6 ms·

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.

by koboll 6y ago

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/9e0c4d11-b5eb-433a-b6e7-e65d2114b8a6/gr1.jpg 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/PIIS0140-6736(18)30134-X/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

ljhsiung 6y ago
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.
goonogle 6y ago
As long as you don't become an addict. I think most people start with 4 drinks per week. 12 years later is a different story.
- eikenberry 6y ago
  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. https://americanaddictioncenters.org/rehab-guide/addiction-statistics https://americanaddictioncenters.org/rehab-guide/addiction-s...
  - osmarks 6y ago
    Presumably an alcohol use disorder is quite bad. Is the benefit of drinking alcohol really enough to offset the fairly significant risk there?
  - goonogle 6y ago
    So tens of millions of people? Sounds like a public health crisis
- watwut 6y ago
  Most non-abstinents are not alcoholics and that holds true even in countries with high rates of alcoholism. Also "most people start with 4 drinks per week" is made up. Regardless of where you put "start".
johnorourke 6y ago
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.
- CarelessExpert 6y ago
  > 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.
  - johnorourke 6y ago
    > gonna have to back up this rather hefty statement Thanks, you're quite right to challenge that, it's a belief based on past reading and should be backed up.
  - rhapsodic 6y ago
    >> 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.
    - CarelessExpert 6y ago
      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.
conistonwater 6y ago
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.
narush 6y ago
Those graphs are epidemiological studies. Saying “effect” implies that alcohol is a cause here, which is might be, but who knows! 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://pubmed.ncbi.nlm.nih.gov/23193004/
UnpossibleJim 6y ago
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. https://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm 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.
heavyset_go 6y ago
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).
- tigershark 6y ago
  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?
  - arcticbull 6y ago
    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. [1] https://www.economist.com/graphic-detail/2019/06/25/what-is-the-most-dangerous-drug https://www.economist.com/graphic-detail/2019/06/25/what-is-...
  - heavyset_go 6y ago
    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.
dionidium 6y ago
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.
- deleted 6y ago
  [deleted]
adwf 6y ago
There's also the fact that they've only argued from the point of economic productivity. As if that's all there is to life...
bsder 6y ago
> 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.

by koboll 6y ago

ljhsiung 6y ago

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.

goonogle 6y ago

As long as you don't become an addict. I think most people start with 4 drinks per week. 12 years later is a different story.

eikenberry 6y ago
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. https://americanaddictioncenters.org/rehab-guide/addiction-statistics https://americanaddictioncenters.org/rehab-guide/addiction-s...
- osmarks 6y ago
  Presumably an alcohol use disorder is quite bad. Is the benefit of drinking alcohol really enough to offset the fairly significant risk there?
- goonogle 6y ago
  So tens of millions of people? Sounds like a public health crisis
watwut 6y ago
Most non-abstinents are not alcoholics and that holds true even in countries with high rates of alcoholism. Also "most people start with 4 drinks per week" is made up. Regardless of where you put "start".

johnorourke 6y ago

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.

CarelessExpert 6y ago
> 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.
- johnorourke 6y ago
  > gonna have to back up this rather hefty statement Thanks, you're quite right to challenge that, it's a belief based on past reading and should be backed up.
- rhapsodic 6y ago
  >> 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.
  - CarelessExpert 6y ago
    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.

conistonwater 6y ago

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.

narush 6y ago

Those graphs are epidemiological studies. Saying “effect” implies that alcohol is a cause here, which is might be, but who knows! 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://pubmed.ncbi.nlm.nih.gov/23193004/

UnpossibleJim 6y ago

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. https://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm 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.

heavyset_go 6y ago

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).

tigershark 6y ago
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?
- arcticbull 6y ago
  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. [1] https://www.economist.com/graphic-detail/2019/06/25/what-is-the-most-dangerous-drug https://www.economist.com/graphic-detail/2019/06/25/what-is-...
- heavyset_go 6y ago
  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.

dionidium 6y ago

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.

deleted 6y ago
[deleted]

adwf 6y ago

There's also the fact that they've only argued from the point of economic productivity. As if that's all there is to life...

bsder 6y ago

> 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.