Chronic alcohol use reshapes the brain’s immune landscape | Hacker News Reader

Chronic alcohol use reshapes the brain’s immune landscape

scripps.edu

191 pointsgmays170 comments

I like to have an occasional drink. I suspect that mild drinking on the order of 1 glass of wine per day is not likely to cause harm and would probably be something that a doctor wouldnt feel bad recommending as being generally safe to possible stress reduction health benefits.

That said, there is plenty of research suggesting not drinking is healthier for you and non drinkers are much less apt to diseases like cancer et al. I also think there are plenty of folks who either dont want to or cant stop drinking that would include some doctors that would not want to suggest not drinking at all.

I definitely notice anxiety increases either the day after or the night of drinking. In some ways I could see it causing a feedback loop, but I also somewhat enjoy what I would consider a jolt of reflection during those times. Am I treating people with kindness? Am I too focused on the wrong thing? That said, as Ive gotten older, I think curbing to completely stopping drinking is the trend for me.

> a doctor wouldnt feel bad recommending as being generally safe

Some doctors would say a different thing.

“This might not be the answer people want to hear, but there is no safe level for drinking alcohol.”

https://www.euro.who.int/en/health-topics/disease-prevention...

It's funny that the only research he mentions is about the positive effects of drinking:

> Research has shown a lower risk of ischaemic events (heart disease, stroke and type 2 diabetes) among middle-aged and older, light-to-moderate drinkers. But the detrimental effects of alcohol far outweigh any potential protective benefits. An older person will get much greater health benefits from being physically active and eating healthy food than from alcohol.

... what? Someone should tell this guy that you can both have a drink and exercise. To paint it as a choice between the two is silly.

> alcohol doesn’t just harm the drinker; it’s related to violence on the street and in the family.

Having a glass of wine does not lead to "violence on the street and in the family" -- this is "War on Drugs" levels of disinformation.

Fun fact. My blood clots super easy. Genetic issue. (Factor 5) This is important.

Also most of family going back at least 3 generations are alcoholics.

  For many years I had this weird sense that alcohol cleared up my head.    But didn’t last long, and felt like crap later, so I almost never drink.  Plus, watching family die young is good motivation to stay away.

Eventually ended up on Blood thinners, wow. Brain fog gone in days.

So I have a pet theory that the reason a lot of my extended family fell into alcoholism is because it was a way to manage the disease even though they didn’t know they had it.

I feel like this is the kind of thing that medicine just misses completely. I like that kind of theory and I'm glad you've found relief.

Thanks! My second pet theory, is that a LOT of the keto/paleo/vegan etc diets are popular because of undiagnosed autoimmune conditions.

Been reading through support groups for years now. A noticeable cohort of people find relief via diet. Sugar=bad, mostly. But even things like tomatoes sometimes need to go.

Or conversely that the standard America Diet is so horrible, that if you have any possibility of an autoimmune condition, then diet will push you over the cliff.

It’s not autoimmune. It’s inflammation. I have been eating LCHF for a decade now and it started with reading about eggs and cholesterol intake. Once I read about the drivers of serum cholesterol, and the interplay between glucose and insulin, it became pretty obvious that carbohydrates, in the quantities and concentrations that many people consume them, are genuinely poisonous.

Expand on drivers of serum cholesterol please...

BMI and glucose levels

I think this might be a case of over-stating all the negatives, because the alcohol industry has done such a good job at promulgating the falsehood that “moderate” alcohol consumption is health _promoting_ — and of course drinking can be fun so people like to be validated in this way. I come from a heavy-drinking culture that is now promoting “Mediterranean-style” drinking habits as being a “healthy alternative” to binge-drinking.

Maybe this is a good public health tactic, to push people to a “lesser evil”, but according to meta-analyses like https://pubmed.ncbi.nlm.nih.gov/17478320/, there really is no safe level for alcohol. And even a “lesser evil” approach can be applied while being honest — know that when you’re drinking, it should always be pure indulgence, not under some false pretense of getting resveratrol or some other nonsense. https://pubmed.ncbi.nlm.nih.gov/25670722/ provides something of an overview.

Apropos of nothing, sci dash hub dot se.

Your link doesn't seem to support what you're saying.

> Our meta-analytic results indicate that the few studies without this error (i.e., those that did not contaminate the abstainer category with occasional or former drinkers) show abstainers and "light" or "moderate" drinkers to be at equal risk for all-cause and CHD mortality.

Equal risk, or in other words, there was no increase in mortality from light or moderate drinking.

TL;DR I pointed at the wrong link for the "no safe level" claim.

That quotation is from the first link, the meta-analysis "Moderate Alcohol Use and Reduced Mortality Risk: Systematic Error in Prospective Studies and New Hypotheses". It's a single piece of work focused on the "sick quitter" phenomenon, which only shows that light or "moderate" consumption is at best providing no benefit, as you say. This was the main thrust of my point -- it's not health-promoting. I did make a mistake and say that this meta-analysis justified a stronger claim though. I should have justified it using the second link.

