I fit into the 10% category for years while building my first start-up age ~22 - 30.
I realized at some point it was out of control and I couldn't stop. The details are as ugly as anybodys addiction story but to most everybody else I managed to externally look "fine".
I am the biggest contrarian and skeptic in the world, eventually sought out medical help and was referred to AA which I was very leery of.
But I did it and recently celebrated year 2 of sobriety along with a way to address the stress, fear, loneliness of startup life.
Not trying to hijack a data-thread into self-help but when I was out drinking I loved consuming these articles to feel like I wasn't the only one.
Having spent some time in AA there are are a LOT of developers, entrepreneurs, hackers that are working the program too, if you're struggling with the alcohol monkey like I was it's a safe thing to at least check out.
I was in the same position for most of my twenties. I did well at work, was in (mostly) good physical shape, and didn’t have any trouble rehearsing/gigging with my band. I really thought I just “liked to go out;” I’d drink when I had band practice or a gig (2-3 nights a week), then would go out on Friday and Saturday nights with my friends. That only left two nights a week to hang out with my girlfriend, so of course we’d go out to dinner or make something to eat at home and end up at a bar.
I honestly didn’t understand what denial was until I woke up one morning and realized I was an alcoholic. I quit drinking 6 years ago and could not be happier with my decision.
Being a "functioning alcoholic" means you are i) addicted to alcohol and thus likely to be drinking much more than is healthy. Long term heavy drinking is associated with a bunch of health risks (the obvious being cirrhosis and the less obvious being some cancers).
"functional" is a low bar - impairment in memory and cognition creeps up on you, and it's possible to boil like a frog until the onset of liver failure and permanent neurological damage (eg delirium tremens) dispels that illusion.
I'm going to try to write this without being inflammatory or sounding insensitive, which I absolutely don't intend to be, but I'm very sorry if this post comes off that way. I'm sure my tone will be lost to the cold, hard text of a web page.
First off, congratulations on turning your situation around and maintaining your sobriety for 2 years. I can't imagine how much work that must have been.
I've never really understood the whole "alcoholic vs. sobriety" thing. Is it not possible to "learn" to drink less? I see time and again the idea of being "out of control, unable to stop". Why is complete sobriety the only answer? Can varying levels of control truly not be learned? Or is the prevailing mindset that it's "easier" (while I'm sure still very difficult) to just go down to zero and maintain that, rather than learn moderation? I wonder if there are any studies or evidence to back that up, if that's the case.
Also a question about AA itself, if you're ok answering it. My understanding is that AA is very faith-based (many steps of the 12-step process invoking a deity), and that a big part of it involves opening yourself to God and Jesus to help. Is that universal, or are there non-religious versions of AA? I know if I (an atheist) ever got into a situation where I needed something like AA, I would be very uncomfortable with the religious aspects.
For most changes of habits where it's possible, taking a hard line is much easier.
When I went vegetarian, I went cold turkey. The first two weeks, I wanted meat all the time, and it was hard to resist the temptation to eat it. The next month or so, I still wasn't sure I'd be able to keep it up, but it was easier.
Since then (years), I sometimes want meat, but it's gotten far easier.
I sometimes think about loosening up--I've considered rules like eating it once in awhile if I know it was humanely and environmentally raised (as much as possible), or bringing seafood back, or even eating meat that I know will otherwise go bad (which basically ends all my ethical objections).
The biggest reason I haven't is that it would be way harder and probably make my life worse overall. At this point, being vegetarian is super easy. I only sort of remember what most meat tastes like, I'm very used to not eating it, and I know I can do it.
Critically, it's never a decision I have to make; it's a given. If I made the line blurrier, then every time I saw meat that looked good, I would have to make a decision. The cognitive load of being a vegetarian would skyrocket, and I would probably have more of a feeling of missing out because I would think more about the possibility of not missing out.
I am logging back in specifically to address this comment in case it prevents somebody from trying AA due to misinformation.
First as others echo if you don't understand the addiction consider yourself lucky. If I drank one drink at the end I was physically compelled to have another. Imagine a terrible itch. You have to scratch it. Heavy drinking alcoholics have such strong physical addictions that detox without medical supervision can be life threatening. Your reaction wondering why millions of people choose AA and abstinence vs trying to "cut back" is misinformed but not uncommon.
Second and more importantly IMO the misconception that AA requires a traditional faith or GOD experience is what kept me out for years. Part of working the steps is finding "a higher power" and I know many atheists in the program that consider that to be Good Orderrly Direction (GOD) vs a spiritual or dogmatic experience.
But the true "work" of the program is centered around confronting your wreckage of the past and confronting life on life's terms vs utilizing alcohol as a mechanism to check out of life.
