Social drinking also a well-worn path to alcohol use disorder | Hacker News Reader

Social drinking also a well-worn path to alcohol use disorder

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I knew all these years of drinking on my own were going to pay up

A => B ≠> A' => B'

A => B ≠> A' => B' ≠> A' ≠> B'

Yes that too ... in general of course. ∀ does the heavy lifting.

I'm a big enough man to admit I'm I haven't seen that one in this semester's Discrete Math.

This may just be me, but the lack of a decent longitudinal study on these narratives is pretty weak science. For the last 40? 50? years there have been alcohol stories fairly consistently in the media, and we still struggle with substantiating claims- about the only thing we can say for certain is that the people who write these types of articles don't like alcohol OR in the opposing view point, they love alcohol.

With all that said I think we have enough info to say alcohol aint good for you physiologically.... but we don't have enough info to say the social benefits might actually outweigh the negatives.

Alcohol has exeptionally bad ergonomics when it comes to intoxicants. Its strong effects on behavior and experience are wildly unpredictable, it has severe undesirable effects, it's stongly toxic, it causes morbid dependence and has particularly bad physiological and psychological after effects.

We can do better than alcohol.

Alcohol is one of the few intoxicants that you can legally buy almost anywhere in the world that is well regulated, has consistent dosages, and can engage in publicly. Being able to consistently source an unadulterated supply is one of its major appeals. Prohibition decreased consumption by as much as 70%.

Yes. None of these are a feature of the intoxicant itself.

It's fairly simple chemistry to get a certain percentage of alcohol into a liquid.

The problem is that it's also responsible for a tremendous cost in terms of life, resources, and human misery. Drunk driving alone account for a quarter of 1.25 annual fatalities on the roads worldwide. I don't know how many people die from alcoholism, or have their lives shortened by it, lost wages, downstream effects of kids raised by alcoholic parents, etc... but it's certainly not a small issue.

So yeah the ease of getting the stuff and the social acceptance makes it popular, but is it a good idea? Drugs like caffeine, khat, and mild psychedelics have much more favorable therapeutic indices and a better track record in terms of death and illness, never mind be a lot less physically addictive and much MUCH easier to quit.

Classical music and emmental cheese can also be an effective mood-altering substance: https://youtu.be/IeLGP2dsjME

> We can do better than alcohol.

I think we won't get past the cultural issues in our lifetime.

Many cultures have 0 tolerance for anything outside of alcohol (and I totally get it when it comes to China for instance), and prohibition of drugs like marihuana was long used to target specific communities.

I'm not even sure if western cultures are still on the path to open to low harm drugs, do we have any research on synthetic drugs that have a change to become fully legal alternatives ?

There are very few cultures with 0 tolerance for e.g. nicotine or especially caffeine.

I'm not sure new drugs are even needed. There are plenty of existing drugs, and the vast majority are less harmful than alcohol. They would of course need legal and cultural regulation. There are also some ideas for new recreational substances like David Nutt's "synthetic alcohol".

Does it taste better than alcohol?

Alcohol is also very easy, which is a huge part of the problem. It's extremely easy to make, and to refine. Anything with sugars in it will easily ferment with simple exposure to the atmosphere and the ever-present yeast in it -- fruit that fall off trees when ripe will very quickly ferment, and our bodies themselves produce some amounts of it as part of metabolism. Once you have some alcohol it's also very easy to refine it to something stronger, you don't need distillation, just some method of removing the non-alcohol components of the mix, such as simply freezing the mixture to a temperature where the water is frozen but the alcohol isn't; You can take a bucket of low-% fermented fruit juice, leave it to freeze overnight, and take out the ice in the morning. Presto, you have a basic braga that's going to be much more potent. Alcohol is also very useful for a lot of chemical processes we rely on for many of our industries, so it will always be in demand industrially.

A lot of humans (and other mammals and birds even) also like the effects that it has, despite the unpredictability and side effects. It's just too good at smoothing out many social interactions in ways that we humans are fans of. It's also a very good source of easy calories that are very shelf stable and for the most part safe to consume even if the storage conditions were poor. Small beer was a thing for a reason - even a low concentration renders most pathogens inactive enough that it's mostly safe to consume.

Until we figure out some way to simulate the positive effects without the negatives, a Synthahol if you will, I don't think we'll be able to do better. And the Synthahol will need to be cheaper and easier to obtain than literally just leaving some fruit juice to ferment in a jar.