The second link is an editorial, "Alcohol’s evaporating health benefits: Industry lobbying and promotion are rife and unchecked by governments". It's more of an overview of many studies and meta-analyses, and is the reference I should have given for my claim of "no safe level". Choice quotation and it's reference.

> A recent mendelian randomisation meta-analysis further concluded that “reductions of alcohol consumption, even for light to moderate drinkers, may be beneficial for cardiovascular health.” [16]

> [16] Holmes MV, Dale CE, Zuccolo L, Silverwood RJ, Guo Y, Ye Z, et al. Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data. BMJ 2014;349:g4164

CHD is the number one killer in the US.

> Someone should tell this guy that you can both have a drink and exercise. To paint it as a choice between the two is silly.

Indeed. I think I get the vast majority of my exercise whilst drunk.

Back, knee, and mood problems that prove obstaculous to exercise due to pain and fatigue are surmounted with the energizing and lubricating effects of alcohol.

I personally don't drink much (a small fraction of the average alcohol consumption) but I disagree strongly with that wording. While it may not be wrong scientifically speaking that there isn't any level of alcohol consumption with no negative effects whatsoever, using the same thinking you could also say things like "there is no safe distance to ride a bicycle". This kind of black and white approach has absolutely no place coming from a supposed public health authority like the WHO.

Furthermore, occasional, moderate alcohol consumption has pretty minimal risks, all things considered, and eliminating every little thing in your life with low risk would leave you with an impossibly dull existence. You wanna live the safest possible life? Don't go anywhere (cars are terribly dangerous and biking has its risks too), don't have too much of a social life (other people can infect you with all kinds of things, even in normal years the flu kills 700k people/year), don't go near water, don't even go anywhere you might slip (fall deaths kill tens of thousands annually in the US!) And don't even think of running off to a farm somewhere to escape it all (more than half of all workplace fatalities occur on farms!) At some point, you just have to live, dammit, because living life in fear is not living life at all.

i don't necessarily disagree with you overall, but your comparisons at the end aren't appropriate because alcohol is an addictive substance

Safe from what exactly? I don’t want my life to be exclusively a maximizing game for length of life & wealth. I’m going to die to matter what, I certainly don’t want to become reliant on alcohol or have an abusive relationship but I would much rather do the things I enjoy with my life than live the most cautious, healthiest life of avoiding fun that is a little bit bad for me.

I think we can all agree that heavy alcohol consumption is bad for your health. However I'm pretty skeptical that a moderate amount of alcohol consumption, say 1-2 drinks per week, is any higher risk to your health than the many other activities we engage in to live a happy and engaging life, as other commentators have pointed out.

Anecdotally it seems that the people who take these things to the extremes (i.e. never have even a single drink because drinking alcohol is bad for you) tend to stress out about a lot of other things as well. Obviously if someone doesn't drink because they find the effects unpleasant that's different, but I'm talking about the kinds of people who for example are overly concerned about microplastics (to the point of not eating any food that has been stored in a plastic container), or air quality (co2 monitors in every room, etc), or diet (will not touch anything with nitrates, only eat unprocessed foods, etc).

To a point, yes all of these things are legitimately harmful to your health, but having this kind of mentality is also not great for your well-being. Really perhaps the highest health-yield lifestyle change they could make is to relax a bit more and try not to get stressed out as much through meditation/mindfulness

Not sure why, but SV in particular seems to attract a lot of people with this kind of mentality.

There are very good reasons to avoid alcohol. Unborn child during (planned) pregnancy, for starters. Having to drive / commute / get home. Employment. Social responsibilities. Then there's the myth that in dinner it 'evaporates' (TL;DR it does not in a meaningful way). Think about it as well: if it would, they wouldn't take the effort to include alcohol. Alcohol is highly addictive, which alone is a valid reason to be afraid of it (e.g. my partner's father was an alcohol addict *and indirectly died from his addiction). There's a nice saying about if it'd get discovered tomorrow instead of 'existing' already it'd get illegal right away. It is also a hard drug. The only one available without a prescription. Having a high enough age ("being an adult") suffices. Turns out, a lot of people have the number of an adult age, but not the responsibility, plus more often than not alcohol addiction is a symptom of deeper rooted issues involving the individual. Still, it aids in a downward spiral.

> Then there's the myth that in dinner it 'evaporates' (TL;DR it does not in a meaningful way)

I'm going to take exception on this one. Alcohol acts as an _amazing_ pan deglazer and general solvent without any real substitute to carry flavors and aromas out of the pan and into the final dish. You don't even need much, maybe 2 tablespoons of wine get fond unstuck and dissolved. Some of it _does_ evaporate, you can literally watch it happen as it reduces in volume. You can flash evaporate a tablespoon of wine and return to a dry pan if it's hot enough. What it's not going to significantly evaporate out of is adding alcohol to an existing volume of liquid like a red sauce. It'll happen but not in an ideal or useful time frame. But for deglazing, try swapping your deglazing wine with broth, water or even vinegar and it's easy to see, smell, and taste that they are not functionally equivalent, an alcohol does the job so much better.