> I've never really understood the whole "alcoholic vs. sobriety" thing. Is it not possible to "learn" to drink less?
I believe that it is both addictive and alters one's state of mine are what makes it difficult to simply "learn to drink less". I suspect that it is technically possible, but going sober (avoiding the addition) is likely to be a much easier choice than trying to control the addiction. When it is something that can impact one's long-term health as significantly as alcholism can, it makes sense to go for the comparatively easier solution of avoiding alcohol altogether.
15 years sober here. Before that I drank like crazy while shipping a bunch of software that you've definitely heard of.
The only way this dumb monkey could quit was to quit altogether. Hey, if you can control your own drinking, that's great. But I know that I cannot.
Also, I'm an atheist in AA. It works for me.
The whole "God thing" of AA stopped me for quite a while. But the whole deity thing is optional, you just need a power greater than yourself and (ideally) a sponsor who can call you on your bullshit. I've heard the name "Jesus" a handful of times, and never from someone running a meeting.
I've never been Involved with AA, so I might not have the most accurate information, but I also wondered this one evening, and ended up reading a bunch of articles, as well as the AA Handbook's section on Step 2[1].
From what I gathered, AA wants you to trust your recovery to a Higher Power, because then you can depend on said higher power to pull you through times of personal weakness (because nobody's strong all the time, let alone a recovering alcoholic). The term Higher Power in the handbook often pretty explicitly refers to the Christian God, but I remember the same handbook saying that the connection to the Higher Power is a distinctly personal one, and that each AA member can choose to define their higher power as they wish.
It is true that a lot of AA members end up finding Jesus as part of their recovery, but many also get through it by trusting in a different god, or in humanity, or in the elegant universe, or in the transcendental power of the AA group itself.
From what I gathered that evening, AA's process is very much faith-based, but what you're putting your faith in is flexible, and doesn't really matter to most AA groups.
Unfortunately, people who have experienced addition are going to have a hard time understanding your position.
I too do not suffer from these kinds of habits directly or even through close family or friends, so other readers forgive me if I'm falling short of level-headed understanding here.
The question you seem to be asking is "Why isn't moderation an option" and addiction is, in part, the inability to moderate. Maybe you can't relate to that, but for somebody that has that inability, participating in any amount of the activity they have difficulty moderating is flirting with ruin. They use all of their ability to form and practice moderation habits on just avoiding taking the first step.
Their reality is very much different from yours or mine, the risks and rewards are entirely changed. Like airgapping an unpatched OS that's gone out of support and which hosts business-critical data, only an absolute countermeasure will suffice.
It's not a flippant response, but I would certainly consider yours to be. You have never suffered from addiction, therefore your frame of reference is skewed, but forgivable.
Having never suffered addiction you physically and psychologically cannot understand the affliction. It controls your thoughts, your body, your actions and decisions. It has costs well beyond every night drinking- costs paid in broken marriages, lost friendships and worse.
Pointing out that you have never suffered from addiction is not flippant. It is in response to a lot of what you have already written. You don't know the pain of which you are so dismissive, far apart from the 'coldness' of text. You express yourself and your understanding very well, and your words are sharp.
I think you don't understand what "flippant" means. The parent's response was certainly flippant. He displayed a (to borrow the phrase from dictionary.com) frivolous disrespect for my curiosity and questions.
I would absolutely agree that my frame of reference is different (I wouldn't say "skewed"; that's a bit of a weird and disrespectful way of putting it), but I'm asking questions with the intent to try to understand better what people who have struggled with addiction have to go through to get better.
You accuse me of being dismissive, but I am anything but: I am asking questions trying to understand the forces at work here. The parent was very dismissive of me and my effort to understand.
Let's teach by example here.
Dismissive: I think addiction isn't real because I've never experienced it.
Dismissive: I'm going to imply that your questions are stupid and invalid just because you haven't experienced what we're talking about.
Not dismissive: [pretty much everything I've said up till now]
Your attitude continues to be less than stellar. You act like a babe in the woods who has no frame of reference and only innocently asks questions to further educate yourself. From my perspective, you condescend, and continue to do so. You are a member of society, presumably older than sixteen, and so you very well know how pointed this line of questioning can be.
Perhaps my uncalled-for overreaction is due to the loss I've experienced at the cost of addiction, from my own mistakes and mistakes made around me. For me there has been a significant loss of life both in my immediate family and friends.
HN is a pretty weird place to ask these questions, and I understand perfectly well what flippant means- thanks for not being dismissive or condescending.
I admit I may overreact, but only because I find your questions- especially the way you responded to be- to me disingenuous.
Though I should never discourage someone from learning, and judging by my reaction i see why anonymity and text are the right place.
