Using Science & Data To Satisfy The Rise In Sober Curiosity
I believe there is an inequity in the conversation of dangerous substances in America today, skewed too favorably towards alcohol. Today, that changes.
I had my first unsupervised drink when I was 14 years old. I was a freshman, we had just won a New Year’s Tournament and my parents let me go to a party the seniors on my team were hosting.
12 years later I had my last drink. Since then I’ve been in the Wall Street Journal, taken on corporate culture, and will be hosting public conversation #1 at SXSW in a few weeks on the topic of sober curiosity.
During my affair with alcohol, I was ill-informed or downright dismissive of its truths. Truths, that I plan to provide, with commentary, below so that you can now at least have the education before you chose to drink next.
I support individuality and admire personal responsibility, but I believe there is an inequity in the conversation of dangerous substances in America today, skewed too favorably towards alcohol.
Today, that changes.
Alcohol is not beer or vodka. Alcohol is an ingredient in both of those beverages, but not the exclusive one. The World Health Organization defines alcohol as a psychoactive substance with dependence-producing properties that have been widely used in many cultures for centuries. The harmful use of alcohol causes a large disease, social, and economic burden in societies. And, we are off!
Of the diseases caused by alcohol, the most common is that of alcoholism. But, alcoholism, according to the New York Times, isn’t an actual diagnosis. In 1980, the American Psychiatric Association’s authoritative Diagnostic and Statistical Manual of Mental Disorders established two different classifications: alcohol abuse and alcohol dependence. In 2013, the D.S.M. combined the categories to create “Alcohol Use Disorder,” a spectrum ranging from mild to severe, based not on how much someone drinks but on how many of 11 behavioral or psychological symptoms a person has. This groundbreaking assertion expanded the population size suffering with AUD, and both humanized and destigmatized the disease.
Let’s go back to the beginning.
I sipped my grandfather’s wine before I had my first beer. I smoked a cigarillo before my first cigarette and my first cigarette before my first joint. I sniffed laundry detergent before cocaine and swallowed Adderal before ecstasy. I followed the exact graduation path of gateway drugs, and it started with alcohol.
Alcohol is a gateway drug and one that studies have concluded that those using it exhibit a significantly greater likelihood of using both licit and illicit drugs.
By now you’ll have realized that the verb chosen to define the consumption of alcohol is not drinking, but using. Using is often reserved for “harder” drugs such as Heroin, Crack, or Opioids, but if we classify a drug as hard based on the number of deaths it causes each year, alcohol surely is a hard drug.
Let’s check the numbers.
It’s estimated that 37,603 people are killed by guns each year in the United States, that 68 people have died from e-cigarettes or vaping associated injury, and in 2018, 67,367 deaths were the result of drug-overdoses, down from 70,200 in 2017.
In 2018, it’s estimated that 88,000 people died from alcohol-related causes, and this is in a year once removed from a 20-year study that returned a gruesome result that from 1999 to 2017 the number of alcohol‐related deaths per year among people aged 16+ doubled.
What all of these numbers mean is that alcohol is now the third leading preventable cause of death in the United States behind tobacco, 480,000 annually, and poor diet and physical inactivity.
Let’s play a game.
Of ALL of the above causes of death, which can be found during commercial breaks, on radio, in movies and music videos, being mass-marketed to an entire population?
Yes, fast food is totally right, but so is alcohol.
The Alcohol industry in 2016, spent a collective $2.2 Billion on traditional media advertising for beer, spirits, ciders, and wines. With little regulations as to what these advertisements have to say, the repetition convinces us that alcohol can’t be that bad.
Yes, life ends at death, and 88,000 is a tragic number but it is still only .0002% of our population so is there really a need to sound the alarm?
Well, yes. Just because you drink and don’t die, doesn’t mean you are unaffected. If 86.3% of people ages 18 or older in America report that they drink alcohol let’s have a look at the health risks they are inviting onto themselves.
We’ll start light with some pillow talk about sleep.
How Does Alcohol Affect Your Sleep?