Now, if you or someone in your home has a problem with alcohol addiction or your religion forbids it, I'm not going to tell you to change your ways but for the average home cook (even a nondrinker) a bottle of wine kept next to the stove strictly for cooking purposes is an undeniably valuable tool.

No one is saying its ok to drink while pregnant, there are many things that you can normally do that you shouldn't do when you are pregnant. Fly for example, or engage in extreme sports like skiing. Similarly, you should not drink prior to driving, in the same way that you shouldn't be texting on the phone, or be sleep deprived when driving.

You can be gainfully employed and meet your social responsibilities while having a beer or two on a Friday evening, as the majority of people are able to do.

I've never heard of this myth about the alcohol evaporating during dinner, so I won't comment on that - when I drink alcohol, I do so because I intend to consume said alcohol.

As for the potential for addictiveness, there are many things in life that certain people are not able to handle well, with ruinous effects on those people's lives. Unhealthy junk food for example, or even something seemingly innocuous like the ability to invest in the stock market. I tend towards the philosophy that we should not have the government ban those things, especially when the vast majority of people are able to enjoy those things responsibly. Certainly we can provide additional resources as a society to help those people, but lets not ban it for everyone else.

You sound like you'd be a lot of fun at parties

This is the big paper in The Lancet from a few years back that basically dispelled the "drinking is healthy" myths.

Drink to relax or drink for fun, but don't expect anyone to tell you to drink for your health.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

That lancet paper always seemed to me a prime example of “statistically significant but not actually significant”. They massaged their data to just barely exclude 1 drink a day from their 95% confidence interval and still end up with an estimate of 1.01 relative all cause mortality at most from 1 drink a day. Realistically if you drink as much as the average American (around 500 drinks a year) the health effects will be extremely minimal unless you have some other health condition.

Sure, it's not likely to cause harm - that's not the point. The point is, it's not of medical benefit.

Don't forget you will get some reduction in sleep quality even from just 1 glass. You may fall asleep more easily but it is not as restorative. I really struggle with that as I get older.

Sometimes getting drunk mid day seems just the tonic for me. Drink too much too late and your sleep is nuked, drink mid day and most of the effects seem out of my system by the time I go to bed.

For me it's a good way to reset myself back to some baseline. Probably not healthy I'm sure, but I don't think life is a competition to see who can live the most perfectly, so I don't worry about it too much.

Definitely agree and this is one reason for my reduction in drinking.

What's interesting is that alcohol will probably kill far more people this decade than Covid or opioids, yet very little attention gets paid to this. It's an enormous negative influence on our society, yet there's a lot of social pressure pushing for alcohol use, and we allow advertisements that encourage it. I wonder if in the future we'll look back on this the way we now look back at how ubiquitous smoking was a few decades ago.

I doubt it. We've been using alcohol for thousands of years. COVID-19 for example has 0 societal benefits. And although opioids do, they were abused and that's what people are upset about.

People have been smoking (in various ways) for thousands of years, yet there has been a substantial shift over the past few decades as to how prevalent it should be in our society. Smoking inside restaurants was common just a few decades ago, and now people will often look at you askew if you smoke outside.

I think this view is fairly American centric. Go to any bar in Tokyo and you will be given an ashtray to smoke cigarettes with your drink. In China they have museums dedicated to tobacco cultivation and use. And even here in America, we mostly just switched to vaping tobacco and smoking marijuana.

> I think this view is fairly American centric. Go to any bar in Tokyo and you will be given an ashtray to smoke cigarettes with your drink.

From March this year: "Japan’s ban on smoking inside restaurants and bars takes effect this week"[1]

Seemingly entrenched cultural trends can and do change.

[1] https://www.stripes.com/news/japan-s-ban-on-smoking-inside-r...

Yea, not to mention cigarettes versus tobacco being a bit different.

Alcohol deaths may have a high mean but lower variance, covid deaths have an unknown mean and potentially a much higher variance. So we have to prevent it from blowing up before seeing proof it could.

The powers that be will ban alcohol and encourage replacing it with weed. Bezos & co. will swill their wine much more contentedly when the population's nice and doped up, rather than drunk and wild.

this sounds like the kind of world I would like to live in

There's an interesting discussion around alcohol and hormetic stress. I can't provide a good summary of it in a comment but the wikipedia page is a good starting point: https://en.wikipedia.org/wiki/Hormesis.

The most relevant part to me:

"an immune protein called Interleukin 10, or IL-10 [...] By boosting IL-10 signaling in the brain, [...] scientists could reverse the aberrant effects [...] a stark reduction in anxiety-like behaviors and motivation to drink alcohol."

As usual, the 'in mice' caveat applies, but if there is a compound which can both reduce anxiety and motivation to drink that works on humans without terrible side effects, it would certainly be huge.

Interesting. My psychiatrist pointed out at one point that drinking can cause increased anxiety for several days. Ever since I’ve paid attention to it and she’s definitely right - days where my anxiety is higher follows drinking 2-3 days before.

If I can notice it after one night out, it doesn’t surprise me that long term the two could be highly linked.

