April 24, 2019

5 questions with an alcohol-abuse researcher

Former social worker now studies how to prevent and treat alcohol abuse in a primary care setting.

Stacy Sterling with her family: husband Wayne, daughter Wynne, and son Noah.

Stacy Sterling, DrPH, MSW, studies how effective methods for treating substance abuse and other mental health problems can be more easily and widely adopted in primary care practices. She also looks at prevention and early intervention programs to reduce alcohol, drug, and other behavioral health problems in at-risk children, adolescents, and adults.

As a research scientist at the Kaiser Permanente Division of Research, she participates in the Drug and Alcohol Research Team, the Behavioral Health Research Initiative in Kaiser Permanente Northern California, and the Mental Health Research Network, part of the Health Care Systems Research Network.

What is the single moment in your life that sparked your interest in what you’re doing now?

I am a social worker by training, and in my earlier experiences working directly with clients — many with alcohol and other drug problems, their own, or a friend or family member’s — I recognized that was a part of the equation that brought them in.

Like most people, I also have friends and family members whose lives have been shaped by alcohol problems. People feel so much shame that they often go unidentified and untreated. My interest has always been in understanding people and their health and well-being, holistically. Because alcohol is so often the cause — or the symptom — of other medical, mental health, and social problems, this work has the potential to affect many aspects of people’s lives.

In your area of expertise, what should people know about their health that you don’t think they know?

Over the years, we’ve heard about the beneficial effects of moderate drinking, for example a glass or 2 of red wine as part of the healthful Mediterranean diet. But emerging research has found that even conservative levels of consumption are associated with adverse health effects and premature death. With few exceptions, there is really no “healthy” amount of alcohol.

People also need to know that recovery is possible. There’s a misconception that alcohol problems are somehow insurmountable, and that’s just not the case. With early intervention, or good specialty treatment — which we have at Kaiser Permanente — most people can overcome alcohol problems. Treatment success rates are similar or better than for medical conditions such as diabetes and heart disease.

If you’re worried about how much you are drinking, or struggling with an alcohol problem, seek help. Kaiser Permanente has some of the best resources around. And if you’re going to indulge, do so in moderation.

Stacy Sterling with her son, Noah, at UC Berkeley.
Stacy Sterling with her son, Noah, at UC Berkeley.

What kind of research are you doing and why is it important?

My current research focuses on how to integrate systematic screening and brief intervention programs for unhealthy alcohol use into primary care, and how to give primary care physicians effective tools for treating patients. A current study is looking at how to guide and support primary care providers in the use of anti-craving medications, which are available but underused for patients who don’t want specialty treatment.

I am also studying how brief talks with one’s primary care doctor about unhealthy drinking can influence other health problems, such as blood pressure control in patients with hypertension, and glycemic control in patients with diabetes. We’re already seeing important positive effects from this low-cost, light-touch intervention.

I hope to see a time in the not-too-distant future when behavioral health is treated no differently than physical health, and every check-up includes equal focus on the emotional, behavioral, mental, social, and physical aspects of health.

We hear a lot about alcohol abuse these days. What are the challenges from your point of view?

There is still immense stigma and shame around alcohol problems, which keeps people at all levels — from those who drink more than recommended guidelines to those with alcohol use disorders — from getting assistance.

These attitudes are prevalent among both patients and providers because they reflect larger societal attitudes and ambivalence about alcohol. People and health systems need to see alcohol problems as health conditions that deserve the same attention and nonjudgmental, respectful care as other health conditions.

Sterling with her daughter, Wynne.
Sterling with her daughter, Wynne.

In your free time, what do you like to do?

My husband and I spend a lot of our free time on the school and extracurricular activities our kids are involved in, like volleyball, marching band, and Girl Scouts. When there’s time, I love to travel and to see musical theater and movies. I’m also trying to visit my local library regularly and read more for pleasure.