(i can tell that i overreacted, and responded emotionally and strangely. I am bipolar on top of addiction issues and reading this post back to myself it's apparent. I'm being an ass. I'm leaving my post because maybe my broken train of thought can be a bit of a learning experience? i'm sorry i am so rude.)
Thanks for explaining. I'm just trying to get the point across that I just don't understand, but would like to. I happen to think that HN is a pretty reasonable and normal place to engage in discussions about these sorts of things, so it seemed natural to me to ask.
I can only ask you to believe me when I say I'm not being disingenuous here: I am genuinely curious about all this stuff, especially since I have no first- or even second-hand experience with it. I am sorry if I come off as somewhat clinical or detached... as I mentioned and we all know, it's very hard to get tone across via a medium like this.
The problem with alcohol (and a lot of drugs) is that being intoxicated also impacts your judgement. Ever had a few drinks and thought "I can barely feel this", then after you sober up your like "wow, I was actually drunk".
That's why it's hard for an alcoholic to control their drinking. Having only a drink or two is easy to say when you're sober, but easy to excuse after the alcohol has kicked in.
I have struggled with addiction, and I don't understand it either.
A person of the right frame of mind can reduce their intake to a point of normality. There is no difference between an alcoholic and a healthy person other than their temporary blood chemistry and a predisposition to drinking. Framing it as an on/off is a tactic used by those who don't believe in the ability of another to moderate volume.
Addicts are getting a different chemical brain reward from non-addicts. An addict drinking alcohol is not someone who just really really enjoys it, anymore than someone who is depressed is really sad.
I like - very occasionally - to put a few coins in to a fruit machine, or to wager on an event. But I don't get the addictive impulse from it, I don't have to fight the voice in my head, I don't get the rush followed by the shame, and I don't and I don't get the feeling of unstoppable momentum from it that marks an addiction. I'd be willing to bet if I did it more frequently that it'd get that way.
I'm wondering what the point of this reply is. It comes off as accusatory and obvious, given the comment you're replying to. Is having struggled with addiction a point of pride for you? I ask this as someone who's struggled with it. The person you're replying to went through a good deal of trouble to make it clear they weren't trying to be insensitive. It just seems kind of rude to someone who seemed to be genuinely trying to understand a horrible affliction.
I think the person I'm replying to used a lot of flowery language to say "Why can't you people just learn self control?" Invariably - because it's certainly not the first time I've heard it - there's an attached "(like me)" on the end of it. Next up: "I've never really understood why depressed people don't just try and make an effort to be happy"
I'm fortunate enough to have escaped from any serious addictions (outside of maybe eating a little too much garbage when I'm feeling a little down), but my mother's side of my family is absolutely packed to the rim with people who have/had powerful drug and alcohol addictions. I also have a close personal friend who has a similar family history and a brother-in-law who comes from a deeply damaged family as a result of alcohol and drug addiction. So, while I can't offer any insight from a first person perspective, I can offer some from a close outside party.
You should be very thankful that you don't suffer from it, nor have had close enough contact to addiction so that a question like you're asking seems reasonable. I urge you to spend a couple hours reading up on it and how it works (at least the parts we know and understand), how it's defined, and how it's treated. If you can find some intervention videos on youtube, it might be worth sitting through.
For my relatives who suffer(ed) from this kind of addiction, it simply becomes all they think about all the time. If they're at work, they're trying to figure out how to get home earlier to start drinking, or they'll try to figure out how to hide the smell of the alcohol behind powerful aftershave. If they're not drinking they're trying to figure out how to drink, and if they are drinking, they're trying to figure out how to stay conscious long enough to get to the next bottle. In my family at least, the addictions are usually co-present with various psychological ailments. The literature on drug/alcohol addiction is jammed full of information on this co-presence.
To an addict, the thing they're addicted to become everything to them. They'll use everybody around them and manipulate them to feed the addiction. If you can't help that purpose, then they'll throw you away and move on to the next supportive person. It becomes more important to them than sex, food, shelter, etc. If you're down to your last $15 and need to decide between food and booze/drugs, to an addict the choice is obvious, you don't have to eat every day.
The best analogy I can give is that addiction of this nature feels a little like slow motion drowning. If you don't get to the surface to get another breath, it's over. A drowning person will climb on top of their own mother to get to that air, and thus it's the same with substance addiction. Everything else becomes secondary.
Bizarrely, it's not always the substances that are addictive by themselves (like morphine), but a powerful psychological predisposition drives many addictions. For an addict who's been able to go clean/sober, giving them a drink or their drug of choice is a little like putting them back in that drowning situation and asking them if they really need that breath or if they can just hold it a little longer. To them it feels like functionally the same situation.
