phd with katie

TOM ROCKS MATHS

Maths, but not as you know it…, maths speed dating – oxford phd student katie.

Oxford Mathematician Dr Tom Crawford chats to @phdwithkatie – a PhD student studying the impact of Amazon communities on rainforest ecosystems at the University of Oxford.

Full list of questions with timestamps:

3:33 – If you could have 3 wishes, what would they be? 6:00 – Where is your favourite place in Oxford? 7:56 – Do you have any nicknames? 9:50 – Did you have any pets growing up? 12:36 – Do you snore? 14:20 – If you could live anywhere in the world where would it be? 16:44 – Exploring or lazing on the beach? 17:30 – Do you have a favourite number? 19:24 – What colour best describes your personality? 20:55 – What do you like to do most in your free time? 24:30 – What YouTube channels do you watch? 29:25 – If I gave you £10,000 how would you spend it? 31:19 – What are you currently listening to? 33:03 – If you were to advertise yourself on a billboard, what would your question be? 35:16 – DIY or call an expert? 37:49 – Do you have a favourite puzzle? 39:10 – Do you have a favourite Millennium Problem? 42:06 – What are you currently watching? 45:55 – If you were an animal, what would you be and why? 48:19 – If you could invite anyone dead or alive to dinner, who would it be? 50:07 – What time in history would you have liked to be born in, and why? 55:01 – What is the best fan mail you have ever received?

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Katie Pace Miles, Ph.D.

Associate Professor

Brooklyn College, City University of New York (CUNY)

Co-Founder & Principal Investigator

CUNY Reading Corps

Reading Ready

Talks and Podcasts

Science of reading leadership.

Transformative Literacy Practices to Empower All Learners and Educators 

August 13, 2024, learning matters.

Carla Chit Chats with Dr. Katie Pace Miles

March 25, 2024, melissa and lori love literacy.

How to Teach Students to Read Irregular Words

March 22, 2024, read: the research education advocacy podcast.

Reaching more Readers, Training more Teachers with Katie Pace Miles, PhD

July 5, 2023, the measured mom.

Teaching word recognition with Dr. Katie Pace Miles

April 17, 2023, word reading instruction and support for struggling readers with katie pace miles, phd, october 5, 2022, alabama literacy network.

NO MORE sight words: Interview with Dr. Katie Pace Miles

November  11, 2021, glean education podcast.

How to Make Sight Word Instruction and Reading Intervention More Effective

October 1, 2020, wsj’s the future of everything.

Teacher's New Assistant: Artificial Intelligence

November 6, 2020, presentations and media.

New York to rethink how teacher prep programs approach literacy instruction

From Alex Zimmerman for Chalkbeat New York

Half of NYC students are behind in reading. More than 800 CUNY tutors are trying to get them on track.

Chalkbeat Article and Panel featuring Dr. Miles - August 2022

Miles, K.P. , Fletcher, A., & Croke, E. (2022). Reading Rescue/Reading Ready: A CUNY-NYCDOE

Collaboration to Respond to Covid-19 Learning Loss. City University of New York Education

Conference . Presentation conducted from home office.

Miles, K.P. (2022). Why, When, and How to Teach Phonics. Everyone Reading conference. Presentation conducted from home office.

Miles, K.P. (2022). Analyzing High Frequency Words and Reconsidering Instructional Approaches. The Reading League: Kansas Chapter. Webinar presented from home office.

Miles, K.P. (2022). Analyzing High Frequency Words and Reconsidering Instructional Approaches. PlainTalk about Literacy and Learning conference. Presentation conducted in New Orleans, LA.

Miles, K.P. (2022). High Frequency Words: Considerations Based on Research. Plain Talk about Literacy and Learning conference. Presentation conducted in New Orleans, LA.

Miles, K.P. (2021). Evidence-based & Culturally Relevant Practices: Working at the Intersection for

Equity. NYC DOE Literacy Summit, Reaching Every Reader: The Next Chapter. Panel Presentation provided from home office.

Miles, K.P. (2021). High Frequency Words: What, Why, How...as it pertains to the Science of Reading.

Literacy Task Force of Wisconsin. Webinar presented from home office.

Miles, K.P. (2021). NO MORE Sight Words: Interview with Dr. Katie Pace Miles. Alabama Literacy

Network’s Podcast. Podcast recorded from home office.

Miles, K.P. (2021). Making Up for Lost Time: How Funders Can Support Tutoring Interventions that

Accelerate Learning. Philanthropy New York. Panel Presentation provided from home office.

Miles, K.P. (2021). High Frequency Words (four modules). NYC DOE Rethink Education. Webinar

provided from home office.

Miles, K.P. (2021). Emergent Word Reading and Spelling (four modules). NYC DOE Rethink Education. Webinar provided from home office.

Miles, K.P. (2021). High Frequency Words: Instructional Considerations based on Word Type and

Orthographic Regularity. The Reading League National Conference. Webinar provided from home office.

Miles, K.P. (2021). High Frequency Words/ Sight Words. Language, Literacy, and Learning Development for K-8 Educators for Orleans-Niagara Teacher Center. Webinar provided from home office.

Miles, K.P. (2021). Orthographic Mapping: Connecting Theory to Practice. Reading Science Professional Development for White Plains, NY School District. Webinar provided from home office.

