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Comment by ryanmim | Hacker News Reader

I drink way too much. I've accepted this. What stops me from drinking way too much? Not much, because I'm able to rationalize my drinking with the many beneficial effects touted. There's a lot of information about how drinking a bit is helpful for heart disease and how it basically reduces mortality across the board. More information is needed about how drinking is HARMFUL beyond cirrhosis and the short term effects (violence, drunk driving). I don't drive while drunk and I'm not a violent drunk, but I drink too much. I know I'm at risk for cirrhosis but I also think there are more dangers than simply that. These other negative effects need to be more prominent for those of us who are these "contributing to society" drinkers.

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I can give you some harmful side effects. This is a sentence about addiction from "Infinite Jest" by David Foster Wallace.[1]

Because if you sit up front and listen hard, all the speakers' stories of decline and fall and surrender are basically alike, and like your own: fun with the Substance, then very gradually less fun, then significantly less fun because of the blackouts you suddenly come out of on the highway going 145 kph with companions you do not know, nights you awake from in unfamiliar bedding next to somebody who doesn't even resemble any known sort of mammal, three-day blackouts you come out of and have to buy a newspaper to even know what town you're in; yes gradually less and less actual fun but with some physical need for the Substance, now, instead of the former voluntary fun; then at some point just very little fun at all, combined with terribly daily hand-trembling need, then dread, anxiety, irrational phobias, dim siren-like memories of fun, trouble with assorted authorities, knee-buckling headaches, mild seizures, and the litany of what Boston AA calls Losses - ... (here DFW interpolates part of a monologue from an AA speaker) -then less mild seizures, D.T.s during attempts to taper off too fast, introduction to subjective bugs and rodents, then one more binge and more formicative bugs; then eventually a terrible acknowledgment that some line has been undeniably crossed, and fist-at-the-sky, as-God-is-my-witness vows to buckle down and lick this thing for good, to quit for all time, then maybe a few white-knuckled days of initial success, then a slip, then more pledges, clock-watching, baroque self-regulations, repeated slips back into the Substance's relief after like two days' abstinence, ghastly hangovers, head-flattening guilt and self-disgust, superstructures of additional self-regulations (e.g. not before 0900h, not on a worknight, only when the moon is waxing, only in the company of Swedes) which also fail - ... -then unbelievable psychic pain, a kind of peritonitis of the soul, psychic agony, fear of impending insanity (why can't I quit if I so want to quit, unless I'm insane?), appearances at hospital detoxes and rehabs, domestic strife, financial free-fall, eventual domestic Losses - ... -then vocational ultimatums, unemployability, financial ruin, pancreatitis, overwhelming guilt, bloody vomiting, cirrhotic neuralgia, incontinence, neuropathy, nephritis, black depressions, searing pain, with the Substance affording increasingly brief periods of relief; then finally no relief available anywhere at all; finally it's impossible to freeze what you feel like, being this way; and now you hate the Substance, hate it, but you still find yourself unable to stop doing it, the Substance, you find you really want to stop more than anything on earth and it's no fun doing it anymore and you can't believe you ever liked doing it and but you still can't stop, it's like you're totally fucking bats, it's like there's two yous; and when you'd sell your own dear Mum to stop and still, you find, can't stop, then the last layer of jolly friendly mask comes off your old friend the Substance, it's midnight now and all the masks come off, and you all of a sudden see the Substance as it really is, for the first time you see the Disease as it really is, really has been all this time, you look in the mirror at midnight and see what owns you, what's become what you are - ... -and then you're in serious trouble, very serious trouble, and you know it, finally, deadly serious trouble, because this Substance you thought was your one true friend, that you gave up all for, gladly, that for so long gave you relief from the pain of the Losses your love of that relief caused, your mother and lover and god and compadre, has finally removed its smily-face mask to reveal centerless eyes and a ravening maw, and canines down to here, it's the Face In The Floor, the grinning root-white face of your worst nightmares, and the face is your own face in the mirror, now, it's you, the Substance has devoured or replaced and become you, and the puke-, drool-, and Substance-crusted T-shirt you've both worn for weeks now gets torn off and you stand there looking and in the root-white chest where your heart (given away to It) should be beating, in its exposed chest's center and centerless eyes is just a lightless hole, more teeth, and a beckoning taloned hand dangling something irresistible, and now you see you've been had, screwed royal, stripped and fucked and tossed to the side like some stuffed toy to lie for all time in the posture you land in.

