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Answering the neo-prohibitionists – a series disclaimer

I’m sure even the most ardent fans of my neopro myth-busting posts would agree it’s time we talked about something else. But just before I leave the topic for a while, I need to be candid and restate my disclaimers around this whole area.

I’ve had a few comments over the past week or so suggesting that I’m riding this too hard, that I’m perhaps in denial about the real health and social perils of alcohol abuse. These comments come from people like Alan and Matt, people I like and really respect, so they deserve a full and frank response.
I can assure you that I’m not in denial about alcohol abuse. It has touched my life, and I’m keenly aware of the effect it has on others. I don’t for one second seek to deny that there is a problem that affects a significant number of people. I feel deeply ambivalent about putting the following out into the blogosphere, but I feel I need to help explain where I’m coming from.
Two points:
Firstly, a close friend of mine trained as a doctor, and about fifteen years ago was working regular Friday night shifts in A&E. They soon realised they were stitching the same people back together every week. This led to feelings of futility and despair, which in turn led to clinical depression, which in turn led to a serious suicide attempt. Fortunately, that person survived, but after a spell in an institution they gave up the career they had trained seven years for. The person is OK now.
Secondly, I grew up very close to someone who is a chronic alcoholic. That person is still in my life today. I’ve had therapy to deal with how their behaviour has affected me, with the guilt I feel every time that person gets so drunk they can’t speak and piss themselves, to come to terms with the fact that it’s their decision, and there is nothing I can do to affect it. I have witnessed at close hand how alcohol can destroy lives, and I fucking hate it – it’s destroyed their life; it’s scarred mine. This is why I’m vigilant about my own drinking.
So why am I here, criticising people who seemingly only want to prevent tragedies like these happening?
Several reasons.
Firstly, because having witnessed it close up, I know that when people step up to fight alcohol abuse, they go for the wrong targets. People don’t drink harmfully because alcohol is there, or because it’s cheap, or because it’s advertised. Restricting the availability of alcohol won’t help alcoholics. These people live for alcohol – it’s the only thing they care about. Make it expensive and they’ll go without food, sell their house, Christ, they’d sell their fucking kids for a drink. Prohibit it altogether and they’ll drink meths, or nail varnish remover, or after shave.
Alcoholics drink not because it’s there, or cheap, or tastes nice, but because they have deeper trauma and/or unhappiness in their lives. Even if you were studying this at GCSE level, if you look at it scientifically, if availability/pricing/advertising of booze caused problem drinking, then everyone exposed to it would be more likely to problem drink. But most people in theUK are drinking less. A minority are drinking to harmful levels. And as far as I can tell, no one is studying that minority in detail and asking what it is about them that makes them different from the majority.
It’s easy to blame the availability of booze. And it is shameful that problem drinkers are not being researched in a way that can highlight what it is that’s different about them that makes them more likely to problem drink.
People drink to excess because they are unhappy, because they feel empty inside, because they are lonely, because they are stressed, because they have shit jobs being bullied in call centres and alcoholic oblivion is the only escape they can see. Why is no one helping them? Because it’s a bit more complicated than just blaming drink, that’s why.
Secondly, I’m doing this because for the vast majority of people, drink is an innocent pleasure with minimal health risks beyond a few extra pounds or the odd hangover. My father died of smoking-related lung cancer when he was 58 and I was 27. I’ve read the science, and I know that there is a direct linear relationship between smoking and ill health – every single cigarette you smoke causes you damage. Drink is not the same. There are healthy levels of alcohol consumption.
My close quarters witnessing of the destruction alcoholism can cause makes me more keenly aware of the benefits of moderate consumption, and the stark difference between the two. So it makes me very angry indeed when someone who doesn’t know what they’re talking about tars all habitual drinkers with the same brush. And even angrier when newspapers distort the facts even further for nothing more than a sensationalist story.
Thirdly – quite simply, because it needs doing. A quick review of press stories about alcohol over the last week alone will show you how drinking is being demonised and made socially unacceptable. It’s based on lies and distortions. The figures say the problem is not getting any worse – if anything, the situation is improving. No one in the media seems to want to report this truth. No one questions press releases from avowedly anti-drink organisations. My blog posts might seem excessive if you’ve been staying tuned over the last week or so, but they amount to a fart in the face of a hurricane compared to the anti-drink propaganda that’s out there every single day.
In summary then – I know the ill effects of alcohol abuse as well as anyone, and care about them as much as anyone. I’ll never deny that there’s a problem, and am not seeking to do so on this blog.
But if that problem is going to be dealt with effectively, it has to be understood properly. I think the neopros are acting against the interests of the majority of drinkers. But worse, because they are approaching the problem over-simplistically, wilfully distorting the evidence, and confusing personal beliefs with real health issues, I don’t think their antics will do anything to help the people who really need helping. And that is just shameful.
That’s why I’m doing this.
And I promise my next post will be about Brew Dog or IPA or hops or something.

23 Comments

23 Comments

BLTP

Just been listening to Today and they mentioned "dentist chair" binge drinking, has anyone ever seen one of these? The famous ( in1996) Gazza incident happened abroad didn't it? And yet this is talked about as if it's daily widespread. I do fear this argument is lost already the BBC has accepted this all as fact there was no querying of any point by both presenters .

