Surgeon General: America Is Experiencing a Loneliness Epidemic. Alcohol Is Making It Worse.

Dr. Shawn H. Marhamati, MD · 6 min read

The Surgeon General declared loneliness a public health epidemic. More widespread than smoking. More widespread than diabetes.

And the tool most Americans reach for to fix it is making it neurologically worse.

57% of Americans Report Feeling Lonely

That number should stop you.

57% of Americans say they feel lonely. 30% feel it every single week. Not occasionally. Not during the holidays. Every week.

We have more ways to connect than any generation in history. Social media, texting, video calls, dating apps, coworking spaces, community platforms. We are saturated with connection infrastructure.

And it is not working.

Loneliness is rising because the quantity of connection went up while the quality went down. We have more contacts and fewer confidants. More interactions and less presence. More people in the room and less genuine attunement to any of them.

The Alcohol Paradox

Here’s where it gets cruel.

The primary social tool Americans reach for to feel more connected is alcohol. Happy hours. Dinner parties. First dates. Networking events. The assumption is that a drink loosens you up, makes conversation easier, and brings people closer.

Research shows the opposite. Lonelier people consistently drink more, not less. And the mechanism explains why.

Alcohol suppresses your prefrontal cortex. That’s the part of your brain responsible for genuine emotional attunement. It handles nuance, empathy, reading the room, being present to what someone is actually saying versus what you think they’re saying.

When you suppress that, you feel more connected. But you’re not actually connecting.

You’re experiencing the sensation of closeness without the substance of it. And the next morning, when the alcohol wears off and your prefrontal cortex comes back online, you feel the gap. Sometimes worse than before.

The Feeling of Connection vs. The Real Thing

This distinction matters more than almost anything else in this conversation.

Connection isn’t a feeling. It’s a state. It requires your brain to be fully online. It requires you to actually hear what someone is saying, to respond with something genuine instead of something rehearsed, to be present enough that the other person feels it.

Alcohol can’t give you that. It gives you the warmth. It gives you the looseness. It gives you the illusion of being “in the moment.” But the part of your brain that actually creates meaningful connection is the first thing it turns down.

That’s why you can spend an entire evening at a party, have a great time, feel like you really connected with people, and still wake up the next morning feeling inexplicably alone.

Because you didn’t actually connect. You performed connection with your prefrontal cortex impaired. Your brain knows the difference, even if you don’t.

We Built Our Social Rituals Around the Wrong Tool

Think about how American social life is structured.

Business networking happens over drinks. First dates happen at bars. Friendships are maintained at happy hours. Celebrations center on toasts. Even grief has a drinking culture around it.

Every major social ritual in American life has alcohol as its default operating system. And if alcohol is actively impairing the part of your brain that creates real connection, then we’ve built our entire social infrastructure around a tool that undermines its own purpose.

That’s not a character flaw. It’s a design flaw. And the loneliness epidemic is, at least in part, the result.

A Physician’s Perspective

“What people are chasing at every happy hour, every dinner party, every first date is genuine connection. Not the feeling of connection. The real thing. Alcohol gives you the feeling. It doesn’t give you the thing. That requires being actually present. Not sedated-present. Not three-drinks-in-present. Present. And until we give people a tool that supports that state instead of simulating it, the loneliness numbers are going to keep climbing.”, Dr. Marhamati

Why We Built SoulBloom Around Presence

Radiance was designed for exactly this moment. The room you’re about to walk into. The dinner you want to actually enjoy. The conversation you want to remember.

It’s not a sedative. It’s not intoxicating. It doesn’t suppress your prefrontal cortex. It works on serotonin pathways to produce a gentle lift in mood and ease without turning down the parts of your brain that do the actual connecting.

The clinical evidence on kanna is early. We say that clearly. But the experience people describe is remarkably consistent: they feel like themselves, just lighter. More present. Less in their own head.

That’s not a marketing claim. That’s the most human thing in the world. And it’s the opposite of what alcohol does.