[1]: http://www.reddit.com/r/books/comments/f8me0/favourite_sente...

My father drank way too much throughout his adult life and now he has what is effectively dementia, please reduce your consumption of alcohol, the physical impact of alcohol abuse does not compare to the impact that it will have on your brain. My father can't remember what happened a few minutes ago and he will die alone, because of alcoholism. Please don't underestimate the impact that alcohol will have on your mental health and your relationships.

The real danger with alcohol is that unlike hard drugs (heroin, cocaine) the destruction takes years and it's very possible to trick yourself into thinking your consumption is fine by leading a normal life alongside the alcoholism... until it's too late, and then there's no turning back.

http://en.wikipedia.org/wiki/Korsakoff's_syndrome

Hey thanks for this man. Yes Korsakoff's is something I've worried about, and the symptoms are terrifying. However, the cause of Korsakoff's syndrome is a vitamin deficiency, and it's easily avoided by an informed alcoholic who maintains a decent diet.

In this case I feel like a hopeless addict trying to rationalize his addiction in any way possible, but people who want to drink REALLY want to drink, and they will find any rationalization available. There needs to be unassailable reasons telling them that they shouldn't, in order for them to be effective.

Korsakoff's syndrome isn't the only kind of brain damage caused by drinking. Other failure modes include hepatic encephalopathy caused by cirrhosis and alcohol-related dementia, which includes but isn't limited to the consequences of B1 deficiency.

There's also something called kindling that makes each withdrawal episode worse than the last, and is believed to make frequent binge drinking especially dangerous. Besides making withdrawal worse, it's associated with cognitive deficits and mental health problems.

Then, there's the increased risk of traumatic brain injury that comes from being drunk, especially if you're crazy enough to drive drunk; or the increased risk of deciding to play with a flamethrower after a few shots of Everclear.

Definitely get your vitamins if you're feeding an alcohol addiction, but know it's harm reduction, not harm elimination. As far as I can tell, there is no known way to make heavy drinking safe.

IIRC, someone else with more expertise may show up, but the studies showing that drinking is helpful for heart disease say that this is about drinking one. Not "way too much" - mortality increases dramatically if you drink way too much, over what it would be if you didn't drink at all. The advantage of drinking is completely erased by drinking too much.

The message isn't as mixed as you think.

This is essentially correct as far as I understand things. There is epidemiological evidence that <=2 drinks per day for men and <=1 drink per day for women is associated with a reduced risk of mortality. However, keep in mind that it is pretty difficult to isolate someone's drinking habits from the rest of their lifestyle. Although controlling for various features of lifestyle is attempted, this is a fundamental limitation of an observational study.

As a physician I tell my patients that there may be a benefit from such very carefully controlled, modest drinking, but there is almost certainly a benefit from abstaining rather than over-drinking.

Alcohol overuse makes you look old (yes I will appeal to vanity); it suppresses your bone marrow and makes you anemic; it causes dilated cardiomyopathy; it destroys the liver in time and will make you gut dump fluid into your belly, causing you pain until you develop liver cancer or bleed into your throat and die; it causes its own form of brain wasting; etc. It is an extraordinarily dirty drug.

Most of these effects come from sustained heavy drinking, but many people can sustain this level of drinking and still be productive, so that is not a useful gauge of how heavy your drinking is.

What do you think of the study mentioned in this article that indicates that heavy drinkers outlive abstainers?

http://content.time.com/time/magazine/article/0,9171,2017200...

Here is the study itself:

http://courses.ttu.edu/jkoch/ETOH/Readings/Late_life_alcohol...

Looks like confounding factors are the reason.

http://www.ncbi.nlm.nih.gov/pubmed/22152665

CONCLUSIONS: Among older adults who are moderate drinkers, the apparent unique effects of wine on longevity may be explained by confounding factors correlated with wine consumption.