Miles, K.P. (2021). Orthographic Mapping and High Frequency Words: Connecting Theory to

Practice. Literacy Symposium 2021 sponsored by Lexia and invited by the LETRS program.

Webinar provided from home office.

Miles, K.P., Barocas, J., Baylin, A., Diviak, B., Fischer, A., Mendez, J., Moulder, T., & Rubin, G. (2021).

Instructional Approaches to Support Orthographic Mapping. The Reading League,

Pennsylvania. Webinar provided from home office.

Miles, K.P. (2020). Research to Practice Disconnect. Philanthropy New York: Uncovering NYC’s

Literacy Crisis and its Effects Across Systems. Presentation provided from home office.

Miles, K.P. (2020). Instructional Practices Grounded in Orthographic Mapping: Research and Projects in Early Literacy. Colloquium for the Educational Psychology department at The Graduate Center, CUNY. Recorded from home due to COVID-19.

Miles, K.P. (2020). Orthographic Mapping and High Frequency Words. Los Angeles County Office of

Education. Recorded from home due to COVID-19.

Miles, K.P. (2020). Types of High Frequency Words: Types of Instruction. The Reading League,

Pennsylvania. Recorded from home due to COVID-19.

Miles, K.P. (2020). Research and Implementation of Amira. The Future of Everything

podcast by The Wall Street Journal. Recorded from home office due to COVID-19.

Miles, K.P. (2020). Above All Else: The Essentials for Lifting Off into Reading and Spelling. EL

Education Virtual Summit What Matters Most: Moving Toward More Equitable Schools. Lecture

conducted from home office due to COVID-19.

Miles, K.P. (2020). Introduction to the Science of Reading. The School at Columbia. Lecture given from home office due to COVID-19.

Miles, K.P. (2020). Skills Block & Remote Learning: Decision-Making to Support Orthographic

Mapping. EL Education Summer Training Institute. Lecture given from home office due to

Miles, K.P. (2020). Reading Science and EL Education: A Strong Pair at the Right Time. Keynote

Address for EL Education Strong Start Training. Speech given from home office due to COVID-

Miles, K.P. (2020). How to Make Sight Word Instruction and Reading Intervention More Effective.

Glean Education: Research to Practice podcast series. Podcast conducted from home office due to

Miles, K.P. (2020). Amira and Reading Rescue: Supporting NYC Students during COVID-19. Teach the

People series posted on Twitter . Lecture conducted from home office due to COVID-19.

Miles, K.P. (2019). How Children Learn to Read and Spell. EL Education National Professional

Development Day on the K-2 Literacy Skills Block. Lecture conducted from the Radisson Inn,

Jersey City, NJ. 

Miles, K.P. (2019). Interpreting and Analyzing Research Data. NYC DOE Department of Literacy

 Professional Development Day. Lecture conducted from the NYC Department of Education Offices, NY, NY.

Miles, K.P. (2018). Articulatory Gestures: Bringing Awareness to How Sounds are Made. Literacy Trust Program Coordinator Day for Reading Rescue. Lecture conducted from Columbia

University, NY, NY.

Miles, K.P. (2018). Effective literacy instruction with non-native English speakers. Teachers

College Program Coordinators Day for Reading Rescue. Lecture conducted from Columbia

Miles, K.P. (2017). The importance of multisensory instruction for word learning. Reading Rescue

Conference. Lecture conducted from Columbia University, NY, NY.

Miles, K.P. (2017). A critical examination of sight word lists and word walls. Reading Rescue

Conference . Lecture conducted from Columbia University, NY, NY.

Miles, K.P. (2017). Phonemic awareness and phonics: What, why, how? LITC-UE 1175 Language and

Literacy in the Early Years. Lecture conducted from New York University, NY, NY.

Miles, K.P. (2016). Rethinking sight words. Reading Rescue Conference. Lecture conducted from

Columbia University, NY, NY.

Lauterbach, M., & Miles, K.P. (2013). Understanding the data: Standardized reading

measures, curriculum-based reading measures, and reading disabilities. Brooklyn Reading

Council. Lecture conducted from Brooklyn College, Brooklyn, NY.

Speaking of Psychology: Sober curious, with Katie Witkiewitz, PhD

Episode 101.

Drinking is ubiquitous in American culture today. It’s hard to go out and not see people imbibing. In the midst of all this booze, there is a burgeoning movement in the opposite direction: Sobriety is having a moment in the spotlight. For the sober-curious crowd, this can mean taking a break from alcohol for a set period or it can mean quitting altogether.

Either way, according to addiction researcher and psychologist Katie Witkiewitz, PhD, stopping drinking even for a short period can be beneficial because it allows us time to explore our relationship with alcohol with a clear head.

About the expert: Katie Witkiewitz, PhD

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Kaitlin Luna: Hello and welcome to Speaking of Psychology, a biweekly podcast from the American Psychological Association that explores the connections between psychological science and everyday life. I'm your host, Kaitlin Luna.

Drinking is ubiquitous in American culture today. It's hard to go out and not see people imbibing. Alcohol flows freely at brunches, baby showers, and birthday parties, not just in bars. In the midst of all this booze, there is a burgeoning movement in the opposite direction. Sobriety is having a moment in the spotlight. For the sober curious crowd, this can mean taking a break from alcohol for a set period such as during specific months, you may have heard of Dry January or Sober October, or it can mean quitting altogether.

