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Let’s file this under unsurprising news: many American adults report drinking more since the pandemic began in March 2020, according to a survey on alcohol use in the time of COVID-19. If you’re among them, you might want to start 2022 on a healthy note by joining the millions who abstain from alcohol during Dry January. Your heart, liver, memory, and more could be the better for it.

What did this survey find?

The researchers asked 832 individuals across the US about their alcohol intake over a typical 30-day period. Participants reported drinking alcohol on 12.2 days and consuming almost 27 alcoholic drinks during that time. More than one-third reported engaging in binge drinking (consuming five or more drinks for men and four or more drinks for women in about two hours).

Moreover, nearly two-thirds of the participants said their drinking had increased compared to their consumption rates before COVID. Their reasons? Higher stress, more alcohol availability, and boredom.

But we can’t blame COVID entirely for the recent rise in alcohol consumption. Even before the pandemic, alcohol use among older adults had been trending upward.

Why try Dry January?

If you recognize your own behavior in this survey and wish to cut down on your alcohol intake, or simply want to begin the new year with a clean slate, join in the Dry January challenge by choosing not to drink beer, wine, or spirits for one month. Dry January began in 2012 as a public health initiative from Alcohol Change UK, a British charity. Now millions take part in this health challenge every year.

While drinking a moderate amount of alcohol is associated with health benefits for some people in observational studies, heavier drinking and long-term drinking can increase physical and mental problems, especially among older adults. Heart and liver damage, a higher cancer risk, a weakened immune system, memory issues, and mood disorders are common issues.

Yet, cutting out alcohol for even a month can make a noticeable difference in your health. Regular drinkers who abstained from alcohol for 30 days slept better, had more energy, and lost weight, according to a study in BMJ Open. They also lowered their blood pressure and cholesterol levels and reduced cancer-related proteins in their blood.

Tips for a successful Dry January

A month may seem like a long time, but most people can be successful. Still, you may need assistance to stay dry in January. Here are some tips:

• Find a substitute non-alcoholic drink. For social situations, or when you crave a cocktail after a long day, reach for alcohol-free beverages like sparkling water, soda, or virgin beverages (non-alcoholic versions of alcoholic drinks.)

  Non-alcoholic beer or wine also is an option, but some brands still contain up to 0.5% alcohol by volume, so check the label. "Sugar is often added to these beverages to improve the taste, so try to choose ones that are low in sugar," says Dawn Sugarman, a research psychologist at Harvard-affiliated McLean Hospital in the division of alcohol, drugs, and addiction.

• Avoid temptations. Keep alcohol out of your house. When you are invited to someone’s home, bring your non-alcoholic drinks with you.
• Create a support group. Let friends and family know about your intentions and encourage them to keep you accountable. Better yet, enlist someone to do the challenge with you.
• Use the Try Dry app. This free app helps you track your drinking, set personal goals, and offers motivational information like calories and money saved from not drinking. It’s aimed at cutting back on or cutting out alcohol, depending on your choices.
• Don’t give up. If you slip up, don't feel guilty. Just begin again the next day.

Check your feelings

Sugarman recommends people also use Dry January to reflect on their drinking habits. It’s common for people to lose their alcohol cravings and realize drinking need not occupy such an ample space in their lives. If this is you, consider continuing for another 30 days, or just embrace your new attitude toward drinking where it’s an occasional indulgence.

If you struggle during the month, or give up after a week or so, you may need extra help cutting back. An excellent resource is the Rethinking Drinking site created by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). For the record, NIAAA recommends limiting alcohol to two daily drinks or less for men and no more than one drink a day for women.

Be aware of problems that might crop up

Dry January can reveal potential alcohol problems, including symptoms of alcohol withdrawal ranging from mild to serious, depending on how much you usually drink. Mild symptoms include anxiety, shaky hands, headache, nausea, vomiting, sweating, and insomnia. Severe symptoms often kick in within two or three days after you stop drinking. They can include hallucinations, delirium, racing heart rate, and fever. "If you suffer alcohol withdrawal symptoms at any time, you should seek immediate medical help," says Sugarman.

In the US, breast cancer is the most commonly diagnosed cancer in women, and the second leading cause of cancer-related deaths. Each year, an estimated 270,000 women — and a far smaller number of men — are diagnosed with it. When caught in early stages, it’s usually highly treatable.