Yes, alcohol is a depressant, but despite getting drowsy you’re impacting your sleep. We know that in healthy people, acute high alcohol intake does disturb sleep and that sleep quality and daytime sleepiness may also relate to rates of alcohol drinking and become a gateway to excessive alcohol use. This, in addition to the disruption of circadian rhythms and REM sleep caused by alcohol known as the rebound effect, confirms alcohol’s negative effect on sleep.
How Does Alcohol Affect Your Mental Health?
Alcohol changes levels of serotonin and other neurotransmitters in the brain, which can worsen anxiety, and in some individuals hangovers from alcohol create alcohol-induced anxiety.
There is also alcohol abuse within social anxiety disorder, as surfaced in Triumph Over Shyness Conquering Social Anxiety Disorder Second Edition, where authors Stein and Walker, inform readers that social anxiety disorder frequently travels in the company of other emotional difficulties such as alcohol or drug abuse, depression, and other anxiety disorders, which makes sense because of alcohol’s depressant and sedative effects.
Alcohol and self-esteem have a mutually destructive relationship. As a chemical depressant, alcohol can negatively impact one’s mental state, especially if they suffer from an external disorder or factors that affect their self-esteem. Alcohol use can temporarily raise or lower self-esteem, but it typically creates lower self-esteem in the long-term. There is also a danger for those living with fragile high-esteem as they think highly of themselves but are sensitive to opinions that call that into question. So, these individuals constantly look for things that can defend or increase those feelings.
Alcohol both creates and amplifies mental health issues. If you are using that glass of wine to reduce stress, you might be amplifying your stress, not in the moment but with alcohol-induced anxiety the next day, or you might be creating an alcohol dependency. Showcasing how alcohol so viciously flanks your mental health.
“But Richie, I meditate, go for walks, and only drink wine because the resveratrol helps my heart.”
To which I’ll reply: It is awesome you meditate and go into nature as commitments to your wellness and don’t use alcohol as a vehicle for escapism, but your defense is misinformed.
Let’s peel back the coroner's sheet on some serious health complications of alcohol.
Alcohol is associated with 2.8 million deaths worldwide each year. These tragic outcomes of regular alcohol consumption result from the negative impacts of alcohol on the body’s organs and tissues, other injuries, alcohol poisoning, self-harm or violence.
Some may read this and give there lower abdomen a pat and say “Well, I guess I should give thanks to my liver for keeping me here” and their first mistake is that the liver is actually located above the intestines, next to the stomach neighboring our lungs, and the second being that they’re slowing giving themselves liver disease.
As the chief organ responsible for the breakdown of alcohol, the liver is particularly vulnerable to alcohol metabolism effects. More than 90% of people who drink heavily develop fatty liver, a type of liver disease. Yet only 20% will go on to develop the more severe alcoholic liver disease and liver cirrhosis. Even outside that 20%, over time, that damage can lead to liver cancer, scarring of the liver, and liver failure, which can be fatal without a transplant.
Still, you might scoff a response such as “Okay bud, well I don’t drink heavily” and to that again, I’ll fact slap you off your barstool and inform you that the heavy drinking cited in all these studies reports that for woman, consuming 4 or more drinks on occasion, and for men, consuming 5 or more drinks on occasion, is heavy drinking.
Get back on the stool, we’re not done.
Alcohol metabolism also occurs in the pancreas, with about 10% percent of heavy alcohol users developing alcoholic pancreatitis — a disease that irreversibly destroys the pancreas.
Now, let’s catch a ride a few exits north to the one you’ve been waiting for.
If you drink wine, you’ve at some point most likely said or heard that consuming red wine is good for your heart health because it contains antioxidants such as resveratrol.
Well, no research has established a cause-and-effect link between drinking alcohol and better heart health. I wanted this one to be true. So I dug deeper and found a study confirming no link between resveratrol levels and the rates of heart disease, cancer, and death. In fact, excessive drinking can also lead to high blood pressure, cardiomyopathy, and cardiac arrhythmia, which puts an individual at risk for heart attacks and strokes later in life.
It’s starting to sound like the end of an FDA approved drug TV commercial when they quickly pass through the side effects at 3x speed.