> Ever since I’ve paid attention to it and she’s definitely right - days where my anxiety is higher follows drinking 2-3 days before.

Yup I've noticed this as well. At first I thought I was drinking too often, so I didn't drink at all for ~3 months and tried again. Same thing. I'm "hungover" for a day and more anxious than usual for 1-2 days after that.

I've made a point to only drink anything on Friday now to avoid anxiety at work

I think alcohol supresses/alters your default state (gets you "high" so to speak). Then when you become sober things are back to normal - which initially is scary but one soon adjust to it again.

with alcohol you can't create more happiness, you can only borrow it from the future.

> with alcohol you can't create more happiness, you can only borrow it from the future.

I like that quote! Can I use it? Whom do I attribute it to?

attribute it to too many late nights in the pub ;)

The neurobiological effects of alcohol are fairly complex. I don't think most of its effects can be attributed to a single mechanism or reason.

It might be that coming back from the (subjectively positive) effects of alcohol could be offsetting in some cases, but I've also found that even smaller things that wouldn't necessarily trigger that much anxiety can do it sometimes after a night of drinking. I don't think it's just a disconcerting return to normal; I've sometimes noticed myself catastrophising after drinking in a way that's significantly greater than I otherwise would.

I wouldn't be surprised if there were some kind of a biological reason for that, although not something singular that uniformly affects all people the same way. (Individual variance is also pretty huge when it comes to any effects of alcohol, so some people might not experience that at all.)

It could of course also be that, for some people, alcohol reduces inhibitions enough to give way to your demons, at least inside of your head even if not in behaviour. That might also be a part of it.

Alcohol is a CNS depressant. This doesn't mean it makes you feel 'depressed', but rather that it dulls some sensations, which can include anxiety (it may also cause mood swings that reverse this affect).. so yeah when it wears off, that anxiety or other thoughts/feelings that it helped avoid may come back even stronger.

There is a difference between feeling anxious and going from high to normal. If you've suffered from anxiety, the difference is pretty clear. This isn't what they're describing.

Alcohol surpresses it - so maybe high was the wrong word, hence I put it in quotes- you are not high from alcohol, just numb I guess.

Perhaps you're just more likely to drink if you're already anxious for some reason.

From my understanding after reading the research:

+ A big part of anxiety is a neutransmitter called GABA which is tied to stress control (GABA is a cortisol antagonist). Less GABA is typically associated with more anxiety and stress.

+ Alcohol acts like a fake version of GABA, giving you temporary euphoria and calmness when you drink.

+ In being a faux GABA, it fills all your GABA receptors and your body stops producing more GABA, thinking it's already full up.

+ Having less GABA and no longer consuming alcohol, you feel anxious.

+ Eventually your body produces normal amounts of GABA again (in healthy people)

What initiates the drinking can of course be chasing that GABA-ergic feeling to begin with, and this may be part of the mechanism of alcohol abuse. Ultimately this can be a spiral of behavior where having an anxious day makes you want to drink to "calm down", which in turn makes the anxiety worse the next day, on and on.

> having an anxious day makes you want to drink to "calm down", which in turn makes the anxiety worse the next day, on and on

That's pretty much what I was trying to say. Thanks for spelling it out, and with details.

I've come to suspect that most persistent problems have a feedback loop in them. The curse of the loop is that it sustains itself, the blessing is that weakening the loop will in turn weaken it some more.

That lines up with my experience. I drank in college and I certainly had started to develop anxiety by then. By the time I was in the service that drinking scaled to a handle or a thirty rack a day.

Post-service I eventually quit drinking completely. It took a while, but I did it. The anxiety has never gone away but it's not as crippling as it was when I was drinking.

CBT really helps at least manage the symptoms and when I feel like I'm breaking down I can at least manage to slowly walk myself back. Having friends who aren't annoyed by the symptoms and are bold enough to walk you through those days is life-saving as well.

This is not medical advice, but have you tried GABA enhancers such as a regular low dose (0.5mg nightly) of melatonin or lemon balm?

I mean I'm willing to try it. My friend did psilocybin microdosing and it had positive net effects for months after he completed the routine. It was not permanent though.

If you shoot me an email (in my profile or just search my handle), I'll send you my collected notes and research at least.

It’s always strange when random Internet people pull the correlation versus causation card on an actual doctor.

No opinion on this particular issue, but actual doctors mess up correlation vs. causation all the time.

This shouldn't surprise; medical doctors generally are not scientists (although there are good scientists who are doctors).

> No opinion on this particular issue

Perfect for a comment on Hacker News(TM)!

IANAD - but the explanation I ha e heard is there your brain compensates for the “slowing down” effect of alcohol by increasing brain activity. When alcohol is eliminated from the system, the brain activity level needs time to come down to baseline causing anxiety. This is also - I think - the mechanism that contributes to the deadly nature of alcohol withdrawal.

Yes, I believe the technical term is "rebound effect"

https://www.nature.com/scitable/blog/mind-read/alcohol_sleep...

I don't know about anxiety, but it totally affects (for the worse) my sleep. What, I suppose, would make more anxious too.