A promising new form of targeted treatment may expand options available to some women with early-stage breast cancer linked to specific genetic glitches. (Early-stage cancers have not spread to distant organs or tissues in the body.)

The BRCA gene: What does it do?

You may have heard the term BRCA (BReast CAncer) genes, which refers to BRCA1 and BRCA2genes. Normally, BRCA genes help repair damage to our DNA (genetic code) that occurs regularly in cells throughout the human body.

Inherited BRCA mutations are abnormal changes in these genes that are passed on from a parent to a child. When a person has a BRCA mutation, their body cannot repair routine DNA damage to cells as easily. This accumulating damage to cells may help pave a path leading to cancer. Having a BRCA1 or BRCA2 mutation — or both — puts a person at higher risk for cancer of the breast, ovaries, prostate, or pancreas; or for melanoma. A person’s risk for breast cancer can also be affected by other gene mutations and other factors.

Overall, just 3% to 5% of all women with breast cancer have mutations in BRCAgenes. However, BRCA mutations occur more often in certain groups of people, such as those with triple negative breast cancer (TNBC), Ashkenazi Jewish ancestry, a strong family history of breast and/or ovarian cancer, and younger women with breast cancer.

Inherited BRCA mutations and breast cancer types

Certain types of breast cancer are commonly found in women with BRCA gene mutations.

• Estrogen receptor-positive, HER2-negative cancer: Women with a BRCA2 mutation usually develop ER+/HER2- breast cancer — that is, cancer cells that are fueled by the hormone estrogen but not by a protein known as HER2 (human epidermal growth factor 2).
• Triple negative breast cancer: Women with a BRCA1 mutation tend to develop triple negative breast cancer (ER-/PR-/HER2-) — that is, cancer cells that aren’t fueled by the hormones estrogen and progesterone, or by HER2.

Knowing what encourages different types of breast cancer to grow helps scientists develop new treatments, and helps doctors choose available treatments to slow or stop tumor growth. Often this involves a combination of treatments.

A new medicine aimed at early-stage BRCA-related breast cancers

The OlympiA trial enrolled women with early-stage breast cancer and inherited BRCA1/BRCA2 mutations. All were at high risk for breast cancer recurrence despite standard treatments.

Study participants had received standard therapies for breast cancer:

• surgery (a mastectomy or lumpectomy)
• chemotherapy (given either before or after surgery)
• possibly radiation
• possibly hormone-blocking treatment known as endocrine therapy.

They were randomly assigned to take pills twice a day containing olaparib or a placebo (sugar pills) for one year.

Olaparib belongs to a class of medicines called PARP inhibitors. PARP (poly adenosine diphosphate-ribose polymerase) is an enzyme that normally helps repair DNA damage. Blocking this enzyme in BRCA-mutated cancer cells causes the cells to die from increased DNA damage.

Results from this study were published in the New England Journal of Medicine. Women who received olaparib were less likely to have breast cancer recur or metastasize (spread to distant organs or tissues) than women taking placebo. Follow-up at an average of two and a half years showed that slightly more than 85% of women who had received olaparib were alive and did not have a cancer recurrence, or a new second cancer, compared with 77% of women treated with placebo.

Further, the researchers estimated that at three years:

• The likelihood that cancer would not spread to distant organs or tissues was nearly 88% with olaparib, compared to 80% with placebo.
• The likelihood of survival was 92% for the olaparib-treated group and 88% for the placebo group.

The side effects of olaparib include low white cell count, low red cell count, and tiredness. The chances of developing these were low.

The bottom line

Olaparib is already approved by the FDA to treat BRCA-related cancers of the ovaries, pancreas, or prostate, and metastatic breast cancer. FDA approval for early-stage breast cancer that is BRCA-related is expected soon based on this study. These findings suggest taking olaparib for a year after completing standard treatment could be a good option for women who have early-stage breast cancer and an inherited BRCA gene mutation who are at high risk for cancer recurrence and, possibly, its spread.

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Psoriasis is a chronic disease in which skin cells rapidly divide, causing the skin to develop rough, red, scaly patches. Plaque psoriasis is the most common form: affected skin has sharply defined, inflamed patches (plaques) with silvery or white scales, often near an elbow or on the shins and trunk.