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DJ

I believe you needed to write that Pete to prove your objectiveness to some people. What you said was spot on and I can't see how anyone could argue with it. I have also been affected by alcoholism from someone close to me and know what lengths they would go to to get a drink. I am disgusted at the press at the moment and their unquestioning reporting of all the drivel they are being spoonfed.

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Mark, Real-Ale-Reviews.com

Pete, I'm 25, and whilst I'm pretty in tune with my duties as a metrosexual 90s child living in a city, not many things actually make me admit that I'd shed a tear, but I too have seen chronic alcohol abuse first hand and it's scared the life out of me, and you've made me stop dead at my desk this morning and think about those times all over again.

A member of my family was treated for alcohol abuse and spent time in a drug rehabilitation centre. That hurt, but not half as much as the months and years it took for their behaviour and health to get to such a stage that treatment took place.

All this doesn't stop me loving beer, it makes me understand its role in my life better, the role of alcohol and why it shouldn't be abused. Alcohol isn't 'bad' per se – a glass of wine or beer cannot be compared to one cigarette – but as with most things (excluding smoking, plutonium and James Blunt) moderation is healthy, I believe both mentally and physically.

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mentaldental

"There are healthy levels of alcohol consumption."

I pretty much agree with everything you say but the above quote is, perhaps, a little simplistic.

On balance there are probably health benefits from low levels of alcohol consumption but in the case of certain diseases this seems to not be true. In particular (with my professional hat on) the increase in risk of oral cancer is directly proportional to the amount of alcohol consumed with no "safe level".

There are about 2000 cases of oral cancer per year in the UK so this is a small but significant consideration. The problem with oral cancer being that, unless detected very early, the surgery required can be very disfiguring and debilitating.

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Martyn Cornell

"These people live for alcohol – it's the only thing they care about."

Well, as you go on to imply, Pete, it's not really the drink: if it wasn't alcohol it would be something else that helps them forget how miserable they are, from gambling to heroin. But it is the big question the prohibitionists don't answer: WHY do people feel the need to drink to excess, and since banning alcohol won't take away that need for oblivion, what do they propose to do about that?

Again, as you imply, that's a much harder question to answer.

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Bods

All well said. And that point that blaming drink for peoples drinking is so very true. Tackle the cause of why some people drink to excess, and you'll stand a better chance of solving the problem.

Just blaming drink and making it harder won't.

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Alan

Hey Pete. I don't think you are riding this too hard at all. You have triggered in me a real interest in thinking about the presentation of statistics related to beer use and how the public is not well served by knee jerk attacks from both anti-alcohol or pro-alcohol groups. Plus, being a first generation Canadian son of Scots parents I am quite interested in the cross-cultural aspects. Finally, I am involved with social policy in my full time job (but not drinking) and have done some small work around that theory of booze advertising and messaging including that chapter I wrote for "Beer and Philosophy" a bit back. So you are speaking to me on a lot of levels.

I think you have actually hit upon a theme (beer and health) and a medium (blogging) that works extremely well together. Rather than a week or two – what would a year of blogging on the topic by a number of people from a number of points of view look like? What would it do to the policy debate? What would be left of the shadowy Portman Group and other self appointed minders? What affect could it also have on the stigmatized who are truly affected? What would the good beer lobby look like it if truly took on the mantle of defenders of moderate healthy drinking – including an anti drunk driving message as well as support for, in the US, lowering the drinking age?

There is much public good in what you are doing. If you don't want to populate your blog with a high percentage of this content, it might be interesting to consider a stand alone group blog to explore all these policy issues and the interests that are behind them. If for no other reason that no one else is doing it objectively and comprehensively.

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Rod Gillies

Whilst the posts sometimes haven't been the easiest reading, you've become the Ben Goldacre of alcohol reportage recently. Pointing out the bad analysis that surrounds this issue is a valuable social service.

I don't think many people would deny that some people have a problem with drink. However, there are clearly some journalists and policy-makers that have a pretty big problem with basic maths.

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Eddie86

Well said Pete. And thank you – someone had to take the time out to have a look at the facts, and I'm glad someone did.

Cheers

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Rabidbarfly

Really great series Pete and I really like the disclaimer, extremely well put. As for banging on about it, I don't think you have, it's been intelligent, informative and passionate writing, frankly what everyone has come to expect from you. Keep it up!

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David

Pete

First mate, well done with all you work on the blog. It is appreciated, and not just in the UK. It is not easy writing material based on data, and not easy taking on the popular media perception of a topic when you actually want to make a living out of writing. Long may that continue.

So thanks.

It irks me as well how the media only runs the same stories about alcohol. We have problem behaviour here (Australia) as well, but the story that is never reported is that Sally and John shared 3 beers and a nice bottle of red over a home cooked meal, had a hell of a nice time, strengthened their relationship and indeed, lived longer because of it (not that this is necessary for all actions in life). That isn't a story, and yet surely 999 out of every thousand units of alcohol sold end up contributing to society in this way. Surely that's the story.