Either way, as our guest for this episode, says, “Stopping drinking even for a short period can be beneficial. Because it allows us time to explore our relationship with alcohol with a clear head.” Today, we're talking to addiction researcher and psychologist, Dr. Katie Witkiewitz from the University of New Mexico. She's part of the university's Center on Alcoholism, Substance Abuse, and Addictions. Welcome, Dr. Witkiewitz.

Witkiewitz: Thank you, Kaitlin, it's great to be here.

Luna: We are really happy to have you on our show today. First, I want to start off with why do you think alcohol has such a tight grip on American society?

Witkiewitz: There's a quote of it being a pervasive fact of life and I think that quote really captures alcohol in our society even since before prohibition, but especially during and after prohibition. Alcohol is a legal substance and it's a legal psychoactive drug that in many cases makes people feel better either in celebration. Or when they're not feeling good, it can provide some relief of negative feelings and is commonly used in celebration and generally brings people small amounts of joy in their life.

I think alcohol is a part of life and part of society. Because it is a legal psychoactive drug that many people view as safe although we could talk about that assumption and that people just generally use to socialize and to have fun. Also, this other side of helping to relieve distress so relieving negative states, negative emotions that relieving pain.

It's generally a drug that provides a lot of different potential short-term benefits in the moment. Given it's legal, it's widely available, it's socially accepted. It's not too surprising that we see alcohol everywhere and we as a culture of most Americans use alcohol, drink alcohol.

Luna: Let's explore that presumption of safety because you said it's legal, of course, and it's socially acceptable, so how does that affect people's drinking knowing that it is quote unquote a safe thing to be doing?

Witkiewitz: I think it's interesting because there is mixed research on even the health benefits of alcohol, supposed health benefits of alcohol. Basically, there's this assumption that low levels of drinking are not harmful at all and might even be beneficial for health. The research is actually pretty clear on this that the amounts of alcohol that are safe and potentially even have health benefits is pretty low. It's pretty low compared to what most people drink.

Less than one drink per day is considered a low level of alcohol use and kind of a safe level of alcohol use and any more than that is potentially associated with health risks. There's some research suggesting some health benefits of low levels of alcohol use, but increasing research showing that alcohol use even in low amounts increases risks for certain cancers, certainly increases risk for liver disease and other disorders. Even low amounts of alcohol for some conditions it is not safe.

For the health benefits of alcohol, it is actually a pretty low amount compared to what many people drink, which is less than drink a day when they drink. It's not completely healthy to drink alcohol and we know more and more about the health risks. That said, I think it's a relatively safer drug compared to other drugs, particularly illicit drugs that can have more significant consequences.

Luna: As an addiction researcher are you alarm by this with the current drinking trends you see in America?

Witkiewitz: Yes, I am, especially given increases in certain segments. I'm actually most concerned about increasing drinking among older adults and among women where we see, actually in recent years, greater increases in drinking. It's alarming to me because there is the social acceptability and there's also treatments available that work, but a lot of people aren't actually getting treatments that they need are not seeking treatment or not getting help.

I think our society as a whole would really benefit from starting to have a conversation about the benefits of reducing drinking. What we know is that it's kind of both things are true, so if any drinking increases your risk of certain health conditions, health diseases, health disorders, that reductions in drinking considerably improves health.

I would love for our society to actually flip the conversation to be really more focused on the health benefits of reductions in drinking. I think about it because it is legal and socially accepted, I really think of drinking alcohol as similar to any other health behavior.

I often use the comparison of eating fried food. We know that eating fried food is not great for us, but it's legal and it's generally socially acceptable and then it's not super healthy to eat fried food. Probably a little bit of fried food is not super harmful to health, but as you increase your amount of fried food intake, you're increasing the health risk of eating fried food.

I think as a society at this point, many people are on board with the idea that we should reduce our fried food intake, that we shouldn't be having the supersized French fries at every single meal. I would love for us to have a similar thinking about the health risks and benefits of alcohol and thinking similarly around reducing alcohol use as important as a society, and instead our society actually glorifies and glamorizes heavy drinking. That to me is concerning.

Luna: How have you seen that patterns of drinking change. Because we obviously know the history of alcohol in America, the prohibition movement and then also the three-martini lunch that was popular a couple of decades ago. You see a TV show like Mad Man where it seems like people are spending every day at work under the influence of alcohol or drunk, however you want to call it. What have you seen in trends in America?

Witkiewitz: It's interesting, the rates of alcohol use they decreased with prohibition. Prohibition was effective in reducing rates of alcohol use. They increased really pretty quickly to pre-prohibition levels shortly after prohibition. Once alcohol became legal again, there was a steady increase in drinking and then drinking pretty quickly matched the pre-prohibition levels of drinking.

There was a decline in drinking prior to prohibition, that's important to know because states rolled out different dry laws prior to even prohibition happening. There was a decrease in drinking than prohibition, a large decrease in drinking after prohibition and increase in drinking. Since that time, alcohol use has remained relatively stable in many segments of society. There's been some increases among young adult drinking that occurred in the '70s and '80s, and more recently we're seeing increases and drinking among older adults and women as I mentioned.

The important thing to know though, even back to the '70s but certainly today, the characterizations of alcohol use in the media is really wrong. [laughs] Most people who drink alcohol in our society do not drink at very heavy levels and that's been true for many years, the majority of people do not drink heavily. It's only about 30% of people in the US currently who engage in what we would call heavy drinking, which is defined as more than four drinks in an occasion for women, four or more drinks in an occasion for women and five or more drinks on an occasion for men.