I've watched several friends and relatives die either directly from their addiction, or from some secondary issue caused by their addiction. It's maddening watching it happen. You can even have full-rational conversations with an addict about why it's bad and terrible and they'll agree and provide thoughtful responses about it. But right after that conversation they'll go and pour a drink. The closest example I can think of right now is to watch a few episodes of "Hoarders", ignore the hoarding itself, and watch the conversations with the hoarders. They're completely lucid, but there's something broken in their psyche that causes them to do what they're doing. An uncontrollable compulsion. If you can get through a half dozen episodes of "Hoarders" without going a little crazy, congratulations. I can barely make it through an episode without wanting to reach into the television and grab the people and shake some sense into them so they can see what they're doing.
To your central question, there are programs that attempt to wean addicts off of their addiction. But usually the goal is to get them down to zero. In many cases it's simply because they are so addicted to their substance that going cold turkey would likely kill them. Getting clean, even off of a serious alcohol addiction, can be medically difficult. It can be unbelievably unpleasant, from seizures to hallucinations.
Tolerances of people with very severe addictions can also be mind blowing. Blood alcohol levels that would kill most people might be the baseline an addict walks around with all day.
I know from some of my friends and relatives that AA has literally saved their lives. It's put them into a support structure full of people who also have gone through the same thing. It means they both have understanding, but also BS checkers...people who know when they're being manipulated because they were themselves manipulators. If you're struggling with a serious addiction, concern about deism is the absolute bottom of the list of things you have to worry about, but it is often used as an excuse not to join the program. I would also urge you to read up on the AA program, it's a powerful system full of some very deep wisdom. You can attend an "open" AA meeting if you're curious. It might be boring to a non-addict, but it can be the life-changing foundation for an addict. My relatives who are in AA never miss a meeting, and always find where the local AA meetings are whenever they travel. It's "religious" in the sense that following the program religiously has turned their entire lives around.
I also urge you to read up on the criticisms of AA and compare to other programs. Also, learning about AA and AA-like programs (like Narcotics Anonymous) as well as sound-alike but different programs (like Narcanon) can be useful as well. It's likely somebody you know does suffer from addiction, and understanding some of the things about it and how it works might enable you to save somebody's life.
drinking less is extremely difficult because at first it goes really well, but then it gradually increases, and then all of a sudden you're drinking to excess again. the term "slippery slope" applies here. saying no to the 3rd drink is MUCH harder than saying no to the 1st - that's why lots of problem drinkers (i'm intentionally not using the word 'alcoholic' here) just stop completely, or drink one glass of wine at thanksgiving per year or whatever.
heavy drinkers find drinking intensely enjoyable - and (subtle difference here...) not displeasurable in any way whatsoever until hangover/puke. if you aren't the kind of person who's ever drank 15+ drinks in a single night, you just have no ability to comprehend this. it's not within your realm of understanding - your personality is just completely different. or your brain chemistry is such that after 3-4 drinks, you feel terrible.
There's another reason which you didn't mention. It's not personality, and it's not that I feel terrible after a few drinks. I drink very little because the following [1] is incomprehensible to me:
Alcohol – Euphoria has been reported during the
first 10–15 minutes of alcohol consumption.
I have gotten very drunk and yet not experienced euphoria or anything similar. To be sure, alcohol has physical effects on me (e.g. impairment of judgement and impairment of coordination). But it just doesn't do anything mental, for better or worse. I'd bet that many/most of the 60% or so of people that have less than one drink a week fall in that category. I.e. to us alcohol is "meh".
I'd much rather have chocolate or sugar than alcohol. E.g. I like Grand Marnier, but that's because it has a pleasant sweet taste, not because it has alcohol. I'll drink a few beers a year, but that's because I'm doing something social, like watching a football game with friends.
it's a combination of euphoria, a slight mania, boost in enthusiasm and motivation, and it quite possibly 'unlocks' part of your personality (i.e. the funny part, since it completely eliminates your inhibitions to tell racy jokes).
so just like you said, this is why it's so hard for problem drinkers to cut down. it's just a whole different experience than a person who has a couple and then feels dizzy and wants to sit down.
I have had 15+ drinks in a single night before, but probably only on 2-3 occasions in my life (one of them being my 30th birthday, where a mostly-sober friend was keeping track until 23 drinks). So I at least know what that's like, in isolation. But my personality doesn't push me to just go and go and go.
I'm not saying there isn't a slippery slope, but I personally cannot imagine my life without at least some alcohol. I assume for the case of someone where their (excessive) alcohol intake has a huge negative impact on their life, zero alcohol sounds like a much better deal than drinking a lot.