I don't understand what you are trying to show with this study. It compares moderate drinkers among themselves according to the type of alcohol consumed. It doesn't compare drinkers vs non drinkers

Interestingly, one study has found that the reasons for abstaining actually determine whether or not it results in slightly worse health outcomes than light drinking:

http://www.colorado.edu/ibs/pubs/pop/pop2012-0006.pdf

"Mortality risk is low for light drinkers and many individua ls who abstain from drinking—including those who abstain for religious and moral reasons, have a responsibility to family, were brought up not to drink, and are not social; it is higher among former, infrequent, and moderate drinkers, and individuals who abstain because they do not like the taste of alcohol, are concerned that they will lose control, or are concerned about adverse consequences. Unsurprisingly, mortality risk is by far the highest for heavy drinkers. We reveal that reasons for abstention capture heterogeneity in the risk of death among lifetime abstainers. "

The covariates for which one is able to control are necessarily limited, so we're left to speculate. I will speculate that if you could add a covariate such as "Used to drink lightly but stopped entirely because of a health problem" you will find the answer.

This study did create a variable which is the number of health problems and symptoms a person has. However, people can have one bad health problem/symptom (e.g., COPD on 3L home O2) which affects them more than 10 minor health problems might affect someone else.

As an aside, it is curious that this study did not replicate the repeatedly-observed finding of an association between obesity and mortality (OR = 1.00 in this study).

I will also add that this study is looking at older adults (aged 55-65 at the outset of a 20-year study, so they ended up dead or 75-85), which is different from the people discussed in the original thread (working age adults).

Same opinion here. Many possible interpretations.

For example: social interaction seems related to mortality as well, and social interaction leads to the very popular activity of consuming alcohol. Moreover, alcohol acts as a social lubricant, helping to fuel back these interactions.

I was a super heavy drinker until 363 days ago. From about 24 until 31 my drinking increased from something I did to alleviate my social anxiety and have the typical 1st world fun to something I did in and of itself. Drinking was no longer a means to an end to meet people and have fun, it was the fun itself.

At that point you're trading drinking for all sorts of other things you could be doing on the weekend. It's a "hobby" and a lifestyle and comes with sacrifices.

Having a problem is a continuum and not black and white. I held a job and did progressively better for myself even in spite of drinking, however, I'd be lying if I said it didn't effect me at all. Only you can decide if the risk is worth the reward.

Honest question: How much is too much?

I drink about 2-4 fairly strong beers a night (5-7% ABV), almost every night, and while I certainly feel it, I've only been "shitfaced" (or whatever you call "drinking to the point that you lose control") maybe half a dozen times in my life. The fact that I'm not doing the (apparently) normal thing for young folk and getting trashed every Friday night (or ever, really) gives me some relief, but I often worry about how much damage I'm doing with my less intense but sustained drinking habit.

The toxic effects of alcohol are cumulative over time, so in the long run you might be at greater risk than binge drinkers. And if you're drinking 4 beers you 're not far from the threshold for liver disease [1] ( 1 liter of beer at 7% = 56 g of alcohol; the threshold is 50g). Alcohol is also linked to high blood pressure; you should check yours. Besides all that alcohol is also high in calories and you'll have to deal overweight issues too.

I have a friend like you, he drinks to unwind, and I don't consider him an alcoholic, I'm just sad that in ten years he 'll be in bad shape.

[1] http://www.institutdanone.org/objectif-nutrition/nutrition-a... (in French)

Thank you for your response. It's a bit of surprise to me, because I had always heard the opposite, that daily drinking lets one build up a tolerance while binge drinking repeatedly hits the liver with more than it can handle, but I suppose that was just folk wisdom. I've cooled off a bit over the years (originally I drank to deal with depression that I eventually "got over"), but maybe it's time I took another hard look at myself.

  And if you're drinking 4 beers you 're not far
  from the threshold for liver disease [1]
  ( 1 liter of beer at 7% = 56 g of alcohol;
  the threshold is 50g).

It is exactly this type of information that the public needs to be made aware of. Not "drinking is bad", but factual information that a person can measure their behavior against.

This is more of a general comment, and not by any means specific advice to anyone: "Binge" drinking may give enough time between consumption episodes to allow the liver to heal, avoiding fatty liver diseases and cirrhosis, while daily heavy drinking may not, though this does take a long period of time to start.

Simple google search, first article:

http://www.webmd.com/mental-health/addiction/features/12-hea...

Anemia, Cancer, Cardiovascular Disease (many of them), Cirrhosis, Dementia, Depression, Siezures, Gout, High Blood Pressure, Infectious Diseases, Nerve Damage, Pancreatitis

Also: Obesity, and likely higher risk of falling or other blunt trauma, it's really annoying to those around you, and it's a waste of money.

Everything is correct except for the last two. Only some people are annoying when drunk. It's also not a waste of money if you are intentionally consuming it for its effects. If that's a waste of money, so is every experience you pay for (travel, amusement parks, donkey shows, etc).

You are not the same person while drunk. If you think that the person you are while sober is a better person, you have a perfectly valid reason for not drinking.

I’ll just leave you with this:

http://www.cracked.com/blog/9-youtube-videos-that-prove-anyo...

Not so much to prove that you can do it, but more for the change that anyone can see. You could hardly tell that it’s the same person in the first videos as the last ones.

P.S.

I found the more relevant article I was looking for:

http://www.cracked.com/blog/7-things-you-dont-realize-about-...

It goes into more detail about what I mentioned above – how you are a different person while drunk, but you might not realize this until you quit.

> You are not the same person while drunk. If you think that the person you are while sober is a better person, you have a perfectly valid reason for not drinking.

What if I think the tipsy me is a better person? He's much more outgoing, interesting, and far less socially awkward.

It's an illusion. I, too share this thinking through.

Beside doing things you regret when drunk - like making an ass out of yourself when talking to more sober people in bars or feeling shitty the next day... it does not make you experience yourself as a better person when sober. You have to be drunk to be that better person. So you drink. It does not help - at least that's my experience. Getting drunk can be fun but...where to stop?

Being outgoing for me is strongly connected to my self-esteem and feeling of self-worth. If it's down the drain I hardly leave the house and run away from social interactions without alcohol. If I accumulated some self-worth and feeling fine with myself I enjoy going out and being social in a sober state even more.

I doubt that you are more socially awkward for other people when sober but your anxiety makes you so uncomfortable that you have this urge to grab a drink and have a feeling of relaxation. After a few beers you feel better...

Be careful it's a vicious circle and it's worth to spend some energy into forcing yourself into social situation in a sober state. It can be fun to sit sober in a bar and watch all the people getting more and more drunk.

See the second article I referenced – it shows how you might think so even though it might be disastrously wrong.

Really interesting videos, thanks.

Amazing how such a relatively small guy could be that coherent after 17 beers....and could put away 40 in one sitting.

One thing to consider is that alcohol use is progressive - and while you drink a significant amount now - what if you doubled it in five years (as often happens) - would you still have it under control and not negatively affecting others? Addiction = (exposure * time) * genetics.

Interesting. My alcohol use has been becoming less and less as I get older. I love a nice wine or good beer, but my nights of going out partying are way behind me.

I'm the same -- at the ripe age of 28, I had two nice beers with dinner the other night and woke up with a headache.

I can barely handle it anymore; which is arguably a good thing. I still enjoy a good beer, but other than that, have basically lost the taste for all other alcohol.

It took me a worryingly long time to work out that 1 cider per night over a week or 2 of summer was why I felt terrible the day after. I suspect this has more to do with the stupidly high sugar content.

I've found my tastes for scotch are directly correlated to how I'm feeling about life at the moment. Like, it's amazing: generally worried about work, scotch tastes great. Feeling upbeat and thinking of future projects? I get frustrated that there isn't more available in the "uppers" category for consciousness adjustment.

The beneficial effects are from drinking small amounts of alcohol. Something like 125 ml of wine at 8% ABV per day would be enough.

I'm not sure why you think we need more research about the harmful effects. There are a long list of known harmful effects, and they kick in at much lower levels than the triggur-levels for English drug and alcohol services. (40 units per day or 20 units per day if you also have severe MH problems (one unit is 125 ml at 8% ABV etc)) - harmful effects can be seen if people regularly drink more than 25 units per week.

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