"Alcohol use disorder" recalls George Carlin on the evolution of language:

"In this classic George Carlin routine, the legendary comedian breaks down how language has been systematically softened over time. From "shell shock" to "battle fatigue" and eventually to "post-traumatic stress disorder," Carlin illustrates how our words have become more complex and less impactful. He argues that Americans have difficulty facing harsh realities and have developed a tendency to euphemize, making the truth sound less direct. Through his sharp wit and astute observations, Carlin explores how language evolves to disguise the true nature of our experiences, particularly in times of war."

https://youtu.be/Me-sGTBhGFc?si=i-VjINRlDhP4xxgN

Meh, Carlin doesn't land the same way in my 30s that he did in my 20s. It changed from shell shock to battle fatigue to PTSD because you can get it without battle (IED) or being shelled by artillery. It lacks oomph but it's more correct imo.

It’s a comedy bit. It’s deliberately not very nuanced. I like Carlin a lot but he got a little too negative and political towards the end for my taste.

The great thing about calling it "alcohol use disorder" is that it lets you diagnose more people.

If you're a nonprofit or advocacy group, "alcoholics" are only going to get you so far in terms of funding, also dealing with them is messy and incredibly difficult.

If you can shift the overton window on whats considered "problematic" drinking you get to "educate" people and get funding for things which have fewer hard criteria or measurable outcomes than treating actual alcoholics. This keeps the money flowing.

If it's a disorder, then it's "not your fault", it's something that's "happened to you". It removes personal liability from the choices we make.

Would you also argue that type 2 diabetes is not a disorder? Or that anorexia/bulimia are not disorders? Or that COPD is not a disorder?

It might be worth re-examining your understanding of the word disorder, because the world has moved on a bit.

God forbid they're looking at patterns of alcohol abuse that falls outside a narrow preconceived scope. "Alcoholism denial" was not what I expected to see when I woke up this morning, but here we are.

This is just conspiracy logic with no evidence that you fashioned yourself out of nothing but ugly cynicism and contrarianism.

I'm glad there's a voice of reason here (and one who put it much better than I could have). I'm failing to see the downside of being able to describe people who have alcohol dependencies that negatively impact their life without being "alcoholics" which is such a weighty term that I think makes people resistant to diagnosis.

People think of “alcoholism” as a binary. It’s not, and the new language reflects this. We absolutely should educate “problematic” drinkers that they are on a sliding slope to an ungroovy dependency.

It also highlights that just because you were classifiable as AUD, you won’t necessarily be so classifiable for the rest of your life.

The language of alcoholism often mirrors sermons of eternal damnation. Not a particularly inspiring starting point for treatment and a big reason why most people who succeed in getting past AUD don’t do it in groups that preach this eternal damnation angle.

> "language [...] Americans have difficulty facing harsh realities"

This makes it sound like it's an American/Western phenomena, where it's definitely not (only there). It's a recurring joke among me and my friends in Japan to say "the moon is beautiful tonight" because in true Japanese culture that's a way to say "I love you".

Though OTOH Spanish went the opposite direction, where my Mexican friends say some times more swear words in a sentence than normal words; but they've become meaningless or softer.

> language has been systematically softened over time. From "shell shock" to "battle fatigue" and eventually to "post-traumatic stress disorder,"

This is literally just called "learning more about the condition" - it's not some deep symbolic neutering of language by the dang liberals.

Imagine someone having PTSD from combat in which a single shell was never launched, and being like "Yeah, they've got shell shock" ???

He was just wrong here. PTSD covers many problems, including "shell shock", but also survivors of, say, natural disasters, serious accidents, sexual abuse, and many other types of traumatic experiences.

And this is hardly an "American" thing; all societies do this sort of thing (although topics and methods vary). Carlin's views, like many Americans, were extremely centred on the US and seemed quite clueless about the rest of the world.

A large part might be due to genetics. I recall when westerners exploited native Americans with distilled liquor. Westerners had many generations of alcohol use, the natives = zero. Europeans have become resistant to alcohol. It might be faster metabolism/excretion? - a physiological adaptation? or is it social experience to walk/talk in a straight line? In small Northern Ontario mining towns the native population is like my mother - drink/fall over. We would hire(in my claim staking days up North) local labor for supervised line cutting/sampling, but we paid the local band through their rep - who then paid the workers late on Friday, we started work again on Monday. On helicopter-in jobs, we paid at job's end and usually worked the long Northern days about 18-20 daylight hours(long days up in NO in May-August) with foods/cigarettes flown in every ~2 weeks (and some local deer shooting as a supplement - we had cooks who ran the camp)/ When the job was done = large payday = all went home. By the end of August there were some freezing nights. Some crews had heated double walled tents and stayed longer, but by the end of September the cold weather most of this was curtailed.

I was born in the UK, my Dad never drank a drop - my Irish mother would drink until she fell over. Dad had lock up the liquor - or else = all gone = fall over. My brother and I do not drink a drop?? I am not drawn to liquor, and tobacco smoking or cannabis = I never touch at all.

> People tend to assume that “the mere presence of other individuals exerts a beneficial effect” that tempers the desire to overindulge when drinking, Fairbairn said.

Who thinks that? I have never personally known anyone who drinks much alone, but plenty who drink too much in groups.

I mean… you wouldn’t necessarily know about the people who drink alone. If you were someone who binged alone why would you talk about it?

I’ve known too many people who indulge to deal with social anxiety. It’s a terrible terrible plan but they’re more likely to drink when with people than alone.

At a certain point that’s all the overindulger has to converse about.

It doesn't have to degrade to that level. There's definitely a population that drinks alone and has interests outside of alcohol. I've known plenty of divorced men that regularly drink while watching sports/TV alone, but when picking a conversation topic will often choose their kids or sports over alcohol consumption.

There are plenty of counter-examples to that. Many heavy drinkers get to the point where they're only feeling 'normal' due to drinking a lot, and can only go about their day by heavily indulging.

One of the Monty Python guys was an alcoholic, at the 'bottle of vodka per day' level. You've probably also known some heavy alcoholics at some point in your life if you've been around long enough, but you wouldn't really know it unless you knew the subtle clues to look for; They tend to become very good at hiding it. They're not chugging vodka out of a bottle, they're putting a bit of a pick-me-up in every cup of coffee they're drinking.

This is basically it. You don't know that Bill from accounting crushes a six-pack every night when he gets home from work, alone. How would you? He's doing it in his kitchen, or on his couch. The guys at the liquor store know. His doctor knows. But his friends and colleagues? Probably not.

Agreed.

Alcoholics pregame in order to reduce criticism by reducing the number of beverages they are observed consuming.

Once your inhibitions are gone you don’t care as much though.

Pregaming is also typically cheaper than consuming every drink in a setting like a bar, restaurant, or other commercial venue

If you are a regular and heavy drinker, the prices establishments charge are unbearable. Plus, the drinks are like watered down pop. Can't even taste what's in it.

I would warn you this is a slippery slope.

I buy single serving junk food, because whatever size I get is single serving. And expensive chocolates. The cost is friction.

Yeah I drink more when being social, and in some circles will even start smoking.

Everybody I personally knew who died of alcohol drank too much alone. They also drank a lot in groups but oftentimes held the drink better than many who drank less.

I think that. When I drink socially, I'm engaging with other people and things like slurring speech become readily apparent. I can tell when I'm stumbling over words and having trouble saying what I mean. It's very obvious. When I drink alone, I'm not talking to anyone. The voice in my head never gets noticeable inebriated. I'm typically not moving around as much so can't rely on my sense of balance to judge intoxication as reliably either. And with social drinking, it's pretty easy to compare the rate at which I'm knocking back drinks versus everyone else. You tend to order in waves with others which slows folks like me down quite a bit.

Ah interesting. For me it's a bit the opposite. Socially I'm very distracted by conversation and easily have more than I really intend to. Alone, I take time to consider each drink and almost never have more than 2.

It is a weird line in the sand that many people draw. If I had two drinks alone every night I would see that as more troubling than having three drinks with friends every night.

Both can be an issue if you find you can't do without the drinks.

It’s an issue regardless because alcohol gives you cancer. It doesn’t matter if you stick bellow the amount that causes acute health issues. If you are having 2 drinks every night your cancer risk is higher than someone who has a lot more but only on occasion because their total drinks consumed is less.

It's his body. He can get cancer however he pleases.

One day the things that I do with my body and mind will not be subject to capital’s desire to milk as much money as possible out of me through sheer longevity.

Seriously, the moralizing of life expectancy makes no sense. Let us each optimize for our own idea of a good life.

How is that weird? Socialization is generally healthy, which is why there's less of a stigma. It's not like the average alone drinker is doing pushups while shooting whiskey.

Not sure about what they actually mean but as a teetotaler (I didn't know it even had a name, just found out not long ago) I find it absolutely weird that alcohol is needed to socialize.

I find it's especially needed for socializing with drunk people.

You see more unhealthy drinking as less stigmatizing because it's associated with a "generally healthy" activity. That's weird.

It'd be like saying eating two burgers with lettuce and tomato is healthier than one without.

Who is comparing 2 burgers to 1 burger.

My original post compared three drinks to two, and it's a similar unhealthy practice many people engage in.

The NHS recommendation is 14 units per week max, over the course of at least 3 days (don't consume the entire budget in a single day or occasion). A pint from a weaker beer counts as 2 units while a stronger one costs 3.

https://www.nhs.uk/live-well/alcohol-advice/calculating-alco...

If true, this throws into relief the dialogue of "What is your alcohol consumption like?", "Just socially".