57% of Americans feel lonely. The answer isn’t more connection. It’s better connection. And that starts with actually being present for the connections you already have.

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. If you are pregnant, nursing, have a medical condition, or are taking medications, consult your physician before use.

Discovering Kanna: A Surgeon’s Path From Burnout to a Clear Head

Dr. Shawn H. Marhamati, MD · 8 min read

I am a urologic surgeon. On paper that means I fix plumbing. In practice it means I see 40 patients on a clinic day, operate on the days I don’t, and carry the quiet weight of every outcome home with me.

Urology is not usually the specialty people picture when they think about physician burnout. They picture the ER, or oncology. But the data tells a different story. In recent national surveys of physician burnout, urology consistently lands at or near the top of every list. We are one of the most burnt out specialties in medicine, year after year. I did not need a survey to tell me that. I felt it in the drive home.

So a little over a year ago, I did something that had nothing to do with medicine and everything to do with it. I stopped drinking.

Not forever, and not with any grand plan. I just wanted to see who I was without the glass of wine that had quietly become punctuation at the end of every hard day. I took almost a full year off alcohol. What I found in that year is the reason I am writing this.

The Market Noticed Before I Did

It turns out I was not alone. While I was rethinking my own relationship with alcohol, an entire generation was doing the same thing at scale.

Gen Z is drinking roughly 20 percent less than Millennials did at the same age. More than a fifth report not drinking at all. And the money followed the behavior. Over the past four years, analysts estimate the global alcohol industry has shed around 830 billion dollars in market value, a drop one analyst described as four times the impact of the financial crash. This is not a fad. Researchers are calling it a structural change.

People are not just putting the drink down. They are looking for something to pick up in its place. That is the part the market has not fully answered yet.

What Alcohol Actually Does, and Why That Matters

Here is the mechanism, in plain language.

Alcohol works largely on a neurotransmitter called GABA. GABA is your brain’s brake pedal. Alcohol presses that pedal for you, broadly and bluntly, which is why a drink quiets your frontal lobe, loosens your inhibitions, and takes the edge off. It also why the edge comes back sharper the next morning, and why the brake wears out with repeated use.

When I went looking for something that could offer a little social ease and calm without hijacking that system, I kept running into the same plant.

Kanna

Kanna is the common name for Sceletium tortuosum, a small succulent that grows in South Africa and has been chewed and used there for centuries. What caught my attention was not the folklore. It was the pharmacology.

Kanna does not press the GABA brake the way alcohol does. Its most studied compound acts as a serotonin reuptake inhibitor and a PDE4 inhibitor. In other words, it appears to work by gently modulating serotonin, the same broad system many mood medications target, rather than by sedating you into submission. Different pathway, different feeling, different morning after.

The research is still young, and I want to be honest about that. But it is real, and it is growing. A few studies stand out.

In 2013, Nell and colleagues ran the first randomized, double-blind, placebo-controlled trial of a standardized kanna extract in healthy adults. Over three months, it was well tolerated, with no meaningful changes in vital signs, ECG, blood work, or body weight. The most common complaint, headache, actually showed up more in the placebo group.

That same year, a brain-imaging study by Terburg and colleagues found that a single 25 mg dose reduced reactivity in the amygdala, the brain’s threat-detection center, in response to fearful stimuli. That gives us a plausible biological fingerprint for the calm people report.

A later randomized, placebo-controlled crossover study by Chiu and colleagues pointed to improvements in cognitive function, consistent with the PDE4 mechanism.

None of this makes kanna a miracle, and I would be a poor physician if I let you believe otherwise. The trials are small. We need larger and longer studies. But the early safety and mechanistic picture is encouraging enough that I stopped thinking of kanna as a curiosity and started thinking of it as a serious tool.

Where My Day Job Comes Back In

As a urologist, one line of research made me sit up.

Investigators are now looking at kanna’s serotonergic activity for a very specific problem in men’s health: premature ejaculation. The logic is not exotic. The most common off-label prescription for premature ejaculation today is an SSRI, precisely because delaying serotonin reuptake tends to delay climax. Kanna touches that same pathway.