Only about 30% of people are drinking at that high-level occasionally. Most people when they drink alcohol, do not drink as much as the media would portray alcohol to be consumed.

Luna: Why do you think alcohol use has increased in older Americans and women?

Witkiewitz: It's a lot of interesting factors that go into the increase in drinking among both older adults and women. There's been a lot of research lately on ideas around disorders of despair that just generally as Americans. A lot of factors play into this and we could spend several hours talking about them, increase social media use, increase 24-hour news cycle, increase injustice daily stressors of society and people living older and longer alone, divorce is more common.

There's just a lot of social stressors right now and women in particular, especially the group that's increasing their drinking which is middle-aged to older women are increasingly being stressed on both sides. More and more women are playing multiple roles both in the workforce, in the home, but also being stretched to be taking care of older parents as well as taking care of children in many cases.

There's a lot of stress right now in these populations and alcohol is a pretty effective stress reliever in the short-term. Many people come to use alcohol to relieve stress because it is effective in the short-term. It's not a long-term solution and that's where getting into health comes in. At the same time, it is effective in the short-term, so more people are turning to alcohol, which again, is legal, it's socially acceptable. It's everywhere, as you noted in the beginning of this. I think more people are turning to alcohol to relieve what is an increasingly stressful world.

Luna: Turning this up to the completely opposite direction, why do you think the sobriety movement, the sober curious movement, whatever you want to call it, why do you think it's catching on?

Witkiewitz: I'm just thrilled about it. I have to say, it's wonderful for us to be starting to recognize that not everyone has to drink heavily, not everyone has to drink. Really shifting the conversation to be focusing on we as a society could make an effort to reduce our drinking and even not drink at all. Frankly, a lot of people are also a little bit fed up with drinking. When you really look at alcohol use, particularly when you're talking about heavy alcohol consumption, there's hangover, there's worries about violating laws and consequences of heavy drinking. There's just the health effects of continual heavy drinking.

A lot of time in the holidays people will just say like, “Every day has been a party and I've just been drinking so much, and I just feel like I need a break.” I think it's wonderful that we would normalize and create a society, a culture that actually supports sober choices, supports non-drinking choices, non-drinking activities.

What's been happening lately is people joining together to choose to not drink and there's a social component to that that I think is really important. I really think that people are starting to just question, “Hey, is this drink, drink, drink, drink culture really what we want? Are we getting what we want out of it?”

A lot of people are answering that questions with, “Maybe not. I'm having consequence, hangover. I don't feel well. I'm saying things that I don't want to say.” Maybe having relationships with people, “I don't want to have relationships. My life is revolving around alcohol and I want other options.” It's great. I think that's why this is catching on because there are other options. We don't have to only drink and a lot of people know that. A lot of people have already discovered.

I think the people who are drawn to this sober curious crowd, or this sobriety movement are people who've filled their life with a lot of drinking activities and are now evaluating whether that's what they really want.

Luna: To that end, there were some sober bars if you will, which way you want to call it. These bars they only serve non-alcoholic drinks and we're seeing a lot of really creative mocktails showing up on bar menus and restaurants. Do you think seeing all these options out there, does this make the sober curious crowd or someone who's just taking a break feel more comfortable? Because it's not they just have to just sit there and sip water they can have nice tasty drink. They don't feel left out of just having a good beverage.

Witkiewitz: Definitely. I think that's one of the really hard things for individuals who want to not drink is they want to be in a social environment with other people, friends, colleagues after work, family members. Oftentimes in those settings for years, the only choice has been water soda, which a lot of people don't want to drink for the sugar or alcohol. It really sets up an environment where people then become uncomfortable, they don't want to be drinking water soda all night.

These mocktails or these really creative avenues for having a social setting where people can engage and non-drinking of alcohol but still be in that environment and feel like they're having something good and rewarding. Especially they do these fun mocktails with fun names and they're expensive. They actually mimic that experience of a reward of having some sort of treat that you're going to have, and that you're going to savor, and really enjoy instead of just downing some ice water in the company of people who are drinking these tonic flavored drinks.

Luna: There's also people who I call sober evangelists out there, who've written books. I'm thinking Holly Whitaker, who wrote, Quit Like a Woman and Ruby Warrington, who wrote Sober Curious: The Blissful Sleep, Greater Focus, Limitless Presence and Deep Connection Awaiting Us All on the Other Side of Alcohol . Quite a mouthful, so there are people out there in this space who are promoting the message of sobriety. Interestingly, as we touched on earlier, a lot of this caters to women. What are your thoughts about this movement out there where people are having these sober role models?

Witkiewitz: I think it's wonderful. Again, as you noted, alcohol use is increasing among women or as we've been talking about alcohol use is increasing among women. it's really part of another culture that at least I hear about in the work that I do of, for example, there's these wine and art classes where you go and paint paintings. I think it has a funny name, maybe you know I don't know it. [crosstalk]

Luna: I think I was talking about, yes.

Witkiewitz: Yes, and you go, and you do paintings with your friends and then you're drinking alcohol or book club. I was in a book club in graduate school and it was really about drinking a bunch of wine with my female friends. Occasionally, I would read the book, but some book club or these art classes or just getting together for mimosa brunch and having several mimosas. Women have been really pulled into this with these other activities that really don't necessarily need alcohol like you're doing this other thing that's also really enjoyable.

