"It can also exacerbate mental health problems, especially anxiety and depression. One major American study suggested that up to a quarter of young alcoholics have social anxiety disorder."
The first sentence might be true for all I know, but I can't see how the second one makes for supporting evidence.
Yes, alcohol works that way. But self medicating with alcohol is risk factor for alcohol dependence. That is why it is not prescribed for anxiety as a cure - long term results are not good.
Right, but I think the point is that, while this method works best for you, there are also higher risks associated with it. And while you might be ok with just two drinks, others in your position might need three or four drinks to make them stop freaking out at a party. And still others might not need that many, but having a couple drinks might lead to more, as inhibitions are lowered and judgment is weakened.
I'm not a drinker, and used to be a recluse, but once in a while there's a birthday I cannot refuse. I get there, stay miserable, drink a bit, keeps miserable, gets home at 3am.
I woke up at 7am like a champ, jumping out of bed as if it was a 2 weeks holidays.
Alcohol gets very bad press today but for me, that tiny bit of alcohol helped me stay at a party which probably refueled some social needs (even if shallow).
A lot of the points here talk specifically about the harms associated with binge drinking or alcoholism. Certainly, those are hazardous in many different ways. But "Against Alcohol" implies harms from any drinking so great that teetotaling is justified, which is questionable.
There's little evidence that light or moderate drinking has major negative health effects. Anything under 10 drinks per week only has a very slight negative effect on all-cause mortality, and anything under 7 drinks per week has no effect: https://marlin-prod.literatumonline.com/cms/attachment/9e0c4... (A standard drink is 14 grams, so the 7 and 10 per week marks are just before 100 and 150 on the x-axis).
Assuming this site has decent numbers, in the US around 5% of people >26 years old have an "alcohol use disorder". Presumably the majority of those are addition disorders. But that means that after 12 years 95% of them will still be fine.
It's a highly addictive substance which creates chemical dependence over time - for some, never, but a vast percentage of people are vulnerable to the gradual creep of addiction.
> but a vast percentage of people are vulnerable to the gradual creep of addiction.
Sorry, you're gonna have to back up this rather hefty statement with some facts. I've never seen any data to suggest that a "vast percentage" of people are at risk of becoming alcoholics.
>> but a vast percentage of people are vulnerable to the gradual creep of addiction.
> Sorry, you're gonna have to back up this rather hefty statement with some facts. I've never seen any data to suggest that a "vast percentage" of people are at risk of becoming alcoholics.
"vulnerable to the gradual creep of addiction" and "at risk of becoming alcoholics" are not the same thing. A person might refrain from alcohol altogether because they believe, perhaps due to their family history, that if they drank on a regular basis they would become alcoholic. IOW, they feel they are vulnerable to the gradual creep of addiction. And they might be right. But as long they don't drink at all, they're not at risk of developing alcoholism.
The claim was a "vast percentage of people are vulnerable" to alcoholism. Their reply supports my interpretation of their comment.
This isn't about the propensity of an individual to develop alcoholism based on personal circumstances. This is a population-level claim with no data to back it up.
Frankly, I'm not even sure what you're arguing but it seems wholly disconnected from the OPs claim or my counterpoint.
> The claim was a "vast percentage of people are vulnerable" to alcoholism.
Uh, the claim was that "a vast percentage of people are vulnerable to the gradual creep of addiction." As it was written, rather than as you interpreted it, it's a statement that, based on my experience and observations, I believe is correct.
Of the many things I've tried, cigarettes (likely the chemicals rather than the tobacco) was the most habit forming. I remember working a co-op term in Montreal in the winter and taking up the habit. At somewhere over a pack a week was habit forming. Less didn't seem to be.
I've drank lots, both socially and just at home for no reason. I enjoyed having many different beers around and consumed what was on-hand but never got to the point I made special trips to stock it. Similarly for wines or spirits (vodka, tequila, whiskey, wine).
Lately since there's little social occasions to drink, I've taken to consuming a bottle of red per week with/after meals. It seems to help with sleep (since I also have a couple cups of coffee throughout the day) than without.
Edit: Also recalling that it wasn't all that long ago, historically speaking, that Quebec still allowed smoking inside the office, and there was one woman who I worked with that had a rolling machine and a large ashtray that always needed emptying. It was like a weird trip in a time-machine.
Probably not, compared with someone (such as me) that does drink lots.
> I've taken to consuming a bottle of red per week ... I also have a couple cups of coffee throughout the day
Careful there!
My point is that different people have wildly different ideas about what is acceptable, damaging and addictive, and their ability to deal with it, in one way or another. I easily managed to give up cigarettes because my girlfriend said she would leave me if I didn't. She gave up alcohol (which she was a heavy user of) when she became pregnant (not by me), which is something I know I will never be able to do.
Yes absolutely. I didn't mean to imply that this was in any way universal. Coffee may be the second hardest thing for me. I've successfully given it up for a month or more a number of times, getting all the way through withdrawal symptoms where I generally feel happier and more energetic. So far I've always restarted consumption. Not out of a physical/psychological want but because it's so easy, mildly pleasant, and aids focus during work hours.
But the next follow-up question to what you said would be, why should we focus on only the risk of death to determine harm? E.g., what happens if I exercise and drink a moderate amount of alcohol per week? I believe, AFAIK, I get worse results from that, and I would care about that wasted effort whether it raises my risk of death or not. I understand the logic of it, but I'm not super okay with saying that "causing no excess mortality" is somehow equivalent to "no effect". There are effects in statistics other than death, I think what you're saying means that mortality data alone is not enough to justify teetotalling.
That's a fair assessment when it comes to addiction, but there's also binge drinking which has a fair number of detrimental effects and a decent rate of overdoses. I looked up the rate of incident and was actually surprised at the prevalence throughout age groups, to be honest.
To be clear, I'm not an abolishonist. I do think, however, we should look at the actual potential harm of a substance when making laws. Alcohol is both physically addictive and habitual vs. marijuana or mushrooms. Alcohol and MDMA have overdose risk, where as marijuana and mushrooms do not. Marijuana and MDMA can pose serious psychological risks, especially in adolescents, where alcohol has a much lesser risk. These should all be reviewed in a scientific and dispassionate manner when defining laws, is all I'm suggesting.
I think there's 2 arguments here. One is, as you pointed out, binge drinking is bad for you. I think most people would agree.
The second argument, primarily in the second half of the article, is that creating the conditions to easily permit binge drinking is just a severe a problem.
>> It’s possible to consume alcohol in a safe manner... But at some margin, you are contributing to the idea that it’s normal to drink it. And we need to break down that norm.
In other words, every drink you order in public has a >1 R0 to make one of your buddies also order a drink. Conversely, every drink you don't get has <1 R0.
I'm sure we've all been in those situations at a bar where we say "I'll get (another) one if you get (another) one".
That's why he vouches for abstinence. Not for health, but to discourage a binge drinking culture that's quite pervasive, in the UK especially.
Instead of just all-cause mortality, measure health and quality of life, as well. I know someone with a seizure disorder from drinking, and someone with heart problems from alcohol. It's yet to be determined whether or not alcohol will contribute to their deaths because they are still alive.
However, their quality of life is certainly lower than it was before alcohol. They require daily medications with side-effects, need to see expensive specialists, require expensive lab work to be run regularly, and have to worry about what happens should they go without their medication (ie suffer brain damage from seizing, have a heart attack, and/or die).
Imagine if instead the same number of people would consume heroine or LSD or other similar drugs at that level, as several people here are advocating for.
Do you think that the human race would have any chance of survival?
LSD and other psychedelics actually have incredibly low harm potential. They're usually at the absolute very bottom of any harm chart.
In fact, mushrooms and LSD are the two least harmful recreational drugs per the Economist chart from 2010. Number 1 is alcohol and number 2 is heroin and crack. Meth is a pretty distant 4th. [1]
They're not addictive, in no small part because they're not really "fun" in the classic way cocaine is. They're interesting, but you're really not in a hurry to do them again. Further, the LD-50 is really, really, really high.
Sounds like a strawman argument to me. I don't see anyone advocating that people do heroin as much as they ingest alcohol.
LSD and other 5-HT2A agonists are self-limiting in that they induce a massive tolerance after a single dose, making subsequent doses either not work or give diminished effects that do not increase with increased doses. They also are not physically addictive like alcohol is, nor does LSD cause organ damage like alcohol does.
Beyond overdoses, opioids, other than ones like MPTP, don't cause physical harm to the body like alcohol does. The dangers of heroin come mostly from its criminalization, the criminalization of addiction and the lack of access to healthcare to treat addiction. For example, there are millions of people who take Suboxone, a long acting and powerful opioid that stays in the blood for 30+ days, without it causing organ damage or seizure disorders. Street heroin is dangerous because it is unregulated and often cut with fentanyl and stuff that should not be going into veins.
The issues surrounding heroin would be solved with a regulated supply of clean heroin, medical support to administer it correctly, addiction treatment and making all of those things accessible and affordable to the people who need it most. There are several examples of governments that provide all of these things, and they indeed cut down on heroin's mortality and the devastating effects of addiction.
Similar to the person I know with heart disease from alcohol, I know a former heroin addict who also has heart disease from their use. Their heart problem was not caused by heroin, but by the fact that they'd crush pills and inject them without properly filtering them, and the pill binders caused heart damage. A clean supply of heroin and access to addiction treatment would have prevented their heart problem.
Nobody will advocate it, no, but there's a significant set of the population with self destructive tendencies. They're gonna use what they can get their hands on, and lots of whatever it is. I know a few folks who have taken tens of tabs of acid, and every single one was traumatized by the experience; some were incapacitated for months or years following.
I'm in favor of universal legalization, but it's definitely worth considering the impact to everybody, not just the people who use drugs responsibly
> Nobody will advocate it, no, but there's a significant set of the population with self destructive tendencies. They're gonna use what they can get their hands on, and lots of whatever it is. I know a few folks who have taken tens of tabs of acid, and every single one was traumatized by the experience; some were incapacitated for months or years following.
When I was in high school and college, kids would regularly get alcohol poisoning and need medical attention. Some of them would drink, drive and die. People like this will exist whether or not it's legal for them to consume whatever substance they're abusing.
> I'm in favor of universal legalization, but it's definitely worth considering the impact to everybody, not just the people who use drugs responsibly
Criminalization isn't going to stop these people, and even if their use leaves them unscathed, the justice system can impose lifelong negative consequences on them.
This is why I'm in favor of funding real drug education so people can make informed decisions, healthcare so people can get help if their use affects their heath, and legalization so that lives aren't ruined by legal consequences.
Suboxone is the trademark name of a eponymous mix of the inhibitor Naloxone added to Buprenorphine.
Many formulations contain small enough amounts of Naloxone to permit a addict to take opiates without any significant adverse effects within a few hours.
The reason why people use the name synonymously is because Buprenorphine is a Mu Kappa Delta antagonist with sufficiently higher affinity to those receptors making it very much harder for other opiods to bind preferentially. Slow release formulation and slow linear bioavailability decline profiles suffice to do the rest of the job of making say heroin ineffective if the patient takes anything else.
I'm saying this so no one is under any impression that Suboxone is a safe drug for anyone to take (accidentally or otherwise) and off the top of my head a commonly used 8mg dose is roughly 100mg Morphine equivalent.
Naloxone isn't orally active, so it isn't actually inhibiting anything for people who aren't abusing it. The opioid blocking effect comes from buprenorphine itself, as it is a partial agonist with a high binding affinity. It binds preferentially to the mu-opioid receptor compared to many opioids, and as a partial agonist, it has a weaker effect than some other opioids.
Most addiction specialists now subscribe to a definition of addiction that's something like, "repeated use in the face of adverse consequences" and I'd just say that in my life practically everyone I know who drinks has experienced adverse consequences from alcohol. These are frequently laughed off as rights of passage or minor embarrassments, but they include stuff like missing work with a hangover, driving when they shouldn't have, saying cruel things they wish they wouldn't have, getting in fights (physical or otherwise) they otherwise wouldn't have, behaving more aggressively than they normally would, behaving embarrassingly in public, skipping social events because they'd drank too much or were hungover, and on and on.
Again, even the people in my life who think of themselves as moderate drinkers without even the hint of a problem would have to acknowledge multiple incidents that fit the above criteria, if they were honest.
Because we live in a culture that tolerates alcohol we view a lot of this behavior as insignificant in a way that you wouldn't if somebody at a party were exhibiting signs of, say, cocaine intoxication. "Bob didn't come to work today because he used too much cocaine" sounds like a serious problem, but "Bob didn't come to work today because he's hungover" may elicit knowing laughs from the co-workers who were with him at the bar the night before.
Most people won't become fall-down drunks who lose their jobs and their spouses and everything else, but that's a pretty weak standard for harm.
> A lot of the points here talk specifically about the harms associated with binge drinking
Except that "binge drinking" is the norm for a lot of people.
Think about how much drinking surrounds sports events--it's really easy to fall into the trap of "having a couple extra"--and a stadium cup is often close to 2 drinks in quantity.
Suddenly, you're in the "7 drinks" range without even trying very hard.
Ah, delightful. The progressive neo-puritanical fringe has come around to 1880 again; time to storm the bars with hatchets and howl for prohibition because that worked So Well last time!
smoking really only became fashionable post-ww1. Alcohol consumption may have motivated early agriculture.
It's unlikely that something as ingrained as alcohol will be made unfashionable except on multi-generational time scales.
That being said, the current trend of alcohol in every aspect of life might become pase, as more individuals seek to avoid drunkeness/temptation outside of a bar.
Or maybe just let be? What's up with this militant righteous, virtuous drive to force ideals upon others. Humans have been getting drunk on fermented crops since the dawn of time. But now, thanks to social media, people can comfortably invent some imaginary moral high ground from their homes, proclaiming the lifestyle of millions of fellow people unacceptable.
Maybe expand the mind a bit, visit a strict Arab country or something. They don't drink much there. Has nothing to do with health though. It might help get a picture what kind of society they are advocating for.
I don't think the point here is some righteous/virtuous one. The argument is that alcohol causes billions of dollars in increased health care costs and decreased productivity, and is a leading cause of death and other health issues.
I'm all for dropping restrictions on things that people can do that don't harm anyone else, but frankly I don't care to spend more money on health insurance because a bunch of people want to drink too much.
I am not for any restrictions on any drug. That's puritanical, surely. However I am very much for BANNING all advertising from alcohol industry. Why do they need to market a drug that basically already sells itself via culture?
While I can't speak for the UK, the US has a small hurdle to bans on particular kinds of speech: the First Amendment. Add to that the first section of the Fourteenth Amendment (i.e. the Equal Protection Clause.) Alcohol producers have as much right to advertise as, say, someone selling chocolate bars (a 'sinful,' sugary food) or bacon (for all its alleged carcinogens) or prescription drugs (some of which have potentially lethal side-effects,) so it'd be tough to single them out for suppression. Not that Americans haven't tried using later constitutional amendments to prohibit things they don't like...
You'll note that, while 'there are many restrictions,' there is no outright federal ban on tobacco advertising--were it possible, why not do it?
I also wonder if there's more to tobacco advertising then meets the eye: unlike alcohol manufacturers, Big Tobacco doesn't seem interested in challenging current restrictions to selling their product. And if they aren't interested, that says more about Big Tobacco than the First Amendment. But it's hard for me to say as I'm no expert on the tobacco industry.
> You'll note that, while 'there are many restrictions,' there is no outright federal ban on tobacco advertising--were it possible, why not do it?
Not super familiar with specifics around the restrictions because I can't remember the last time I saw a ad for tobacco; meanwhile I have seen 10+ alcohol ads today. I would say the restrictions effectively ban tobacco advertising
I agree with your point; from skimming Wikipedia [1] I would argue that restrictions were gradually imposed through acts of Congress and I would imagine largely uncontested by Big Tobacco because they lacked leverage due to the series of scandals involving them. I think you are right that the major alcohol brands would fight back largely because they don't have their hands behinds their back
American obsession with the 1st amendment is so odd. It doesn't allow for any reasonable discussion of nuance of speech.
But, i think there is precedent for advertising, there are restrictions on tobacco advertising. I don't see why it can't be extended to other things that are advertised.
> American obsession with the 1st amendment is so odd. It doesn't allow for any reasonable discussion of nuance of speech.
Who defines 'reasonable'? As the federal government can't involve itself (which is at the heart of this so-called obsession,) the participants in the discussion will have to determine that for themselves. And if they can't agree on what is 'reasonable'?
> restrictions on tobacco advertising
There are restrictions, a brief history of which can be found at Truth Initiative[0]. I wonder, though, if these restrictions remain in place because no one in Big Tobacco will challenge them? Especially if these same restrictions help to keep smaller players out of the market...
Idk why you picked on the word reasonable. But your proving my point by attempting to shut down the discussion already
In reality the government is already discussing what is protected and what isn't. Free speech is an illusion. Otherwise we wouldn't have exceptions to free speech. There wouldn't an fcc if it it was truly free.
I think we should be explicit about what is protected and what isn't. We want to protect the expression of criticism of our government. I don't think we should be making choices about how society functions based off of ambiguous tweet sized one liners. This site your commenting on has higher expectations, maybe our bill of rights should too.
Is advertising really speech? It's ideas with the intent to manipulate people, commercial propaganda. What is speech, maybe we should define that better. It could be the ideas and opinions of individuals. Its a mistake to provide the same protections to a corporation.
There's nuance to speech, the 1st amendment is ambiguous. The intent is protect people, government exists to protect people. The rest of the world is successful without a almost religious devotion to free speech, there's no reason why the us can't, if anything it's detrimental to our society.
> Idk why you picked on the word reasonable. But your proving my point by attempting to shut down the discussion already
I picked 'reasonable' because the word has different connotations depending on the participants, for example, I may believe I'm being reasonable, whereas you may believe I'm being obstinate. And that's just talking about the word 'reasonable.' Toss the question of 'who's being reasonable?' into a heated discussion between opposite sides of a Covid-19 debate, or an immigration debate, or an abortion debate, or an Apple debate, and see where it gets you.
> There's nuance to speech, the 1st amendment is ambiguous.
The FA is anything but ambiguous. 'Congress shall make no law...' That's Ten Commandments territory as far as clarity goes. Speech coupled with action, or with imminent action, or with likely physical harm is where the US Supreme Court has generally allowed lawmakers to go hog-wild. Burning the US flag (political speech,) using racial epithets (hate speech,) publishing graphic pornography (sex speech,) and refusing to testify against one's spouse (silence) have all been green-lit by SCOTUS.
As has propaganda. Why do you suppose the press is given such wide latitude in libel cases against them by public figures[0]? The press can sway public opinion for or against a politician via lie by omission, reliance on alleged anonymous sources, outright lies and later retractions, out-of-context quotes, associating irrelevant stories or images with a politician, interpreting the politician's words, non-reporting, etc. What is this other than outright manipulation (of both facts and people) and propaganda?
We can further discuss the propaganda(s) of national holidays, of political treatises (e.g. Das Kapital,) of American invasions into the Middle East, all of which are seemingly allowed by SCOTUS, but I'll wrap up by sticking to television commercials--why should ASPCA or The Humane Society be allowed to tug at my heartstrings via dogs in cages? Why should the Reverend Franklin Graham be allowed to preach the word of Jesus to me when I've lost a loved one? Why should a PAC be allowed to run ads associating my pick for the US Senate with forest fires, an abhorrent murder or the decisions of another unpopular politician? Should non-profits and tax-exempts be allowed more/better free speech rights than commercial entities when they engage in the same manipulation techniques as those entities?
reasonable was probabaly a bad word choice on my part then, sure we can have unreasonable view points in a a discussion, but even if your not talking from an extreme point of view it gets shut down, people believe free speech is all or nothing, where "all" is ambiguous. There is plenty of middle ground of expression.
I don't know why you think im talking about the first 5 words. Look at the relevant part
> Congress shall make no law ... or abridging the freedom of speech, or of the press; ...
That is all it says, its open to interpretation. Free speech for who, and how is speech defined. What did the they have in mind when they wrote it, it likely wasn't 21st century communication. It is ambiguous. Did they even have businesses in mind? We already not all forms of expression are covered.
Yes all those points you bring up suck about advertising. Why should it be allowed? Why is the news able to be misleading. Why are are we being emotionally manipulated by corporations to buy? Because we can't have a discussion about free speech in America and it nuances. People are so die hard about their right (that doesn't even exist the way they think it does) and fall for slippery slope fallacies. We absolutely should real in advertising, both corporate and political, we should real in manipulative news reporting. None of these freedoms are helping the world, and if anything chipping away at others.
100% Free speech is a detriment to society, it is too idealistic. We can start with these ideals, but the need to figure out how they apply in a world with moral-less actors. We should figure out what we want in regards to forms of expression and content, be clear about it and protect society from entities that want to abuse their rights to take advantage of others.
As this thread has died, I'll leave off with a couple of parting comments--as I previously mentioned, the idea of 'reasonable' will change depending on who you ask. When you say 'We should figure out...,' rather than leave reasonableness to an individual 'I,' now it's given to a multitudinous 'we.' That is, the idea is given a democratic flavor, wherein if a majority (even by just one person) thinks this or that speech act is unreasonable, it can enforce its prohibition.
Given your reasonable fear of manipulation/propaganda by those in power, can you see where this might go wrong?
Thus, as Americans, we've done more or less what you've asked--we laid out the ideal, 'Congress shall make no law...,' then we set our local, state and federal bodies of government on the problem of how to work within this ideal. Which, if the solutions are reasonable, will remain law. Which, if an individual (e.g. a flag burner) or a multitude (e.g. a religious sect) thinks are unreasonable, will be challenged through later legislation or through the courts. Potentially landing at the doorstop of a nine-member group called SCOTUS who, using their collective wisdom, will tell us whether we've (or our bodies of government have) gone too far. (And if we as a nation disagree with their decisions, we as a nation have remedies for that as well.) All in a world of moral-less actors.
I wouldn't describe it as a particularly "progressive", "neo-puritanical", or "fringe" belief. Tyler Cowen advocates for abstaining from alcohol. While Matt Yglesias doesn't go as far as abstention, he does support higher taxes as a means to curb consumption, both as a way to balance budgets and curb some of the nastier public-health side effects. There's a public policy conversation to be had here.
Taxing alcohol is not straight forward because everybody can make it at home with everyday items. Raise taxes too much and people will start their own basement distilleries which will then send methanol poisoning cases through the roof.
Brewing beer for example is extremely easy. Everybody can do it and there is even a whole community around brewing at home.
As the article notes, at least in the UK, taxes in the 50's were three times as high. As someone who has distilled alcohol in a garage before, it's incredibly labor intensive at small scales. Brewing beer is doable, but it is not "extremely easy" by any measure, especially if the goal is reasonably decent tasting beer. Alcohol taxes would need to be extremely high before black market alcohol became an issue of any significance.
The article isn't pushing prohibition. It's arguing for disincentives (higher taxes, minimum unit pricing, restrictions on when and where alcohol can be purchased), which has shown to reduce drinking vs. a lack of those restrictions.
Another option it pushes for is for people to abstain voluntarily, if they are of the type of person who doesn't get much out of alcohol, but mainly drinks it out of social obligation.
That's a strawman argument. I enjoy alcohol on occasion, but essays like this make me wonder if the limited pleasure I get from alcohol is worth it. I know a number of people who struggle or struggled with alcohol addiction. Do I really want to promote drinking by buying a round at the bar, bringing a case of beer to the party, or just conforming to the norm of drinking at parties? Maybe not.
Any thoughts on how to avoid the folly of restriction on alcohol? There seems to be multi-pronged issues, one being that the chemical messes up our body and is largely incompatible, and even if we altered the chemical someway and left the fun effects, we still have the issue of people being taken advantage of while experiencing the effects. But the trade in alcohol is so great that any state sponsored curbs on consumption results in a worse illicit reality.
these exist. ghb, methqualone, barbiturates, and benzodiazepines all have a similar mechanism of action, cross-tolerance, and similar withdrawal syndromes, but fewer side-effects than alcohol. alcohol withdrawal is often treated with benzodiazepines.
they are all heavily controlled, and benzodiazepines are considered some of the most damaging and addictive substances of abuse.
Right, it's less draconian than outright prohibition and while the illicit trade will surely exist, for most people the default bias will (probably) be there.
I don't think anyone is arguing for prohibition. We've seen that fail with every substance we've tried it with.
Public health/education campaigns, however, can be wildly effective with enough funding. Smoking cessation in particular has been massively successful even with no change to legality and billions of dollars of tobacco industry money doing everything they can to reverse it. The public health campaign in the US managed to turn cigarettes from chic to trashy and have made prohibition unnecessary. I could imagine the same happening with alcohol (and other problematic substances) on a long enough timeline.
I agree they aren't arguing for prohibition at all. I don't fully believe what you said about health campaigns because, for example, obesity is also really bad for people and none of the existing campaigns against it had much of an impact, as far as I know. Furthermore, if one of the key concepts was to turn cigarettes from chic to trashy, then that seems really unlikely to work with either alcohol or obesity. How do you even really know why that one particular massive campaign was successful?
Obesity is very bad example. You don't wake up in the morning and decide to be obese this day and you don't wake up next morning and voila you are thin.
The campaigns against obesity don't make people thin, because half the time they don't even promote stuff that makes people thin. Half the time they promote diets that makes situation worse in the long term.
Campaigns against smoking did worked in the past. Drug use is down. Teenage v pregnancies are down. All stuff that involved campaigns.
Yeah. While I imagine quitting smoking isn't itself easy, the concept of "don't smoke anymore" is very different and easier to grasp than "be less fat". Not smoking is a direct action you can take; losing weight is a complex process that can involve many lifestyle and diet changes, and the exact route to losing weight can be very different for different people.
As far as I know, quitting smoking cold-turkey is one of the hardest ways of doing it, and most people change their habits gradually over time, so I don't know that your example is the best here.
I have no evidence, just observation. With regard to obesity, it's a relatively newer problem compared to smoking and I haven't seen nearly as much public facing campaigning to fix it. For example, I don't think I've ever seen a PSA about eating less, whereas I've seen literally hundreds about cigarettes since I was a child.
Admittedly, most anti-obesity campaigns also seem to be neutered by lobbying. "Stop drinking soda" becomes politicized and turned into "move" by lobbyists. Taking a 30 minute walk is great advice for overall health, but will do absolutely 0 to address obesity.
I guess overall, there's no guarantee of success here, but I tend to view the shift in public sentiment about tobacco as a direct result of public health efforts. Which leads me to believe it's at least possible for other issues (obesity, alcohol). But certainly it is difficult and with unknown risk of failure.
I smoked for years and the public health campaigns had no positive effect on me or anybody I know. I actually developed a certain level of contempt for how much they manipulated the statistics, and generally took a non-evidence based approach to their regulation. The primary piece of government intervention that got me to quit was taxing the hell out of it. As much as I don’t like the government presuming it can make risk decisions regarding how I choose to live my own life, I like paying it taxes even less. My personal motivations were firstly avoiding the nuisance of dealing with the odor, and secondly the health impacts. I also expect that all the advertising restrictions has likely had an impact, but that didn’t personally influence me at all.
There are loads and loads of laws that prohibit smoking in all sorts of places and massive sin taxes among many other things. Chalking it 100% up to public health PSAs is inaccurate
Fair point. But still a far cry from current drug prohibition and alcohol prohibition of the 20s. Not being allowed to smoke in a restaurant is an entirely different animal than mandatory minimum jail time for anyone who possesses a cigarette.
I think the greatest gift of American prohibition is that it removed prohibition from the menu completely for generations. I believe its legacy has also aided arguments against the broader War on Drugs.
Alcohol abuse is the problem; not all alcohol abuse is tied to alcoholism. Plenty of non-alcoholics abuse alcohol. (And some alcoholics don’t, though that’s a constant struggle.)
It's the difference between long-term dependency and short-term overuse. There's plenty of overlap, of course. Many people's need for alcohol leads to both behaviors. But they're still conceptually different things. It's possible, though perhaps rare, for an alcoholic to drink every day but never enough to be a danger to themselves or others. It's all too common for people in their teens or twenties to binge drink and get themselves or others killed, without ever being alcoholics.
There are plenty of people who will drink every day of their life in a way that evidences dependence, but with little or no evidence of abuse. I've had some of these in my family. They drank at the same time in the evening and in the same quantity every day for decades, and they were likely in some state of mild chemical dependence, but the addiction, as it were, never caused any trouble whatsoever.
It's not useful to call these people alcoholics.
Likewise, it would be absurd to label people who drink coffee or tea daily with "caffeinism", even if physical dependence is present. And we don't label people who are chemically dependent on anti-depressants with "SSRI-ism".
In my mind, attaching an "ism" to a substance is only useful to identify pathology, which doesn't necessarily have anything to do with dependence.
> were likely in some state of mild chemical dependence
> It's not useful to call these people alcoholics.
Whether it's useful is not the point, especially whether it's useful to you personally. Alcoholism has a definition, which revolves around dependence. If they're dependent they're alcoholics, and it's still different than non-dependent binge drinking. You're basically trying to make the same distinction I just did (contrary to your own "they're the same" from two posts earlier), except that that you're using the term "alcoholism" for the wrong side of the distinction.
> In my mind, attaching an "ism" to a substance is only useful to identify pathology
You're using "pathology" in a very idiosyncratic way, almost opposite to its real meaning. To a clinician, social effects are not pathology. The pathology is the causes and effects on the individual, so dependence qualifies but wrecking your car doesn't.
> Alcoholism has a definition, which revolves around dependence.
Not... really.
The problem here is that the term "alcoholism" is a colloquialism, not a technical term. Neither the DSM nor ICD uses it. So I suppose it can mean whatever you want, but it would be good for the common usage of the term to be useful in some way, and indeed it is in this case. In everyday language, the term alcoholism overwhelmingly connotes problem drinking. I'm quite steeped in the culture for personal reasons, and I've never in my entire life heard anyone use the word "alcoholism" to refer to completely harmless and controlled consumption.
> contrary to your own "they're the same" from two posts earlier
No, I asserted that alcoholism, in its everyday colloquial sense, connotes abuse. I definitely do not assert the same regarding the notion of "dependence", which does have a widely used technical definition.
If it's dependence that we're debating, I'll argue that mere dependence on alcohol should not qualify it for the "alcoholism" label in the common pejorative sense. If you disagree, then I really am curious why you would not likewise label daily coffee drinkers with "caffeinism"?
In the other direction, I assert that any regular, pathological pattern of consumption indicates a degree of dependence, but I recognize that there's some semantic debate there.
> You're using "pathology" in a very idiosyncratic way, almost opposite to its real meaning. To a clinician, social effects are not pathology.
We're not talking about oncology here. Alcoholism is not diagnosed, treated, studied, or managed quite like a medical condition such as cancer or diabetes. Outside the world of medical doctors, the term "pathology" is usually truer to its greek root "pathos". "Pathologic behaviour", "pathological gambling", etc.
For what it's worth, the DSM and ICD largely classify mental disorders based on behavioural evidence. This is certainly true for alcohol dependence and abuse (DSM-IV) and alcohol use disorder (DSM-V).
> Alcoholism is not diagnosed, treated, studied, or managed quite like a medical condition
Don't throw around terms like "pathology" then. If you have moral opinions about other people's drinking, just say so.
> DSM and ICD largely classify mental disorders based on behavioural evidence
"Behavioral" does not mean only effect on others. The distinction you're trying to make keeps shifting around, but AFAICT it hasn't at any point matched any common one.
That's right. I assert that the term "alcoholism" is most widely and commonly used to denote "alcohol abuse". That's what I said before and that's what I'm saying now. I'll say it again if you'd like :)
And again, I have never in my life heard a pattern of harmless and controlled consumption of alcohol referred to as "alcoholism".
Regarding the notion of dependence, I assert that (1) there is such a thing as alcohol dependency that does not result in or qualify as alcohol abuse, and (2) that in practice all alcohol abuse involves some degree of chemical or psychological dependence. I understand there is semantic debate about this, especially among cognitive scientists, and I'm comfortable taking a side. In DSM-IV, dependence and abuse are diagnosed by completely separate criteria. In DSM-V the criteria are merged under the diagnosis of "Alcohol Use Disorder".
Regarding binge drinking, I'll argue that all regular binge drinking should be considered disordered or abusive. Both DSM-IV and DSM-V guidelines appear to allow some amount of binge drinking to escape a clinical diagnosis, but in my experience regular binge drinking is always abusive in the ways that matter. I bet you every addiction counsellor you'll ever meet will agree with me on that.
> Don't throw around terms like "pathology" then.
Like I said, the word pathology is widely used with a broader meaning outside of hospitals and doctor's offices. But if you're really intent on policing that particular word, I invite you to take up the debate up with a clinical psychologist. Tell them that they're using that word all wrong, and they should use it only the way MD's do. Let me know how that goes.
> If you have moral opinions about other people's drinking, just say so.
No, I have no problem with alcohol, and I'm regularly around quite a bit of drinking. I have no problem making a run to the liquor store for dinner or a party, and I'm always glad to be the designated driver.
My experience leads me to believe that addiction is a disease, not a moral failure. I have the disease of alcoholism, a disease that is diagnosed clinically on the basis of my behavior. Not on my genes or brain structure, but on my behavior. I will never be "cured" of this disease. The best I can hope for is remission, and that's why I can never touch alcohol again, not even a single drink. But that's just my approach. I know there are others, and I don't judge them.
So this would seem to support my assertion that an "ism" generally denotes excessive consumption leading to "problems" by whatever definition one chooses.
If by "not be dependant" you mean "I can quit any time", I think only an unreformed alcoholic would strongly agree.
Even if you could arrange a definition of dependence such that it doesn't apply to a regular problem drinker, then I think the term loses it's utility. The physiology and psychology of dependence is an interesting topic, but the disease of substance abuse IS the problematic behavior.
EDIT: I had to clean this up a bunch, apologies for the butchered first attempt.
Not really; even moderate use is associated with worse long-term health outcomes. The article mentions that one unit per day seems to be an ok amount, but anything more than that (even if you just drink, say four units on a single day, once a week), isn't good for your health.
I enjoy drinking from time to time, and have definitely had nights of excessive drinking that I've found incredibly fun, but I won't try to convince myself it's been good for me.
I doubt there's any study that have determined that single excessive drinking leads to long term consequences. If you know of any please post a reference.
Also, measuring consumption by number of drinks is very inaccurate(for example beer can be 0-32%/vol), plus individual metabolism plays huge role how well alcohol is tolerated.[1]
For anyone clicking through to the comments thinking "I think I sort of need to do something about this but it's too hard/inconvenient/boring/...", I'd like to highly recommend the book "This Naked Mind" by Annie Grace. It's about $7 on most electronic bookstores.