By the way, transcranial magnetic stimulation (TMS) also is surprisingly effective in reducing alcohol dependence.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4292849/

Psilocybin too. There's a clinical trial running at the moment.

https://clinicaltrials.gov/ct2/show/NCT02061293

And LSD: https://www.ncbi.nlm.nih.gov/books/NBK99377/

Naltrexone, too.

And Kratom.

TBH the greatest thing I ever found to help was to drink so much over such a long period of time that you get the most amazingly horrific withdrawal symptoms. Sober 6 years because I don't like to drink any more. YMMV

I know a guy that stopped smoking by imagining vomiting in graphic detail every time he had a cigarette. YMMV

On mobile so don't have links/refs, but I've read papers claiming modafinil reduces cravings for alcohol and other drugs too.

I used armodafinil for a while, made me want to have a drink after work even more. That said I was efficient/focused during office hours, although more annoyed at stupid people than usual. As long as I was able to focus on my own work it was great.

I wouldn't say it had a positive effect overall. The effects lasts long enough that you can't really take any more after early afternoon if you want proper sleep, and once the effects wear off, well, you want a drink...

Just my personal experience though.

It would nice if you could find those links when you get back to the mainland^W a proper computer.

Maybe if you are dopamine deficient

Very interesting paper I had not seen before. Seems like with more targeted magnetic stimulation the effects could be enhanced.

I missed the mechanism they use to boost Interleukin 10. Anyone catch the relevant section in the study?

> To determine the impact of CeA IL-10 overexpression on dependence-induced drinking, a cohort of mice (N = 32) was injected with control or IL-10 virus as described below in ‘Viral injections in the brain’ 4 weeks prior to starting the 2BC-CIE paradigm.

One thing to note is that il-10 seems to be more immunostimulatory and less immunosuppressive in humans than in mice.

Interesting that "anti-inflammatory" is mentioned several times in this short piece.

I used to be a moderate drinker, having 1-2 per day several times a week. After stopping completely about 8 or 9 months ago, I no longer have acid reflux or that burning feeling in the back of my throat from spicy food.

This was an unexpected and wonderful result, to say nothing of dramatic weight loss and other benefits.

I used to think there could be health benefits to moderate drinking, but in retrospect it was only a justification for unhealthy behavior.

An altered immune response makes sense, given what alcohol puts your body through.

> After stopping completely about 8 or 9 months ago, I no longer have acid reflux or that burning feeling in the back of my throat from spicy food.

How long did it take before you noticed this change?

About a couple months in. First noticed that my occasional bouts of difficulty swallowing (spicy/acidic foods) completely disappeared. Later noticed I wasn't using antacids anymore.

I believe it's more than just alcohol itself though. Alcohol leads to eating more food (especially late at night) among other unhealthy behaviors that contribute to an overall feeling of an inflamed body.

I had the same experience and these kinds of health benefits started after a couple of weeks of stopping alcohol consumption and continued to get better for a couple of months until I've reached a point where they haven't been issues at all (So far at least, about 18 months).

It wasn't obvious how much use or how chronic the use had to be - is it implied to be chronic heavy drinking or just the glass of wine a day that causes the changes?

Apparently enough alcohol exposure to show addictive behaviour: the study used mice with the "2BC-CIE" exposure method:

> To induce alcohol dependence, we used the two bottle choice - chronic intermittent ethanol vapor exposure (2BC-CIE) paradigm, as previously described (Patel et al. 2019). This method consistently produces alcohol dependence in C57BL/6J mice (Becker and Lopez 2004; Bajo et al. 2016; Huitron-Resendiz et al. 2018), as exhibited by escalated alcohol intake, anxiety-like behavior and reward deficits. Briefly, mice were exposed to limited access alcohol (15% w/v) and water - two bottle choice (2BC) sessions followed by either chronic intermittent alcohol (CIE) exposure in vapor chambers (La Jolla Alcohol Research, La Jolla, CA), to induce alcohol dependence (dependent mice) or control air exposure (non-dependent control mice) in identical chambers. Naïve mice were not exposed to any alcohol either by drinking or vapor exposure.

A diagram on a similar study can be found at https://www.researchgate.net/figure/A-General-CIE-protocol-f... - for the diagram from this study, see page 4.

10% of Americans drink 90% of the alcohol. They're doing a bottle of wine a night.

Implying a bottle of wine a night is anything other than exactly the right amount

How does this answer the question?

It doesnt, it's just a dramatic one liner.

A dramatic, unsubstantiated, one liner.

https://image3.slideserve.com/6300839/cumulative-distributio...

this says 10% of the people drink 60% of the alcohol

Any suggestions for alcohol-free things to do in Covid-era NYC after hours in autumn and winter when you live by yourself and have spent all day at your desk in your bedroom?

What do you normally do to unwind? Do that, without drinking alcohol.

Go to the gym!

With a bit of commute it could fill up to 2 hours of your day and have a plethora of benefits. Once you get into the whole "getting better than yesterday" thing, it's exciting to go train every day and improve your "stats".