Another piece of this is that women have generally been left out of treatment and research and thinking about alcohol use disorder. It's up until recently, it's primarily been a male disorder. The majority of people in earlier clinical trials for alcohol use disorder, for example, were men. Alcoholics Anonymous is another example, is very male dominated. It was created by men, it used to be a men's group and the wives were supporting the men in their path to sobriety.

It's really only recently that alcohol use disorders increased among women, that alcohol use has become socially acceptable among women, that alcohol use is encouraged among women. Even drinks types that are coming out to really cater to women, so these so-called low calorie like the hard seltzers, the drinks that specifically advertised and market to women.

You've seen this increase of women being targeted by the alcohol industry, of women increasingly engaging in alcohol use. I think it's absolutely wonderful that women are also leading the charge and providing some other ways to think about how to reduce drinking and reevaluate alcohols use in your life.

Luna: I often think about someone with an alcohol use disorder as someone who drinks excessively all the time. I don't think I'm alone in that. I was reading an article from the Cleveland Clinic that said, “The definition of an alcohol use disorder is being unable to stop despite negative consequences. That threshold could be one drink a night or one drink a week.” That was really interesting to me that it wasn't necessarily physical dependence, or it wasn't you're drinking 10 drinks a day, it could just mean you feel like you need to have that nightly glass of wine.

Witkiewitz: Yes, exactly. Another problem with our society what I loved about the sober curious movement is people who are not at that severe end of what we think of as someone who has a problem. We had had this vision in our culture or our society that, if you're drinking 10 drinks a day and having terrible problems then you have an alcohol use disorder and you can never drink again, and everyone else can drink as much as they want.

Really that idea that there's this us or them that people either are addicted to alcohol and physically dependent on alcohol or they can drink as much as they want because they're not physically addicted. That whole notion is completely wrong based on the science. What the science tells us and years of science has shown is that there's really a continuum and so people who can drink a lot of alcohol don't necessarily have symptoms of alcohol use disorder. Some people who drink very little do have symptoms of alcohol use disorder.

The thing that I use as my rubric is, so there's obviously a longer assessment the diagnostic system to diagnose someone with an alcohol use disorder, which I'm sure the Cleveland Clinic outlined. Which largely does revolve around consequences of drinking as well as having a tolerance and needing alcohol in your life.

I would really simplify it to, if alcohol is starting to cause problems in your life, then alcohol is causing problems in your life and you should take a look at it. It doesn't mean that you are have severe alcohol use disorder. It means that, yes, alcohol is maybe not fitting into your life the way you want it to. It might be worth taking a look or reducing your drinking.

Then if reducing your drinking is hard, if you're unable to reduce your drinking, if you're finding yourself really wanting to drink and really struggling to not drink then that might be a sign that it's time to get some help or reach out to get some help.

Luna: The terminology I think is important, and you and I touch on this when we had our initial call about the episode is that and you corrected me when I said alcoholic, and you said it's somewhat as an alcohol use disorder. Can you talk about the importance of how we label someone? How we describe someone who has an alcohol use disorder and getting away from that term alcoholic?

Witkiewitz: Yes, definitely. Thank you for raising the question of terminology. It's really so important. One of the biggest reasons that alcohol and other drug use disorders are so difficult in our society is the stigma associated with them. One thing that perpetuates stigma that we know perpetuate stigma is labels. The term alcoholic, and I wish you could see me using air quotes because I'm using air quotes around that term.

The term alcoholic is very pathologizing and stigmatizing. In fact, there has been research on this idea that even seeing that term makes people, general population feel more negatively towards a person if they are labeled with that term and even bigger concerns. There's a stigma concern and is associated with negative pathologizing views of a person that the person is inherently flawed if that term is applied to them versus what we really should be thinking about is, this is someone who has had problems with alcohol.

This is an individual who maybe has had difficulty in controlling their alcohol use or has had problems associated with alcohol may be criteria for alcohol use disorder. Those problems with the term. Another problem with the term and generally is that it really creates an either/or that you either, again, using air quotes are an alcoholic or you're not.

That is where I think another big problem lies because actually alcohol use disorder occurs on a continuum, as I was saying. People have a range of severity of symptoms and there really isn't a line at which you are a quote unquote, alcoholic versus when you're not. People meet criteria for just one or two symptoms of alcohol use disorder, might still be experiencing problems related to their alcohol, might still benefit from reducing their alcohol use, might still benefit from seeking treatment, but because of this false notion that there is a line at which you become a quote unquote alcoholic versus not.

By perpetuating that false notion, we actually people don't get the help that they need early on. Alcohol use disorder is a progressive neuroadaptive disorder, so the more you drink over time, the more your brain adapts to having alcohol on board. The longer you go, without recognizing that there's a problem with your alcohol use, the more your brain is going to become disrupted by the use of alcohol.

If we could get away from this rock bottom, there's a line at which you'd be having alcohol use disorder to a perspective of, “No, this is a health behavior that occurs on a continuum. It's not something you want to wait until you're so badly beaten by the disorder before you seek help.”