The cause of psoriasis isn’t known, but there are a number of treatment options. Possibly you’ve seen a glossy, happy ad for one of these treatments, a drug called Skyrizi. It’s been in heavy rotation and in 2020, hit number four on a top 10 list for ad spending by a drug company.

Splashing in blue water

A woman in a bathing suit sprints down a dock and jumps into the water with several friends. There’s lots of smiling and splashing. A voiceover says “I have moderate to severe plaque psoriasis. Now, there’s Skyrizi. Three out of four people achieved 90% clearer skin at four months after just two doses.”

Then, the voiceover moves to warning mode: “Skyrizi may increase your risk of infections and lower your ability to fight them. Before treatment your doctor should check you for infections and tuberculosis. Tell your doctor if you have an infection or symptoms such as fever, sweats, chills, muscle aches, or cough, or if you plan to or recently received a vaccine.”

As these warnings are delivered, we’re treated to uplifting pop music — “nothing is everything,” a woman sings — while attractive young people flail about in the water.

“Ask your doctor about Skyrizi,” a voice instructs. Did I mention a plane is skywriting the drug’s logo? I guess it’s putting the “sky” in Skyrizi.

What is Skyrizi?

Skyrizi (risankizumab) is an injectable medication that counteracts interleukin-23, a chemical messenger closely involved in the development of psoriasis. The standard dosing is two injections to start, followed a month later by two injections once a month, and then two injections once every three months.

Did you catch that “injectable” part? This is not a pill. If you missed that point while watching the commercial, it’s not your fault. The word “injection” appears once, written in faint letters at the very end of the commercial.

By the way, the FDA has only approved this drug for moderate to severe — not mild — plaque psoriasis. The studies earning approval enrolled people with psoriasis on at least 10% of their skin and two separate measures of severity.

What the ad gets right

• The ad states that 75% of people with moderate to severe psoriasis experienced 90% clearance of their rash within four months after only two doses of Skyrizi. This reflects the findings of research studies (such as this one) that led to the drug’s approval.
• The recommendations regarding screening for infections (including tuberculosis) and telling your doctor if you’ve gotten a recent vaccine are appropriate and should be standard practice. By lowering the ability to fight infection, this drug can make current infections worse. It may reduce the benefit of certain vaccines, or increase the risk of infection when a person gets a certain type of vaccine called a live-attenuated vaccine.

And the theme song? People with visible psoriasis often cover up their skin due to embarrassment or stigma. The rash isn’t a contagious infection or a reflection of poor health, but other people may react as if it is. So, an effective treatment could potentially allow some to forego covering up and show more skin: it means “everything” to someone suffering with psoriasis to cover “nothing.” Thus, a theme song is born.

What else do you need to know?

A few things about this ad may be confusing or incomplete, including:

• Currently, each dose of Skyrizi is actually two injections. So, a more accurate way to summarize its effectiveness would be to say that improvement occurred within four months after four injections (rather than “just two doses”).
• Like most newer injectable medications, this one is quite expensive: a year's supply could cost nearly $70,000. The drug maker offers a patient assistance program for people with low income or limited health insurance, but not everyone qualifies. Health insurance plans generally require justification from your doctor for medications like Skyrizi, and your insurer may decide not to cover it. Even if covered, this prior approval process can delay starting the medication, which may still be expensive due to copays and/or deductibles.
• There is no mention of the many other options to treat psoriasis, some of which are far less costly. These include medications that do not have to be injected (such as oral methotrexate or apremilast), and UV light therapy (phototherapy). And there are other injectable medications. So, ask your doctor about the best options for you.

The bottom line

Some people appreciate the information provided by medication ads. Others favor a ban on such advertising, as is the case in most other countries. And recently, two advocacy groups asked the FDA not to allow drug ads to play music when the risks of drug side effects are presented, arguing that it distracts consumers from focusing on this important information.

Since these ads probably are not going away anytime soon, keep in mind that they may spin information in a positive light and leave out other important information altogether. So, be skeptical and ask questions. Get your medication information from your doctor or another unbiased, authoritative source, not a company selling a product.

