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The alcohol crisis quietly hitting high-stress, “high-status” workers

What The Pitt can teach us about addiction.

Alcohol use in the United States has reached historic lows. That’s good news for the public’s health. A 2024 study from the CDC concluded that alcohol was the direct or indirect cause of more than 175,000 deaths annually in the United States, so any positive movement is cause for celebration.

But amid that overall decline, there are still pockets of the population that suffer from disproportionately high rates of alcohol misuse. In general, people with lower incomes tend to suffer the worst outcomes if they develop a problem with alcohol, but alcoholism is also found among professions that our society thinks of as “high status,” including lawyers, journalists, and — especially — doctors and nurses.

One 2023 global metaanalysis found that one out of every five health care professionals drink enough for it to be hazardous to their health and frequently engage in binge drinking. The rates of problematic drinking in this group, perhaps unsurprisingly, rose during the pandemic. Another international paper found that rates of alcohol abuse among providers rose in recent years — the opposite direction of the celebrated drop-off among the general public.

When it comes to American physicians, a 2015 study found that 13 percent of male physicians and 21 percent of female physicians would meet the criteria for alcohol misuse. Alcohol misuse by health care providers is associated with a poorer work performance and worse patient outcomes, raising the stakes not only for the person with an alcohol dependency but the people they’re caring for.

And for health care workers, the pandemic could still be having a lingering effect on the high rates of alcohol use. The deep trauma of those years persists, medical work remains very stressful, and using some kind of substance to cope with those difficult feelings can be tempting.

We have come a long way in recognizing alcohol and substance abuse as not a moral failing but as a combination of physiological, dependent, and life circumstances. But these “high status” workers can present unique challenges as we strive to make further progress. Persistent beliefs about who is (and isn’t) affected by addiction means their risky drinking may not be obvious. They may........

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