I would love for our society to just move away from this binary us or them, there is a problem or there's not a problem in more towards, again, seeing alcohol as a behavior where we can engage in at low levels and still experience problems. Then when we're experiencing problems from alcohol, that's a signal that it might be time to reduce your drinking, to reevaluate your relationship with drinking and possibly seek help.

Luna: If you are questioning your relationship with alcohol, what should you do? What are the first steps you should take?

Witkiewitz: Excellent question. The first step, that's really important is to just know what you're drinking. To pay attention to what you're drinking and actually log what you're drinking, just like we would keep track of a food log. If we were on a diet, we would keep track of what we're eating. If we're thinking about changing our drinking, I think the first step is to keep track of what we're drinking and that also includes knowing what's in a drink.

A lot of people don't even recognize what to log because so many of our drinks now are actually more than a single standard drink. A standard drink is 14 grams of pure alcohol. How that translates is roughly a five-ounce glass of 12% wine 12-ounce glass or a can or bottle of regular beer at about 5% alcohol, and about one and a half ounces of 80 proof liquor.

What that means, though, is that a lot of us when we're drinking, especially in bars or other places where we're not controlling what we're pouring, we're often getting actually larger than that in standard drink units. For example, if you go to a restaurant and a lot of higher-end restaurants do these just absolutely massive pores of wine that are like nine-ounce pours, and so that's almost two standard drinks if it's a 12% glass of wine. What that means is you think you're just having two drinks at the restaurant, but you're actually having almost four drinks.

As I noted earlier four drinks for a woman is considered heavy drinking, so your two glasses of wine actually corresponds to a heavy drinking event. Similarly, for the microbrew movement, then there's microbreweries everywhere and these microbreweries and brewpubs, they have pretty high alcohol content beer. For example, if you have a 16-ounce pint of an India Pale Ale, that might actually be closer to one and a half to two standard drinks, not the one drink that you think you're having.

What we encourage people to do has just become more aware of what they're drinking, what they're putting in their glasses and how much alcohol they're consuming. Then keeping track of that logging that over time and so just paying attention to what they're drinking over time.

Then maybe evaluating, where could you make some changes? Where could you maybe decide to insert? “I don't have to have drinks every night of the week, I'm going to have one sober day where I'm not going to drink any alcohol,” and try implementing that. Or maybe deciding that “I typically have two to three drinks on Monday nights and I really would get by with well with just one drink on a Monday night. Looking at places in your schedule of drinking of where you could maybe cut back or reduce your drinking or have an abstinence day where you're not drinking at all.

Then from there, if you're noticing that you're having trouble with living by your own guidelines and setting your own rules, if you're having trouble sticking to that, let's say you're two drinks a night that you were going to have you wanted to make it a one drink at night and you can't do it that you keep failing. Or that you're not successful in cutting down or having that one abstinence day a week, for example, that might be an indication that there's some something going on here. In fact, that's a symptom of alcohol use disorder is repeated attempts at cutting down that are unsuccessful.

If you're having trouble cutting down, this might be a time when you start looking for more support. That might involve looking online for an online support group among people who are reducing their drinking. Maybe reaching out to a friend and seeing if a friend would be interested in making the same change that you're making like an exercise buddy, a drinking reduction buddy, where you're both of you are going to decide that when you meet for your book club, instead of having three glasses of wine at book club you're going to have one glass of wine at book club.

Enrolling some social support and making these changes can be really helpful. If that's not working, then potentially seeking out some mutual support group such as Alcoholics Anonymous or SMART Recovery or Women for Sobriety. There's a lot of different online groups that are geared towards helping people reduce their drinking providing social and peer support for that. If that's not working or that doesn't feel comfortable for you, then another option can be talking to your primary care provider. We actually have effective medications for alcohol use disorder that primary care providers can prescribe that are very effective.

One of my favorites, particularly for people who don't want to stop drinking altogether but who are interested in reducing their drinking is naltrexone. Naltrexone can be prescribed by a primary care provider it has pretty minimal side effects. It has helped people take the edge off drinking where they don't want to drink as much, and they might have less craving for alcohol. Instead of having five drinks, they'll be okay with having two and they won't want to keep drinking. It helps people put the brakes on their drinking when they're drinking.

That's a great medication for individuals who just really want a little bit of extra support in reducing their drinking. We also have medications for people who are more geared towards abstinence and supporting abstinence. One of those medications is called acamprosate. Acamprosate can help people who are wanting to maintain not drinking at all, particularly for people who are maybe struggling with not drinking as far as having a lot of withdrawal symptoms or negative moods coming in.

We also have really great behavioral therapies that work for alcohol use disorder. I would also encourage people to potentially seek out a treatment provider who's a therapist or counselor, or social worker who's trained in delivering brief behavioral treatments for alcohol use disorder.

These can be as short as two sessions, of just looking at your alcohol use with a provider to talk about your alcohol use, to talk about where you want to make changes, how you might make some of those changes, problem solving about what's getting in the way. Or a longer treatment, anywhere from four sessions to maybe eight sessions of treatment with a provider where you look a little bit more closely on some of the reasons why you're drinking. Maybe treating some of the underlying problems.

A lot of people, like I said before, are drinking for reasons to feel better, to relieve pain, to relieve negative moods, to reduce social anxiety and so getting some treatment to support those underlying causes can really help in supporting people in reducing their drinking. Because they're not turning to alcohol to deal with those problems.