Multiplayer Video Games with your friends

mary jane aint a bad alternative

A bit off topic but is there a medical consensus that a glass of red a day is a net positive?

It's still debated. The reason people think a glass per day might be helpful is observational studies, which show that people who don't drink are slightly worse off than those who drink a little. However, you can imagine how these can be confounded (e.g., not drinking because of terminal illness or some other exogenous harm). It's hard to properly adjust your model to fully eliminate this sort of problem.

In contrast, Mendelian randomization studies generally suggest that there is no safe level of alcohol intake.

I am mostly convinced by the MR studies and think that alcohol is harmful for physical health (while being mindful that physical health is just one of many competing things that people value).

I think it mostly comes down to having a standard routine, whether it's a nice glass of wine with dinner (implying a regular dinner) or something similar.

Most of the times people say the secret to my health is "i do this every day" I think that implies not having too much chaos in life and a stable environment

That's a really good observation. Thank you for that.

"In contrast, Mendelian randomization studies generally suggest that there is no safe level of alcohol intake."

I believe this is the case. The idea that moderate alcohol consumption is "healthy" or beneficial in some way is a misunderstanding of their data.

What we see is the following:

People who drink no alcohol at all and people who abuse alcohol have, generally, poorer health outcomes than people who drink, but do not abuse, alcohol.

The poor health outcomes for the alcohol abusers needs no explanation.

It is the poor health outcomes of the abstainers that is misunderstood: they're simply not robust, or constitutionally enabled, to drink even small amounts of alcohol without feeling bad.

So my conclusion is that the abstainers are not having poorer health outcomes because of the absence of alcohol - they're having poorer health outcomes anyway.

Could it be those who abstain from alcohol tend to lean towards having other unhealthy vices that fill the gap? Poor diet, sedentary lifestyle, etc.?

One of the main researchers behind all the health buzz around red wine, was revealed as a fraud. Having falsified data at least 145 times. I guess he wouldn't have had to do that if red wine was healthy.

https://en.wikipedia.org/wiki/Dipak_K._Das

Quite likely it's just something people like to hear, so it is being told to them. I vaguely recall that correlation between red wine consumption and longevity disappears if controlled for wealth. Can't find any links tho.

I've also heard that the control, those who don't drink, are often not drinking because they used to be alcoholics thus scewing the longevity stats for non-drinkers.

Ah yes, that too.

The red wine vs beer discrepancy could be down to wealth.

The drinker vs non-drinker could be down to the fact that seriously ill people fall into the non-drinker category.

Another possible reason for drinker Vs non-drinker distinction could be social life, those with lots of friends tend to be happier and also tend to drink as a byproduct of that social life

Drinking is best done alone. I think your argument does not hold.

Everyone I know (except for one alcoholic) consume 60-80 percent of their alcohol at social occasions such as at after work drinks or Friday at the local bar with friends

How so?

Most people who drink mostly do so whilst getting together with friends.

Seen many dive bar regulars 40s to 60s, seeking relief from reality 4 nights a week. Drinking is how they coalesce a social life, but it's created with other problem drinkers. Their drama, commiserating and complaints were really depressing.

Ha, I wish this were true. Decent Italian reds are 12-15 dollars a bottle and craft beers are getting up to 6-7 a pint!

It might be that more educated (wealthy) people self-select into red wine consumption because (1) wealthier people are more likely to have read somewhere that it's healthier (even if it's untrue) and (2) it's more culturally sophisticated, more likely to be drunk over a fancy expensive dinner for example

The craft beer trend might not be old enough to show up in data. Drinking wine might, as far as existing data from several past decades goes, still be statistically connected to higher socioeconomic status.

I have found zero medical societies/health institutes that recommend someone begin drinking alcohol who currently abstains for any reason. If you already drink alcohol, consuming a single serving of red wine per day is probably not detrimental.

The pop science articles (think NYT, etc.) love to lead with clickbait like "Wine could extend your life by X years" but from what I can tell alcohol in the west, to the extent that it extends lifespans, does so by thinning blood, which is needed because of our poor (high fat) diet.

There's a growing body of evidence that there is no safe level of alcohol consumption: https://www.bbc.com/news/health-45283401

I'd say that there's probably also sufficient evidence of no safe level of sobriety, either. Those studies always annoy me. It's kind of like asking the question: how many times can I smack my head safely?. Well, none—but if you spend your whole life concerned about it you're probably not going to have a great time.

(Speaking as one who apparently probably has had to have given up alcohol for the rest of my life because my pancreas decided it wants me to die)

Edit: I really should have said sorry to hear about your health troubles. All the best!

People have been told it’s healthy to drink “in moderation” so many times. I think it’s good to dispel that myth. People can still drink as an indulgence, just like they can skydive as an indulgence. No amount of skydiving will _decrease_ the likelihood of you falling 3km to your death.

Oh yeah, I suppose you're right about that. I guess I just figured it was common sense. I always put drinking was about as healthy as crossing a car-trafficked street—in that it might get you somewhere but it increase your risk of being roadkill. I forget that some people might buy into more convenient interpretations of the information at hand... hence the ranting! (and thanks)

There is always dealcoholised wine and fresh squeezed grape juice. If it is about antioxidants, both have them without the alcohol.

