Reimagining Your Relationship with Alcohol: How Newport Mental Health Can Assist

The Impact of Alcohol on Chronic Health Conditions

Did you know that six in 10 Americans have at least one chronic disease, and four in 10 have two or more? For those living with chronic conditions, every decision can significantly affect their health and well-being. One such decision is the use of alcohol, which can potentially worsen existing health issues, especially for individuals taking medication.

Alcohol use can lead to serious physiological effects, including elevated blood pressure, disrupted blood glucose regulation, weakened cardiac function, and a compromised immune system. Additionally, it poses several risks:

• Increased Falls: Alcohol impairs balance and coordination, increasing the likelihood of falls and fractures.
• Cognitive Impairment: It can worsen memory problems and interfere with medications that affect mental alertness.
• Interactions with Medications: Alcohol may interact negatively with prescriptions, reducing effectiveness or causing adverse side effects.
• Worsening Chronic Health Conditions: Excessive alcohol can exacerbate existing health issues such as heart disease, liver problems, and hypertension.
• Depression and Mental Health: As a central nervous system depressant, alcohol can contribute to or worsen feelings of depression.
• Sleep Disruption: While some may use alcohol to help with sleep, it can actually disrupt sleep patterns and reduce sleep quality.

Over time, these impacts may quietly diminish quality of life, often going unnoticed until a crisis occurs. This is particularly true for those without consistent access to primary care. In severe cases, people may end up on dialysis or facing emergency care without understanding how alcohol contributed to the problem.

Consulting Healthcare Providers

It’s always best to consult with a healthcare provider to determine what level of alcohol consumption, if any, is safe for your individual circumstances. What is considered "moderate" can vary from person to person based on overall health, medications, and other factors. Establishing a relationship with a primary care provider is very important. However, making an appointment can be difficult due to shortages of primary care providers in some areas. Without a connection to a primary care provider, critical conversations about alcohol use and its impact on chronic conditions don’t happen.

Support and Resources

Nationally and locally, alcohol remains one of the most commonly used substances among people living with chronic health conditions. Maybe you only drink occasionally, or perhaps your drinking increased after a major life event like retirement, the loss of a loved one, or prolonged social isolation.

At Newport Mental Health, we understand how alcohol use and chronic illness intersect, and how challenging it can be to navigate both. Whether you’re concerned about your own drinking or worried about someone you care about, we're here to help address the stress and life challenges that may be contributing to alcohol use. And if you don't have a primary care doctor, our clinicians and care coordinators can help you find a healthier path forward and support challenging healthcare navigation.

Here’s what we can offer to anyone concerned about alcohol or substance use:

• Substance use assessments to explore how alcohol or other substances may be affecting your health and daily life.
• Mental health support for depression, anxiety, grief, or other challenges that may contribute to increased alcohol use.
• Care coordination to help connect you with primary care providers or other necessary services.
• Medication-Assisted Treatment (MAT) for individuals looking to reduce cravings or manage alcohol dependence.

Medications for Alcohol Misuse

There are three main medications used to treat alcohol misuse:

• Disulfiram (Antabuse) has been in use for decades. It doesn’t reduce cravings directly but instead creates a physical reaction (such as nausea and vomiting) when alcohol is consumed. Recent research shows it may reduce cravings slightly, but primarily it works through behavior modification. People avoid drinking because they get very sick.
• Naltrexone (Revia, Vivitrol) is a newer treatment option and works by blocking opioid receptors in the brain, which reduces the rewarding effects of alcohol and can significantly decrease cravings. You can still drink alcohol while taking it, but research shows most people drink significantly less because they simply don’t have the same urge. Naltrexone is now our first-line treatment.
• Acamprosate (Campral) is another effective option. It works by balancing chemicals in the brain that are affected by stress and alcohol dependence. It’s effective, but it requires more frequent dosing – usually three times daily – which can be a challenge for some people.

"Naltrexone and Acamprosate have revolutionized the MAT approach," says Dr. Philip Schmitt, the psychiatrist at Newport Mental Health who oversees the Medication-Assisted Treatment program. “About three in 10 adults either have had, or currently have, an alcohol use problem. This contributes to an estimated 10% of deaths among people aged 20 to 65 being linked to alcohol-related causes.”

These medications are generally considered safe for people who are taking medications for other chronic conditions, but they’re not entirely risk-free. “It has to be evaluated on a case-by-case basis,” he says. “Personally, I believe the benefits outweigh the risks in most situations. If someone is at risk of dying from their drinking or severely worsening their health, then it’s worth the conversation. But patients need informed consent and a clear understanding of any potential risks.”

“The vast majority of people I've talked to say, 'That's fine. I've got to get this alcohol under control.'"

A Person-Centered Approach

Labeling someone as having an "alcohol abuse" problem can often act as a barrier to seeking help, fostering feelings of shame, stigma, or defensiveness. Instead of using stigmatizing labels, it is more helpful to adopt a personalized approach that considers each individual’s unique health status, medication regimen, and behavioral health goals.

By framing alcohol use within the context of overall well-being and emphasizing collaborative, goal-oriented discussions, we create a supportive environment that encourages open communication and empowers individuals to make informed choices. This person-centered perspective fosters trust, reduces barriers to care, and promotes healthier behaviors tailored to each person’s specific needs and circumstances.

Primary Care Matters

We strongly support statewide efforts to strengthen Rhode Island’s primary care system, because access to a trusted provider is essential to health and healing. A primary care doctor can help patients make informed decisions, identify early signs of illness, and explain how alcohol may be affecting chronic conditions. Medical providers can also prescribe the medications discussed above.

In collaboration with our partners at East Bay Community Action Program (EBCAP), Newport Mental Health operates a part-time primary care clinic to help meet the needs of our clients. While workforce shortages have limited its availability, Rhode Island's recent increases in Medicaid reimbursement rates offer hope for expanded services in the near future.

Newport Mental Health and all of Rhode Island's Certified Community Behavioral Health Clinics (CCBHCs) are here to have compassionate, confidential conversations about your health. You don't have to be in crisis to call 401-846-1213 or visit during our walk-in hours (Monday-Friday, 9 a.m.-2 p.m. at 42 Valley Road).

Dayna Gladstein is president & CEO of Newport Mental Health in Middletown. Peace of Mind, which is co-written with Kristan McClintock, appears monthly in The Newport Daily News and on newportri.com.

Newport Mental Health is the Certified Community Behavioral Health Clinic (CCBHC) that provides mental health and substance use treatment to those who live, work, and study in Newport County, regardless of their income, insurance, or ability to pay. Newport Mental Health is a 501(c)3, charitable nonprofit and offers programs and services for children and adults; immediate access to care is available by calling 401-846-1213. For more information, please visit newportmentalhealth.org.