alcohol

I started writing about alcohol nearly seven years ago now. Little did I imagine I would still be hard at it today. “Why are you?” you may well ask.

Well, for one, alcohol problems still kill 3m a year globally, playing a role in the untimely demise of one-in-ten people under 50, and bring misery to many millions more. 

That’s a story, even if few seem to care. But, for two, just as important, is that tackling alcohol problems hints at routes to wider renewal when we seem short of ideas.

Alcohol problems arise from an interplay of individuals, social groups, business and regulation. An effort to minimise alcohol harm allows us to imagine ways to improve all four.

As individuals we can learn to make better sense of the misleading first-hand impressions alcohol gives and to identify the half-truths passed to us by word-of-mouth and media.

Alcohol sellers employ populist methods: dubious science, misleading propaganda, uncritical coverage, denying consumers information and opportunistic advertising.

Not being duped can reduce our risk of harm, reduce the chances we harm others, slash our overheads, improve our critical thinking, and find upsides typically ascribed to alcohol elsewhere.

Our social groups, meanwhile, are improved by becoming more accepting of differences on this choice. This requires us to develop tolerance and respect to replace of a herd mentality.

On the bigger scale, it means holding elected politicians and nobody else is responsible for alcohol regulation. They cannot be allowed to evade blame for what is their indivisible responsibility.

Fixing the institutional flaws, influence peddling and muddled thinking which allows persistent regulatory failure could form part of a programme of democratic renewal.

The type of principles, laws and institutions which prevent undue commercial influence on alcohol regulation could be applied other vexed areas of government decision-making. 

Alcohol offers a window onto our vulnerabilities as individuals and as societies, and should provide our political leaders with plenty of ideas and inspiration for how to improve lives. 

This is why I think it remains important to write about alcohol. It is unglamorous, awkward and woefully ignored, but it is also a rich source of untapped ideas on how to improve at a time when we badly need them. ■

Consistently drinking little or no alcohol is a solid foundation for our mental health. So why don’t we say so?

Alcohol worsens and causes common aggravations like low mood and anxiety, while prolonging our recovery from traumatic events. So why would we make our lives harder?

There is not a one-size-fits-all alcohol guidelines for mental health, but the UK’s low-risk guidelines of drinking no more than 14 units (140ml) a week is, perhaps, a reasonable starting point.

Avoiding drinking entirely can be easier than trying to drink little. So a “sober sprint” like Dry January could be a good way to begin a long-term low-risk drinking lifestyle.

Finding our bounce
Developing an ability to cope with life’s slings and arrows of outrageous fortune without drinking alcohol tends to be better for our mental health in the long term.

Drinking alcohol has the opposite effect, worsening our mood and increasing our anxiety, although it may seem otherwise. This misleading impression can make it hard to go without it.

This misconception can mean we drink heavily when we suffer more significant traumas, and this may mean we start developing side-effects when we are alcohol-free, including low mood and anxiety.

Drinking more than a small amount of alcohol increases our chances of suffering more psychological discomforts. We are all likely to feel better for reducing this risk.

Drinking little or no alcohol is the best way to spare ourselves such needless mental anguish in the long term. This applies to everyone, regardless of our current drinking habits.

Lost in vaguery
This simple message is seldom clearly expressed. We tiptoe around it rather than simply telling people a simple fact which might spare them discomfort.

Counsellors and other caring professional are often loath to say it to clients, though the reasons for this reluctance are not easy for an outsider to understand.

Some say they do not want to “label” their clients, something they prefer to leave to the medical system. Perceived labelling, they say, would imperil the client-counsellor relationship.

There would also be, one counsellor says, legal risks to giving such advice too. Instead, then, counsellors prefer to point clients with alcohol worries to their GPs.

But patients often do not want to talk to their GPs. And GPs too can be squeamish about talking to their patients about our alcohol drinking, again for fear of dropping a clanger.

Put it straight
Wariness is understandable. But sensitivity should not get in the way of relaying simple information that can help us. The stigma around this advice is born of misunderstanding.

Observing that little or no alcohol drinking provides us the most reliable platform for better mental health applies to us all, regardless labels. ■

The world continued to bump its way through the covid pandemic, with alcohol playing a fringe role in public discussion, despite inflicting a far heavier death toll than before.

The year ended with the discovery that the US suffered a mystery 26% increase in alcohol-induced deaths last year, according to provisional CDC figures. This is higher than the UK’s 19% and five times the rise in Germany. The unexplained leap is set to be followed by 14% rise this year. The closest thing to an explanation for the US rise is the rise of home delivery.

In November Wales launched the first framework for caring for people with alcoholic brain damage, about 10% of people with dementia. At the same time the alcohol industry boasted that one in five alcoholic drinks in the UK does not include official guidelines, five years after they were introduced.

A lack of adequate labelling partly explains why few Brits know the basic facts about the alcoholic drinks they consume. Just one in five know how many calories are in their alcoholic drinks or know the official low-risk drinking guidelines, a survey found in July.

The UK Budget in October ignored health advice, freezing alcohol tax in 2022. This means prices will fall relative to inflation, so lowering the barriers to deadly levels of drinking despite 2020’s record rise. Tax reforms slated for 2023 were praised, but also leave a loophole for ultra-cheap cider.

There was little positive news for those who might develop alcohol drinking problems. Local government alcohol treatment services have seen their budgets cut by 17% over the last five years, according to Health Foundation figures. Alcohol was not part of its drugs strategy in December.

Not having an alcohol strategy may ultimately prove unpopular, with steps to help to curb future alcohol drinking problems wildly popular among the British public. Three-quarters of Brits want to see curbs on alcohol ads reaching children, an Alcohol Health Alliance survey found in August.

Not having an alcohol policy also runs counter to the government’s goal of “levelling up” society. A third of England’s alcohol deaths were among the most deprived, a Public Health England report said in July. Why, some ask, avoid popular policies and undermine a central manifesto commitment?

The government’s position was first confirmed in April by then health minister Lord Bethell to a parliamentary committee. His wife is a board member of alcohol giant Diageo and Tescos, the biggest UK alcohol retailer. Alcohol Review‘s reporting was followed up by Private Eye. He was removed in September amid controversy over covid contracts.

Among those who might appreciate action to spare media consumers of constant reminders about something we wish to avoid is the newly-sober-curious Queen Elizabeth. In October Vanity Fair reported she is skipping her favoured martinis ahead of her Platinum Jubilee in June.

French footballer Paul Pogba caused a stir in July when he tried to skip endorsing a Heineken-branded alcohol-free beer in a Euro 2020 [sic] press conference. Alcohol Review discovered it may be an option only open to the religious, Alcohol Review , and apparent breach of UN human rights principles.

The end of the covid era may finally be nigh, but only time will tell whether shortcomings that have led to so many more alcohol deaths are corrected or ignored. ■

We could make alcohol health guidelines easier to picture, calculate and compare internationally by giving them all in millilitres.

We measure oil, water and every other liquid in metric units, so why use 20-odd different units for alcohol?

It is like a throwback to the bygone days in which Europe operated on a bewildering array of measurement systems.

An account of a medieval journey might mean converting the Finnish virsta (Russian or Swedish) to the Rheinland miele. 

This week’s new proposed weekly guideline of saw us scrabbling for the definition of the “Australian standard drink”.

Once converted to 125ml it could be compared easily to the UK one of 140ml, itself normally given in local units.

Offering it to begin with in millilitres would avoid this process, allowing consumers and nerds a ready-made comparison.

It would make recommendations more intuitive too. We can imagine 100ml far more easily than a bespoke unit.

The volume of alcohol is a good guide too, giving a direct picture of the number of molecules it contains, so its effects.

Using millilitres as a standard means only needing to do a one-step calculation to work out a dose, not two or three.

The alcohol present in a drink is just a drink’s alcohol percentage by volume multiplied by its volume. That’s it.

So, for example, in 500ml of 5% beer there is 0.05x500ml of alcohol, or 25ml. 

One large continental lager is, then, a fifth of the Australian weekly low-risk guideline total of 125ml.

Using alcohol specific units, by comparison, we might have two more stages, perhaps converting to mass on route.

We need not drop local units, which some may find helpful, but we could easily add the equivalent amount in millilitres in brackets.

This would be a simple way to reduce barriers in a field in which international cooperation is essential. ■

Taking an alcohol break, as many are doing now, can be seen as a step towards a purposeful pursuit of pure pleasure, or hedonism, instead of a spartan act of self-denial.

Maximising pleasure is more than giving ourselves a series of nice feelings. Otherwise we might simply lie around all the time gorging ourselves on delicious snacks and, er, tickling ourselves.

Some pleasures we discover are transient and not connected to anything else. So, over time, we learn not to invest excessive amounts of time in pleasures which do not pay off, or which bring downsides.

Thankfully, however, as uniquely sophisticated, conscious mammals capable of reasoning, our range of pleasures are uniquely wide, varied and adaptable. It is no coincidence they take in activities which help us thrive.

We typically get great pleasure from learning, practising and succeeding, getting a buzz from passing exams and triple-twenties in darts. And we enjoy work, music, movement, socialising, sights, sounds and sensations.

And we can even conjure joy from outwardly tedious activities which pay off. Some of us can, for instance, with the right mind-games, elicit unlikely gratification from catching up with paperwork or sweeping behind the tumble dryer.

Epicurus, a Greek hedonist from 2,300 year ago (pictured), plumped for chilling in a communal garden talking with mates about philosophy. He rejected the idea that drinking a lot of alcohol as the best route to pleasure.

Alcohol, a psychoactive, gives us an out-sized impression of its reward. This can mean we invest more time and energy in alcohol than it deserves. Our human relish for persistence in the face of hardship does us no favours here.

We can persist in drinking alcohol even though it  brings scant pleasure and is causing us grief. We can want alcohol without liking it, with its pleasures and rewards long outweighed by hangovers, crappy sleep and low mood. 

Not drinking for a month or longer is a good way for us to weigh up the pleasures and downsides of alcohol. What things positive and negative do we correctly attribute to it? And what downsides does it have we did not notice?

It can take us from three months to a year to be free of side-effects that heavier alcohol drinking can bring, like anxiety and low or changeable mood. If we make one month it can be worth banking the investment and carrying on.

Taking time without alcohol is a route to finding more pleasure in life. And it can also be the beginning of a life devoted to pursuing of long lasting pleasures without serious downsides. This is a pure form of hedonism. 

Stopping alcohol for any length of time we choose is not a hair-shirt exercise. It is time we can use to rid ourselves of any illusions conjured up by alcohol and to focus on greater pleasures. ■

The difficulty of putting a lid on our alcohol drinking for a month or more provides us with important understanding of alcohol and the often bewildering public debate around it.

How can we understand the impact of advertising, taxation tweaks or the complex interplay of mind, body and environment? The answer is, by experiencing them ourselves.

Having an ad for our favourite tipple pop up just as we managed to ignore the urge to pour ourselves one helps us understand how advertising stimulates alcohol demand.

The effort we need to make to swerve the alcohol aisle in the supermarket or the offie shows how availability is a challenge to those wanting to limit their consumption.

How can we understand the social pressures to drink alcohol without at some point trying to rebuff the alcoholic ribbing of our friends, family and colleagues?

Opening our wallets to find folding money in there on Sunday morning shows us in no uncertain terms that increasing alcohol prices increases the incentive to cut down.

So it is that Dry January, and all similar short-term quitting initiatives, offer valuable first-hand insight into the key elements of the policy discussion around alcohol.

It allows us to feel first-hand the challenges faced by anyone looking to reduce their alcohol intake, difficulties experienced most intensely by those of us most deeply affected.

Dry January and the like establish a valuable common ground of shared experience which can inform an often off-putting discussion which, nevertheless, has huge potential to improve health and well-being.

The exercise of quitting alcohol, albeit often temporary, connects a personal assessment of the benefits of changing our own alcohol habits to something far wider.

A DIY quitting exercise was fundamental to my writing. Alcohol’s complex challenges need to be tackled with empathy as well as analytical thought.

Wider understanding provides the platform needed for informed alcohol policy. Dry initiatives go a long way towards informing us on every level. ■