortunate and factually incorrect.”

The Food and Drug Administration has approved three medications for treatment of alcohol use disorder. However, they don’t work for everyone. There are no known biomarkers that reliably predict which patients would be good candidates for these therapies.

“Tragically, there are some people who have biological characteristics which make them more susceptible to  alcoholism. What we’d like to do is better understand the genetic and molecular underpinnings of this susceptibility, so we can understand drug response and take an individualized approach to helping these patients overcome alcohol use disorder,” says Richard Weinshilboum, M.D., one of the researchers involved in this project and co-director of the Mayo Clinic Center for Individualized Medicine Pharmacogenomics program.

In a team science approach, Mayo Clinic will launch a coordinated study in conjunction with and funded by two National Institute on Alcohol Abuse and Alcoholism grants. The study will focus on the search for genetic markers of response to the drug acamprosate, which has been shown to help alcoholics stay sober.

“For some of our patients, the medicine known as acamprosate is a remarkably effective supplement to the clinical therapy and peer support, helping to curb cravings during and after treatment,” says Marvin D. Seppala, M.D., chief medical officer of the Hazelden Betty Ford Foundation, which is collaborating on the study. “Unfortunately, we have no idea who it will work for and who it won’t, so we just provide it to patients and hope that it helps.”

The five-year study expands previous pharmacogenetic research completed by the Mayo Clinic Department of Psychiatry by scanning the entire genome and metabolome in search for biological markers — clues to disease cause and treatment.

“Knowledge of the biology of alcohol use disorder and response to medication may allow us to zero down on meaningful molecular targets and see how we can intervene with genetic manipulations or new medications to reduce a person’s vulnerability to this disease,” says Dr. Karpyak.

Applying pharmacogenetics for an individualized treatment approach on a large scale

Researchers will follow 800 people receiving care for alcohol use disorder through Mayo Clinic affiliates as well as at the Hazelden Betty Ford Ford Foundation’s residential treatment facility in Center City, Minnesota. Study participants will have genetic testing to identify variants to help predict their response to the use of acamprosate or placebo.

The study will then combine pharmacogenomics — how the body processes and responds to medication — and metabolomics — small molecules known as metabolites that interact in the body — to try to better understand why the drug works for some but not others.

“We will look at the metabolites in their blood and bring together metabolomics with genomics. We hope that using the drug as a molecular probe will help us determine if there are different genes that might affect how each individual responds to anti-alcohol therapy,” says Dr. Weinshilboum, co-principal investigator of this study. “When we have used this approach before for psychiatric diseases like depression, we identified genes that we had never heard of before that appeared to be related to drug response, and then we used artificial intelligence and machine learning techniques to incorporate that information into a predictive algorithm.”

Researchers hope that if they find new genes linked to alcoholism treatment response, they might be able to identify new therapies compatible with a patient’s genetic fingerprint. That’s important in part because alcohol use disorder is linked to a number of other mental health conditions as well as conditions such as fetal alcohol spectrum disorders, hypertension, cardiovascular diseases, type 2 diabetes and liver cirrhosis.

This study  reflects many years of collaborative work and support between the Mayo Clinic Department of Psychiatry and Psychology, the Mayo Clinic Center for Individualized Medicine Pharmacogenomics Program, and the Samuel C. Johnson Genomics of Addiction Program.

Beside Dr. Karpyak and Dr. Weinshilboum, the study team includes:
Joanna Biernacka, Ph.D., co-principal investigator
Doo-Sup Choi, Ph.D., co-principal investigator
Mark Frye, M.D. chair, Mayo Clinic Department of Psychiatry and Psychology

The research team would like to give special recognition to the late David Mrazek, M.D., upon whose pioneering work this study builds.

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