With respect to the heart health conversation, I anticipate responses with ill-researched, but satisfying headlines, that justify continued consumption of red wine, so I’ll share more health concerns.
A carcinogen is any substance, radionuclide, or radiation that promotes carcinogenesis, the formation of cancer. The consumption of alcoholic beverages is known to be a human carcinogen based on sufficient evidence of carcinogenicity from studies in humans.
Even without complete knowledge of biological mechanisms, the epidemiological evidence can support the judgment that alcohol causes cancer of the oropharynx, larynx, esophagus, liver, colon, rectum and breast. Cancer.gov has even more on the subject.
That’s 7 cancers. Is your red wine supporting Buzzfeed headline still worth it?
To a degree, it would be fair to debate that the risks of alcohol consumption are deep in our distant futures, and potential health conditions later in life shouldn’t stop you from living to the max today. You may even have one of those “Only live once, arrive at the grave dirty with memories and a cocktail in one hand” signs hanging in your kitchen, and to that, I say fuck you, you selfish fuck.
You have family, friends, and loved ones that you are risking bringing tragedy to through this mindset. Defending your selective consumption is wrong, especially after having covered the mental health, self-harm, and violence consequences alcohol produces.
So, to get really real for a second, I want to surface how the consumption of alcohol today, like right now, effects you today.
Alcohol weakens our immune system and the effects of a weakened immune system can affect us today or tomorrow, specifically through respiratory stress syndromes, which is of great concern today with the global coronavirus threat.
Harm yourself all you want, but don’t allow your selfish decisions to harm others.
Health risks are usually the most compelling, but alcohol drips into so many different aspects that I wanted to surface them too, beginning with finances.
During my final year of drinking, I was spending close to $200 on alcohol-related purchases weekly. This included the drinks themselves, late-night ride-shares, late-night food, and reckless spending. That’s close to $10,500 annually on alcohol. In one year of drinking, I could have paid off half my remaining student loan debt.
You can estimate this for yourself by manually going through your purchases, or using a calculator. The calculator doesn't factor in alcohol-related spending such as the foods, rides, and others that most wouldn’t spend on had they not been drinking.
It would be difficult to discuss money, and then walk past the effects alcohol has on communities so we’re going to stop here for a bit.
Greater exposure to alcohol outlets in a neighborhood appears to be related to greater alcohol use and related problems such as violent assaults. But, you want to know some bullshit? This is by design.
Greater numbers of outlets will tend to open in areas where rents are low, which encourages the concentration of outlets in low-income areas. But, alcohol consumption is lower in neighborhoods with lower incomes so the greater concentration of outlets in these areas would not appear to be explained by a simple supply-demand relationship. Retail businesses choose locations that maximize profits by locating near customers with high demand while minimizing operating costs. This mismatch between supply and demand may cause people in the most deprived neighborhoods to disproportionately suffer the negative consequences of living near alcohol outlets.
So who are the real victims?
The communities. When you purchase alcohol, like any purchase, you’re voting for something with your dollars. So, if an alcohol outlet, in an attempt to maximize profits and minimize operating costs, has chosen a low-income neighborhood, please understand that those living in neighborhoods with a high density of alcohol outlets disproportionately suffer the negative health consequences of living near alcohol outlets. Therefore we must stop stigmatizing not only those with alcohol use disorder but residents in communities with a high density of alcohol outlets because they are victims of oppression via the greed of store owners, not the core customer base.
Many people reward athletic efforts with alcohol. Whether it is a team sport, a spin class, a weekend run, or a softball league, we use alcohol to replace the pizza parties of our youth. Alcohol inhibits performance, FYI.
In a performance test between alcoholic beer, non-alcoholic beer, and water, it was only alcoholic beer that could negatively affect sports performance and health.
But we knew this.
We knew that alcohol decreases aerobic performance, impairs motor skills, decreases strength, power and sprint performance, slows recovery, negatively affects body composition, increases the risk for nutrient deficiencies, and increases the risk of illness and injury.