But I still question the accepted "fact" that this is really a fixed "personality" thing. We humans have extraordinary brains and have the power to -- possibly with help -- change a lot of things about our personality and emotional state. It seems hard to believe that "once an alcoholic, always an alcoholic" is actually absolutely true.
of course it's not absolutely true. you're not wise to something everyone else is blind to - some people are totally able to cut down. the people who say it's impossible are AA people, and that's basically a religion.
but look at you - 2-3 occasions in your life - the people who have problems cutting down are doing that 2-3 times a week and are completely functional. it's a completely different personality type.
the bottom line is, for a lot of people, it's a LOT easier to stop than to 'cut down'. this isn't a magical premise. in fact i think it makes a lot of sense. similarly, for a lot of people, stopping is impossible. and that's how you get numbers like 74 drinks a week which sounds fucking ludicrous at first blush, but is in fact quite doable.
One might expect alcohol consumption to be roughly normally distributed, but clearly it is not when the top 10% is so far off the chart. Imagine what it would be like to drink 74 drinks in a week. I've been a heavy drinker at times, but that amount blows my mind. And that's just the middle of the top 10%. I love me some booze, but that amount is so far beyond what I would consider enjoyable that there would have to be something seriously, irrationally wrong with me to partake to that degree on a regular basis.
That's what addiction is. It's like asking why someone with OCD can't simply not wash their hands. It's mind bending to even imagine for someone who hasn't had that experience. I've dealt with obsession and compulsion at times in my life (not as a disorder), and I know how hard it is for me to modify habits and fixations. True addiction is some next level shit.
I can understand why it's difficult for you to imagine how a person could be unable to stop with just one drink. It's similarly difficult for a non-depressed person to understand why a depressed person is miserable even when things seem to be going well, or for a neurotypical person to understand why an autistic person is freaked out by seemingly minor stimuli.
These are, however, all things that have been extensively studied and documented and affect millions of people. It's not necessary for you to be able to really get inside the head of an alcoholic, but that shouldn't keep you from accepting that this is simply how things are for some people.
Congrats! I often question my incline of drinking between 1 and 2 glasses of beer, wine or whisky a night. At this point I've become so used to it that I feel like it's part of my normal routine, which is a bit scary.
That's actually the recommended amount of alcohol intake though. Clearly, alcoholics shouldn't be drinking, but for non-alcoholics there are significant health benefits to having a couple of drinks every day (to the point where NOT drinking is actually considered a risk factor for heart disease).
Dr. Jarin, the American Heart Association has a slightly different take on alcohol consumption. For starters they recommend that women do not exceed 1 drink per day. Most importantly they do not seem to think that abstaining from alcohol is considered a risk factor:
> How alcohol or wine affects cardiovascular risk merits
> further research but right now the American Heart Association
> does not recommend drinking wine or any other form of alcohol
> to gain these potential benefits
Keep in mind that almost no organization (outside alcohol sellers) can "recommend" alcohol consumption for the simple reason that alcohol is extremely negative for certain cohorts (i.e., alcoholics). Therefore, even if there are demonstrated benefits for the majority of the healthy population, no one wants to be seen as supporting the harms, which, in fairness, are often extremely bad. That said, even your quoted text admits that there may be potential health benefits to alcohol consumption in moderation.
Keep in mind that a "potential benefit of moderate alcohol consumption" is not the same thing as "NOT drinking is actually considered a risk factor."
If the science clearly indicated that "NOT drinking is actually considered a risk factor for heart diseasee" do you think AHA would:
(A) Refrain from mentioning the risk factor.
(B) Present the risk factor with a stipulation that individuals
"consult your doctor on the benefits and risks of consuming
alcohol in moderation"
I agree that it is silly to think that not drinking is actually a risk factor for heart disease. I was never trying to support that claim. I was just trying to point out the institutional biases that may be at play when AHA makes recommendations about alcohol consumption.
I would also like to point out that the very AHA page you linked to states "The incidence of heart disease in those who drink moderate amounts of alcohol (no more than two drinks per day for men or one drink per day for women) is lower than in nondrinkers." So there may be a potential benefit there that AHA acknowledges.
6 years ago, a med school student friend had a really detailed powerpoint presentation showing actually, yes, drinking no alcohol is far better for you. I think this edge case benefit is just promoted by people wanting to feel better about their alcohol consumption, and not to mention pushed as a repetitive PR point by alcohol companies.
promoted by people wanting to feel better about their alcohol consumption
Maybe, but this works in reverse too. There is a bias towards assuming that behavior perceived as sinful must also be harmful. This manifests in bad science in any number of examples: meat consumption, fat consumption, and yes, alcohol consumption. The USDA food pyramid (1992 one) came out against sinful fats and guess what happened? A low-fat/high-carb craze that was completely ruinous to public health.
Please do not mix the serving sizes people use with "one drink". You have no idea how much wine goes into the glass, not the strength of that wine.
A standard drink of wine is 125 ml at an ABV (alcohol by volume) of 8%.