Luna: You use mindful based treatment for addiction relapse prevention in your work. Can you explain what that is and how effective it is?

Witkiewitz: Yes, I failed to mention our own treatment program and talking about treatment options. [laughs] Mindfulness-based treatments we've been working with for almost 20 years now.

It's an incredibly effective treatment for alcohol use disorder and other drug use disorders, for getting at some of the root causes of addiction and really looking at and being aware of how our mind works. Really being able to come to terms with ourselves and with our minds and with our bodies, and to just increase our awareness of the stressors of daily life, of other co-morbid problems that we have, pain, anxiety, depression. To really be able to sit with those experiences and be with them without turning to alcohol.

Really being able to experience distress in the moment and sit with distress and to do so with acceptance and without judgment. It's a really helpful training program for-- We even say retraining the brain to basically retrain the brain to be able to be with the present moment. Our society is very much not in the present moment and oftentimes we're reaching for things or we're living in the past, and we very rarely really relish and appreciate and savor the present moment experience. Alcohol actually takes us way out of present moment, it changes our experience.

We, in mindfulness-based treatment, train people to reconnect with the open, to accept and non-judgmentally be aware of the present moment experience. In doing so can help change their relationship to themselves, the world but also their relationships with alcohol and drugs. Because alcohol and drugs can really, again, in the short-term, get us out of the moment when the moment is hard. Mindfulness-based treatments retrain us to be okay with the moment even when it's hard and not reach for alcohol and drugs.

Luna: Of all the treatment options you mentioned, from tracking, to the self-help books, to the medication, to the mindfulness treatment, are there research on what might work best or is it particular to the individual?

Witkiewitz: It's really particular to the individual. What we know is that for some individuals, just tracking their alcohol use will result in pretty drastic reductions in their drinking. Just seeing how much you're drinking can be really helpful to reduce your drinking. For other individuals, particularly people who've been drinking for a very long time who might be more physiologically dependent and have neural adaptations from drinking they probably will benefit more from probably a combination of medication and a mindfulness-based treatment, potentially even having a detoxification in there to clear alcohol from their system.

It really depends on the individual and individual range of severity. I think most people who are questioning and in this less severe range, even just tracking their drinking, having some social support around reducing their drinking, even just talking to their primary care provider could be really helpful in reducing their drinking. That's going to be most people.

Luna: How does taking a break from alcohol benefit you mentally and physically? Does there need to be a set period of time? Or what are your thoughts on that?

Witkiewitz: Excellent question. What we know is that alcohol is toxic. It actually requires work from the liver to clear it out. It impacts actually all systems of the body. It impacts the brain as well. Our latest work is showing that any reduction in drinking is associated with mental and physical benefits. Even reducing by one drink a day, or reducing from four drinks to two drinks, you're going to see benefits.

For people who take a longer break from alcohol, let's say a week or two weeks, or up to four weeks, so people who complete one of these Dry January months or Sober October months or take a longer break from alcohol, they might see even larger improvements. People report when you take a longer break from alcohol, that you'll have better sleeping patterns is one of the first ones that people notice that they sleep better. Alcohol does interfere with sleep in a number of different ways. People report their skin looks better and that they just feel better. They have more energy.

Of course, it's not just the alcohol, right? If you're reducing your alcohol and then you're sleeping better, you're going to have more energy, so it's kind of a cascade of effects from even stopping for a short time. I also really like to reiterate that you don't necessarily have to stop for an entire month or even stop for several weeks. Even reducing your drinking is likely to result in some benefit, albeit a little bit more subtle than what people report when they stopped drinking altogether.

Overall, what we know is going back to what we started saying at the beginning of the podcast around any increase in drinking is associated with worse health outcomes, including mental health and physical health. Any reduction in drinking is associated with better health outcomes. In the long run, any reductions you can do is going to be good for your health and well-being.

Luna: It seems like a lot of people understand this, as you mentioned, the end of the year, holiday time people feel like they are overdoing it in a lot of different ways. That's why you see a lot of people will participate in Dry January, which we've recently ended. Do you think that's a good way to have that crowd sourcing effect for a lot of different people who are all trying to get through the month without any alcohol?

Witkiewitz: Definitely. Because there's a movement behind it creates a very natural and socially acceptable statement around not drinking that a lot of people can be like, "Okay, that's cool. Where is that?" I recently actually was at a work event with several people, and it was in January and we offered a drink to one of the people in attendance and the person said, "Actually, I'm doing Dry January." It was so liberating to hear someone say that.

Then that person just felt really comfortable not drinking the rest of the night because he made a social proclamation that he was doing Dry January. It didn't have to be like this really big deal that he was stopping drinking forever, that he was just out of treatment or some other stigmatizing scary notion it's just like, "Yeah, I'm doing Dry January. I'm not drinking this month and it's fine." I loved that about it. It does create this crowd source of support.

Personally, I did Dry January years ago. Four of my friends and I, we all did it together and we didn't even actually go to the same bars that we would go to. We would go to each other's houses. We would still hang out socially, but we would do so without alcohol. Because we were doing it together, it did that crowdsourcing effect of just feeling, not feeling left out and not feeling like you're missing out.

That said, I think one thing to be aware of, is that abruptly stopping alcohol when you're severely dependent on alcohol is actually deadly. Withdrawing from alcohol is lethal for people who are consuming a lot of alcohol.