And we know that when Germany was tied for the lead of most medals during the Pyeongchang Winter Olympic Games, that Johannes Scherr, the doctor for the German Olympic ski team, told the New York Times, that nearly all of his athletes drink non-alcoholic beer during training.
The science behind that is a bit complicated, but essentially non-alcoholic beer contains a plant-based compound called polyphenols, and polyphenolic antioxidants have shown promise as recovery strategies from fatiguing and damaging bouts of exercise, making them appealing options in recovery from an intense resistance exercise session.
But, we’re not all focused on being elite athletes so performance isn’t as important as allowing alcohol to be a social bonding agent.
Like let’s grab a coffee, let’s go for a beer is not about drinking a beer as much as it’s about the conversation and the community that this interaction creates.
To that, the biggest responding argument is you don’t need to drink to go for a beer. I go for “beers”, go to happy hours, and I go to events, I just don’t drink alcohol, because I don’t want to, and I don’t need to.
“Bar menus are featuring long sections of spirit-free cocktails. Liquor stores are carrying alcohol-free spirits. Brewers are launching IPAs boasting 0.0% ABV.”
Alexia Elejalde Ruiz of the Chicago Tribune reported on the increase of availability of non-alcoholic options across Chicago, confirming the lack of needing to drink. There is even a “booze-free” bar in New York, created by Lorelei Bandrovschi, Listen Bar, where all drinks are alcohol-free. So, you can still go for a drink you’ll just most likely be ordering an Athletic Brewing Beer or a Seedlip cocktail.
If alcohol is a bonding agent, and our goal is to hang out with our friends, not drink, then we don’t need alcohol, we just need alternative ways to create community. Which exist. Faith congregates people, music congregates people, fucking Crossfit congregates people.
Giving up alcohol doesn’t mean giving up friends, or giving up sporting events, or parties. It’s just giving up alcohol.
Okay, now I need a favor. Would you mind holding the reigns to my high-horse as I step down for a moment?
I am sober, so I have a confirmation bias, and to be fair I wanted to find the studies that suggest the benefits of alcohol. Why else would Dan Buettner include it as a key ingredient to long life found in the Blue Zones?
There are only 5 Blue Zones on earth, so for these pockets of centenarians much goes into their longevity including diet, happiness, community, and natural movement, in addition to their moderate drinking habits.
They are outliers.
But surely, there are some benefits.
The New York Times found that drinking can reduce fears and take your mind off of your troubles. It can help you feel less shy, give you a boost in mood, and make you feel generally relaxed.
A Harvard School of Public Health report did find a connection between moderate drinking and lower risk of cardiovascular disease along with improvements in factors that cause many heart attacks and the most common kind of stroke. This same report highlighted that gallstones and type 2 diabetes were less likely to occur in moderate drinkers than in non-drinkers.
That same Harvard paper included an emphasis on moderate drinking, which we know requires quite a disciplined and consistent user habit to qualify for, according to the CDC.
By subscribing to the above you may be avoiding the long-term health risks of alcohol use but are still subjecting your immune system to weakening, putting your mental and emotional health at risk, increasing financial stress, inhibiting restorative sleep and performance with the use of a potentially addictive gateway drug, as well as contributing to community oppression.
So I’ll congratulate you on your discipline and at the same time suggest you consume quietly rather than continue defending a substance that is known to kill 88,000 people a year, be abused by 26.45% of our population, and has 14.4 million Americans suffering with an alcohol use disorder.
Today, many want to sound deep, or profound, and on another day I’d pursue that, but today I only want to be clear: Alcohol is a danger to those who consume it, and those who exist around it.
I am not campaigning for prohibition, but what I do seek is equity in the public conversation of alcohol. That’s the hardest part. Most, don’t want to hear this, so they’ll go out and find the cheap misleading headlines that support their bias. But make no mistake, to drive debate conversations about gun safety, pander to pandemic fears, and support lawsuits against the creators of the opioid epidemic but dismiss facts about a substance that claims more lives than those is inequity.
I don’t know if a single voice will be loud enough to speak over the billions of dollars encouraging individuals to enjoy these beverages, but I do know my voice is louder than the silence of ignorance, complicity, and caskets.
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