Most people pour more than that, and most wine is stronger than that. 175 ml at 12% would be 2 units; 2 glasses of that is 4 units. See how easy it is to drink double the recommended limit?
The heart disease benefits are far from being proven, and besides alcohol consumption is directly linked to cancer risk. There is no safe amount of alcohol to drink, and the cancer risk certainly makes all benefit/risk ratio close to nil. Net, if you care about your health in the long term, just don't drink.
Don't single out cancer without considering all-cause mortality. A number of studies show that moderate alcohol consumption results in overall less death even if cancer risk is increased.
"The beneficial effects of alcohol are not only evident in cardiovascular disease, but also in reducing mortality from all causes."
There is no cardiovascular benefit for alcohol intake. The only evidence for this is an observational study, which does not prove causation at all and is heavily disputed. It would not be the first time that observational studies are proven wrong in actual trials :
> In recent years we have seen that the results of similar “observational” studies were disproved when subjected to a “randomized controlled trial”—the standard bearer of scientific proof. A good example of this is female hormone replacement. For decades it was believed that female hormone replacement was beneficial. But a randomized controlled trial, called the Women’s Health Initiative, demonstrated that the exact opposite was true. The study was stopped in 2002 because women taking the study pills of estrogen plus progestin were developing heart disease and breast cancer at increased rates compared to those taking the placebo or inactive pills."
That page cites 188 articles, almost all of them finding health benefits to drinking alcohol. Without having gone into all of them to look for methodological flaws, that hints at a very consistent pattern of correlation.
That page alleges that it is maintained by a professor emeritus, who at least at this time, does not have nor need any funding from e.g. the alcohol industry. That's far from an exhaustive proof that he's free of bias, but it clears the most obvious source.
Well you'll have to explain me how you fit "greater longevity" claimed by the page you linked with the indisputable fact that alcohol consumption drives the rate of cancers, which are one of the leading causes of death in the developed world. There is clear evidence that alcohol contents cause mutations, which in turn cause cancers when out of control. A number of deadly cancers are directly correlated with alcohol intake, such as oesophagus, stomach and digestive tract cancer. Plus, all alcohol drinks contain some amounts of formaldehyde which is a powerful poison for humans (http://www.niehs.nih.gov/health/materials/formaldehyde_508.p...).
So I'm not sure how a doctor can say with a straight face that 1-2 drinks a day has no detrimental effect on your health at all.
The explanation of greater longevity is simple. Heart disease and stroke, at least in the US, together account for slightly more deaths than cancer. Suppose that moderate alcohol consumption increases cancer risk by 5%, but decreases heart disease and stroke risk by 10%. Although there would be more cancers due to alcohol, the overall death count would still be reduced, because of the protective effect on the cardiovascular system.
No one is saying that alcohol doesn't have negative effects on health. It's just that the positive effects of moderate consumption are stronger, enough so that overall mortality is reduced (at least according to the available scientific evidence, which I admit may not tell the whole story).
I'm a heavy drinker who runs in a crowd of heavy drinkers. I am typing this at a bar. I should probably drink less.
I cannot imagine drinking an average of 10 drinks a day.
Even playing with the numbers a little bit: if you were to have five drinks every weeknight (which seems doable, but still high), it would take more than 20 each night of the weekend to hit an average of 10, which seems unreasonable.
So, three questions:
1. Anecdotally, is anybody else having this reaction?
2. Has anybody found the raw data? The linked summary of the original study is not very helpful. I'd like to look at the area of this data that spans the 20%-10% range more closely. The jump between the two categories is huge, and it seems to me that about halfway between (so, say, 35 drinks a week) fits where I would expect there to be a band of heavy-drinking culture. Is there demographic or age data in the study?
3. Given that this is a summary of the way a book that is trying to make a political argument represents these data, has anybody seen a different analysis of the same study?
The behavior of the top decile is confusing as it's laid out presently. If the it's possible that the top 99th percentile drinks on average 16 drinks per night which would make it possible for the 91st decile drinking only 4 drinks per night and still get the results shown in the graph. My bet is that the data here is getting heavily skewed by a subset of alcoholics at the top end.
> 1. Anecdotally, is anybody else having this reaction?
How do you define "one drink"? One serving? Or some measured amount of alcohol?
England has a public health measure of "units of alcohol" - 10 ml of pure alcohol.
With metric it's easy to convert. Serving size in litres * Alcohol by volume.
Thus, a 330 ml bottle of beer at 5% is about 1.65 units.
A bottle of wine at 12% would be 9 units (for a 0.75 l bottle)
A litre of vodka at 40% would be 40 units.
10 drinks a day seems high, even if we use this small "unit" figure for alcohol. That's EDIT 2 litres of alcohol per week; more than a bottle of wine every day; more than a lot of beer every day.
