4 ms·

That's the current WHO position apparently, but it's only motivated by lack of evidence of a threshold below which alcohol is safe. I find that approach actuall

by exitb 3y ago

That's the current WHO position apparently, but it's only motivated by lack of evidence of a threshold below which alcohol is safe. I find that approach actually harmful, as it creates an impression that there's little difference depending on the amount consumed, when in reality it's the amount that makes ALL the difference.

shrubby 3y ago
I'm thinking about substance use in general that it might even have some benefits but with each repetition the problem use threshold is getting closer. And we have no way of knowing where the threshold is for each of us. It might be ten reps or ten thousand, but even considering the genetics, trauma, etc we cannot know whether the next rep is going to be over the threshold. In addition the threshold in most cases becomes visible after a long time it's been crossed.
- exitb 3y ago
  The same thing applies to things like chocolate. Yet no one says that since we can't pinpoint a threshold of chocolate consumption harmfulness, we need to assume it's ZERO.
caeril 3y ago
I think it's likely that the WHO is considering people like me in their recommendation. I have friends who can drink a beer, maybe two, and be quite happy and satisfied. This is a phenomenon I have never been able to understand, because even a small amount of alcohol switches my reward system to REQUIRE more. If I have zero alcohol, I'm fine. But if I have one beer, I WILL have 7 more. For some portion of the human population (I've seen estimates at 15-20%), the concept of moderation is impossible - and for us, zero is the correct amount. If the WHO said "drink moderately if you don't experience dopaminergic response to ethanol, but drink zero if you do", it would be more nuanced and accurate, but public health organizations need to target their recommendations to the LCD, as simply as possible. It's the same as dietary cholesterol and salt. No health organization is going to say "run a double-blind study on yourself to find out if you are part of the population for whom dietary cholesterol impacts serum cholesterol, or sodium intake affects blood pressure, then consult this chart to see what our recommendation is for you" Instead they'll just say GROG SAY SALT AND EGGS BAD, NO EAT.
- toomuchtodo 3y ago
  I have a hunch if you tried a GLP-1 agonist, this reward center would evaporate. https://www.nature.com/articles/s41598-023-48267-2 https://www.nature.com/articles/s41598-023-48267-2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8820218/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8820218/
  - caeril 3y ago
    Yes, I've seen this, but I am a bit of a fitness enthusiast, and nobody's going to prescribe semaglutide or tirzepatide until I gain 200lbs and wreck my health, which I am unwilling to do. I'm not sure if you're tried visiting a doctor lately with your own research, but they look down your nose at you if you try to advocate for your particular edge case, with pubmed articles in hand - because they are better than you, as a filthy plebian patient. These are the people who murder a quarter million Americans annually due to preventable medical errors. Why anybody with an IQ over 90 would ever bother doing business with them is beyond me. At this point, I'm just waiting for the more reputable darkweb market suppliers to catch up. But yes, you're right, I'm looking forward to trying this approach, but I refuse to grant moral sanction or financial resources to the Gatekeeper class who demand we beg Daddy's permission to make decisions about our own bodies. They are all evil, full stop.
    - deleted 3y ago
      [deleted]
    - toomuchtodo 3y ago
      All fair points.
- coremoff 3y ago
  I'm similar to you there; the old addage "one is too many, two is too few" (or whatever the current version of that is) always ruled my drinking; I didn't need alcohol, but when I started I'd keep going - nice to have a name for it. Unrelated to any of this, I have a number of mental health issues, and recently I found that alcohol no longer gives me any of the euphoria effects that is used to do (obviously I still had the negative effects); once I noticed that, my desire for alchol went to zero and I've not touched it since - no idea if I am still have the same response to alcohol, but I'm not going to test it, for obvious reasons :)

by exitb 3y ago

shrubby 3y ago

I'm thinking about substance use in general that it might even have some benefits but with each repetition the problem use threshold is getting closer. And we have no way of knowing where the threshold is for each of us. It might be ten reps or ten thousand, but even considering the genetics, trauma, etc we cannot know whether the next rep is going to be over the threshold. In addition the threshold in most cases becomes visible after a long time it's been crossed.

exitb 3y ago
The same thing applies to things like chocolate. Yet no one says that since we can't pinpoint a threshold of chocolate consumption harmfulness, we need to assume it's ZERO.

caeril 3y ago

I think it's likely that the WHO is considering people like me in their recommendation. I have friends who can drink a beer, maybe two, and be quite happy and satisfied. This is a phenomenon I have never been able to understand, because even a small amount of alcohol switches my reward system to REQUIRE more. If I have zero alcohol, I'm fine. But if I have one beer, I WILL have 7 more. For some portion of the human population (I've seen estimates at 15-20%), the concept of moderation is impossible - and for us, zero is the correct amount. If the WHO said "drink moderately if you don't experience dopaminergic response to ethanol, but drink zero if you do", it would be more nuanced and accurate, but public health organizations need to target their recommendations to the LCD, as simply as possible. It's the same as dietary cholesterol and salt. No health organization is going to say "run a double-blind study on yourself to find out if you are part of the population for whom dietary cholesterol impacts serum cholesterol, or sodium intake affects blood pressure, then consult this chart to see what our recommendation is for you" Instead they'll just say GROG SAY SALT AND EGGS BAD, NO EAT.

toomuchtodo 3y ago
I have a hunch if you tried a GLP-1 agonist, this reward center would evaporate. https://www.nature.com/articles/s41598-023-48267-2 https://www.nature.com/articles/s41598-023-48267-2 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8820218/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8820218/
- caeril 3y ago
  Yes, I've seen this, but I am a bit of a fitness enthusiast, and nobody's going to prescribe semaglutide or tirzepatide until I gain 200lbs and wreck my health, which I am unwilling to do. I'm not sure if you're tried visiting a doctor lately with your own research, but they look down your nose at you if you try to advocate for your particular edge case, with pubmed articles in hand - because they are better than you, as a filthy plebian patient. These are the people who murder a quarter million Americans annually due to preventable medical errors. Why anybody with an IQ over 90 would ever bother doing business with them is beyond me. At this point, I'm just waiting for the more reputable darkweb market suppliers to catch up. But yes, you're right, I'm looking forward to trying this approach, but I refuse to grant moral sanction or financial resources to the Gatekeeper class who demand we beg Daddy's permission to make decisions about our own bodies. They are all evil, full stop.
  - deleted 3y ago
    [deleted]
  - toomuchtodo 3y ago
    All fair points.
coremoff 3y ago
I'm similar to you there; the old addage "one is too many, two is too few" (or whatever the current version of that is) always ruled my drinking; I didn't need alcohol, but when I started I'd keep going - nice to have a name for it. Unrelated to any of this, I have a number of mental health issues, and recently I found that alcohol no longer gives me any of the euphoria effects that is used to do (obviously I still had the negative effects); once I noticed that, my desire for alchol went to zero and I've not touched it since - no idea if I am still have the same response to alcohol, but I'm not going to test it, for obvious reasons :)