Regardless of how you feel about medical advertising, it’s hard to hate the Skyrizi theme song. Feel free to sing along.

That recurring sound that you hear but nobody else does? It’s not all in your head. Well, not exactly.

You may be one of the estimated 50 million-plus people who suffer from tinnitus. The mysterious condition causes a sound in the head with no external source. For many it’s a high-pitched ringing, while for others it’s whistling, whooshing, buzzing, chirping, hissing, humming, roaring, or even shrieking.

The sound may seem to come from one ear or both, from inside the head, or from a distance. It may be constant or intermittent, steady or pulsating. One approach to managing this condition is different forms of sound therapy intended to help people tune out the internal soundtrack of tinnitus.

What causes tinnitus?

There are many possible causes of tinnitus. Long-term exposure to loud noises is often blamed. But other sources include middle ear problems like an infection, a tumor or cyst pinching nerves in the ear, or something as simple as earwax buildup. Tinnitus also can be a symptom of Meniere’s disease, a disorder of the balance mechanism in the inner ear.

Even old-fashioned aging can lead to tinnitus, which is common in people older than age 55. As people get older, the auditory nerve connecting the ear to the brain starts to fray, diminishing normal sounds.

“Neurons (nerve cells) in areas of the brain that process sound make up for this loss of input by increasing their sensitivity,” says Daniel Polley, director of the Lauer Tinnitus Research Center at Harvard-affiliated Massachusetts Eye and Ear. “The sensitivity knobs are turned up so high that neurons begin to respond to the activity of other nearby neurons. This creates the perception of a sound that does not exist in the physical environment. It’s a classic example of a feedback loop, similar to the squeal of a microphone when it is too close to a speaker.”

At times, everyone experiences the perception of a phantom sound. If it only lasts for a few seconds or minutes, it’s nothing to worry about. However, if it pulsates in sync with your heart rate, it’s definitely something to get checked out by a physician, says Polley. If it’s a relatively continuous sound, you should see an audiologist or otolaryngologist (ears, nose, throat specialist).

Can sound therapy help tune out tinnitus?

There is no cure for tinnitus, but it can become less noticeable over time. Still, there are ways to ease symptoms and help tune out the noise and minimize its impact. Treatments are a trial-and-error approach, as they work for some people but not others.

One often-suggested strategy is sound therapy. It uses external noise to alter your perception of or reaction to tinnitus. Research suggests sound therapy can effectively suppress tinnitus in some people. Two common types of sound therapy are masking and habituation.

• Masking. This exposes a person to background noise, like white noise, nature sounds, or ambient sounds, to mask tinnitus noise or distract attention away from it. Listening to sound machines or music through headphones or other devices can offer temporary breaks from the perception of tinnitus. Household items like electric fans, radios, and TVs also can help. Many people with tinnitus also have some degree of hearing loss. Hearing aids can be used to mask tinnitus by turning up the volume on outside noises. This works especially well when hearing loss and tinnitus occur within the same frequency range, according to the American Tinnitus Association.
• Habituation. Also known as tinnitus retraining therapy, this process trains your brain to become more accustomed to tinnitus. Here, you listen to noise similar to your tinnitus sound for long periods. Eventually your brain ignores the tone, along with the tinnitus sound. It’s similar to how you eventually don’t think about how glasses feel on your nose. The therapy is done with guidance from a specialist and the time frame varies per person, usually anywhere from 12 to 24 months.

Additional approaches may help with tinnitus

Depending on your diagnosis, your doctor also may recommend addressing issues that could contribute to your tinnitus.

• Musculoskeletal factors. Jaw clenching, tooth grinding, prior injury, or muscle tension in the neck can sometimes make tinnitus more noticeable. If tight muscles are part of the problem, massage therapy may help relieve it.
• Underlying health conditions. You may be able to reduce the impact of tinnitus by treating conditions like depression, anxiety, and insomnia.
• Negative thinking. Adopting cognitive behavioral therapy and hypnosis to redirect negative thoughts and emotions linked to tinnitus may also help ease symptoms.
• Medication. Tinnitus can be a side effect of many medications, especially when taken at higher doses, like aspirin and other nonsteroidal anti-inflammatory drugs and certain antidepressants. The problem often goes away when the drug is reduced or discontinued.