by Abel Pharmboy, ScienceBlogs

I don't know if Kim Severson of the New York Times knew this when writing her thought-provoking article earlier this week ["Mixing Drinks With Work and Staying Sober, Too"], but it coincided with the annual meetings of the Research Society on Alcoholism (RSA) and the College of Problems on Drug Dependence (CPDD).

 (btw, this timing is annoying for researchers who work in the general area of substance abuse who would normally like to go to both meetings. DrugMonkey has pointed out that the pending merger of NIH's NIDA and NIAAA, a logical step, has not been met with enthusiasm by RSA, further reflective of the rift in the substance abuse research community).

But I digress.

My point of bringing up Severson's article is a question that interests me given the context of The Friday Fermentable; namely, what happens if you have a career in the alcoholic beverage industry but become an alcoholic or alcohol abuser?

    Leaders in the hospitality industry have long acknowledged that alcohol and drug abuse are dangerous byproducts of a stressful business with ready access to both. Food service workers have the highest rate of illicit drug use and the third-highest rate of heavy alcohol use among major occupations, according to the latest data from the United States Department of Health and Human Services. (Construction workers and miners drink the most, and installation and maintenance workers are second.)

According to the results of the National Institute on Alcohol Abuse and Alcoholism's (NIAAA) 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) where over 43,000 Americans are queried every ten years, an average of 4.65% of the US population (or about 10 million citizens) met the DSM-IV criteria for alcohol abuse or alcoholism over the preceding 12 months.

The breakdown by sex, age, and ethnicity as well as trends between 1991-1992 and 2001-2002 can be found in tables at the NIAAA website but the complete, peer-reviewed publication is BF Grant et al., Drug Alcohol Depend 2004; 11:223. Lifetime alcoholism prevalence among the general population of Western countries runs at about one in six individuals.

One of the main tenets of any alcohol treatment program is to avoid people, places, or situations where alcohol might be available or provide cues that otherwise trigger alcohol use.

But what if you have invested in a career as a wine merchant, bartender, or high-level hospitality manager and are diagnosed with alcoholism?

And what if, as Severson reports, you are a recovering alcoholic with seven years of sobriety and about to graduate from the Culinary Institute of America but face an intensive, three-week wine course?

And, if already in the industry, does one jeopardize one's job by not drinking?

    Some restaurant owners say they have no problem making room for employees who don't drink (although no one suggested that a sober sommelier would be a great hire). Chefs can ask other cooks to taste dishes with alcohol, bartenders can follow formulas and waiters can gather pairing suggestions from knowledgeable colleagues.

    "Service is so much about reading other people and verbal skills and eye-hand coordination," Ms. Gand said. "We have waiters who are allergic to chocolate and they can still serve chocolate desserts. And certainly, when Beethoven went deaf he could still write music."

    But a stigma exists. Bartenders, waiters and wine experts who are in Alcoholics Anonymous contacted for this story wouldn't talk publicly -- not only because the organization's traditions suggest they don't reveal their membership to the media but also because they don't want to jeopardize their livelihoods.

Nevertheless, several individuals agreed to share their stories and this is the best part of this report. In the article, Severson interviews several people who have been successful at maintaining both their jobs and their sobriety including a New York City bartender, former private chef Liz Scott and author of Zero-Proof Cocktails, and British celebrity chef Michael Quinn whose Ark Foundation helps other chefs and restaurant workers with alcohol issues.

(one tangent: when pulling up Liz Scott's book, I cam across Preggatinis: Mixology for the Mom-to-be and Margarita Mama: Mocktails for Moms-to-Be.)

While these stories are encouraging, my gut feeling is that they are exceptions to the rule. For example, well-known British wine writer, Alice King, wrote the book High Sobriety: Confessions of a Drinker based upon her early rise to writing success and subsequent descent into the vortex of alcoholism.

King's February 2008 article in the Daily Mail is sobering - literally - and details how the need for drinking for a living catalyzed the deterioration of her life.

In any case, kudos to Kim Severson in writing a very interesting article for Friday Fermentable fodder.

An aside: alcohol and substance abuse in academia

The concept of availability in substance abuse prevalence is relevant in the context of health professionals. By far, the most-studied groups are physicians and other health care professionals who are subjected to board licensure (pharmacists, nurses, dentists).

For example, while physicians as a group exhibit a lower prevalence of alcoholism than the US average, their abuse of other substances runs at least twice that of the national average, depending on the study (source).

Interesting to me is that I cannot find a single paper that addresses alcoholism or abuse of other substances amongst biomedical researchers or, more broadly, university professors (Although readers will remember the hotly-discussed 2008 Nature survey on use of cognitive enhancers by profs.).

While most of us do not have unusual access to substances to abuse, one need only go to a scientific or educational conference to obtain anecdotal evidence of alcohol abuse amongst our peers. As many of us in cancer research have been driven to the career by family experiences with cancer, I, for one, would love to know the prevalence among substance abuse researchers of personal or familial substance abuse.

But is the prevalence really greater than that of the national average? Is our stress level close to that of a laid-off automobile worker. I don't know.

What do you think? Am I missing any relevant literature?

See original for links: ScienceBlogs

Image: bartender Del Pedro carefully tasting a drink, from article Mixing Drinks With Work and Staying Sober, Too. (NY Times)