What I would say for someone who is very severely dependent on alcohol, who's physiologically very dependent on alcohol, who's drinking many, many drinks a day, every single day to stop abruptly could have health risks. I would encourage anyone who's drinking at that level and wants to try Dry January, to do so under the care of a medical physician and with awareness of some of the health risks of stopping drinking abruptly.

Luna: Yes, that's very important to share. Because I think, like you said, people need to make sure that they're taking care of their health, but also doing it safely.

Witkiewitz: Exactly. Actually, speaking of that, another piece is if you do Dry January, or if you do Sober October coming up, or you decided to take a break from drinking, then it's also important to know that your tolerance for alcohol is going to go away pretty quickly. It's not a great idea to like February 1st, to go out and have a bender have an evening where you're drinking a ton of alcohol, because you're at risk of overdosing.

Both things are true, like the extreme going from a lot of alcohol use to nothing that's going to put you at risk of withdrawal. Going from no alcohol use to a lot of drinking is going to put you at risk of overdose. Just being aware of those risks around us over a period of tapering to sobriety, if you're going to go to sobriety and then definitely not returning to drinking what you used to drink after a period of sobriety. Because your body will not be able to process it as much as it used to.

Luna: Thank you so much for that very insightful information Dr. Witkiewitz. I think our listeners will really appreciate the tips you've given them and also the importance of staying safe whether you decide to give up alcohol completely or if you do give up alcohol completely, and maybe want to start trying again. I think it's important for people to understand the health risks and what they need to do to keep themselves healthy. You have offered a lot of really wonderful information about how people can take a better look at their drinking if they feel that that's needed in their lives.

Witkiewitz: Thank you for having me. It's been great.

Luna: For links to resources, you can visit our website  speakingofpsychology.org , or check the link in the episode notes. Before we go, just a reminder that we want to hear from you. You can email your comments and ideas to Speaking of Psychology at apa.org. That's speakingofpsychology, all one word .org, and please consider giving us a rating in iTunes we'd really appreciate it.

You can find previous episodes of Speaking of Psychology on Apple, Stitcher, Spotify, or wherever you get your podcasts. You can also go to our website,  speakingofpsychology.org . I'm Kaitlin Luna with the American Psychological Association. Thanks for listening.

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Speaking of Psychology

This audio podcast series highlights some of the latest, most important, and relevant psychological research being conducted today.

Produced by the American Psychological Association, these podcasts will help listeners apply the science of psychology to their everyday lives.

About the host: Kaitlin Luna

Kaitlin Luna was the host of Speaking of Psychology from September 2018 to March 2020. A former broadcast journalist, she worked in APA's Office of Public Affairs as a public affairs manager.

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Katie Wang, Ph.D., is an associate professor in the Department of Social and Behavioral Sciences at Yale School of Public Health. She received her Ph.D. in Social Psychology from Yale University and completed a postdoctoral fellowship through the Yale AIDS Prevention Training Program. Dr. Wang's research broadly focuses on the role of stigma as a psychosocial determinant of mental and behavioral health inequities among diverse marginalized populations, with a specific emphasis on people with disabilities and individuals with mental health and/or substance use disorders. Some of her recent and ongoing projects include an investigation of mental illness stigma as a risk factor for substance use among adults with depression (funded by National Institute on Drug Abuse), a longitudinal study examining the mental health impact of the COVID-19 pandemic on people with disabilities, and a mixed-methods study to develop and validate a questionnaire measure of daily intersectional stigma experiences among Black people with disabilities (funded by National Institute on Minority Health and Health Disparities). Dr. Wang utilizes a wide range of methodologies in her research, including surveys, experiments, psychophysiological measures, ecological momentary assessment, and qualitative interviews.

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• Social and Behavioral Sciences

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Research at a glance, yale co-authors, publications timeline, john pachankis, phd, john dovidio, denise esserman, phd, melissa r schick, phd, sarah lowe, phd, barriers to mental health service use among people with disabilities during the covid-19 pandemic, the role of emotion dysregulation in the association between substance use stigma and depressive symptoms among trauma-exposed, substance-using individuals, rejection sensitivity and sexual minority men’s social anxiety disorder: the moderating role of sexual identity strength, toward cognitive-behavioral therapy for sexual minority women: voices from stakeholders and community members, perceived provider stigma as a predictor of mental health service users' internalized stigma and disempowerment, depression and substance use: towards the development of an emotion regulation model of stigma coping, what reduces sexual minority stress a review of the intervention “toolkit”, the role of distress intolerance in the relationship between childhood sexual abuse and problematic alcohol use among latin american msm, looking on the bright side of stigma: how stress-related growth facilitates adaptive coping among gay and bisexual men, gay-related rejection sensitivity as a risk factor for condomless sex, academic achievements & community involvement, american psychological association, rising star, perceived discrimination increased the risk of worse health outcomes after a heart attack, the pandemic weighs on disabled people's mental health, health equity and social justice theme of ysph alumni day 2021, new grants fund ysph research for adult caregivers and those with depression, get in touch.

Katie Galloway

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• Chemical Engineering (ChemE)

Room: 

Phone number: , email: , faculty bio: , research areas: .

• Bioengineering and Neuroengineering
• Cancer Systems Biology
• Cellular Biophysics
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• Single Cell Manipulations and Measurement
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• Synthetic Biology and Biological Design

Research Summary: