Recommendations like this should always include suggestions on what to replace it with. Cannabis works for the relaxation part very well, but not exactly for the sociability aspect.
Sorry for the snark but I'm nursing a hangover created in the company of a important friend who's promising to quit drinking after moving state next month, so this is a rather timely paper. However if my friend were to merely substitute another intoxicant I'd lose my mind and probably my wonderful friend. So I personally wouldn't suggest alternative habits at least.
Replacement could imply more than habitual use of substances. I've found the hardest part of not drinking to be the loss of the sociable activities I engage with while drinking. I've certainly used marijuana as an "intermediary" between drinking and not drinking as it seemed like a way to engage with inebriation without drinking and later would stop using marijuana when I realized I was enjoying my activities more or less the same with or without its use.
Maybe one day we will have the scientific studies, but your comparison is not a great correlation.
Where Oxycontin, heroin, and alcohol are all easy to overdose on, have highly physically addictive properties. Thc does not have the characteristics. Oxy is sold that it reduces physical addiction, when used for short periods and per instructions, but it does not eliminate physical addiction.
I am not sure I can /recommend/ it; sobriety is underrated. But a number of people have proposed GHB or perhaps a prodrug of GHB as an alcohol substitute over the years (for example [1]). It acts on the same receptors in nearly the same way. (It reverses alcohol withdrawal so effectively it is used for this purpose in some countries medically.)
Subjectively it feels very much like alcohol. It is probably about as addictive. But it's almost non-toxic by comparison. No liver damage. Doesn't affect nutrient absorption. Milder hangover.
It'll probably never be legal for regulatory reasons. (If alcohol were introduced today, it would likely be banned. Even a relatively safer alcohol substitute runs into the problem of still being rather dangerous and so getting through the red tape.)
GHB is a great alcohol substitute in many ways but also has an extremely unforgiving dose response curve with doses that can't be safely eyeballed and that build up in unpredictable ways over successive dosings. The lethal to effective dose ratio is worse than for alcohol, with doses that are much smaller and easier to accidentally ingest. Almost all regular users will have overshot the mark and knocked themselves out at some point, the edge for this level of mild overdose is much lower and sharper than for alcohol.
It is safer than alcohol in terms of properly dosed effects, but it has many safety drawbacks in terms of using safely in public social settings the way alcohol is used.
It's not just regulatory difficulties with it as an alcohol substitute.
Kratom hits the spot for me. It's not without concerns as it has addictive potential but it takes the edge off emotionally and smooths over my chronic pain.
I used to use cannabis but I still do (ahem), but it makes me stupid and so I try to save it as a special treat.
Depends on why you drink. If you're doing it because you have social anxiety for example, CBT therapy / exposure therapy is the real solution to avoid dependence on alcohol. If you're drinking to cope with negative emotions, again CBT, mindfulness, making yourself busier, social connections, exercise, medicine.
For simple 'relaxation' I am significantly more relaxed sober than I ever was when drinking. The day after a binge spiked my anxiety sky high, and even when drinking I was always preoccupied with the next drink.
Does it control for price and availability of alcohol? The linked article seems to imply that the correlation between changing environment and changing consumption levels stems from a societary/conformist component, but I’m not sure that’s the most obvious conclusion. I might be misreading the (very short) linked article.
I stopped drinking for a month. In that month, there were multiple times when someone offered me a drink, I politely declined saying I’d given it up, and then the other person did not drink either. Hard to say for sure, but it seems clear to me these folks would have indulged if I had.
It was surprising to me how socially-controlled this behavior seemed to be. The paper’s conclusion rings true to me.
For me non-drinking month is a normal month, without any personal rule. I've heard about people drinking everyday, but that's hard to imagine for me.
Recently, after a party where I drank alcohol, I concluded that I actually don't like the state alcohol puts me in. The slower reaction time, slower thinking, the need for preparation regarding eating and then after the fact drinking water before sleeping etc. Luckily I don't spill any secrets I shouldn't spill when I'm drunk, as some people do. I'm also the sort of person who gets annoyed at hot weather mainly due to its detrimental effect to the speed of my mind. It's just very unpleasant to me. So even though I don't have the slightest problem with alcohol (for a typical year I can count the number of times I drink alcohol on the fingers of a single hand, and no substance ever even began to take a hold over me), I've decided to quit it entirely, because I prefer to drink something as peasant as lemonade or tea, which doesn't inhibit my mind.
I quit drinking after more than 25 years of problematic drinking by taking naltrexone just before drinking for 3-4 weeks. Given my prior experience with alcohol and trying to quit, it was the easiest thing I've ever done.
I urge people who have a problem with drinking and wish to quit, who for whatever reason do not feel that 12 step programs like Alcoholics Anonymous are right for them to find a doctor who is willing and able to prescribe naltrexone and have a serious discussion with them. Had I had access to it and known it was effective as it is I probably would have been able to stop drinking 20 years sooner than I did.
Yes, I used the Sinclair method but there are multiple therapies which use naltrexone and I don't think the Sinclair method is obviously better than any other.
Seconded. It was insanely effective for me - from daily binges to zero. It is issued on the NHS in the UK, but they wait until you've relapsed a few times before prescribing it, which is maddening - it should be offered immediately IMO.
If someone's had a medical detox (which they'd get if they were drinking more than 30 units per day (in one litre of 40% ABV spirits there are 40 uk units) they should be offered naltrexone when they've done the detox.
Frustratingly, if someone hasn't needed that they're offered psychological support first, and only get naltrexone if that doesn't work.
If the patient knows they want naltrexone and clearly says "I'd like to try medication, can we talk about naltrexone?" then the doctor should consider prescribing it, but that requires patients to know about it and ask for it.
"In harmful drinkers or patients with mild alcohol dependence, a psychological intervention (such as cognitive behavioural therapy) should be offered. In those who have not responded to psychological interventions alone or who have specifically requested a pharmacological treatment, acamprosate calcium or oral naltrexone hydrochloride can be used in combination with a psychological intervention."
The intoxication from drinking having taken naltrexone is profoundly different than just drinking alcohol alone but it does satisfy the urge to drink, until one day you're able to just walk away from drinking. I never really felt the urge to drink without it while I was using naltrexone.
I still have an unfinished box of naltrexone which I kept because I was sure I would start drinking again and wanted to have it at hand. I just looked at it, it expired in 2013 and I've yet to use it at all since I quit drinking in '09 or '10 (I forget exactly, it's been a while).
Is there a genetic predisposition that just makes alcohol drinking not pleasant?
I don't like drinking and none of my family likes drinking. It feels like being sleepy, but with a looming headache. There's zero period of time during my drunkness, that I feel "pleasure". Even as I visit a vineyard, I like their non-alcoholic grape juice better than the actual wine.
I consider myself to be lucky that I'm born into a generation where "social drinking" is less of a problem. None of my friends pressure me to drink, and we have a good time regardless. (I'm a easy person to get hyped without alcohol anyway)
Yes, the Asian flush gene comes with a headache and nausea for some. Two friends who experience versions of this had it confirmed on their 23andme results. Explanation:
> Alcohol or ethanol is broken down or converted in the liver to acetaldehyde, a highly toxic compound that contributes to the hungover feeling. In most people, acetaldehyde is rapidly transformed to harmless acetate and water.
> However, for some Asians, Ashkenazi Jews and others whose gene pool contains a mutant or altered form of the ALDH2 gene, the toxic acetaldehyde isn’t broken down as quickly, so it hangs around and accumulates in the liver and body [...]
The thing I really wonder is whether on balance, this works out to be a bug or a feature. Personally I don't get a headache, but I also don't feel the euphoria that many clearly do.
I’m like many of you in enjoying drinking quite a bit. Too much in fact. As I’ve aged I realize that I like being fit and avoiding hangovers more than having an aid to relax in the evening. By cutting drinking I’ve also been able to cut my caffeine intake since I sleep more and better. And less caffeine means being able to sleep better at night. I’ve layered in less meat too.
This isn’t a self righteous pitch. It’s been part of a long term struggling of feeling what’s right. And when I grab a few beers with some friends, and it turns into a lot of beers with me suggesting “one more round” the fatigue the next day reminds me of the better equilibrium.
I make no judgments on others because I’ve been there.
He makes three big assumptions: that readers use alcohol, that they use it closer to the median rate in their area than to zero, and that they drink with others in the middle of a respiratory pandemic.
Looking at the sales of alcohol in the USA, the average person likely is doing all the above. Especially with campaigns to help local bars et al stay open after a challenging period.
Disclaimer: I don't drink, not American, partner is half-American.
Well, this has been known for a while. A French demographer, Sully Ledermann, observed in the late 40s that there was a connection between total alcohol consumption and certain illnesses and accidents - in other words, that it appeared total consumption and harmful consumption were tightly connected. A lot of research has been done on it over the years, basically confirming it and uncovering how it works socially in practice.
It has also been the basis for much successful alcohol policy, especially in Scandinavia where public health statistics has a long history (much due to the Lutheran state churches, but that's another story). They have focused on reducing total consumption, rather than, say, targeted interventions aimed at heavy drinkers, and it has worked well (except politically, arguably. There's a price to be paid for trying to nudge everyone including moderate drinkers to drink less!)
I'd say there's a broad acceptance in Sweden for the restrictive alcohol policy:
- age limit of 20 (18 in restaurants)
- state monopoly on sales of alcoholic beverages >3.5% ABV
- high taxes on alcoholic beverages
Of course, there's a lot of gray imports from the EU, and some home production (hembränning). These have probably taken the edge off political opposition to the monopoly.
There's acceptance, but at least not in here Norway, not exactly approval. A broad majority in the political parties have agreed that the main line in alcohol policy is restricting harms by restricting access - they refer to this consensus themselves explicitly, so it's not a conspiracy theory by any means.
But that's politicians, drawn from the activist class. I'm quite certain there's a lot less consensus in the people, and possibly many "quit bothering us over alcohol, why can't it be cheap and accessible?" votes to be populistically fished for.
If there's a big fault line developing in Sweden it's about recreational drugs (weed, specifically). The politicians will have a harder and harder time holding the hard line as more and more countries and regions legalize.
I like a cocktail. I like a glass or two of wine. I like to make my own liquor using recipes that my grandparents have treasured and passed down.
I don't like to get drunk and I stay away from drunk people. The last time I got drunk was 20 years ago. I threw up an awful lot.
But I understand the feelings of many people who are sober or curious about being sober. If one had the misfortune to grow up in families in which people started drinking at 8 a.m. and finished at midnight, it is easy to see alcohol as detrimental to one's life, associated with violence and despair, ultimately evil.
Anti-alcohol proselytism makes me a little uncomfortable, though, because it seems that people with little control over themselves--through no fault of their own, probably--want others to stop engaging in activities that they find enjoyable, enriching, and well blended into their happy lives. Drunks do not pay attention to that noise.
Fortunately, I did not grow up in such environments and tend not to associate with people who like to obliterate their self-awareness.
And tonight I will definitely have a glass of wine with a rib-eye steak.
> Anti-alcohol proselytism makes me a little uncomfortable, though, because it seems that people with little control over themselves--through no fault of their own, probably--want others to stop engaging in activities that they find enjoyable, enriching, and well blended into their happy lives.
Just to play devil's advocate, I would argue that if I am required or at least expected to interact socially with you, your alcohol consumption effects me whether I am drinking or not. In the same vein but to a much lesser degree as you smoking a cigarette, or a blunt, or a vape pen.
Yes, many things I might do could affect you and vice versa. For example, say I show up in a suit and tie rather than in a T-shirt and a pair of jeans. The mood of the evening will probably be a little more formal in the former case.
One rule I have is that if we're going out, and I know you've had a problem with alcohol, I will refrain from drinking or ask if you have a problem with me having a glass of wine.
If you're sober because, like Tyler Cowen, you want your brain to always run at full speed and for some reason you think alcohol would make it run at half-speed, I won't ask you if you're okay with me drinking, assuming I want to drink—I will just order a Negroni.
If we are out, I get a drink, and you start a tirade about the benefits of sobriety, it's unlikely we'll be in touch for very long.
A final point is that we need to keep in mind that we tend to claim the beneficial properties of the activities we engage in and to which we are predisposed. Tyler Cowen likes to talk about sobriety and the benefits of giving up alcohol. More than anything, he doesn't like alcohol, so it's easy for him not to consume it. Not surprisingly, he does not evangelize the benefits of moderate eating and physical activity, which, from what we can tell from his appearance, are not particularly congenial to him.
FWIW there are quite a few good de-alcoholized beers now. If you enjoy the taste of beer, but do not need/want the buzz, it’s worth giving them a shot. I won’t promote any particular brand here; it’s easy to find reviews on the web. (Also FWIW, a shot of bitters, lemon, or lime juice is very tasty in the pale ale styles.)
The major issue is whether the overall health and safety detriment of alcohol compares to the benefits it provides in terms of marginal enjoyment and benefit to the user. On the whole obviously not, but in small amounts during opportune social gatherings where noone is at risk of overdosing or drunk driving perhaps otherwise.
This is getting absolutley ridiculous. I have tried on purpose to get addicted to alcohol and I couldn't. I can get shit-faced drunk but I can't keep doing it frequently enough.
Stuff like this makes me pro-cigarette and pro-hard drugs because instead of informing people clearly of their findings they presume to know why people use substances to begin with and the substance is always the worst choice. No my friend, there are many many things worse than dying be grateful if you don't know that first hand. Substances help people deal with shit or overcome mental obstacles. I don't care for yet another research about alcohol being bad, show me a safer alternative then I would have respect for your work.
This society is bonkers! "What you are doing does not affect me but don't kill yourself, let us kill you earlier in a socially acceptable way"
> This is getting absolutley ridiculous. I have tried on purpose to get addicted to alcohol and I couldn't
You’re saying that alcohol addiction is made up? And you’re only evidence is that you are not an addict? Or, at least, don’t admit to being one
> Substances help people deal with shit or overcome mental obstacles. I don't care for yet another research about alcohol being bad, show me a safer alternative then I would have respect for your work
Substances don’t help people deal with shit. An alternative that’s safe would be talk therapy, for example.
> You’re saying that alcohol addiction is made up? And you’re only evidence is that you are not an addict? Or, at least, don’t admit to being one
Not at all, just that it is difficult for me and presumably others like me. Other substances like cigarette only take a few days of usage to form a very strong habit.
Substances do help people deal with trauma and pain, any pharmacist will tell you as such as well. Things like alcohol and even cocaine and cigarettes used to be perscribed by doctors precisely because of their ability to improve the quality of life of patients (what medicine is about ultimately, not artificially extending life). There are better and safer alternatives now, so for alcohol's case for example, show me what that alternative now don't tell me how bad it is, and make it available OTC like alcohol. You can't even get depression meds OTC without doctors and insurances so they are non-existent to someone who can't or won't jump through those hoops. This is also what I mean about how ridiculous this society is, you presume everyone can tak to a therapist or that therapy would work (or even would not worsen the condition) for everyone. And then you complain about crime, suicide rate and incarceration rate as if you didn't orchestrate them by saying "let them talk to a therapist" imagine the suffering caused by this one view alone.
Drinking is correlated with others drinking. It's a sort of community effect. Cowen's argument is to stop because it's contributing to problematic drinking.
Start screwing yourself, now! With this line of reasoning, there is no behavior that people who think like this will not justify themselves in managing.
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[ 4.0 ms ] story [ 109 ms ] threadSorry for the snark but I'm nursing a hangover created in the company of a important friend who's promising to quit drinking after moving state next month, so this is a rather timely paper. However if my friend were to merely substitute another intoxicant I'd lose my mind and probably my wonderful friend. So I personally wouldn't suggest alternative habits at least.
Edit: punctuation
Where Oxycontin, heroin, and alcohol are all easy to overdose on, have highly physically addictive properties. Thc does not have the characteristics. Oxy is sold that it reduces physical addiction, when used for short periods and per instructions, but it does not eliminate physical addiction.
Subjectively it feels very much like alcohol. It is probably about as addictive. But it's almost non-toxic by comparison. No liver damage. Doesn't affect nutrient absorption. Milder hangover.
It'll probably never be legal for regulatory reasons. (If alcohol were introduced today, it would likely be banned. Even a relatively safer alcohol substitute runs into the problem of still being rather dangerous and so getting through the red tape.)
[1] https://www.imperial.ac.uk/news/135106/synthetic-alcohol-sub...
It is safer than alcohol in terms of properly dosed effects, but it has many safety drawbacks in terms of using safely in public social settings the way alcohol is used.
It's not just regulatory difficulties with it as an alcohol substitute.
I used to use cannabis but I still do (ahem), but it makes me stupid and so I try to save it as a special treat.
For simple 'relaxation' I am significantly more relaxed sober than I ever was when drinking. The day after a binge spiked my anxiety sky high, and even when drinking I was always preoccupied with the next drink.
It was surprising to me how socially-controlled this behavior seemed to be. The paper’s conclusion rings true to me.
Recently, after a party where I drank alcohol, I concluded that I actually don't like the state alcohol puts me in. The slower reaction time, slower thinking, the need for preparation regarding eating and then after the fact drinking water before sleeping etc. Luckily I don't spill any secrets I shouldn't spill when I'm drunk, as some people do. I'm also the sort of person who gets annoyed at hot weather mainly due to its detrimental effect to the speed of my mind. It's just very unpleasant to me. So even though I don't have the slightest problem with alcohol (for a typical year I can count the number of times I drink alcohol on the fingers of a single hand, and no substance ever even began to take a hold over me), I've decided to quit it entirely, because I prefer to drink something as peasant as lemonade or tea, which doesn't inhibit my mind.
I urge people who have a problem with drinking and wish to quit, who for whatever reason do not feel that 12 step programs like Alcoholics Anonymous are right for them to find a doctor who is willing and able to prescribe naltrexone and have a serious discussion with them. Had I had access to it and known it was effective as it is I probably would have been able to stop drinking 20 years sooner than I did.
Here's the NICE guidance for alcohol use disorders: https://www.nice.org.uk/guidance/cg115/ifp/chapter/treatment...
If someone's had a medical detox (which they'd get if they were drinking more than 30 units per day (in one litre of 40% ABV spirits there are 40 uk units) they should be offered naltrexone when they've done the detox.
Frustratingly, if someone hasn't needed that they're offered psychological support first, and only get naltrexone if that doesn't work.
If the patient knows they want naltrexone and clearly says "I'd like to try medication, can we talk about naltrexone?" then the doctor should consider prescribing it, but that requires patients to know about it and ask for it.
https://bnf.nice.org.uk/treatment-summaries/alcohol-dependen...
"In harmful drinkers or patients with mild alcohol dependence, a psychological intervention (such as cognitive behavioural therapy) should be offered. In those who have not responded to psychological interventions alone or who have specifically requested a pharmacological treatment, acamprosate calcium or oral naltrexone hydrochloride can be used in combination with a psychological intervention."
How does it work? Don't you know you wanna get high and stop taking it instead?
It sounds like that "change your password to INeedToExcerciseMore" and you magically start loosing weight :|
I still have an unfinished box of naltrexone which I kept because I was sure I would start drinking again and wanted to have it at hand. I just looked at it, it expired in 2013 and I've yet to use it at all since I quit drinking in '09 or '10 (I forget exactly, it's been a while).
I don't like drinking and none of my family likes drinking. It feels like being sleepy, but with a looming headache. There's zero period of time during my drunkness, that I feel "pleasure". Even as I visit a vineyard, I like their non-alcoholic grape juice better than the actual wine.
I consider myself to be lucky that I'm born into a generation where "social drinking" is less of a problem. None of my friends pressure me to drink, and we have a good time regardless. (I'm a easy person to get hyped without alcohol anyway)
> Alcohol or ethanol is broken down or converted in the liver to acetaldehyde, a highly toxic compound that contributes to the hungover feeling. In most people, acetaldehyde is rapidly transformed to harmless acetate and water.
> However, for some Asians, Ashkenazi Jews and others whose gene pool contains a mutant or altered form of the ALDH2 gene, the toxic acetaldehyde isn’t broken down as quickly, so it hangs around and accumulates in the liver and body [...]
https://news.usc.edu/112489/antihistamines-prevent-asian-flu...
The thing I really wonder is whether on balance, this works out to be a bug or a feature. Personally I don't get a headache, but I also don't feel the euphoria that many clearly do.
This isn’t a self righteous pitch. It’s been part of a long term struggling of feeling what’s right. And when I grab a few beers with some friends, and it turns into a lot of beers with me suggesting “one more round” the fatigue the next day reminds me of the better equilibrium.
I make no judgments on others because I’ve been there.
Disclaimer: I don't drink, not American, partner is half-American.
It has also been the basis for much successful alcohol policy, especially in Scandinavia where public health statistics has a long history (much due to the Lutheran state churches, but that's another story). They have focused on reducing total consumption, rather than, say, targeted interventions aimed at heavy drinkers, and it has worked well (except politically, arguably. There's a price to be paid for trying to nudge everyone including moderate drinkers to drink less!)
- age limit of 20 (18 in restaurants)
- state monopoly on sales of alcoholic beverages >3.5% ABV
- high taxes on alcoholic beverages
Of course, there's a lot of gray imports from the EU, and some home production (hembränning). These have probably taken the edge off political opposition to the monopoly.
But that's politicians, drawn from the activist class. I'm quite certain there's a lot less consensus in the people, and possibly many "quit bothering us over alcohol, why can't it be cheap and accessible?" votes to be populistically fished for.
I don't like to get drunk and I stay away from drunk people. The last time I got drunk was 20 years ago. I threw up an awful lot.
But I understand the feelings of many people who are sober or curious about being sober. If one had the misfortune to grow up in families in which people started drinking at 8 a.m. and finished at midnight, it is easy to see alcohol as detrimental to one's life, associated with violence and despair, ultimately evil. Anti-alcohol proselytism makes me a little uncomfortable, though, because it seems that people with little control over themselves--through no fault of their own, probably--want others to stop engaging in activities that they find enjoyable, enriching, and well blended into their happy lives. Drunks do not pay attention to that noise.
Fortunately, I did not grow up in such environments and tend not to associate with people who like to obliterate their self-awareness. And tonight I will definitely have a glass of wine with a rib-eye steak.
Just to play devil's advocate, I would argue that if I am required or at least expected to interact socially with you, your alcohol consumption effects me whether I am drinking or not. In the same vein but to a much lesser degree as you smoking a cigarette, or a blunt, or a vape pen.
One rule I have is that if we're going out, and I know you've had a problem with alcohol, I will refrain from drinking or ask if you have a problem with me having a glass of wine.
If you're sober because, like Tyler Cowen, you want your brain to always run at full speed and for some reason you think alcohol would make it run at half-speed, I won't ask you if you're okay with me drinking, assuming I want to drink—I will just order a Negroni.
If we are out, I get a drink, and you start a tirade about the benefits of sobriety, it's unlikely we'll be in touch for very long.
A final point is that we need to keep in mind that we tend to claim the beneficial properties of the activities we engage in and to which we are predisposed. Tyler Cowen likes to talk about sobriety and the benefits of giving up alcohol. More than anything, he doesn't like alcohol, so it's easy for him not to consume it. Not surprisingly, he does not evangelize the benefits of moderate eating and physical activity, which, from what we can tell from his appearance, are not particularly congenial to him.
Stuff like this makes me pro-cigarette and pro-hard drugs because instead of informing people clearly of their findings they presume to know why people use substances to begin with and the substance is always the worst choice. No my friend, there are many many things worse than dying be grateful if you don't know that first hand. Substances help people deal with shit or overcome mental obstacles. I don't care for yet another research about alcohol being bad, show me a safer alternative then I would have respect for your work.
This society is bonkers! "What you are doing does not affect me but don't kill yourself, let us kill you earlier in a socially acceptable way"
You’re saying that alcohol addiction is made up? And you’re only evidence is that you are not an addict? Or, at least, don’t admit to being one
> Substances help people deal with shit or overcome mental obstacles. I don't care for yet another research about alcohol being bad, show me a safer alternative then I would have respect for your work
Substances don’t help people deal with shit. An alternative that’s safe would be talk therapy, for example.
Not at all, just that it is difficult for me and presumably others like me. Other substances like cigarette only take a few days of usage to form a very strong habit.
Substances do help people deal with trauma and pain, any pharmacist will tell you as such as well. Things like alcohol and even cocaine and cigarettes used to be perscribed by doctors precisely because of their ability to improve the quality of life of patients (what medicine is about ultimately, not artificially extending life). There are better and safer alternatives now, so for alcohol's case for example, show me what that alternative now don't tell me how bad it is, and make it available OTC like alcohol. You can't even get depression meds OTC without doctors and insurances so they are non-existent to someone who can't or won't jump through those hoops. This is also what I mean about how ridiculous this society is, you presume everyone can tak to a therapist or that therapy would work (or even would not worsen the condition) for everyone. And then you complain about crime, suicide rate and incarceration rate as if you didn't orchestrate them by saying "let them talk to a therapist" imagine the suffering caused by this one view alone.
Drinking is correlated with others drinking. It's a sort of community effect. Cowen's argument is to stop because it's contributing to problematic drinking.
Start screwing yourself, now! With this line of reasoning, there is no behavior that people who think like this will not justify themselves in managing.