The way you described it looked like trolling, hence the downvotes, I think. But your thinking is sound. People most commonly count their alcohol in shots and shot-equivalents.
1.5oz = 44ml. Most liquor is 40% ABV. That's ~18mL of pure alcohol.
The average beer bottle size is 330mL - 500mL, at 4-6% ABV. Again, that's in the 16-25mL of pure alcohol range.
Maybe rounding to 20mL might be a better definition of a "unit" of alcohol. It's still easy enough to do math with, and more representative of what people consider one drink.
1. Yes, it seems astonishingly high. Montaigne mentions some acquaintance who drank just an astonishing amount (five liters?), but who knows who strong the French wine of that day was?
2. No.
3. No.
if you were to have five drinks every weeknight (which seems doable, but still high)
Perhaps instead of drinking them all at once, a couple of drinks at lunch, and a few in the evening. It's easy to drink a lot more when you spread it out over the day. You can drink a lot and never get drunk that way.
Or if you're a high-powered movie lawyer, a shot from your whiskey carafe every time you talk to a client in your office.
I work with a number of sales folks who changed my impression of what it means to be a "drinker." I know personally several people who will easily and regularly down a few (3-4) 4-ounce vodka martinis before dinner, split a bottle of wine at dinner, then drink five spirit-based drinks after dinner.
More than one of these folks has admitted they simply "don't get hangovers." They could be lying, but with the amount of alcohol they can drink and still be perfectly functional the next day, I bet these folks skew the average.
If you're drinking regularly and in large amounts like that, your tolerance for alcohol is going to be quite high, and your hangovers much more benign. If they quit drinking for a few months and then tried to drink like that again, they probably wouldn't make it through the night, and the next day would be rough.
I don't think you can pin "alcoholic" to number of drinks, even if you control for weight/sex/etc.
I drink reasonably heavily, but variably, on the order of 15-35 drinks per week. I wouldn't consider myself an alcoholic, mainly because I can -- and do -- stop whenever I want.
I spent a year of my life drinking 8-10 imperial pints a day, which is way over this 10 standard drinks thing. Part of that was accomplished simply by drinking for 6+ hours a day (usually 8pm to 2am)
After a year of that I stepped back to one or two a day. It was never an addiction thing for me, more just a social environment and expense account that encouraged drinking (which in retrospect included several hard core alcoholics)
I've watched people close to me really struggle with addiction and do a lot of harm to people around them with smaller amounts of alcohol. It's not necessarily an issue of quantity, I believe that why you drink may well be the determining factor
1. It is standard drinks. A reasonable sized medium strength beer can be ~1.6 standard drinks, so you'd only need 3 of those for 5 on a weeknight. A standard drink generally corresponds to one shot (44ml) of spirits.
2. You're a "heavy drinker" and 20 drinks on a weekend seems like a lot? I'm done that numerous times and I hardly even enjoy drinking, to the point where I completely quit with almost no effort.
Surely there's some miscommunication or exaggeration there. I don't think most people could drink 12-14 wine bottles of water a day. Forget alcohol poisoning, you'd be risking death just from hyperhydration.
Could be the difference between the definition of "a drink" and what we colloquially call a drink. For example a glass of wine contains 8 "drinks", but none of us would say that. There are like 4 or 5 glasses of wine in a bottle.
I'm not sure about this conclusion with regards to alcohol:
> The Pareto Law states that "the top 20 percent of
> buyers for most any consumer product account for
> fully 80 percent of sales," according to Cook. The
> rule can be applied to everything from hair care
> products to X-Boxes...
> ...But the consequences of the Pareto Law are different
> when it comes to industries like alcohol, tobacco, and
> now marijuana. If you consume 10+ drinks per day, for
> instance, you almost certainly have a drinking problem.
> But the beverage industry is heavily dependent on you
> for their profits.
If you're having ten drinks per day you're almost certainly going to be drinking the cheap stuff, not the high-profit-margin luxury alcohol brands.
There's probably more profit in a single bottle of Johnnie Walker Blue than an entire month's supply of the cheapo local beer that's chugged by an alcoholic.
Rich people can be alcoholics, too – and in fact they can often conceal and maintain it better. A well-off white collar worker is unlikely to spend a significant percentage of their income on alcohol, even if they're drinking to excess; they also are likely to have flexible work hours, sick time, and other mechanisms to cover for their binges and hangovers.
There are even (up to a point) social and professional benefits that come from drinking with colleagues. Alcohol is a huge part of many companies' culture, and people can easily hit the 80th percentile (>15 drinks per week) simply by accepting a reasonable fraction of the offers to share a drink with their peers in a given work week.