We even had a top copper write to bottle shops telling them not to sell grog with greater than something like 3% alcohol on Australia day. What about all the mum's and dad's buying some grog for the family barbie on Australia's national day? Madness!

And the worst thing is the rank hypocrisy. Journos are notorious piss-swillers, as are doctors, and for that matter, coppers (and don't get started on lawyers including judges).

Makes you sick.

So keep fighting the good fight mate. The question is how to increase the exposure of your message. Perhaps we should put the hat round so you can self publish a book on "Why grog is not destroying us" – make contributions anonymous and put up an appeal. Hopefully the breweries would throw in a few quid.

David

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BigNastyBrew

"Because it's a bit more complicated than just blaming drink, that's why."

Thank you for that one little sentence.

Just as you said, it's the collective personal beliefs and those personalities distorting the facts.

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Curmudgeon

Very, very well said, Pete. The inclusion of difficult personal information in your post only serves to underline the message that attacking drinking in general doesn't necessarily do anything to curb problem drinking.

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David Strange

An excellent, clear and thoughtful piece to end you series of, also excellent, articles. Well done, Mr Brown.

It is clear that there are problem drinkers in the UK and these people need help. However, the existence of a small minority of problem drinkers does not justify the demonisation of all drinkers by the moral crusaders.

Moreover, a stand should certainly be taken against the over-overwhelmingly uncritical, one-sided reporting of anti-alcohol stories in the mass media. All such stories do is frighten and malign people who are doing nothing wrong.

As I said, a series of excellent articles, I hope they will be widely read and taken seriously.

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Joe

Couple of questions back.

Who is asking for drinking to be prohibited?

What are the facts about alcohol-related hospital admissions and deaths?

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Curmudgeon

They're clever enough not to call for an outright ban on alcohol, but they clearly want its price to be greatly increased and its availability to be greatly reduced. Their aim is progressive "denormalisation".

We have had supposedly reputable people call for an 80p a unit minimum price (thus doubling the typical price of off-trade alcohol), for customers of pubs and bars to be limited to three alcoholic drinks, and for personal alcohol rations controlled by an electronic card.

What matters is not so much the specific measures as the overall direction of travel.

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Joe

I think you're arguing against a straw man. The argument I've heard is for a 40p or 50p minimum. Not heard of those other proposals – where have you seen them?

Anyone care to comment about the rising health impacts?

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Pete Brown

Hi Joe,

To answer your initial points:

No one is (yet) arguing for prohibition and I don't think they will – history has proven it never works. But what they have learned from the smoking ban is that in order to justify stronger restrictions, you have to create a public acceptance that those restrictions will be permitted. What's currently happening is a campaign to 'denormalise' the idea of alcohol, and that's why so much of it is propaganda masquerading as fact.

Re health/hospital admissions, my post on that is here: http://petebrown.blogspot.com/2010/01/answering-neo-prohibitionists-5-of-10.html

Alcohol-related hospital admission and deaths are rising – and I'm sure that's what you're getting at here. This is the area of my research that needs a lot more time than I've been able to give it so far, but in addition to the points raised in the above post, here are a few more:

– Calculation methods for what constitutes 'alcohol-related' harm mortality have changed drastically over the last decade, and now include many more conditions than they once did – thus claims if huge increases are very suspect

– questions have been raised over how alcohol is defined as a cause. Stats include figures from paramedics and ambulance men who assert that alcohol is a cause when they attend a scene. I'm sure they're right in most cases, but as alcohol moves up the medical agenda, so they are more aware of it and more likely to include it where they may not previously have bothered.

– Even so, while figures are still rising, the rate of increase is levelling off (Source: NHS figures)

– With something like cirrhosis, which develops over many years, today's hospital admissions relate to yesterday's drinking. There is bound to be a time lag between the falls in alcohol consumption and binge drinking that are happening now, and the resultant fall in alcohol related illness. No one in neo-pro ranks will point this out of course. That's why when we point to falling consumption, falling rates of binge drinking, falling rates of alcohol related crime and disorder, they increasingly focus on hospital admissions.

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John Q. Publican

Joe and Pete:

I was going to mention this anyway, but Joe's questions make it more immediate.

There is another note when correlating alcohol-related death and disease (Pete, this is particularly true of the whole liver disease issue) which is often not drawn, and I didn't notice Pete mentioning it, which may be my carelessness.

There is a significant time-lag between when someone's drinking habits form and when they typically die of alcohol-related liver failure and disease. Most such deaths occur in people over the age of 50 who have been heavy drinkers for most of that time. In other words, the incidence of alcohol-related disease and death now reflects primarily the drinking patterns of the cohorts who were teenagers between 1960 and 1980, not those of current century at all.

Pete has covered the sine-wave shape of drinking habits, and the 70s and 80s were not only heavy drinking periods, but what was being drunk was radically different as well.

It is only in twenty to forty years that anyone will actually know what health effects modern drinking patterns have. I suspect that speculations derived from the drinking habits of the punk era and the Decade of Excess may not accurately reflect our future.

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