Early preclinical work has been promising. A specific kanna-derived alkaloid, KH-001, delayed ejaculation in a dose-dependent way in an established animal model, while other alkaloids did not, and that finding has moved into the patent and early clinical pipeline. This is preclinical and early-stage science, not a treatment you can buy, and I want to be clear about that distinction. But as a surgeon who spends his career on men’s health, watching a botanical touch the same lever we currently pull with prescription antidepressants is genuinely interesting.

The Bigger Conversation

Robert F. Kennedy Jr. is a controversial figure, and reasonable people land all over the map on him. But when he recently put a spotlight on America’s reliance on SSRIs and the way we sometimes reach for a prescription before we reach for anything else, he touched something real. Many patients start these medications without a clear sense of the risks, the timeline, or how they will eventually come off them.

You do not have to agree with the messenger to agree that the conversation is overdue. Tens of millions of people are quietly managing daily stress, low mood, and social anxiety, and our default answer has narrowed to a prescription pad. That is not a knock on antidepressants. They are the right call for a great many people and they save lives. It is simply a recognition that the space between “totally fine” and “needs medication” is enormous, and most of us live there.

I believe kanna has a role to play in that middle ground. Not as a replacement for medicine, but as one honest option for the person who wants to take the edge off a hard day without a drink and without a prescription.

One Important Safety Note

Because kanna acts on serotonin, it should not be combined with SSRIs, SNRIs, or MAOIs. If you take an antidepressant of any kind, do not add kanna without talking to your physician first. This is not fine print. It is the single most important sentence in this article.

Why I Built Something

“I did not set out to start a company. I set out to get through a hard year without a drink.”, Dr. Marhamati

Somewhere in there, the physician in me could not leave the science alone, and my co-founder and I ended up building SoulBloom Wellness, a line of physician-crafted, kanna-based supplements designed as an honest alternative to the after-work drink.

I am biased. I helped make the thing. So take my enthusiasm with the appropriate grain of salt, do your own reading, and start with the studies I named above rather than with me.

But if you are one of the millions rethinking the role of alcohol in your life, or just looking for a calmer way to close out a hard day, I think this plant is worth your attention. It certainly changed mine.

Scientific References

1. Nell H, Siebert M, Chellan P, Gericke N.
A randomized, double-blind, parallel-group, placebo-controlled trial of extract Sceletium tortuosum (Zembrin) in healthy adults.
J Altern Complement Med. 2013;19(11):898-904.
PubMed

2. Terburg D, Syal S, Rosenberger LA, et al.
Acute effects of Sceletium tortuosum (Zembrin), a dual 5-HT reuptake and PDE4 inhibitor, in the human amygdala and its connection to the hypothalamus.
Neuropsychopharmacology. 2013;38(13):2708-2716.
PubMed

3. Chiu S, Gericke N, Farina-Woodbury M, et al.
Proof-of-concept randomized controlled study of cognition effects of the proprietary extract Sceletium tortuosum (Zembrin) targeting phosphodiesterase-4 in cognitively healthy subjects: implications for Alzheimer’s dementia.
Evid Based Complement Alternat Med. 2014;2014:682014.
PubMed

4. Pfeiffer T, Gericke N, Razanakolona M, et al.
KH-001 delays para-chloroamphetamine-induced ejaculation in anaesthetized rat.
J Sex Med. 2026;23(4):qdag044.
DOI

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. If you are pregnant, nursing, have a medical condition, or are taking medications, consult your physician before use.

Dr. Shawn Marhamati is a board-certified urologist and co-founder and CMO of SoulBloom Wellness. You can learn more at soulbloomwellness.co, connect with him on LinkedIn, and follow along on Instagram and TikTok at @soulbloom_wellness. This article is for general education and is not medical advice. Dietary supplements are not intended to diagnose, treat, cure, or prevent any disease. Talk to your own physician before making changes, especially if you take any prescription medication.