Like everything we use to numb/escape our own minds, alcohol and all the marketing we're fed, and the examples we're set while growing up, make it easy to rationally think we should cut down but there's no way that message is going to be easily accepted by your subconscious!
This is amazing. I just installed it (it's a free app with donations at the end) and is exactly the kind of format that I think will help me succeed at taking more control of my alcohol intake. It actually reminds me of the Ten Percent app which is also excellent if your looking for meditation help. I cringe when I say multimedia is what things need but I really think hearing people talk about what you're trying to accomplish is super helpful in staying motivated.
I find that reading many many articles like these enough has me at least feel a little guilty before grabbing a drink with friends, and I think even that small amount of guilt has reduced my consumption significantly.
The issue is not the existence of alcohol itself. The problem is drinking culture and lax/accepting/apologetic attitudes towards excessive alcohol consumption.
That's why a ban on alcohol won't work this time, either.
I think an under-appreciated angle here is that alcohol, like most other addictions, has a major mental health component. How many alcoholics are self medicating with cheap and easily accessible palliatives, and how many are addicted because of social norms? I’m not sure how to measure that but from personal anecdotal experience I would expect the former to be an order of magnitude larger.
I also think if we look at it from a human suffering perspective as humanists, the Christian moral angle is unneeded. We can offer alternatives to alcohol that are better for people by understanding why they drink. Mental health and general life satisfaction are certainly reasons we would need to tackle for the worst cases, in addition to the established rituals the article talks about. Making moral arguments primarily through Christian theories of sin is a major reason the last temperance movement (in the US) failed, because it did not understand the reasons people drank and offer any alternatives.
From my basic experience and observations of living in the UK (in some not very affluent areas), alcohol is used mainly to relieve daily stresses and the obvious social norms.
I suspect society has normalised taking alcohol to numb daily stresses or problems. So any sudden top down decision to ban it or trying to force a reduction in consumption by raising the prices would be met by a very forceful backlash. Any reduction would have to be conducted with a long term plan that redirects people from this reaction to stress
and also for me, alcohol has seemingly helped me through depression , along with excerse
Problem with government-run alcohol shops is how they reduce available selection of drinks. I'm an avid whisky drinker (though in moderation of course), and being able to buy rarer bottles from specialist shops adds a lot to the experience. It also helps small producers since they don't have to negotiate with a behemoth of a stockist (imagine if the only way to sell whisky would be to negotiate a deal with the state to stock the entire UK's alcohol shops). The ABV limit has also caused trouble in the beer industry where types of beers that require higher ABV aren't produced.
I think the minimum pricing law of Scotland is the way to go when regulating alcohol. When I was living there, the system seemed to work well and incentivised buying higher quality drinks as well. I guess the problem is populist politicians who could easily brand it as limiting poor people's drinking, instead of posh ones.
The thing that's odd to me about only allowing sales from government-run shops is that it's entirely unnecessary. There's no material difference between a government-run shop and the type of privately-run specialist shop you mention. The government can still require that specialist shop to have the same restricted hours that a government-run shop might have.
I live in a state where restrictions on alcohol sales are pretty limited; grocery stores and corner/convenience stores, for example, can sell whatever they want alcohol-wise. Many stores will keep the more expensive stuff in locked cabinets as a shoplifting-prevention measure. I don't think it'd be too crazy to require that all hard liquors be kept that way, and then sales there can even be restricted by time of day if that was desirable. Beer and wine could be left as-is, with no restrictions. (On the downside, this would hurt smaller shops that aren't specifically liquor stores; locked cabinets are an added expense and take up more space.)
Yeah there are already supermarkets that aren't allowed to sell alcohol outside certain hours. I don't know why you need an entire chain of government run shops for that.
I'm not really "for" monopobooze shops but there are solid reasons a government might want them.
Government run shops let you track sales by area in a fine-grained way.
They can be a more effective way to ensure rules around supply are enforced than random inspections / checks.
They let you change the rules (eg opening hours, id requirements, record keeping, banned drinker registry, customer limits) easily without an outcry from retailers who would no doubt claim that any restrictions are onerous and impractical.
They can be placed so as to avoid completely saturating low income areas with booze.
No price wars or loss-leader marketing strategies.
They mean one can buy essentials without going "near" alcohol. Supermarket sales can be an issue for problem drinkers.
Retail profits can go back to the community.
There are other ways you can achieve each of these points of course but monitoring, enforcement and change will all tend to be more difficult in a decentralised vs centralised system.
HN is, for the most part, straight edge as can be about drugs. The only time weed or other drugs are mentioned favorably is when they have some "objective value."
Prevailing opinion of HN comments seems to be getting a lil stupid for fun is Bad.
I don't know, I have seen a lot of pro LSD and psilocybin mushroom micro-dosing posts and comments. I think this place still has a generally libertarian ethos and most people think of drugs questions as best sorted out by a rational market. (My own take is different from that, fwiw).
> Prevailing opinion of HN comments seems to be getting a lil stupid for fun is Bad.
That part might be true. I think there's a tendency to be a little robotic/scientistic/productivist about...just about every topic.
> The only time weed or other drugs are mentioned favorably is when they have some "objective value."
> I don't know, I have seen a lot of pro LSD and psilocybin mushroom micro-dosing posts and comments
These ideas are very much in line with each other. The pro-psychedelic comments very often talk about the "objective" value (studies on mental health benefits and comparative safety) rather than only the subjective experience or ethics of criminalization.
Personally I want all drugs legalized on ethics/freedom principles, but especially with Psilocybin, MDMA, and Ketamine there seems to be a mounting wealth of evidence suggesting these things are miracle drugs in many respects.
He was chairman of the UKs Advisory Council on Misuse of Drugs for seven years until his dismissal for advocating that that illicit drugs should be classified according to the actual evidence of the harm they cause. In Nutts ranking, alcohol and tobacco were more harmful than LSD, ecstasy or cannabis and should thus be subject to stricter regulations.
Its kind of interesting to see which substances people wont give up vs what is seen as a 'menace to society'. Plotted on a graph I suspect we would see Alcohol and Opiates closer together than many other drugs. On the other hand, drinking alcohol is human tradition dating back thousands of years- how do you unwind this? Do we really want to regulate alcohol more strictly? The last time the US tried that it backfired as bad or worse as the war on drugs.
Seems somewhat oversimplified. It's much easier to "overdose" on LSD or MDMA than tobacco or alcohol. Additionally, frequent use of LSD and MDMA have pretty severe health consequences much sooner than frequent use of tobacco or alcohol. I'd also add that LSD poses a similar driving hazard to alcohol. On the other hand, tobacco and alcohol don't have any therapeutic qualities unlike MDMA and LSD. Personally. I think alcohol's harm is amplified by its prevalence throughout society, if one could buy MDMA and LSD at every shop and venue it'd be a disaster on par or worse than alcohol.
As far as I know, there are literally no deaths attributable to LSD overdose. It is safe (if only in the sense of acute poisoning) to take even at much higher than the typical dose. On the other hand, thousands of people die of alcohol poisoning in the United States every year.
You can't meaningfully compare absolute numbers there, though, given the huge disparity in availability and perception. (LSD is "special" in a way alcohol is not: people may be more likely to be cautious when using it.)
You have a source on this? Mdma and lsd are pretty self regulating. mdma will just stop working and lsd likely will just kick your ass sooner or later. opiates and alcohol can be insidious addictions that become normal parts of your life.
Lsd and mdma build up tolerance quite fast and have crosstolerance between each other. Also, almost zero people take lsd and drive. And lsd is anti addictive in general.
This chart clearly is incomplete.
The dimension of tolerance is missing. Can I really take a Xanax every weekend and consistently feel as good as my first time with it? And not feel bad the other days of the week? (the same way as alcohol)
If so then I guess everybody should trade Alcohol for Xanax, is that so simple?
Also Khat is the best on this chart yet I believe that it makes you feel extremely tired the next day.
That being said the topic is really interesting and I am looking forward to a better rational chart.
> I guess everybody should trade Alcohol for Xanax
Benzodiazepines are at virtually the same position on the chart that alcohol is, so I don't think the chart should be viewed as an endorsement for switching. They are of roughly the same level of danger, but that doesn't mean that they are dangerous in exactly the same ways.
David Nutt (the author of the book that was reviwed) is a professor at Imperial College London. He was famously fired as the UK government's chief drug adviser for saying that alcohol and tobacco are more harmful than many recreational drugs.
I've seen his harm score chart quite a few times here on HN [1]
It already exists: GHB. The problem is the drug’s reputation and the problem with dosage, which could be alleviated when legalized. It’s also addictive but then again, so is alcohol but alcohol wrecks your health.
No I didn't get that quite right. Still GHB is a major improvement upon alcohol and I think the dosage problem is mainly an issue of illegality. It's fairly dosable and redosable when you know what exactly you're ingesting. Also GHB doesn't disinhibit aggression as much as alcohol does.
It's pretty easy to drink 3 cups of coffee and not come anywhere near overdosing on caffeine. And then after that you can drink 3 more. And then after that you are probably sick of coffee, but go ahead and drink 3 more if you really want.
I've never taken GHB and don't plan to, but it looks like a recreational dose is ~1/2 of a dangerous dose, both of which would be (at least somewhat) difficult to obtain.
With caffeine, the typical recreational dose is a beverage that is easily obtained and isn't dangerous. That you could buy caffeine powder doesn't make that a typical way to consume it.
Apparently 500 mg of caffeine is considered potentially dangerous. That would be 5 or 6 cups of coffee (I'm in the habit of drinking that much coffee and have a pretty low resting heart rate during the consumption, so I dunno).
I talked to him about it when I met him 10 years ago and was much more optimistic then. As far as I know this isn't any closer to being on the market now than it was back then.
From someone who has tried many drugs and met people who were in the lifestyle.. its not completely true.
Long term use of most substances ALWAYS lead to problems and even the short term there are bad trips, brain zaps that alcohol dont bring. Also even for stuff that do not lead to physical cravings such as mdma, i have seen soo many people falling into an addiction. Its not a game.
Alchol wont be banned ever, but i think is a retarded debate to say "we should decriminalize other stuff be cause alcohl is bad". This is the worse reason possible.
Im quite happy drugs are banned and not mainstream so that my children will stay away from them and maybe try later when they feel more mature.
That doesnt mean i support the american war on drugs or jailing people for 3g of cannabis.. but the decriminalization of weed is stupid to considering two of my friends who have an impaired short term memory after 1 - 2 years periods of abuse.
Alcohol brings seizures, which are considerably worse (and potentially fatal).
>That doesnt mean i support the american war on drugs or jailing people for 3g of cannabis.
How do you intend to enforce the illegality of substances (and in a manner that will cause your children to fear possessing them) without punitive measures?
> Alcohol brings seizures, which are considerably worse (and potentially fatal).
This is literally the first time ive heard about that. That said i do think alcohol is dangerous.
> How do you intend to enforce the illegality of substances (and in a manner that will cause your children to fear possessing them) without punitive measures?
The status quo in my country is fine to me:
Drugs are easily available, fines are low (i know a ecstasy dealer who got caught in a club woth 60 pills and got 3 month of 'potential' jail time that will apply only if he gets caught again) , its badly seen by society and "forbidden".
That means not a lot of people do drugs. Motivated people can acess them, but you dont have a society of degenerate zombies. All good to me.
>This is literally the first time ive heard about that.
I had hoped it was common knowledge that alcohol withdrawal could lead to fatal seizures. People should be aware that going cold turkey (abruptly stopping heavy drinking) can put them at serious risk.
"All the people who want to do drugs are already using them, but society will crumble into degeneracy if they are legalized"?
What do you anticipate changing if they are legalized?
Fascinating graph. However, the methamphetamine measures for economic harm and crime seem intuitively off (undercooked). I've seen people on speed and they are often not fun to be around.
It's measuring total harm across society given current usage rates. Alcohol use being 100x more common than methamphetamine use dominates the relative harm comparison.
Exactly, this is disingenuous to say the least. To measure the danger a drug poses it should be comparing the drugs effect per user, not multipied by how popular it is, or at least show both charts together to remove any doubt.
I have read the study (DOI:10.1016/S0140-6736(10)61462-6) and, although it's vaguely written, it seems to be estimating total society-wide harm given current usage rates. Statements from Nutt such as "Overall, alcohol is the most harmful drug because it's so widely used" (reported at https://www.bbc.com/news/uk-11660210 regarding this study) seem to confirm this.
This is, in fact, the only sensible way to compare the relative harms of drugs. Otherwise, you can't put a number on how harmful X is without specifying the quantity and frequency of use, and they vary widely. With alcohol we know that lots of people consume small amounts weekly with little harm, and some people consume large amounts daily with major harm. The same is true for all drugs. The only data we have is for the current usage levels in society, so it makes sense to report harms for those levels.
At any rate, the paper boils down to "We asked a panel of experts how harmful are X, Y, Z in various ways on a 100 point scale and we averaged those numbers using some weights that seem vaguely plausible and here are the results!" And somehow the Lancet published it.
Having grown up in an area rife with it, it's one of the most destructive things you can imagine. Once it takes over someone's life I just write them off. The become a totally different husk of a person than you knew before. I'm all for legalizing weed but stuff like meth and crack just destroy people completely. Even if they get off of it somehow, it'll likely their brain is so damaged that life is going to be hell for them.
I could be wrong but is that chart showing total deaths. I think it's an unfair picture: many more people take alcohol than illegal drugs. Also as someone who massively regrets their drug use in their youth, I personally feel alcohol didn't damage me as much as weed and mdma. Those drugs really screw with your head. Personally I find booze not so much.
The chart shows a "harm score", made up of 16 criteria, not total deaths. I haven't pulled the full article for what the 16 criteria were, but a little more detail is in the abstract on the Lancet where it was originally published https://www.thelancet.com/journals/lancet/article/PIIS0140-6... . A contemporaneous article from the BBC describes more of the methodology https://www.bbc.co.uk/news/uk-11660210 A choice quote: "The study involved 16 criteria, including a drug's affects on users' physical and mental health, social harms including crime, "family adversities" and environmental damage, economic costs and "international damage".
A friend of mine once told me that he was fortunate to have Asian flush. ADH2 deficiency makes him unable to enjoy alcohol, so he would never get alcohol addiction either.
Addiction does not require enjoyment, and while ADH2*2 (the particular gene associated with the “Asian flush”) does reduce the risk of alcoholism, it doesn’t seem to be a guarantee against it, at all.
There's a few talks by David Nutt available on YouTube and they're well worth watching. One of the most interesting things he mentions is a possible antidote for alcohol. It's theoretical but seems like it should be possible but nobody seems interested in developing it. The other thing is how the alcohol industry drive a lot of the fear and hysteria around other drugs. Loads of people die every single day as a direct result of alcohol, but the one time a girl died while using ecstasy the media went into a frenzy about it.
The alcohol industry seems to me as bad as the tobacco industry.
I've been teetotal for coming up to two years now. I feel better than ever. Alcohol has no positive effects. It serves only to numb the senses. I prefer to experience the world in all its glory. Luckily it's very easy to be teetotal now. As Nutt mentions, you do need to have a glass of drink (that isn't water) at all times in social settings, but I can get a lime soda anywhere and now have a mocktail from many places. Loads of people don't drink either for health reasons, religious or just because they don't want to. It's easy.
When I was a young adult, the rule for meals or other food events for the Episcopal Church in North Carolina was if you serve alcohol you must serve an equally attractive non alcoholic drink. I.E. not water/three cool beers/2 wines, but you know equal. I follow that principal myself and it seems right. It also helps people from drinking a bit then a bit too much, if they wish.
As has been repeated many times before, it's hard to protect people from themselves while at the same time allowing them to be independent and free.
Many things people put into their bodies hurt them in the long run and sometimes the more the faster. Should we prevent them from doing it? In the US, we mostly say no.
It seems to me that most Americans are ok with that.
I think this is true. But there are some ways I think the US inadvertently creates a culture of getting drunk rather than a culture of drinking e.g. many states allow zero underage drinking (so ppl illegally do it anyway and to excess) and we make every other drug illegal (again, depends a bit by state).
Maybe these restrictions do more good than harm. But they definitely do some harm.
The article's conclusions aside, I wonder how many people enjoy the taste of alcohol itself? While my personal beliefs prohibit me from imbibing in a way that would cause inebriation/dependence (and getting buzzed fits in the former), I have tried most kinds of alcohol and have never really "gotten" it. A coworker bought me my first drink on my 21st (a bottle of Jack Daniel's) and a friend made me a Jack and Coke with it. Halfway through the glass I just wanted a plain coke.
Since then, I've tried a wide variety of beer, wine, rum, bourbon, etc and have only once come away from the experience with a "I didn't hate that/I'd buy that again.". The vast majority of the time I've failed to finish what I'm served (or do so out of politeness) and reflect that I'm simply "missing the point" because I'm not interested in inebriation/"buzzed". I'm sure there are those that enjoy the flavor (perhaps in the same way that I "enjoy" very spicy hot sauce), but wanted to ask.
Some alcohols are the best drinks I've ever tasted such as Caipirinha with strawberry and a lot of sugar. If only I could achieve this taste without alcohol.
(note that I rarely drink so my taste is not amplified by an addiction).
Unfortunately such alcohols 1) have a lot of sugar and 2) are not mainstream in my culture but this is e.g in Brazil.
I don't know if it's just the taste or some conditioned response, but having a glass of cold lager (or particularly a pilsner) at the end of a long day tastes like heaven to me, in a way that no other drink does.
I’m similar - rarely drink and dislike most alcoholic drinks - except that I have found certain flavors I like. Usually it’s sweetened wines, or cider. Also it’s often about pairing - the acidity or tartness sometimes just hits the spot.
Good things to compare to are:
- spicy food
- stinky foods (eg cheese)
- coffee
All of the above are acquired tastes. I could barely eat spicy before, now I love it. Stinky cheese makes we want to vomit, but others enjoy it. I only drink decaf, yet periodically enjoy a black coffee, something which seemed absurd when I was younger.
To me alcohol is just one more flavor option. I wouldn’t want it banned just because other people can’t control themselves.
It tastes better when your taste buds age. It was gross until I was about 24 then it became delicious.
This is why when the price of beer went up 18+ people stopped buying it because they only used to buy it as a cheap way to get drunk. Drinks companies switched to making extremely sweet alcoholic drinks to counteract that and marketed them towards this audience to make up the loss.
I used to work in advertising and worked on marketing one of these a products so this is what I heard from one of the worlds largest breweries while doing it.
He seems to be deliberately missing the point. Obviously drinking, especially heavily, is bad for health and plenty of other things. The question is why people still get so much benefit out of it that they keep doing it, despite the downsides. I‘d posit that social lubrication is something people want, and sadly in the UK, self-medication is something a lot of people turn to.
Agreed. Something in us seems to require exogenous chemicals to facilitate social interaction and bonding. I don't think it necessarily has to be that way, but it is. You can't talk about getting rid of alcohol or tobacco without discussing their benefits and offering alternatives.
> The question is why people still get so much benefit out of it that they keep doing it, despite the downsides.
No, this isn't even the question. It is clear that people will keep doing things that have downsides, with out any explainable benefit. This is called addiction. It isn't a new idea.
People clearly derive benefit from drinking; not the hard core alcoholics but the shy guy that likes to tell stories volubly and dance with less shame.
So I have alcohol a few times a month when I go socially with friends and now I'm an alcoholic. Hokay then! Is that why alcohol (whiskey/vodka/rum) sits on my counter for literally months (couple of years?) before completely consumed? That definitely seems very addictive of me.
The term “addiction” is dangerous in discussions about these topics because it can has such a range of meanings. Sometimes it’s used to mean chemical dependency that you can observe in lab rats and which causes clinical withdrawal symptoms. Some people use it for anything people do to “cope” despite it being bad for them, so you could be addicted to almost anything and it need not have any obvious chemical basis.
You certainly can - I’d guess that fewer people feel those drugs benefit them and/or society in the long term, but not zero (insert Paul Erdos anecdote here).
I was thinking the other day the world would be a better place if alcohol wasn't so prevalent and alternatives were available. Everything defaults to including some kind of alcohol, it just makes people insufferable and sleezy to be around when you're not part of the drinkers (even sometimes when you are part of them). Doesn't everyone cringe when you have a nice spot outdoors and a group shows up with a 6 pack each or a case of bud lights?
Even in the last year you can look at the pandemic response, so much of the unhappiness was around the fact bars were closed. The world is ending because you can't drink? People were outraged, Its bizarre. Theres also a travel gatekeeping thing around visiting bars that is odd too. The idea where you need to go to some dive bar in a foreign place to really get the culture. The article is kind of right, cheap alcohol culture kind of just preys on people who can't help themselves. There isn't anything of substance going on when cheap alcohol is involved.
I don't really drink much anymore, maybe one or two drinks,a good wine or interesting cocktail. Alcohol kind of physically hurts now. All about the dabs, psychedelics and mdma. Imagine a world where those can be a regular alternative to excessive drinking at a bar. There might still be drug abusers but atleast we would all be a little more relaxed.
> Even in the last year you can look at the pandemic response, so much of the unhappiness was around the fact bars were closed. The world is ending because you can't drink? People were outraged, Its bizarre.
No, they were outraged because they couldn't meet their friends. If they just wanted to drink, they could have got alcohol from supermarkets.
You can see your friends without a bar too. Bars being closed was a huge thing for people. Opening bars up was more important then getting kids back to school.
> You can see your friends without a bar too. Bars being closed was a huge thing for people. Opening bars up was more important then getting kids back to school.
Possibly for kids getting bullied at schools in the anglo saxon world...
In many East Asian countries like the one I’m from, there’s a bustling night culture of open air cafes, watching sports on big projector screens etc, no alcohol involved.
Then after my friends came back from college overseas all they wanted to do was to go to bars and pubs instead, ugh
256 comments
[ 3.2 ms ] story [ 262 ms ] threadArchive link: https://web.archive.org/web/20210409170904/https://fergus-mc...
The first sentence might be true for all I know, but I can't see how the second one makes for supporting evidence.
I'm not an alcoholic but I am an anxious wreck. Single best way to make me stop freaking out at a party? Two old fashioneds.
I'd prefer to be gregarious and unworried sober, but that's not an option. (Yes, there are other approaches. This works better than all of them.)
I'm not a drinker, and used to be a recluse, but once in a while there's a birthday I cannot refuse. I get there, stay miserable, drink a bit, keeps miserable, gets home at 3am.
I woke up at 7am like a champ, jumping out of bed as if it was a 2 weeks holidays.
Alcohol gets very bad press today but for me, that tiny bit of alcohol helped me stay at a party which probably refueled some social needs (even if shallow).
There's little evidence that light or moderate drinking has major negative health effects. Anything under 10 drinks per week only has a very slight negative effect on all-cause mortality, and anything under 7 drinks per week has no effect: https://marlin-prod.literatumonline.com/cms/attachment/9e0c4... (A standard drink is 14 grams, so the 7 and 10 per week marks are just before 100 and 150 on the x-axis).
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
I think most people start with 4 drinks per week. 12 years later is a different story.
https://americanaddictioncenters.org/rehab-guide/addiction-s...
Sounds like a public health crisis
Also "most people start with 4 drinks per week" is made up. Regardless of where you put "start".
Sorry, you're gonna have to back up this rather hefty statement with some facts. I've never seen any data to suggest that a "vast percentage" of people are at risk of becoming alcoholics.
Thanks, you're quite right to challenge that, it's a belief based on past reading and should be backed up.
> Sorry, you're gonna have to back up this rather hefty statement with some facts. I've never seen any data to suggest that a "vast percentage" of people are at risk of becoming alcoholics.
"vulnerable to the gradual creep of addiction" and "at risk of becoming alcoholics" are not the same thing. A person might refrain from alcohol altogether because they believe, perhaps due to their family history, that if they drank on a regular basis they would become alcoholic. IOW, they feel they are vulnerable to the gradual creep of addiction. And they might be right. But as long they don't drink at all, they're not at risk of developing alcoholism.
This isn't about the propensity of an individual to develop alcoholism based on personal circumstances. This is a population-level claim with no data to back it up.
Frankly, I'm not even sure what you're arguing but it seems wholly disconnected from the OPs claim or my counterpoint.
Uh, the claim was that "a vast percentage of people are vulnerable to the gradual creep of addiction." As it was written, rather than as you interpreted it, it's a statement that, based on my experience and observations, I believe is correct.
I've drank lots, both socially and just at home for no reason. I enjoyed having many different beers around and consumed what was on-hand but never got to the point I made special trips to stock it. Similarly for wines or spirits (vodka, tequila, whiskey, wine).
Lately since there's little social occasions to drink, I've taken to consuming a bottle of red per week with/after meals. It seems to help with sleep (since I also have a couple cups of coffee throughout the day) than without.
Edit: Also recalling that it wasn't all that long ago, historically speaking, that Quebec still allowed smoking inside the office, and there was one woman who I worked with that had a rolling machine and a large ashtray that always needed emptying. It was like a weird trip in a time-machine.
Everything is "chemicals".
> somewhere over a pack a week was habit forming
Try three packs a day
> I've drank lots,
Probably not, compared with someone (such as me) that does drink lots.
> I've taken to consuming a bottle of red per week ... I also have a couple cups of coffee throughout the day
Careful there!
My point is that different people have wildly different ideas about what is acceptable, damaging and addictive, and their ability to deal with it, in one way or another. I easily managed to give up cigarettes because my girlfriend said she would leave me if I didn't. She gave up alcohol (which she was a heavy user of) when she became pregnant (not by me), which is something I know I will never be able to do.
Nutritional epidemiology is real questionable - it pretty much can tell you nonsense - like the fact that most items we cook with give us cancer [1]
[1] https://pubmed.ncbi.nlm.nih.gov/23193004/
https://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm
EDIT:
To be clear, I'm not an abolishonist. I do think, however, we should look at the actual potential harm of a substance when making laws. Alcohol is both physically addictive and habitual vs. marijuana or mushrooms. Alcohol and MDMA have overdose risk, where as marijuana and mushrooms do not. Marijuana and MDMA can pose serious psychological risks, especially in adolescents, where alcohol has a much lesser risk. These should all be reviewed in a scientific and dispassionate manner when defining laws, is all I'm suggesting.
The second argument, primarily in the second half of the article, is that creating the conditions to easily permit binge drinking is just a severe a problem.
>> It’s possible to consume alcohol in a safe manner... But at some margin, you are contributing to the idea that it’s normal to drink it. And we need to break down that norm.
In other words, every drink you order in public has a >1 R0 to make one of your buddies also order a drink. Conversely, every drink you don't get has <1 R0.
I'm sure we've all been in those situations at a bar where we say "I'll get (another) one if you get (another) one".
That's why he vouches for abstinence. Not for health, but to discourage a binge drinking culture that's quite pervasive, in the UK especially.
However, their quality of life is certainly lower than it was before alcohol. They require daily medications with side-effects, need to see expensive specialists, require expensive lab work to be run regularly, and have to worry about what happens should they go without their medication (ie suffer brain damage from seizing, have a heart attack, and/or die).
In fact, mushrooms and LSD are the two least harmful recreational drugs per the Economist chart from 2010. Number 1 is alcohol and number 2 is heroin and crack. Meth is a pretty distant 4th. [1]
They're not addictive, in no small part because they're not really "fun" in the classic way cocaine is. They're interesting, but you're really not in a hurry to do them again. Further, the LD-50 is really, really, really high.
[1] https://www.economist.com/graphic-detail/2019/06/25/what-is-...
LSD and other 5-HT2A agonists are self-limiting in that they induce a massive tolerance after a single dose, making subsequent doses either not work or give diminished effects that do not increase with increased doses. They also are not physically addictive like alcohol is, nor does LSD cause organ damage like alcohol does.
Beyond overdoses, opioids, other than ones like MPTP, don't cause physical harm to the body like alcohol does. The dangers of heroin come mostly from its criminalization, the criminalization of addiction and the lack of access to healthcare to treat addiction. For example, there are millions of people who take Suboxone, a long acting and powerful opioid that stays in the blood for 30+ days, without it causing organ damage or seizure disorders. Street heroin is dangerous because it is unregulated and often cut with fentanyl and stuff that should not be going into veins.
The issues surrounding heroin would be solved with a regulated supply of clean heroin, medical support to administer it correctly, addiction treatment and making all of those things accessible and affordable to the people who need it most. There are several examples of governments that provide all of these things, and they indeed cut down on heroin's mortality and the devastating effects of addiction.
Similar to the person I know with heart disease from alcohol, I know a former heroin addict who also has heart disease from their use. Their heart problem was not caused by heroin, but by the fact that they'd crush pills and inject them without properly filtering them, and the pill binders caused heart damage. A clean supply of heroin and access to addiction treatment would have prevented their heart problem.
I'm in favor of universal legalization, but it's definitely worth considering the impact to everybody, not just the people who use drugs responsibly
When I was in high school and college, kids would regularly get alcohol poisoning and need medical attention. Some of them would drink, drive and die. People like this will exist whether or not it's legal for them to consume whatever substance they're abusing.
> I'm in favor of universal legalization, but it's definitely worth considering the impact to everybody, not just the people who use drugs responsibly
Criminalization isn't going to stop these people, and even if their use leaves them unscathed, the justice system can impose lifelong negative consequences on them.
This is why I'm in favor of funding real drug education so people can make informed decisions, healthcare so people can get help if their use affects their heath, and legalization so that lives aren't ruined by legal consequences.
Many formulations contain small enough amounts of Naloxone to permit a addict to take opiates without any significant adverse effects within a few hours.
The reason why people use the name synonymously is because Buprenorphine is a Mu Kappa Delta antagonist with sufficiently higher affinity to those receptors making it very much harder for other opiods to bind preferentially. Slow release formulation and slow linear bioavailability decline profiles suffice to do the rest of the job of making say heroin ineffective if the patient takes anything else.
I'm saying this so no one is under any impression that Suboxone is a safe drug for anyone to take (accidentally or otherwise) and off the top of my head a commonly used 8mg dose is roughly 100mg Morphine equivalent.
https://www.gloshospitals.nhs.uk/gps/treatment-guidelines/op...
Again, even the people in my life who think of themselves as moderate drinkers without even the hint of a problem would have to acknowledge multiple incidents that fit the above criteria, if they were honest.
Because we live in a culture that tolerates alcohol we view a lot of this behavior as insignificant in a way that you wouldn't if somebody at a party were exhibiting signs of, say, cocaine intoxication. "Bob didn't come to work today because he used too much cocaine" sounds like a serious problem, but "Bob didn't come to work today because he's hungover" may elicit knowing laughs from the co-workers who were with him at the bar the night before.
Most people won't become fall-down drunks who lose their jobs and their spouses and everything else, but that's a pretty weak standard for harm.
As if that's all there is to life...
Except that "binge drinking" is the norm for a lot of people.
Think about how much drinking surrounds sports events--it's really easy to fall into the trap of "having a couple extra"--and a stadium cup is often close to 2 drinks in quantity.
Suddenly, you're in the "7 drinks" range without even trying very hard.
No one gives me crap about shaky caffeine hands.
Oh well I'm off everything now, the neutral state is okay, but I wonder if I lost potential.
It's unlikely that something as ingrained as alcohol will be made unfashionable except on multi-generational time scales.
That being said, the current trend of alcohol in every aspect of life might become pase, as more individuals seek to avoid drunkeness/temptation outside of a bar.
Maybe expand the mind a bit, visit a strict Arab country or something. They don't drink much there. Has nothing to do with health though. It might help get a picture what kind of society they are advocating for.
I'm all for dropping restrictions on things that people can do that don't harm anyone else, but frankly I don't care to spend more money on health insurance because a bunch of people want to drink too much.
I also wonder if there's more to tobacco advertising then meets the eye: unlike alcohol manufacturers, Big Tobacco doesn't seem interested in challenging current restrictions to selling their product. And if they aren't interested, that says more about Big Tobacco than the First Amendment. But it's hard for me to say as I'm no expert on the tobacco industry.
Not super familiar with specifics around the restrictions because I can't remember the last time I saw a ad for tobacco; meanwhile I have seen 10+ alcohol ads today. I would say the restrictions effectively ban tobacco advertising
I agree with your point; from skimming Wikipedia [1] I would argue that restrictions were gradually imposed through acts of Congress and I would imagine largely uncontested by Big Tobacco because they lacked leverage due to the series of scandals involving them. I think you are right that the major alcohol brands would fight back largely because they don't have their hands behinds their back
[1] https://en.wikipedia.org/wiki/Regulation_of_nicotine_marketi...
But, i think there is precedent for advertising, there are restrictions on tobacco advertising. I don't see why it can't be extended to other things that are advertised.
Who defines 'reasonable'? As the federal government can't involve itself (which is at the heart of this so-called obsession,) the participants in the discussion will have to determine that for themselves. And if they can't agree on what is 'reasonable'?
> restrictions on tobacco advertising
There are restrictions, a brief history of which can be found at Truth Initiative[0]. I wonder, though, if these restrictions remain in place because no one in Big Tobacco will challenge them? Especially if these same restrictions help to keep smaller players out of the market...
[0] https://truthinitiative.org/research-resources/tobacco-indus...
In reality the government is already discussing what is protected and what isn't. Free speech is an illusion. Otherwise we wouldn't have exceptions to free speech. There wouldn't an fcc if it it was truly free.
I think we should be explicit about what is protected and what isn't. We want to protect the expression of criticism of our government. I don't think we should be making choices about how society functions based off of ambiguous tweet sized one liners. This site your commenting on has higher expectations, maybe our bill of rights should too.
Is advertising really speech? It's ideas with the intent to manipulate people, commercial propaganda. What is speech, maybe we should define that better. It could be the ideas and opinions of individuals. Its a mistake to provide the same protections to a corporation.
There's nuance to speech, the 1st amendment is ambiguous. The intent is protect people, government exists to protect people. The rest of the world is successful without a almost religious devotion to free speech, there's no reason why the us can't, if anything it's detrimental to our society.
I picked 'reasonable' because the word has different connotations depending on the participants, for example, I may believe I'm being reasonable, whereas you may believe I'm being obstinate. And that's just talking about the word 'reasonable.' Toss the question of 'who's being reasonable?' into a heated discussion between opposite sides of a Covid-19 debate, or an immigration debate, or an abortion debate, or an Apple debate, and see where it gets you.
> There's nuance to speech, the 1st amendment is ambiguous.
The FA is anything but ambiguous. 'Congress shall make no law...' That's Ten Commandments territory as far as clarity goes. Speech coupled with action, or with imminent action, or with likely physical harm is where the US Supreme Court has generally allowed lawmakers to go hog-wild. Burning the US flag (political speech,) using racial epithets (hate speech,) publishing graphic pornography (sex speech,) and refusing to testify against one's spouse (silence) have all been green-lit by SCOTUS.
As has propaganda. Why do you suppose the press is given such wide latitude in libel cases against them by public figures[0]? The press can sway public opinion for or against a politician via lie by omission, reliance on alleged anonymous sources, outright lies and later retractions, out-of-context quotes, associating irrelevant stories or images with a politician, interpreting the politician's words, non-reporting, etc. What is this other than outright manipulation (of both facts and people) and propaganda?
We can further discuss the propaganda(s) of national holidays, of political treatises (e.g. Das Kapital,) of American invasions into the Middle East, all of which are seemingly allowed by SCOTUS, but I'll wrap up by sticking to television commercials--why should ASPCA or The Humane Society be allowed to tug at my heartstrings via dogs in cages? Why should the Reverend Franklin Graham be allowed to preach the word of Jesus to me when I've lost a loved one? Why should a PAC be allowed to run ads associating my pick for the US Senate with forest fires, an abhorrent murder or the decisions of another unpopular politician? Should non-profits and tax-exempts be allowed more/better free speech rights than commercial entities when they engage in the same manipulation techniques as those entities?
[0] See https://en.wikipedia.org/wiki/New_York_Times_Co._v._Sullivan
I don't know why you think im talking about the first 5 words. Look at the relevant part
> Congress shall make no law ... or abridging the freedom of speech, or of the press; ...
That is all it says, its open to interpretation. Free speech for who, and how is speech defined. What did the they have in mind when they wrote it, it likely wasn't 21st century communication. It is ambiguous. Did they even have businesses in mind? We already not all forms of expression are covered.
Yes all those points you bring up suck about advertising. Why should it be allowed? Why is the news able to be misleading. Why are are we being emotionally manipulated by corporations to buy? Because we can't have a discussion about free speech in America and it nuances. People are so die hard about their right (that doesn't even exist the way they think it does) and fall for slippery slope fallacies. We absolutely should real in advertising, both corporate and political, we should real in manipulative news reporting. None of these freedoms are helping the world, and if anything chipping away at others.
100% Free speech is a detriment to society, it is too idealistic. We can start with these ideals, but the need to figure out how they apply in a world with moral-less actors. We should figure out what we want in regards to forms of expression and content, be clear about it and protect society from entities that want to abuse their rights to take advantage of others.
Given your reasonable fear of manipulation/propaganda by those in power, can you see where this might go wrong?
Thus, as Americans, we've done more or less what you've asked--we laid out the ideal, 'Congress shall make no law...,' then we set our local, state and federal bodies of government on the problem of how to work within this ideal. Which, if the solutions are reasonable, will remain law. Which, if an individual (e.g. a flag burner) or a multitude (e.g. a religious sect) thinks are unreasonable, will be challenged through later legislation or through the courts. Potentially landing at the doorstop of a nine-member group called SCOTUS who, using their collective wisdom, will tell us whether we've (or our bodies of government have) gone too far. (And if we as a nation disagree with their decisions, we as a nation have remedies for that as well.) All in a world of moral-less actors.
Is this not reasonable?
Brewing beer for example is extremely easy. Everybody can do it and there is even a whole community around brewing at home.
Another option it pushes for is for people to abstain voluntarily, if they are of the type of person who doesn't get much out of alcohol, but mainly drinks it out of social obligation.
Your overreaction is unnecessary here.
Any thoughts on how to avoid the folly of restriction on alcohol? There seems to be multi-pronged issues, one being that the chemical messes up our body and is largely incompatible, and even if we altered the chemical someway and left the fun effects, we still have the issue of people being taken advantage of while experiencing the effects. But the trade in alcohol is so great that any state sponsored curbs on consumption results in a worse illicit reality.
i don't recommend trying it
they are all heavily controlled, and benzodiazepines are considered some of the most damaging and addictive substances of abuse.
Public health/education campaigns, however, can be wildly effective with enough funding. Smoking cessation in particular has been massively successful even with no change to legality and billions of dollars of tobacco industry money doing everything they can to reverse it. The public health campaign in the US managed to turn cigarettes from chic to trashy and have made prohibition unnecessary. I could imagine the same happening with alcohol (and other problematic substances) on a long enough timeline.
The campaigns against obesity don't make people thin, because half the time they don't even promote stuff that makes people thin. Half the time they promote diets that makes situation worse in the long term.
Campaigns against smoking did worked in the past. Drug use is down. Teenage v pregnancies are down. All stuff that involved campaigns.
Admittedly, most anti-obesity campaigns also seem to be neutered by lobbying. "Stop drinking soda" becomes politicized and turned into "move" by lobbyists. Taking a 30 minute walk is great advice for overall health, but will do absolutely 0 to address obesity.
I guess overall, there's no guarantee of success here, but I tend to view the shift in public sentiment about tobacco as a direct result of public health efforts. Which leads me to believe it's at least possible for other issues (obesity, alcohol). But certainly it is difficult and with unknown risk of failure.
As an alcoholic myself, the terms have always meant the same thing to me.
There are plenty of people who will drink every day of their life in a way that evidences dependence, but with little or no evidence of abuse. I've had some of these in my family. They drank at the same time in the evening and in the same quantity every day for decades, and they were likely in some state of mild chemical dependence, but the addiction, as it were, never caused any trouble whatsoever.
It's not useful to call these people alcoholics.
Likewise, it would be absurd to label people who drink coffee or tea daily with "caffeinism", even if physical dependence is present. And we don't label people who are chemically dependent on anti-depressants with "SSRI-ism".
In my mind, attaching an "ism" to a substance is only useful to identify pathology, which doesn't necessarily have anything to do with dependence.
> It's not useful to call these people alcoholics.
Whether it's useful is not the point, especially whether it's useful to you personally. Alcoholism has a definition, which revolves around dependence. If they're dependent they're alcoholics, and it's still different than non-dependent binge drinking. You're basically trying to make the same distinction I just did (contrary to your own "they're the same" from two posts earlier), except that that you're using the term "alcoholism" for the wrong side of the distinction.
> In my mind, attaching an "ism" to a substance is only useful to identify pathology
You're using "pathology" in a very idiosyncratic way, almost opposite to its real meaning. To a clinician, social effects are not pathology. The pathology is the causes and effects on the individual, so dependence qualifies but wrecking your car doesn't.
Not... really.
The problem here is that the term "alcoholism" is a colloquialism, not a technical term. Neither the DSM nor ICD uses it. So I suppose it can mean whatever you want, but it would be good for the common usage of the term to be useful in some way, and indeed it is in this case. In everyday language, the term alcoholism overwhelmingly connotes problem drinking. I'm quite steeped in the culture for personal reasons, and I've never in my entire life heard anyone use the word "alcoholism" to refer to completely harmless and controlled consumption.
> contrary to your own "they're the same" from two posts earlier
No, I asserted that alcoholism, in its everyday colloquial sense, connotes abuse. I definitely do not assert the same regarding the notion of "dependence", which does have a widely used technical definition.
If it's dependence that we're debating, I'll argue that mere dependence on alcohol should not qualify it for the "alcoholism" label in the common pejorative sense. If you disagree, then I really am curious why you would not likewise label daily coffee drinkers with "caffeinism"?
In the other direction, I assert that any regular, pathological pattern of consumption indicates a degree of dependence, but I recognize that there's some semantic debate there.
> You're using "pathology" in a very idiosyncratic way, almost opposite to its real meaning. To a clinician, social effects are not pathology.
We're not talking about oncology here. Alcoholism is not diagnosed, treated, studied, or managed quite like a medical condition such as cancer or diabetes. Outside the world of medical doctors, the term "pathology" is usually truer to its greek root "pathos". "Pathologic behaviour", "pathological gambling", etc.
For what it's worth, the DSM and ICD largely classify mental disorders based on behavioural evidence. This is certainly true for alcohol dependence and abuse (DSM-IV) and alcohol use disorder (DSM-V).
In https://news.ycombinator.com/item?id=26763944 you used the exact words "meant the same". Don't retcon.
> Alcoholism is not diagnosed, treated, studied, or managed quite like a medical condition
Don't throw around terms like "pathology" then. If you have moral opinions about other people's drinking, just say so.
> DSM and ICD largely classify mental disorders based on behavioural evidence
"Behavioral" does not mean only effect on others. The distinction you're trying to make keeps shifting around, but AFAICT it hasn't at any point matched any common one.
That's right. I assert that the term "alcoholism" is most widely and commonly used to denote "alcohol abuse". That's what I said before and that's what I'm saying now. I'll say it again if you'd like :)
And again, I have never in my life heard a pattern of harmless and controlled consumption of alcohol referred to as "alcoholism".
Regarding the notion of dependence, I assert that (1) there is such a thing as alcohol dependency that does not result in or qualify as alcohol abuse, and (2) that in practice all alcohol abuse involves some degree of chemical or psychological dependence. I understand there is semantic debate about this, especially among cognitive scientists, and I'm comfortable taking a side. In DSM-IV, dependence and abuse are diagnosed by completely separate criteria. In DSM-V the criteria are merged under the diagnosis of "Alcohol Use Disorder".
Regarding binge drinking, I'll argue that all regular binge drinking should be considered disordered or abusive. Both DSM-IV and DSM-V guidelines appear to allow some amount of binge drinking to escape a clinical diagnosis, but in my experience regular binge drinking is always abusive in the ways that matter. I bet you every addiction counsellor you'll ever meet will agree with me on that.
> Don't throw around terms like "pathology" then.
Like I said, the word pathology is widely used with a broader meaning outside of hospitals and doctor's offices. But if you're really intent on policing that particular word, I invite you to take up the debate up with a clinical psychologist. Tell them that they're using that word all wrong, and they should use it only the way MD's do. Let me know how that goes.
> If you have moral opinions about other people's drinking, just say so.
No, I have no problem with alcohol, and I'm regularly around quite a bit of drinking. I have no problem making a run to the liquor store for dinner or a party, and I'm always glad to be the designated driver.
My experience leads me to believe that addiction is a disease, not a moral failure. I have the disease of alcoholism, a disease that is diagnosed clinically on the basis of my behavior. Not on my genes or brain structure, but on my behavior. I will never be "cured" of this disease. The best I can hope for is remission, and that's why I can never touch alcohol again, not even a single drink. But that's just my approach. I know there are others, and I don't judge them.
So this would seem to support my assertion that an "ism" generally denotes excessive consumption leading to "problems" by whatever definition one chooses.
I've used a month's worth of scare quotes today.
A person can regularly binge drink, but not be dependant on alcohol.
Even if you could arrange a definition of dependence such that it doesn't apply to a regular problem drinker, then I think the term loses it's utility. The physiology and psychology of dependence is an interesting topic, but the disease of substance abuse IS the problematic behavior.
EDIT: I had to clean this up a bunch, apologies for the butchered first attempt.
Alcoholism a behavioral health condition which inclines one toward unhealthy alcohol use.
Alcohol abuse is a behavior which can exist with or without that underlying condition.
I enjoy drinking from time to time, and have definitely had nights of excessive drinking that I've found incredibly fun, but I won't try to convince myself it's been good for me.
Also, measuring consumption by number of drinks is very inaccurate(for example beer can be 0-32%/vol), plus individual metabolism plays huge role how well alcohol is tolerated.[1]
[1]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6527027/
Like everything we use to numb/escape our own minds, alcohol and all the marketing we're fed, and the examples we're set while growing up, make it easy to rationally think we should cut down but there's no way that message is going to be easily accepted by your subconscious!
Other links: - https://www.oneyearnobeer.com/ - https://thisnakedmind.com/ - https://medium.com/ainyf-alcohol-is-not-your-friend
HTH.
Not sure if they have an Android or other version.
That's why a ban on alcohol won't work this time, either.
I also think if we look at it from a human suffering perspective as humanists, the Christian moral angle is unneeded. We can offer alternatives to alcohol that are better for people by understanding why they drink. Mental health and general life satisfaction are certainly reasons we would need to tackle for the worst cases, in addition to the established rituals the article talks about. Making moral arguments primarily through Christian theories of sin is a major reason the last temperance movement (in the US) failed, because it did not understand the reasons people drank and offer any alternatives.
I suspect society has normalised taking alcohol to numb daily stresses or problems. So any sudden top down decision to ban it or trying to force a reduction in consumption by raising the prices would be met by a very forceful backlash. Any reduction would have to be conducted with a long term plan that redirects people from this reaction to stress
and also for me, alcohol has seemingly helped me through depression , along with excerse
I think the minimum pricing law of Scotland is the way to go when regulating alcohol. When I was living there, the system seemed to work well and incentivised buying higher quality drinks as well. I guess the problem is populist politicians who could easily brand it as limiting poor people's drinking, instead of posh ones.
I live in a state where restrictions on alcohol sales are pretty limited; grocery stores and corner/convenience stores, for example, can sell whatever they want alcohol-wise. Many stores will keep the more expensive stuff in locked cabinets as a shoplifting-prevention measure. I don't think it'd be too crazy to require that all hard liquors be kept that way, and then sales there can even be restricted by time of day if that was desirable. Beer and wine could be left as-is, with no restrictions. (On the downside, this would hurt smaller shops that aren't specifically liquor stores; locked cabinets are an added expense and take up more space.)
Government run shops let you track sales by area in a fine-grained way.
They can be a more effective way to ensure rules around supply are enforced than random inspections / checks.
They let you change the rules (eg opening hours, id requirements, record keeping, banned drinker registry, customer limits) easily without an outcry from retailers who would no doubt claim that any restrictions are onerous and impractical.
They can be placed so as to avoid completely saturating low income areas with booze.
No price wars or loss-leader marketing strategies.
They mean one can buy essentials without going "near" alcohol. Supermarket sales can be an issue for problem drinkers.
Retail profits can go back to the community.
There are other ways you can achieve each of these points of course but monitoring, enforcement and change will all tend to be more difficult in a decentralised vs centralised system.
Prevailing opinion of HN comments seems to be getting a lil stupid for fun is Bad.
> Prevailing opinion of HN comments seems to be getting a lil stupid for fun is Bad.
That part might be true. I think there's a tendency to be a little robotic/scientistic/productivist about...just about every topic.
> I don't know, I have seen a lot of pro LSD and psilocybin mushroom micro-dosing posts and comments
These ideas are very much in line with each other. The pro-psychedelic comments very often talk about the "objective" value (studies on mental health benefits and comparative safety) rather than only the subjective experience or ethics of criminalization.
Personally I want all drugs legalized on ethics/freedom principles, but especially with Psilocybin, MDMA, and Ketamine there seems to be a mounting wealth of evidence suggesting these things are miracle drugs in many respects.
I see a decent amount of posters talk about using nootropics, THC, mushrooms, and alcohol.
There seems to be a lot of interest in "hacking" the body in various ways using chemicals.
He was chairman of the UKs Advisory Council on Misuse of Drugs for seven years until his dismissal for advocating that that illicit drugs should be classified according to the actual evidence of the harm they cause. In Nutts ranking, alcohol and tobacco were more harmful than LSD, ecstasy or cannabis and should thus be subject to stricter regulations.
edit: adding some sources
https://www.sciencedirect.com/science/article/pii/S000709121...
https://www.cambridge.org/core/journals/psychological-medici...
Also Khat is the best on this chart yet I believe that it makes you feel extremely tired the next day.
That being said the topic is really interesting and I am looking forward to a better rational chart.
Benzodiazepines are at virtually the same position on the chart that alcohol is, so I don't think the chart should be viewed as an endorsement for switching. They are of roughly the same level of danger, but that doesn't mean that they are dangerous in exactly the same ways.
For me most bad habits come down to peer pressure or boredom.
I drink socially and people often gift me drinks in the club. Sometimes the parties are boring and I drink a bit so I stop caring.
That all went away with Corona.
I've seen his harm score chart quite a few times here on HN [1]
[1] https://www.economist.com/graphic-detail/2019/06/25/what-is-...
Source : addiction happened to people i met and the HR happened in a friends party.
sounds like caffeine (from those criteria)
[0]: https://en.wikipedia.org/wiki/Effect_of_caffeine_on_memory
[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3777290/
[2]: https://www.webmd.com/heart-disease/news/20060815/coffee-may...
It's pretty easy to drink 3 cups of coffee and not come anywhere near overdosing on caffeine. And then after that you can drink 3 more. And then after that you are probably sick of coffee, but go ahead and drink 3 more if you really want.
How's the recreational dosing of GHB go?
Example: https://www.inquisitr.com/1909754/caffeine-powder-death-teas...
I've never taken GHB and don't plan to, but it looks like a recreational dose is ~1/2 of a dangerous dose, both of which would be (at least somewhat) difficult to obtain.
With caffeine, the typical recreational dose is a beverage that is easily obtained and isn't dangerous. That you could buy caffeine powder doesn't make that a typical way to consume it.
Apparently 500 mg of caffeine is considered potentially dangerous. That would be 5 or 6 cups of coffee (I'm in the habit of drinking that much coffee and have a pretty low resting heart rate during the consumption, so I dunno).
Long term use of most substances ALWAYS lead to problems and even the short term there are bad trips, brain zaps that alcohol dont bring. Also even for stuff that do not lead to physical cravings such as mdma, i have seen soo many people falling into an addiction. Its not a game.
Alchol wont be banned ever, but i think is a retarded debate to say "we should decriminalize other stuff be cause alcohl is bad". This is the worse reason possible.
Im quite happy drugs are banned and not mainstream so that my children will stay away from them and maybe try later when they feel more mature.
That doesnt mean i support the american war on drugs or jailing people for 3g of cannabis.. but the decriminalization of weed is stupid to considering two of my friends who have an impaired short term memory after 1 - 2 years periods of abuse.
I dont see any sort of upside in legalizing drugs at the society level considering the effects ive see on people. THATs a simple position.
Alcohol brings seizures, which are considerably worse (and potentially fatal).
>That doesnt mean i support the american war on drugs or jailing people for 3g of cannabis.
How do you intend to enforce the illegality of substances (and in a manner that will cause your children to fear possessing them) without punitive measures?
This is literally the first time ive heard about that. That said i do think alcohol is dangerous.
> How do you intend to enforce the illegality of substances (and in a manner that will cause your children to fear possessing them) without punitive measures?
The status quo in my country is fine to me:
Drugs are easily available, fines are low (i know a ecstasy dealer who got caught in a club woth 60 pills and got 3 month of 'potential' jail time that will apply only if he gets caught again) , its badly seen by society and "forbidden".
That means not a lot of people do drugs. Motivated people can acess them, but you dont have a society of degenerate zombies. All good to me.
I had hoped it was common knowledge that alcohol withdrawal could lead to fatal seizures. People should be aware that going cold turkey (abruptly stopping heavy drinking) can put them at serious risk.
"All the people who want to do drugs are already using them, but society will crumble into degeneracy if they are legalized"?
What do you anticipate changing if they are legalized?
People will do them thinking "if its decriminalizef they must be fine" which is not a fine mindset at all and its a good thing to fear them.
Illegal drugs are much more accessible to teenagers than alcohol is.
Alcohol is quite accessible to teenagers outside the US..
I think you're both vastly misinterpreting the data. It's not classifying drugs based on how popular they are.
This is, in fact, the only sensible way to compare the relative harms of drugs. Otherwise, you can't put a number on how harmful X is without specifying the quantity and frequency of use, and they vary widely. With alcohol we know that lots of people consume small amounts weekly with little harm, and some people consume large amounts daily with major harm. The same is true for all drugs. The only data we have is for the current usage levels in society, so it makes sense to report harms for those levels.
At any rate, the paper boils down to "We asked a panel of experts how harmful are X, Y, Z in various ways on a 100 point scale and we averaged those numbers using some weights that seem vaguely plausible and here are the results!" And somehow the Lancet published it.
It makes me less fun at parties, but I can only imagine how much trouble I've avoided because of this.
The alcohol industry seems to me as bad as the tobacco industry.
I've been teetotal for coming up to two years now. I feel better than ever. Alcohol has no positive effects. It serves only to numb the senses. I prefer to experience the world in all its glory. Luckily it's very easy to be teetotal now. As Nutt mentions, you do need to have a glass of drink (that isn't water) at all times in social settings, but I can get a lime soda anywhere and now have a mocktail from many places. Loads of people don't drink either for health reasons, religious or just because they don't want to. It's easy.
Many things people put into their bodies hurt them in the long run and sometimes the more the faster. Should we prevent them from doing it? In the US, we mostly say no.
It seems to me that most Americans are ok with that.
Maybe these restrictions do more good than harm. But they definitely do some harm.
Since then, I've tried a wide variety of beer, wine, rum, bourbon, etc and have only once come away from the experience with a "I didn't hate that/I'd buy that again.". The vast majority of the time I've failed to finish what I'm served (or do so out of politeness) and reflect that I'm simply "missing the point" because I'm not interested in inebriation/"buzzed". I'm sure there are those that enjoy the flavor (perhaps in the same way that I "enjoy" very spicy hot sauce), but wanted to ask.
Good things to compare to are:
- spicy food
- stinky foods (eg cheese)
- coffee
All of the above are acquired tastes. I could barely eat spicy before, now I love it. Stinky cheese makes we want to vomit, but others enjoy it. I only drink decaf, yet periodically enjoy a black coffee, something which seemed absurd when I was younger.
To me alcohol is just one more flavor option. I wouldn’t want it banned just because other people can’t control themselves.
This is why when the price of beer went up 18+ people stopped buying it because they only used to buy it as a cheap way to get drunk. Drinks companies switched to making extremely sweet alcoholic drinks to counteract that and marketed them towards this audience to make up the loss.
I used to work in advertising and worked on marketing one of these a products so this is what I heard from one of the worlds largest breweries while doing it.
No, this isn't even the question. It is clear that people will keep doing things that have downsides, with out any explainable benefit. This is called addiction. It isn't a new idea.
This part is what I was commenting about. Not your shy guy.
Do you see any downsides in your use of alcohol? No? Then you're not what my comment was about.
You could ask the same thing about speed and meth.
Even in the last year you can look at the pandemic response, so much of the unhappiness was around the fact bars were closed. The world is ending because you can't drink? People were outraged, Its bizarre. Theres also a travel gatekeeping thing around visiting bars that is odd too. The idea where you need to go to some dive bar in a foreign place to really get the culture. The article is kind of right, cheap alcohol culture kind of just preys on people who can't help themselves. There isn't anything of substance going on when cheap alcohol is involved.
I don't really drink much anymore, maybe one or two drinks,a good wine or interesting cocktail. Alcohol kind of physically hurts now. All about the dabs, psychedelics and mdma. Imagine a world where those can be a regular alternative to excessive drinking at a bar. There might still be drug abusers but atleast we would all be a little more relaxed.
No, they were outraged because they couldn't meet their friends. If they just wanted to drink, they could have got alcohol from supermarkets.
https://www.epi.org/blog/we-prioritized-open-bars-before-giv...
https://www.washingtonpost.com/nation/2020/12/03/macs-staten...
> “The people have rights!” one protester yelled, reported the Daily News. “Open the door, I’m thirsty!”
Possibly for kids getting bullied at schools in the anglo saxon world...
Then after my friends came back from college overseas all they wanted to do was to go to bars and pubs instead, ugh
ofc treat the it with the respect you'd treat any recreational drug.