Intuitively I would imagine it depends on the person. If you’re a person with a weak liver or kidney, there is probably no positive. If you’re a person with thicker than average blood, I could understand how alcohol might alleviate the amount of work the heart has to do, at least for a little while.

I thought the sulfites and alcohol outweighed the antioxidants, but I don't think there's a real medical consensus.

Are sulfites thought of as generally being bad for you? I was under the impression they were pretty neutral unless one happens to be in the very small group of people who are particularly sensitive to them.

You are correct. Gonna trust Good Housekeeping on this one:

https://www.goodhousekeeping.com/health/wellness/a44807/what...

Why a net positive? I think a single glass should have no discernible effect over time.

Mirror: https://archive.is/0SRPm

After not drinking alcohol for more than a year, I just feel alcohol is such a drag on life. A lot of mental energy and time consumed in alcohol related activities. Planning, buying, drinking and recovery from hangover if you had too many. Not to mention physical effects like upset stomach, feeling cranky next day, headaches etc.

Just like we don't like to overwork, so our body. Not processing alcohol and its side effects - few less things to do for our body. I feel very calm most of the time and less anxious than before. I also didn't fell sick in last one year. No visit to doc.

Above all net positive in mental and physical wellbeing are too good to have one or two drinks.

2020: bad diet >> little or no exercise >> stress from society and work >> poor sleep = weak immune system

is this why I am immune to COVID?

If I had to guess, the alcoholics are probably getting covid the worst so I’m a way, maybe yes?

Social drinkers maybe. Nobody is getting covid staying at home killing a 12 case while they play video games

The great defense against COVID is renewing your World of Warcraft subscription...

I actually did renew my subscription this summer before realizing how much of a time sink it is and how incredible it is that I had that much time as a kid.

Even working remote, I don't have enough time to play games like that anymore while working full time.

WoW feels like a remote job. I can barely convince myself to show up to meetings on time, sure as hell am not going to show up on time to raid.

Yes, stay home, consume product, and order your sex toys off of amazon.

Right but imagine two people pushing their shopping carts through Costco when it’s busy. One drinks a pack or more of beer everyday and the other is a teetotaler. Which is more likely to get infected? I think the former, but I have no clue.

If Biden follows the playbook he had with Barack goodness knows he'll give the boys in blue and black whatever they want when it comes to surveillance of private citizens.

From the paper:

"To induce alcohol dependence, we used the two bottle choice - chronic intermittent ethanol vapor exposure (2BC-CIE) paradigm"

Is this pure ethanol ? If so, conclusions about wine and health do not apply here.

Wine - as in fermented, not distilled beverage - is much more than ethanol, much like coffee is much more than caffeine.

Addiction to alcohol does not discriminate. It hits even wine lovers. Don’t try to fool yourself.

Not referring to addictive behavior, but to the one a day glass of wine.

Alcohol has long term detrimental effects on your working memory which is a bad thing if you are a knowledge worker.

btw, what was I saying? nvm.

I had a terrible memory anyway so I'm not losing much, I learned to just write everything down all the time.

That is what I do as well. Write everything down, and now that I am working from home: vocalizing what I am doing.

Vocalizing what you do is a good way to reinforce your attention.

I genuinely believe that if alcohol wasn't "invented" thousands of years ago most societies would treat it like they treat dangerous and physically harmful drugs like heroin or cocaine. Looking at the data and what we know about biochemistry and human physiology, it's absolutely indefensible that alcohol is available in every corner store but possessing the marijuana equivalent of a single bottle of liquor sends someone to prison for years.

I dunno. Where I live I can go to the cannabis store across from the liquor store in the big-box mall and purchase reasonable rations of each using my credit card and not get arrested. I can even go to the government-owned websites and order cannabis or liquor online for delivery.

I have also been to Peru where I was woken each day with a hot cup of coca tea and I could buy packaged coca leaves in the supermarkets.

I think "most societies" treat psychoactive substances with respect and toleration and view the over-consumption or inappropriate use as a disease that needs treatment. It is only a few social outliers that do not.

Are you aware that purchasing marijuana this way puts you on a list that prevents you from passing a NICS background check for firearms? How do you feel about that?

I’m amazed at how many of my friends have MMJ cards or go to recreation stores and have no problem with their ID being scanned — fully unaware that they’re permanently rescinding their 2nd amendment rights so that they can get a little high.

This (IMO) is why Biden is unlikely to support federal legalization of pot, by the way. They want to keep it on the books with decriminalization and unenforcement policies so the ATF policy stays in place.

Anyway, my broader point is that buying marijuana, even in legal states, is not at all the same as buying beer or tea. You’re not made a second class citizen by buying tea or beer.

Given they’re paying with a credit card, it’s very safe to assume they’re not in the United States and don’t care at all.

Which is very dumb. I'd venture that someone under the influence of alcohol (especially with a history of DUIs) is more likely to cap the wife and kids than a primarily cannabis user.