This thread is cluing me in that I need new wording to describe my rare consumption of alcohol.

I have a glass of whiskey a couple of times a year

I mostly just tell people I don't drink at all

If I tell people that I drink "rarely", they put it into their own framework based on how often they drink themselves. Heavy drinkers might assume "rarely" means one night a week. Moderate drinkers might think a couple times a month

Same. To people who regularly drink, I don't drink at all.

When I was young, I would always get asked why. I'm pushing 40 now, and people rarely ask anymore.

I drink socially. Maybe once a month. And usually it is just one beer. And have never craved it. I think if I drank more often, my desire for it would not change. My brain is not wired to crave it I guess. If yours is, then it doesn't matter if you are drinking, socially or not, you have put yourself on a slippery slope.

It's a spectrum. I started to slip at some point, stopped drinking for a year and a half, and now I have an occasional beer with friends and it's not a big deal. Peoples' experiences with alcohol are extremely variable.

>I think if I drank more often, my desire for it would not change.

I highly doubt this would be the case (as in, alcohol doesn't work like that). Let's say that for every 10kg of your bodyweight you drink 2 beers per night (330ml), then by the time you get to day four you might be more worried about not getting a drink.

I would imagine by the time you get to day 4 of drinking 4-5 litres of beer per night, you’d be disgusted by the idea of another beer. You have to build up to numbers like that.

> I think if I drank more often, my desire for it would not change.

I think that's a dangerous assumption, when you first start using any drug (or any other addictive activity), you can absolutely quit any time you want. But if you keep doing it with that mindset then you'll almost certainly get addicted eventually. The worst part is that you don't even realize that it's happening, it really sneaks up on you.

But the only serious addiction I've ever had (and quit) was nicotine so YMMV with alcohol.

This strikes me as a "safe" psychology study, one virtually certain to produce a publishable outcome.

Surprisingly, the linked technical article, which was paid for with tax dollars, is paywalled -- isn't that practice supposed to end?

Without being able to read the article, I'll go out on a limb and guess that the article's data were collected by interviewing people, asking about their drinking habits. This is a very unreliable method compared to measuring people's blood alcohol levels -- granted that the latter design would be prohibitively expensive.

Anecdotal studies are notoriously unreliable. A young researcher once performed an interview-based study that showed married people live longer than single people. On reviewing the paper, an older, more experienced scientist suggested that public records would cost less and produce better results. The young scientist tried again, using actuarial data, and the original conclusion was falsified: married people don't live longer, it just seems longer.

A lot of people lack the framework of knowing what a substitute social lubricant can be

I think revealing those frameworks helps a lot

I date a lot of adult Gen Z as well as spiritual people: alcohol use is down, way down, for multiple reasons. I had to relearn what outtings and date ideas could be.

Fortunately, a lot of people in both of those demographics are down to have sex without needing excuses for themselves or socially. So there wasnt much relearning to do. Just not relying on pregaming with alcohol, bars or drinking at clubs as a crutch before being more social or assertive.

Social internet use well worn path to social media abuse...

Social swimming has higher risk of drowning...

Social cycling has higher risk of traffic accidents...

I have heard of using drinking socially as a justification for drinking excessively. I've never heard someone justify excessive swimming. One is a more common problem.

Both are pointless truisms.

Now someone tell Scott Galloway to stop telling men to "go out and drink more" to meet women.

I never heard of Galloway until a year or two ago when he was doing an obviously paid promotional circuit for cryptocurrency scammer Craig Wright, but since then his name seems to crop up all over the place.

I'm generally not surprised to learn when someone around Wright is themselves an addict, substance abuse appears to be a common comorbidity for people involved in or falling for that fraud.

So all of those years chugging beers, and keg stands with the boys wasn’t social drinking but full blown drinking disorder?

(( im cooked ))

I don’t doubt its potential to lead to a full blown drinking disorder/addiction/problem. But I feel like certain populations are more pre-disposed, especially poorer demographics.

There should be a study that examines addiction in general and cross referencing with socioeconomic conditions of the area.

Areas hit hard by industries fleeing for cheaper labor force (ie, American steel industry and Appalachian region). Decrease in stability followed by decrease in upwards mobility being proportional to drug or alcohol addiction.

If you find yourself alone and needing a drink, that may be a sign.

If you find yourself in any circumstances and needing a drink, that may be a sign.

Yeah, agreed, although I understand that many people need a drink to feel relaxed in a social setting. It’s the need for a drink when alone - I think thats where the habit turns into abuse.

If they need a drink to feel good in a social setting than maybe it's not a good setting for them. It would be better to find that out rather earlier than after ingesting gallons of literal poison.

Still, I understand your point about needing the alcohol for itself or for something else.

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