The big alcohol study that didn't happen
dynomight.net
dynomight.net
If we look at another societal thing that historically a huge chunk of the population did -- smoking -- it was known that it kills you, horribly, but it took taken more than sixty to eighty years for the public to get that message, and now society is slowly adjusting [at least in Europe] with real public benefits. If an effect is present with alcohol, even a small one, the integrated effect would be massive and it's a very scientifically valid question to ask.
Alcohol is really interesting -- people under report how much they drink, and how much they under report is a function both of the amount of booze, and the covariates that affect life expectancy like education (Prof Raymond Caroll at Texas A&M has an excellent book on this -- there's a method to correct for it by bootstrapping called SIMEX -- e.g. applied in [1], in which a sample of about 3000 adolescents and young adults around the age of 20 shows that binge drinking "may not be causally related to deficiencies in working memory, response inhibition or emotion recognition"). The paucity and conflicting of evidence probably means that the effect size is small, but the error bars are huge and as the article says, the covariates are many. It's just a shame that we can't have nice things because of the bent actions of a few.
[1] https://onlinelibrary.wiley.com/doi/full/10.1111/add.15100?c...
But it's not if an effect is present: we do in fact know that alcohol consumption causes cancer. The link is well-established. What is surprising is that most people aren't aware that this link exists. IIRC the number of Americans aware of the link is something like 30%. According to this (https://www.theguardian.com/society/2018/jan/08/only-one-10-...) only 1 in 10 Britons is aware. (I assume even fewer people are aware that processed meat causes cancer.)
I understand what you're saying, of course, given that there might be some benefits that outweigh the risks when you calculate overall mortality. However, speaking personally, I think I would rather die of heart disease than cancer. In fact, compared to death by cancer, a heart attack sounds like a blessing (of course I'm aware there are other, slower and also nasty ways to go that are related to heart disease — but still). The main issue being, of course, that at least a slow death gives you some time to say goodbye and arrange your affairs. Still: I'd rather go quick and clean.
It's a morbid subject, but after recently reading The Emperor Of All Maladies, a masterful "biography" of cancer, this has been on my mind quite a bit. I love to drink, but I'm wondering if it's worth it.
I'm still an alcoholic. I may drink less than before, but it's the only drug that affects GABA receptors that I can reliably get. If doctors won't help me, well, it's the only thing that keeps me sane lol.
I used to be careful with drugs, now I try everything I can get my hands on and note the results. It became sort of a hobby of mine.
Still remember the time I was fading in and out of consciousness from phenylethylamine and alcohol (wack interaction, do not recommend), the absolute despair that 7+ grams of pure GABA puts me into, and the time I passed out and pissed myself on too much Imipramine+L-DOPA+Valerian extract.
Ah, if only I could get the good stuff that works for my actual problems, but apparently prescriptions are not for subhuman citizens like me.
If I die, I die. If I become disabled/impaired, I die. Harder than it sounds, but I'm gonna test the limits.
I don't know if it's improving but the current state is pretty shocking if you're used to seeing better.
Alcohol though has a very strong influence, unfortunately.
It is common knowledge in the Whoop community that any amount of alcohol will impact your recovery score(a in house metric combined of HRV, amount sleep gotten, amount sleep needed, recent activity strain, & more) for near 72 hours.
Biofeedback is underrated. I have foregone many drinks out of concern for my heart health, which otherwise would be invisible.
Whoop's recovery score, in my experience, is highly correlated with mental performance, not just physical. The only market to athletes, which is horrible because I wish there was a model that would make sense to give to my parents. You have to really want that data to pay $30/month.
And that's a big assumption. Alcohol is addictive. How many times do you hear of people drinking a lot less than they planned to on a night out?
Indeed, this extremely obvious fact is why there hasn't been an RCT for alcohol before. It's not that the idea hasn't occurred to anyone, it's that would-be reseachers have thought "no way would we get that past an ethics committee".
So what has changed? Well, it looks like this Mukamal guy lives in an extremely friendly regulatory climate. They're so friendly, in fact, that they go out of their way to shoo him in as their researcher, seek funding from the alcohol industry, and try to conceal the whole thing! If there's any group that might be willing to overlook the extremely obvious ethics issues of running a RCT telling people to drink, looks like it's the NIAAA!
Alcohol is about self-medication, at the core of human civilization for a long, long time. China, India, Egypt so many early examples (https://www.cato.org/commentary/alcohol-caffeine-created-civ...).
How many people would be under more stress, have less relationships without alcohol? It absolutely works as social grease, loosens up nerves and is a very nice way of calming down.
I know so much in modern culture is about this weird asceticism, removing anything tasteful, fun, stupid and optimize for longevity - but what's the point to live in total boredom?
I like alcohol, it connects across millenia.
We seem to be on the cusp of solving aging and dying problems to a massive degree.
200 years ago we knew nothing, in another 50 we might know all we need to achieve immunity to aging.
I would bet my net worth that we figure that out in the next 1,000.
Anyway I still don't optimize for longevity, but I think it makes sense, at least.
I also enjoy that alcohol connects across millenia. Lately I've been trying some things from a Slavic brewery, they brew some ancient mead recipes. One was unchanged since about 1300, according to the label. That's pretty cool. If you want to check it out, the one I have now is a honey apple wine called Ribe Mjod. Same company.
That elixir has changed names, but the concept is still around.
Aging is just another biological process. It's controlled by genetics and environment like everything else, and can be manipulated using similar principles.
It seems likely (thinking of CRISPR and similar inventions) the rudimentary tools for controlling aging are coming of age. I believe biological immortality is closer than we think.
Living biological processes by their nature resist decay, but that's an uphill battle... eventually entropy wins. Errors and waste products accumulate, materials become brittle and fragile, with every year lived the probability of dying before the next increases.
Can we help our biology to become more efficient at maintenance and repair? Probably, but not all that much. We are already very long lived. The only complex terrestrial beings that live longer do so by living very slowly... in terms of subjective time experienced, maybe they don't live any longer at all.
However, in medicine, most doctors will tell you that the doctors from 200+ years ago were idiots that did more harm than good.
Why is that? Is modern medicine too hubristic? Were the doctors of ages old really that dumb? Is this a trend that will repeat itself in 200 years?
Most artists (art consumers anyway) are very big on newness and rejecting tradition. Art historians even more so.
So yes, 200 years ago doctors knew a great deal far less than today. I'm sure a doctor 200 years in the future looking back on today will feel similarly. There's still so much we don't know & there's a lot of guesswork involved. I wouldn't say they were idiots but the outcomes were certainly not at levels we'd accept today (just as the outcomes today won't be acceptable 200 years from now).
FWIW, the same is true in other disciplines. The 20th century marked a rapid exponential curve in learning. No one really studies any of the masters you note except for maybe Newton & Galileo. The former because the kinematics equations are actually extremely good approximations for Einstein's equations (& also his work on light and lenses remains accurate and foundational to this day). The latter as a warning of the dangers of putting ideology ahead of science and scientific thinking. Galileo's heliocentric model isn't actually used today except as a way to teach kids about the solar system because it's really simple & is good enough at that level (his work on gravity was an important influence for Newton's ideas on the topic).
[1] https://en.wikipedia.org/wiki/Ignaz_Semmelweis [2] https://en.wikipedia.org/wiki/Louis_Pasteur
The way it is often done just creates trust issues for people who really care about accuracy...
A safer bet there's never been, at least in the sense that unless life extension advances very soon, your expiration will pre-date your wager's.
And yet I do tend to agree, barring a dark age or human extinction event, both very possible.
I guess the way to bet on it is compounding interest, at least in the current world.
The two drink a day meme is something I knew was totally bullshit, but could never really prove. Two of my uncles (one died recently) believed that meme and happily torched both their mental and physical health by drinking to excess. Their healthcare providers didn’t say anything either, until it was much too late, at which point the damage had become very obvious.
I believe that the idea that people are to blame for their alcohol problems is totally false and basically a conspiracy by the alcohol advertising industry. The problem is alcohol, not the people consuming it. It naturally induces almost every person to want to drink more alcohol while inhibiting their ability to make good decisions such as about continuing to drink.
The perennial issue is finding and designing the right levers to get the results that are wanted. Prohibition didn't work, moralistic pressure doesn't work, education doesn't work. The right incentives need to be discovered, and I think an acceptance that humans have a need for changing their state of mind will lead closer to answers.
Excuse me, what? I certainly would, and I don't know how you could possibly think that nobody else would.
(At least for Europeans)
Like most addictive substances, the negative health benefits don't manifest themselves immediately, but often after years or decades, and those who haven't suffered claim all the benefits while the harms loom on the horizon. They change their tune later in life...sometimes.
As for the other harms, such as the amplification of violence, the loss of mental faculties – that same "social greasing" is the removal of inhibitions, including those that prevent people from committing certain crimes or harm against other people. How many alcohol-fueled rages would it take to make the equation flip for someone?
If the argument is that it is fine as long as it is done responsibly, how do we police that?
Will alcohol always be around? Of course. It's something that cannot be avoided, even in societies that have banned it for one reason or another. But to welcome it with all its complications, just because one enjoys it, and closing a blind eye to the harms, is imprudent.
And is alcohol truly a good solution as a self-medicant? I think you are spinning that as a net positive, but I highly doubt this is a professional's opinion on that matter, such as a therapist or a doctor.
Finally, to equate a negative view of alcohol as "...removing anything tasteful, fun, stupid..." and "...total boredom..." – to be honest, this is reducto ad absurdium, isn't it? If nothing is fun if there's no alcohol, then I think there's a different problem.
We will never be rid of alcohol, in my opinion. It's too simple and effective, and too deeply engrained in our society. What we can do is work to better educate and support society so that alcohol can exist in a safer atmosphere. Addicts don't get addicted just due to chemical means: there are deep social implications.
Should we police responsible consumption more than we currently do? Perhaps, it's worth discussing for sure.
Will alcohol always be around? Of course. It's something that cannot be avoided, even in societies that have banned it for one reason or another. But to reject it with all its benefits, just because it has harms, and closing a blind eye to the good, is imprudent.
And is alcohol truly always a _bad_ solution as a self-medicant? I think you are spinning that as a net negative, but I highly doubt this is professional consensus on the matter, such as among therapists or doctors.
Finally, I don't think there's anything wrong with making boring/stressful stuff less boring/stressful, sometimes you just gotta do boring/stressful stuff
>it connects across millenia
Ya, just like all those other great constructs of human civilization: war, slavery...
(Obviously alcohol is not as harmful as those examples, just trying to illustrate how that line of thought is flawed.)
Maybe if we could eliminate all the things that make people drink to extreme excess, or drink when it's dangerous, this would be a fun little quirk of the human species but as it is a huge amount of harm is correlated with heavy drinking and I think if you've only ever seen and understood the good side you are a very very lucky person.
Well, I can personally confirm that you can just as well train yourself to consciously overcome this specific restraint which is also a rather useful skill in itself. Sure, it takes work and effort but all things that don't "come to you naturally" require that.
And if where talking about cases of actual psychic illness, carefully chosen prescription drugs even when imperfect always beat self-treatment with alcohol.
It boils down to: Self control is strongly correlated with good health
https://bmcmedicine.biomedcentral.com/articles/10.1186/s1291...
I can't help but feel bias against drinking has religious roots. This has been studied to death, and generally moderate drinking is shown to be beneficial, or at very least not harmful. But some folks are so opposed to that result they keep moving the goal posts.
That said, I have no specific criticism on the paper you refer to. It might be that the lower risk of heart disease is outweighed by an elevated risk for e.g. cancer? In that way both results can be true.
I don’t think it’s necessary to propose novel explanations for opposition to drinking. Alcohol has enormous negative effects on society and individuals. Nobody who has ever lived with an alcoholic is even remotely confused about this, but even those of us who have been lucky in that respect can easily observe large societal detriment. A staggering percentage of all violent crimes are committed by drunk people, most of us know someone who died in a drunk-driving related incident, and we’ve all been around drunk people who we found to be incredibly annoying (and often actually violent).
Opposition to drinking doesn’t require additional explanation.
There was a (ineffective and violent) prohibition on drinking a century ago. Some religions also have strong views against drinking. To ignore these societal influences on western culture and call it a novel explanation is a bit of a stretch.
Prohibition is widely regarded today as an obviously ridiculous blunder, but that's mostly revisionist and ahistorical.
German Lopez at Vox did a couple good pieces on what people get wrong about it:
* https://www.vox.com/2015/10/19/9566935/prohibition-myths-mis...
* https://www.vox.com/the-highlight/2019/6/5/18518005/prohibit...
There's also a bit of an asymmetry that makes weighing the pros and cons difficult. If 40 people enjoy a night at the bar, but one one of them goes home and beats their wife and another kills a family in a drunk-driving accident on the way home, do we just say, "well, 38 of the 40 peacefully enjoyed their evening, so it's mostly good." That looks like a horrific outcome, to me.
Unfortunately, an overly pedantic Supreme Court interpreted "intoxicating liquors" very broadly, resulting in a national ban that far exceeded the state and local legislation with which most people were accustomed and comfortable. It was the narrower definition only encompassing distilled liquor that the public knowingly gave their consent.
Obviously drunkenness is another issue altogether, but that's not what such studies examine in the first place, so that's a different discussion.
As for the benefits of wine in moderate drinkers, I remember reading a study which compared consumption of wine vs equal amounts of other types of alcohol, and concluded that the antioxidants and tannins in wine were the main carriers of that benefit, and if anything alcohol still had negative effects but simply the benefit from the other substances in wine overrode the harm caused by the moderate amounts of alcohol in wine.
Obviously since I don't remember the study to cite it, this makes it an anecdotal claim here, but ...
They didn't read in the Bible that alcohol was bad. They looked around at society and blamed a lot of its ills on problematic alcohol use.
Some background here: https://www.thegospelcoalition.org/article/9-things-you-shou...
Everybody gets this causal arrow strangely backwards. Alcohol causes people to sin; that's why Christians opposed its use. It's the negative effects of alcohol that led people to oppose its use, not "religion" per se (or even in any kind of explicit scriptural or liturgical sense).
That’s all I meant by “sin.” I only used the religious term because I was speaking from the viewpoint of the religious of the time. Didn’t mean anything by it other than ordinary misbehavior.
Perhaps, but P(A|B) is drastically different from P(B|A). In other words, what percentage of consumed drinks of alcohol are associated with a homicide?
Beyond that, could alcohol use be prevalent enough that alcohol could be implicated in 50% of everything? It's sort of like how "excessive speed" is a factor in most car accidents, but that's because posted speed limits are too low and everybody speeds at least sometimes.
I think of it as an "alcohol as a plaque solvent" model.
Careful. That result is not so clear-cut:
>> In the few studies that excluded former drinkers from the non-drinking reference group, reductions in risk among light-to-moderate drinkers were attenuated. [Section Abstract/Results]
>> Pooled analysis of estimates relative to non-current drinkers showed a reduced mortality risk for an alcohol intake up to approximately 75 g/day. However, when studies with former drinkers in the reference group were excluded, the association was considerably weakened (see Additional file 1: Figure S9). In addition, among those studies using post-event alcohol measures, the result did not change substantively; a similar trend was seen in studies with multiple measures but failed to reach statistical significance, probably because of the low number of curves (n=2) in this subgroup (see Additional file 1: Figure S10). [Section Alcohol consumption and all-cause mortality among CVD patients]
Btw, "post-event" means that participants reported their results after they had their major cardiovascular event:
>> In addition, most of the included studies asked patients to report their average consumption since the occurrence of their primary events (post-event alcohol assessment), whereas three studies used alcohol intake in the year prior to primary events (pre-event), assuming drinking habits remained stable over time, even following events [14, 44, 45]. [Section Data extraction and quality assessment].
Is there any reason to believe the chemicals in alcoholic drinks would boost your health?
My intuition is it's behavioral or emotional in that maybe drinking a glass of wine a day is relaxing, maybe more likely to be drinking with friends?
Alcohol thins the blood, much like aspirin, which at small doses decreases all cause mortality.
Some types of alcohol, especially wine, are rich with antioxidants and flavonoids.
Alcohol may decrease stress and anxiety.
Alcohol is often consumed with friends and family, and we know socialization is correlated with better health.
Yes 100% on socialization that was my first intuition.
Can't we just reserve judgement here, and use some humbleness in the face of our ignorance to drive for a real RCT funded by the public?
Can we try to avoid the trap of becoming confidence-men?
For example: there are zero RCTs that prove to us cigarettes cause cancer. But we're still comfortable in saying cigarettes cause cancer.
It's entirely ridiculous to suggest we do a RCT and ask someone to smoke for 30 years to remove all doubt that cigarettes cause cancer. And who would pay for it? So all we have are mountains of data showing that cigarettes shorten lifespan.
The same is true here, but the opposite result. Doing a RCT on alcohol for decades will never happen. All we have are mountains of data showing either no harm or a small benefit on lifespan. So that should be our null hypothesis: that moderate drinking is either harmless or slightly beneficial.
About 80 to 90 percent of people who have lung cancer were smokers.
Only about 10 to 15 percent of smokers will develop lung cancer.
So it's not a guarantee. It increases the risk.
Just like alcohol (https://www.cancer.gov/about-cancer/causes-prevention/risk/a...)
The problem with doing RCT with alcohol and with smoking is that we're talking about lifestyle studies. You can't really do a study with the goal being "see if we can give this dude cancer during his lifetime".
And let's also remember that the study that people who drink moderately had longer lifespans just really notes correlation. It does not prove a causation.
Drinking is ubiquitous. Most people drink. Drinking is also a luxury. So if you're poor, you either drink a lot or very little. Because you either have a problem or you're too broke to afford it. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3185179/)
Guess which income bracket engages in moderate drinking the most? That's right, the income bracket that also allows you to afford better health outcomes overall. So while it may be true that moderate drinking correlates with longer lifespans, it's a knock-on effect to the fact that being poor sucks.
The control part would be particularly difficult (unless maybe you gave everyone a real or sham nicotine patch? But then you can’t exclude some other benefit from straight nicotine itself).
One could control for all the confounders they want, but you still risk missing some that are unknown or undervalued.
Not only does that conclusion not follow from your premise (a logical fallacy), but it's an absurd suggestion as a process for deriving truth. Observational studies, at best, offer an insight into possible hypotheses, and should by no means be considered persuasive unless all interacting systems have been controlled for. In the case of ethanol, there are an enormous amount of interacting systems that need to be controlled for.
Your premise is also strictly false, as it's clear that not only is an RCT for ethanol consumption possible, but it was planned and partially in progress before it was terminated.
It's truly incredible to see the kind of language that you use here, how confident you are about your fallacious argument. I kindly request that you turn down your confident language. Science is a long and careful process of pushing back the fog of ignorance, and if you are serious about the search for truth you shouldn't use such confident language.
I think the most likely outcome is boring: moderate amounts of alcohol are moderately harmful, but not harmful enough to be immensely obvious and not harmful enough to outweigh the non-biological benefits some people extract from it.
Is this "no one reads the article anymore" again?
My complete layperson theory is that no amount of alcohol is "healthy" per-se: its negative effects are well known and documented, and almost assuredly outweigh the few dubious positive effects. Instead, the benefits of drinking small amounts of alcohol might be entirely tied to stress management. Stress kills. It absolutely ages people and leads to early death.
Having a wind-down ritual in the evening is probably the important bit. A glass of wine with dinner is a firm punctuation mark in a person's day. It signals that work is now over, and what's been left undone can be resumed tomorrow.
It's just a morality/cultural issue. They see people drinking & driving, excessively drinking and being violent, depicted IRL and in movies, and want to distance themselves from these bad types of people that drink alcohol.
Plenty of very secular countries have drink and smoke a lot (for communist countries, for example).
And of course, what those "studies to death" you mention have established is that alcohol is even nastier than suspected, causing birth defects and cancer like no comparable substance we consume, in addition to all the obvious negative health effects we all can see.
The supposed dip at the low end, for only a few of the nasty effects, is a counter-theory to distract from the (pink?) elephant in the room. And even that counter-theory has been discredited by mendelian randomization studies.
I think that has to be typical of a significant chunk of population. People on the wagon due to alcoholism exist but are likely to be a smaller group.
The UK tried something like this for building materials - unfortunately, it doesn't seem to work very well.
To achieve certain standards of fire resistance, manufacturers could choose from a range of independent test houses, who would conduct the relevant fire performance tests at the manufacturers' expense.
Except it turns out, manufacturers don't want to go to difficult, argumentative test labs. They choose the friendly test lab, that knows how to treat its paying customers. The lab that will advise them on how to pass the test, that will leave them unsupervised as they add defeat devices to the test rig, and that will remove problematic photos from the test report.
The result? Loads of our tower blocks are clad in flammable insulation and ACM panels - including one where 72 people died in a single fire.
Here it was the NIH, it should always be an independent organization. The money is committed to the institution before the institution decides who gets the job.
I love how he mounts a reasonable defense of everyone involved, then proceeds to argue against his own defense and tear them down.
I want to be friends with the author.
I don't know why more journalists don't write like this. Is it just that people prefer being told what the right and wrong opinion to have is? Or is it simply because most journalists care more about reporting their opinion than trying to fairly represent both sides of the story in question? I guess it could be argued some opinions are so clearly wrong that they don't deserve the benefit of the doubt, but even then there is often a lot more nuance than is typically reported.
I mean... this piece actually has much more opinion in it than "journalism" is "supposed" to, doesn't it? It's an opinion piece, not a piece of journalism, although he does a bit of research for it.
So I find it a bit confusing to ask for "more journalists" to write like this, while also saying you think most journalists care more about reporting their opinion than OP... OP actually centers it's opinion pretty directly, no? Mostly I think this piece is doing something that is not what journalism is even expected to do at all.
But to be sure the distinction between "journalism" and "opinion" is pretty confusing and blurry these days (because opinion rather than journalism both gets more clicks and is cheaper!). I'm not sure the solution to problems with journalism lies in asking journalists to write journalism more like an opinion piece, even a very well-written opinion piece!
But by far my favorite pieces of journalism are dripping with opinion and character and full of bias. The X factor that makes the result, to me way less biased than most journalism, is that they are introspective of their own biases, display empathy toward everyone involved, argue in good faith for everyone involved, and draws their own conclusion from the results of their imaginary argument with their crew of alter-egos.
It takes something special (and a lot of practice) to argue for someone you disagree with in such a way that that someone would say you did a good job.
If you ask me, the main issues with modern journalism are the poor command of written English and a lack of depth/context. Neither of those seem to apply here.
It is surprising the alcohol industry is going to such huge lengths, and I can't remember ever hearing of such things. It would be a huge blow to your credibility at the time I was in science.
I do enjoy the author trying to look at both sides at the end.
I've always been curious how harmful these drugs would be under a profile of long-term recreational abuse, when contrasted with alcohol. I have a sense that you'd be far better off being addicted to such drugs, than you would being an alcoholic. Similar to how vaping, no matter its absolute health consequences, could still be beneficial relative to smoking tobacco, if that would be your alternative.
Maybe if we could figure out how to make an aqueous GABA-A agonist with a really high LD50, we could see the development of a "synthahol" in our lifetimes?
Note: Alcohol hangover is not the same as the immediate withdrawal symptoms of other drugs that let‘s you crave for taking another hit shot whatever. It‘s caused by the myriad of trash by-products in metabolizing ethanol, not for the lack of alcohol. (and for certain alcohols additional also tannins, aroma substances and similar - think of whiskey and cheap wine)
Realistically his chance of any nation (especially a western one) legalising such a thing is very slim indeed, at least in the medium term. Which is a real shame, as alcohol causes huge harm to society.
LD50 for benzos is already “really high” - that is not an issue. Alcohol affects other neurotransmitter pathways other than GABA. That isn’t even the one responsible for the psychological dependence. So a GABA-A agonist with a high LD50 exists in multiple (benzos), but it’s not an alcohol substitute. There is a reason why these medications are used for acute withdrawal, but are not used for treating dependence.
Also, being addicted to benzos is far more debilitating than the “vaping” equivalent. They’re quite harmful for chronic use except in very limited circumstances.
Maybe synthahol might be a thing - I mean you’re probably closer with something like ecstasy - but a GABA agonist isn’t it.
LD50 for benzos is already “really high” - that is not an issue. Alcohol affects other neurotransmitter pathways other than GABA. That isn’t even the one responsible for the psychological dependence. So a GABA-A agonist with a high LD50 exists in multiple (benzos), but it’s not an alcohol substitute. There is a reason why these medications are used for acute withdrawal, but are not used for treating dependence.
Also, being addicted to benzos is far more debilitating than the “vaping” equivalent - this has been well studied since they had their heyday in the 70s. They’re quite harmful for chronic use except in very limited circumstances.
Maybe synthahol might be a thing - I mean you’re probably closer with something like ecstasy - but a GABA agonist isn’t it.
I agree with you that something like chronic Diazepam abuse is probably less harmful to the body than a similar alcohol habit - but I'm skeptical (but hopeful) one could design an effective, recreationally-useful GABA-ergic drug that didn't come with the baseline shift and rebound anxiety (and in the limit, seizure/death) usually associated.
You can already choose to abuse pills in contrast to alcohol, and it's generally not very pretty either.
[1] https://www.theguardian.com/science/2019/mar/26/an-innocent-...
The withdrawal from any type of GABA antagonist/PAM type drug can be lethal. The acute and long term side effects of ethanol discourage abuse.
Also acute overdoses of the safe benzo/Z-drugs are strange & alarming since you can put yourself into a 24-48 hour coma but recover pretty quickly.
Does anyone know anything more about the person who writes at this site?
(I know, I know, it doesn't matter who they are if their arguments are good. I'm just at the point where I pretty much have to assume bad faith until proven good faith when faced with any new source of online information.)
[1] Smashing the Liquor Machine: A Global History of Prohibition - https://www.amazon.com/Smashing-Liquor-Machine-History-Prohi.... Especially Chapter 14.
If you, like most professionals, consume alcohol for social clout and for fun, this is extremely crucial.
Once you develop kindling (sneaks up on you), even a few beers can trigger almost life threatening withdrawals, so your option is to not drink any, or drink yourself to death. There is no middle way.
For those interested, check out the cripplingalcoholism subreddit on reddit. Tons of first hand experience there. You have been warned. Kindling is a pandoras box of all kind of regrets and there is no way to reverse it apart from abstaining from alcohol for 10+ years.
https://en.wikipedia.org/wiki/Kindling_(sedative%E2%80%93hyp...
but what it is?
For the first 100 or 1000 or 5000 times it's OK. Then you start showing physical symptoms. Little anxiety. Headache. Light sweats.
Once this starts (showing physical symptoms) you can never binge again without them showing up. And each time they get worse. Progresses to morning shakes, seizures, even death in extreme cases. All from binges you happily came out of as a teenager.
OP seems to push the idea that we could have trusted this study, even if it was funded by industry and run by a professor with cushy ties to that industry.
```Sixth, in the final review, the NIH made no attempt at cost/benefit analysis. Their final report is a fair summary of the problems with the trial. But it doesn’t consider the information that was lost by cancellation, or the fact that that there was little cost to taxpayers. (Though Collins’ letter to Senator Grassley reveals the NIH did pay around $4 million out of pocket.) Could a different principal investigator be put in charge? Could the study design be modified to address the concerns? Could the monitoring bodies have been strengthened so people could trust the results? Maybe the trial was unsalvageable, but it’s telling that the NIH didn’t bother to make that argument.```
1. A shady dude and his business colleagues try to shoe-horn in a preconceived conclusion into a large RCT and co-opt the NIH brand for authenticity.
2. They have some initial success but once enrollment starts a variety of red-flags are raised and the whole thing is canned before any results are produced or large amounts of money spent.
3. Shady dues reputation is ruined, people are fired, and new safe guards are in place.
But it's hard to take seriously when the very first figure has a logarithmic y-axis without any callout in the discussion, exaggerating the appearance of the negative effects.
Isn't there another reading of this story that goes "NYT spikes cool thing for quick sensation?" File it with "Slate Star Codex" and other examples of predatory reporting there.
This was along the lines of what I was thinking. I just found it odd that the others seemed to be direct and this one is a second order (or higher) impact.
Go to clubs fully sober, the music is too loud, people are obnoxious, its not probably pleasant experience.
So alcohol users can develope whole different requirements for fun and if they quit, the world seems so depressive, because their habits and friends are still from that alcohol world.
What's the protocol for detox?
Autistic individuals appear to have more aluminum (specifically in their brains, maybe?) than others. But this is only correlation, not causation (and, so far as I know, not proven even as correlation).
If the correlation is correct, it remains to be determined whether the aluminum causes autism, or whether autists absorb aluminum as a consequence of their autism.
He had a hair tissue mineral analysis done last October, and it showed a high level of aluminum in his system.
I mean technically anything can exist if it has a label in the DSM, but you know what I mean.
haha I actually laughed out loud that a very good line.
(aluminum salts being in antiperspirant is the "biggest" source for odd levels people bring up)
haha I actually laughed out loud that was a very good line.
(aluminum salts being in antiperspirant is the "biggest" source for odd levels people bring up)
At the very least, a study has been warranted but to date never produced.
Because aluminum is associated with so many neurological issues and autism comes with consistent gut issues, there’s a thought that some type of gut issues could be causing higher levels of absorption of aluminum from the environment when your body would normally filter most of it out.
The biggest issue is that it’s compelling enough to warrant a study.
I always love hearing about all the things that are more fatal than covid, directly under our control, and otherwise completely tolerated by society. Not that we shouldn't respond to Covid, but that we should probably have proportionate responses to such other things...
[1]: https://www.who.int/publications/i/item/9789241565639
[2]: https://archive.is/zlvBY (WaPo)
It is surprising the alcohol industry is going to such huge lengths, and I can't remember ever hearing of such things. It would be a huge blow to your credibility at the time I was in science.
Am I naive for thinking that everyone knows that Alcohol is not good for them? Funding research into it seems like a waste of money, since I also believe that people should be 100% free to ingest whatever they want. You can't ban alcohol, its too easy to make. I barely drink, but its undeniably important to our culture.
e: Apparently I am quite naive. My crowd is more likely to have cannabis addictions than alcohol.
It'd be interesting to see the experience of folks in continental Europe, where I gather wine with meals is much more commonplace.
750 mL ÷ 2 * 0.12 = 45 mL = 4.5 "UK units"
45mL * 0.789g/mL ÷ 14 = 2.54 "US standard drinks"Yes, I know several people that fit that description by much more than 2 drinks every single day.
I believe people should be free to chose to drink too, but alcohol is truly in the "culture", like you said. Very few clearly harmful activities like that are part of any culture and that is what makes it important for us to educate society about this. I believe that alcohol should come with the same level of warning as cigarettes do, but the society is not there yet.
I haven't personally managed (or even tried) to convince anybody because people feel personally attacked when their preferences are questioned, especially when these people believe themselves to be "scientifically-minded". I think everybody has to discover this on their own.
Separately, when I was in the army, and much younger, we all consumed significantly more than 2 drinks day and were still high performers at our job.
A bottle of 5% beer is defined as 1.7 units, therefore a bottle of 6.5% or 7% craft beer would be well over 2 units.
Most of the beers I like are 7.5%, except stouts which are 10-12%. They also come in large 16oz cans. Two of these is almost 4 drinks. "Craft beer enthusiast" can start to approach heavy drinker very quickly.
Here was the reference I used. Small glass of red/white/rosé wine (125ml, ABV 12%) 1.5 units Bottle of lager/beer/cider (330ml, ABV 5%) 1.7 units
473ml*0.12 = 57ml of alcohol (!) - so almost 6 10ml units in a single can??? so two of those 12% stouts would be 11.4 units! Ouch... Yeah. Maybe switch to one of them as a special treat once in a while. :)
I often socialize with a Belgian guy, and he will choose similarly strong Belgian beers, but will almost always split the bottle with someone else. I think that can would probably be split three ways — it is equivalent to 2½ to 3 reasonable glasses of wine.
Sometimes that means drinking less, but it might also mean each person tries a wider selection of beers.
(A deleted comment asked for a "European" view, and I should make clear this is not a unified European view. That's impossible, as drinking culture varies massively between countries, by drink, culture, law and tax.)
I guess if you're paying by the bottle who cares. Ensures more consumption?
And, was more noting how people could deceive themselves. I just fetched one of the large wine glasses from the kitchen. Filled but well below the rim (maybe a couple of cm below) it was 2 cups of water (so 6 units!) - I emptied out the water and filled it with 1 cup of water (so well over the 2 units) the glass was less than half full. Visually looked about a third of the way up the glass due to the curve.
But the comparisons in this discussion are all confused, as the first person wrote "US measuring cup" but used UK alcohol "units" (which are 10mL = 6g), but the US "standard drink" contains 11g = 18mL alcohol.
UK units are nicer to calculate, as an example 150mL glass of 13% wine contains 150 × 13 ÷ 1000 → 1.95 "units" alcohol (19.5mL).
But the US standard drink is probably nearer to what people actually consider one drink. The UK site shows that typical drinks are nearer 2-3 units [3].
[1] https://www.wineware.co.uk/professional-stainless-steel-thim...
[2] https://www.gov.uk/weights-measures-and-packaging-the-law/sp...
[3] https://www.nhs.uk/live-well/alcohol-support/calculating-alc...
"For example, in the United States, a standard drink contains about 14 grams of alcohol." "Different countries define standard drinks differently. For example, in Australia, a standard drink contains 10 grams of alcohol,[4] but in Japan, one "unit" contains approximately 20 grams."
I think people definitely understand that heavy drinking (e.g. more than 2 drinks per day) is bad for you. The question is really about the impact of moderate drinking (1-2 drinks) where the science is unsettled, and people have differing opinions. Answering this was the goal if this particular study.
I really feel like moderate drinking is a poor standard invented by the industry to prevent loss of sales due to science, and ultimately an oxymoron not unlike safe cigarette, clean coal.
Though alcohol is out of the drinker's system within 24 hours, what that drink does to their system takes a month to play out. Yet someone who has had strictly 1-2 drinks a day for decades is somehow a moderate drinker? If a drinker hasn't gone a single month without a drink since their junior year of high school, I believe the more accurate label is alcoholic.
Joking aside, the dose makes the poison. On a society level, alcohol is a problem, but on a personal level, it is still unclear how much of an effect moderate drinking has, and in which direction it goes, that's the topic of the article.
If you want a strong poison most of us use, take acetaminophen. More than 12g and it can kill you by liver failure. It is the leading cause of acute poisoning, and yet, it is very safe at normal doses (1gx3/day).
During one stretch of my life where I was really stressed out I was having 2-3 glasses of wine a night for about 3 straight months. Aside from that, I can't imagine having more than a glass or two of something every week or so.
A single coffee costs $4 before tip most places I've visited in Austin.
[0] https://www.cnbc.com/2019/02/01/how-much-a-case-of-beer-cost...
[1] https://www.mercurynews.com/2020/01/21/two-buck-chuck-return...
My local beverage store has lots of wine choices < $5, many have pretty good reviews (4+ stars out of 5)
Though if you're looking for the best bang for the buck, they have a 1.75l vodka for $8.99 - at 40 servings per bottle, that's about 50 cents a day for 2 servings a day.
That said, I'm interested in the moderate drinking results.
Some alcohol intake is perhaps self medication for other issues - ie, stress etc. Perhaps there is a small positive there - though a larger positive would be to try and solve root causes?
Not - HN has gotten a bit downvote heavy these days - don't take it too seriously.
Both my parents, who were successful professionals, did this.
I wasn't even aware it was abnormal.
I know many people who fall in the second from the top decile of drinking (i.e. between 2 and 10 drinks a day). Some of the people who I think are in this group are probably actually in the top decile (above 10 drinks a day) and conceal the real quantities they consume
Let me put it this way, 75% of alcohol is sold to people who drink more than 10 drinks per day and this group comprises 10% of the US (the top decile of drinking.) Given the numbers it is pretty clear that a strong majority of this group is not homeless.
I was in engineering school so many of my friends at the same intellectual caliber were more interested in robots than partying, but even the more enthusiastic drinkers would only drink that much if we were partying.
None of them show physical symptoms yet, all highly functioning people, but I suspect that is mostly due to their youth (20-40).
I personally went teetotaler about a year ago. Drinking is loads of fun and I miss it, but I appreciate a steady mood now way more than the ups and downs of alcohol induced euphoria, then potential anxiety etc.
All of a sudden, I was on the road to alcoholism, just by trying to fit in and be a little more extroverted. And the booze certainly helps someone who is anxious and introverted do exactly that.
Sometimes people spend years trying to find the right prescription drug to quiet their daemons (with awful side-effects along the way) but oh so often, good ol’ over-the-counter alcohol JustWorks.
Yes, extremely. Aside from the fact that I know plenty of people in my extended family who drink more than 2 drinks per day, the vast majority of my family clings to the "a drink a day is better for you than none".
> Does anyone actually know anyone who drinks more than 2 drinks every day? The only people I knew like that were homeless
My uncle died a couple years ago. He was a functional alcoholic and workaholic for almost his whole life, until his age caught up with him and he couldn't work anymore. Then he just became an alcoholic. He was a multi-millionaire when he died, so he could have afforded the help if he wanted it and could have admitted to anyone (not least of all himself) that he had a problem.
Alcohol itself is not a problem. Alcohol ADDICTION is a very serious problem that does not get anywhere near the attention and seriousness that it should.
> Am I naive for thinking that everyone knows that Alcohol is not good for them?
Yes. And of those who know, many simply don't care and value the buzz more than the health downsides. Or feel helpless to stop due to the grip of addition. Or are so far gone that they secretly hope for an early death.
> You also can't ban alcohol.
I agree that a flat-out alcohol ban would be a failure. It was already tried and not only did it not work and caused all kinds of strife, it essentially gave rise to organized crime. If it was tried today, it would look identical to the War on Drugs which did nothing to help society, lined the pockets for various government organizations, contractors, and politicians, and filled prisons with non-violent offenders.
> I barely drink, but its undeniably important to our culture.
I'll agree that it is "important" in the sense that it is omnipresent in many people's daily lives. Even if I don't drink regularly, many friends, families, and neighbors do. People drink on the TV shows I watch. Co-workers make jokes about how many beers it takes to debug a particular program. People I know die directly or indirectly from it.
But is it a necessary part of any culture? Absolutely not. And just to be clear, I'm not arguing for a ban or any other method, but when I ask myself whether the world would be better off without mass alcohol consumption, the answer is an unequivocal yes.
I'm 5'11", 235lbs - I could stand to lose a little weight, but I've got a lot of muscle mass. I can drink a standard 12-oz 5% beer with a meal and not even notice the alcohol.
I can do that at lunch and dinner and not be noticeably intoxicated at all.
If, as you say, you cannot (and should not) ban alcohol, then finding out how bad it is, and in what ways, is somewhat important.
Where are you located? My impression --- which I'd like to see better evidence for --- is that in the US, heavier drinking is more prevalent in higher social classes on the East Coast than the West Coast.