> alcohol is available in every corner store

The problem is: Alcohol is available to anyone, whether corner stores offer it or not. Just take your favorite type of fruit and let it rot. So alcohol being legal is probably also a consequence of the fact that it is very hard to forbid. (Case in point: The Prohibition.)

Anyone can grow marijuana (it's called "weed" for a reason) but our punitive justice system does a decent job of discouraging most people. We don't have to prohibit alcohol completely to blunt most of the large scale social and health problems it causes.

Big difference is how easy it is to spot weed growers vs fermenters.

Fermentation simply requires a warm dark place to take place (the darker the better). Which means you can EASILY ferment a lot of alcohol with very little input.

Weed, on the other hand, is a plant. Plants need light and water (and quite a bit of it). This is why weed gets busted so frequently. Small scale is harder to detect, but large scale weed growth has a BUNCH of tell tale signs.

Fermentation is also pretty quick - if you know what you're doing, you can turn around a very tasty 5% beer in a week. Growing cannabis requires months, plus time to cure.

> Plants need light and water (and quite a bit of it)

Cannabis plants are also rather... fragrant. Large illicit grows often have a duct and fan system to try to deal with it.

I do think alcohol is qualitatively different in how easy is it to make, though. For MJ you need specific seeds, which you can't just buy at target. Whereas with a google search and a quick trip to the grocery store you're better equipped to make moonshine than the best shiners of prohibition.

One reason alcohol is so prevalent is that it's a natural product of fermentation of items that we consume. There are videos of dozens of different species of animals drunk on alcohol in rotten food out in the environment. I wouldn't be surprised that the reason we can function relatively well with alcohol use is that we evolved to tolerate it.

I had a class on human development where the professor went in the exact opposite direction on this point. Alcohol is basically a mild poison, but it doesn't trigger morning sickness in pregnant women, which you'd think it should given the negative effects it has on the fetus. The lack of evolved response suggests that widespread alcohol consumption is actually a relatively recent development for human beings.

It is indefensible that alcohol is available, or it is indefensible that marijuana possession leads to prison?

Both, in my opinion. I don't think we should return to Prohibition times but I do think it should be significantly more difficult and costly to purchase alcohol.

It is even more trivial to brew and optionally distill alcohol than to grow marijuana. So all that "difficult and costly" would achieve is an increase of dangerous homebrew substances being consumed.

Prohibition was a failure for a number of reasons, but alcohol use did go down and has remained lower than it was pre-Prohibition. Not everyone is going to have the time/energy/resources/interest to brew their own alcohol.

No it hasn't https://apnews.com/article/f1f81ade0748410aaeb6eeab7a772bf7

Did you read the article?

> Historians say drinking was heaviest in the early 1800s, with estimates that in 1830 the average U.S. adult downed the equivalent of 7 gallons a year.

> These days it’s about 2.3 gallons, according to federal calculations. That works out to nearly 500 drinks, or about nine per week.

That's a valid view, but some alcohol in moderation certainly helps grease the wheels of social interaction.

This is probably why alcohol was known since ancient times. I'll cite: [https://en.wikipedia.org/wiki/History_of_alcoholic_drinks] [https://www.nationalgeographic.com/magazine/2017/02/alcohol-...]

In many developed countries with universal health care, alcohol is significantly taxed in part to contribute to health care costs. Canada is one example and, as a result, alcohol is generally much more expensive than in USA. This despite the large volumes and purchasing power of the provincial liquour boards (as private sales are limited, to varying degrees according to province).

IDK. During my trip to Finland, where alcohol sales follow this paternalistic approach, it struck me as odd how many "obviously problematic" alcoholics I met in the streets of Helsinki. Some of them drank window cleaning fluids and similar substitutes.

Libertarianish Tallinn 90 kms away seemed to cope better.

People want to drink, and those who want to drink the most will also be the least reserved about what they drink. It's the circle of life!

Well there is a huge effort to legalize marijuana and that effort appears to be slowly winning.

MJ has been smoked for centuries as well, the reasons why it ended up being superillegal in the USA are rather recent and rather weird.

I agree, but it depends on where you live. Here in California it’s legal recreationally. Psilocybin mushrooms are next.

It is a great hypocrisy that some substances are so vilified and criminalized while others are sold openly to great profit. I have a feeling it simply has to do with _who_ stood to benefit the most when those substances first became known.

It will take a lot of work to correct but with good education and open minds we’ll get there.

It wasn't invented. It was discovered. Even wild animals know alcohol.

Why do you think I put quotes around "invented"?

I never had a drinking problem, but quitting alcohol altogether has resulted in nothing but positive outcomes.

It's curious how my friends from college are largely in two groups now (not correlated to intelligence or motivation);

A) not really that interested in alcohol and focussed on work

B) focused on work but drink every night and still "party" all the time

This is seemingly an American phenomenon that's incredibly regressive and also seems to negatively affect women more than men. For whatever reason, women also seem more susceptible to the trap of drinking and partying excessively.

> seemingly an American phenomenon

You should visit Asia (once covid is over)

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