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What does alcohol give us? Why do some people drink alcohol past the point of danger, and others abstain?
From multiple sites of the earliest civilisations, archaeologists have recovered evidence of alcohol being made. It seems that humans, all over the world, have enjoyed a tipple throughout history: from the 13,000 year old beer found near Haifa, to the 7000 BC fermented drinks discovered in the Yellow River Valley, to the Georgian winery of 6000 BC, and the medicinal use of alcohol in Egypt, 2500 BC. Indeed, many have suggested that the move to what is agriculture and civilisation may have been triggered by the intent to cultivate for alcohol production.
If so, human society today has been shaped, and maybe even created, by our drunken ancestors.
Today, when we hear of someone taking alcohol ‘purely for medicinal purposes’, many of us smile, thinking that such is a jocularly delivered, socially acceptable, excuse for a nice tipple.
Historically, alcohol did have medicinal uses. Imagine a world where there is no source of water free of pests and diseases. In that reality, consuming liquid comprising of a little alcohol could be the difference between life and death. Why? Alcohol kills most water borne causes of illness. Our survival as a species may have been influenced by those who were under the influence, and secured by the sozzled.
It is ironic that the number of humans alive when it appears alcohol was first being deliberately created (approximately 2 million) was less than the number who currently die of alcohol related diseases each year: 2.8 million. How widespread is the problem? Globally, 2.2% of women, and 6.8% of men die of alcohol related diseases.
Let’s put that in perspective. At time of writing there had been 5.2 million deaths from Covid, of 262m cases. That is 1.98%. The world mobilised to address Covid in the last two years. In that same time, more people (5.6 million) have died of alcohol-related diseases.
What accounts for the difference in our response to Covid and alcohol fatalities? One causes huge numbers of deaths, but gives fun along the way, and one causes only misery.
Despite its harms, alcohol can do good. The old tale that alcohol reduces the chances of food poisoning turns out to be true. Those exposed to salmonella, in one study, and Hepatitis A, in another, who had consumed most alcohol were least likely to have been affected.
According to the WHO (World Health Organization), 5.3% of yearly deaths are related to alcohol. That is more that 1 in 20. And the cost to the world is huge: one-twentieth of all healthcare cost go to treating alcohol induced problems. There are over 200 different disease and injury conditions related to alcohol consumption.
For years governments have counselled that there is a ‘safe’ drinking amount. We now know that is not accurate. There is no safe drinking amount. All alcohol does damage. It seems that alcohol is causally connected in 9% of all cancers, and even moderate drinkers (below the ‘safe’ amount) have a 10% increased risk of cancer.
If many of the people who know of alcohol’s damaging properties, still like to have a drink, for example, medical specialists, there must be very compelling reasons. What are they?
Frankly, in small amounts, alcohol makes humans feel good. How does it work? The neurochemistry is still not well understood, but he general understanding is that, overall, alcohol is a nervous system depressant, and that has different consequences across the brain. The sedative effect on some parts of the brain can be euphoric. For instance, it is thought that suppressing the activity in the frontal cortex, where it is imagined that we control our thinking, makes is feel more liberated.
If alcohol is a nervous system depressant, why are our natural opioids released when alcohol is present? Normally they are released when the body is under stress, or we are in pain, or we perceived positive experiences. Does the body perceive the alcohol as a stressor, and respond by releasing opioids? If so, the euphoric feeling of small amounts of alcohol may be the effect of our bodies reacting to damage.
Whatever the biochemical cause of the euphoria induces by the first few drinks, alcohol starts a damaging feedback loop. We have a small amount of alcohol, and enjoy it. That induces us to want more. Before long, the nervous system is experiencing depressant effects: memory is impaired, reasoning starts to fail, speech becomes slurred, coordination disappears, and all organs are damaged at the cellular level as the alcohol is distributed via the blood stream.
‘Hangover’ is the euphemism to describe the illness caused by alcohol poisoning. Some people will ‘cure’ their alcohol poisoning by taking a ‘hair of the dog’: thus taking more alcohol to ‘cure’ alcohol poisoning.
What an odd phrase! Its origin comes from the belief that one way to treat a bite from a rabid dog was to place hair from the dog in the bite wound. ‘Hair of the dog’ does not cure alcohol poisoning. It will, however, trigger the release of the same natural pleasure creating opioids that led to increased alcohol consumption. In that act, lies the start of alcohol dependency. Taking ‘hair of the dog’ no more cures alcohol poisoning than putting dog hair in a bite wound cures rabies. In fact, the bacteria in the hair could add infection to the list of injuries.
Alcoholics, people who drink alcohol past the point of serious danger, are chasing the early euphoric feeling. Contrary to popular myth, most alcoholics are high functioning. They rarely get drunk, and drink just enough to keep that euphoric feeling. They are not hopeless drunks, but they are alcohol dependent. Alas, their tolerance increases over time and, alcohol becomes their, out of control, silent killer, one addictive drink at a time.
Some people will only discover just how dependant they have become when they try to stop for a month. While many will be able to break the cycle themselves, others will realise that they need help. A few, towards the end of the month, will feel so much better, that perhaps they choose to change their drinking habits, or even decide to drink only non-alcoholic beverages.
With so many people engaged in Dry January it is a chance to take control of alcohol in an environment of mutual support.
Professor Nigel MacLennan runs the leadership coaching practice PsyPerform and is a visiting professor at the University of Bolton.