Some normal signs in tech companies:
* Company-stocked beer fridges
* Hosted weekly (or more often) happy hours
* Personal bottles of expensive whiskey on desks
* Expense reports for "team dinners" that are 60-70% booze
Startup cofounder here who spends ~20 days/mo on the road - also don't forget about BD meetings, meetups, happy hours, etc. A ton of deals get done over a few drinks, and when you're stacking a meetup, a dinner, cocktails, latenight, and a hotel bar together regularly, it's pretty easy to hit the 15/20 drink figure.
Also, when i'm out drinking with friends, I tend to keep a bit of a mental note of how many i've had because the tab's coming out of my pocket. When i'm on the road i'm on the company's tab, and the moral hazard totally wipes out my concern for how many i've had and instead i'm focused on whatever I'm at that meeting for (close deal, increase client expenditures, lock in investment, whatever).
The solitude also definitely plays a role, and like the top commenter on here it's really easy to be totally oblivious to how much you're drinking as it just becomes part of the routine. I had a mentor once point out that the best salespeople are usually alcoholics with shitty relationships who work too much, so I think there's a lot of parallels between the personality traits that are helpful for an entrepreneur but can be wildly destructive if pointed in a negative direction.
I was a double-major at a party school and in a top fraternity, so over the last decade i've become rather accustomed to being a borderline functioning disaster. However, over the last few months I really peeled it back and have instead spent a ton of time getting back into the gym, running, rowing, and doing crossfit.
Going out all night is fun, but getting up at 5a and cranking out a workout while it's still dark, running back to the office, and having breakfast while most people are just getting out of bed has become my new high to chase.
Fifteen drinks a week is not problem drinking. Fifteen drinks a week is -depending what you drink- under English government safe drinking limits for men and only just over for women.
Problem drinking anything over the current safe limits which are "two to three units per day, without saving units up for the weekend, with some days drink free (for men)".
To give some context: Alcoholism detox medically assissted treatment starts when the person is drinking forty 40 units per day unless you have a comorbid mental health problem when they drop it to 30 units a day unless it's a severe enduring problem when they drop it to 20 units a day. Under those amounts you get outpatient treatment. You're going to struggle to get treatment for fifteen units a week unless you're under 18.
40 units a day would be one litre of spirits with an ABV of 40%.
I find it weird that >15 drinks a week is 80%ile, given that that's a pretty standard moderate level of drinking in many parts of the world and is significantly healthier than not drinking at all.
IQ and alcohol consumption are highly correlated. IQ and health & longevity and highly correlated. I think even a lot of alcohol in the context of a good diet is benign, but I'm skeptical about the health benefit claims. I think they're just not properly controlling for other factors like intelligence. Somebody needs to run the data controlling for IQ.
I assume the book goes into more detail about the actual economics behind the ideas. It would be silly to turn discussion about this hype piece into a pseudo-intellectual argument over methodology we haven't read.
There's probably more profit in a single bottle of JW than a case of beer, but beer is CHEAP. For example - take the local brewery in my hometown in Montana. Most of their costs in distributing their beer was canning. Each can was about 40 cents. The beer itself, the brewmaster guessed, was less than a nickel per can to produce. They sold a six pack for eight bucks, and a twelve pack for thirteen. There's a ton more profit to make in JW, but there's plenty of change rattling around in that beer can too!
I have times when I drink every day two or three drinks per day (mainly cocktails and I don't think I will ever be alcoholic), have only normal brands at home, but I don't think I would switch to cheaper brands if I ever increase my consumption.
The alcohol industry also relies heavily on tourism and festivities. People that may not drink daily or weekly might drink at a wedding. People travel to the US from out of the country and many of them hang out in bars & restaurants and drink. Look around the bars of a major city on the weekend and it's clear even the non-compulsive drinkers are putting a decent amount of money toward the alcohol industry.
I was reading a book yesterday where one character offers another one a drink. He declines, and the guy says something like "Come on, the sun's over the yardarm somewhere."
This struck me as a very odd phrase, so I looked it up.
The yardarm is the horizontal beam on a sailing boat. Back in the day, once the sun rose above the yardarm, the Royal Navy would start issuing the first of the rum rations for the day. There were several throughout the day.
This was about 11am.
The U.S. Navy had similar rules. George Washington's army pounded back quite a bit as part of their daily rations. The first major uprising in the U.S. was due to alcohol production. Foreigners traveling to the states were always impressed at the amount of booze the colonists could put away. Even folks who mostly teetotaled kept a cider barrel and took a good-sized cup to get the day going.
Some anthropologists believe that the natural state of man up until a hundred years or so ago was intoxication, it just wasn't spelled out as clearly in the literature, mainly because it wasn't unusual. In fact, some believe that civilization itself started with the fermentation of grain.
I'm still trying to absorb those numbers, which I feel are inflated. But I note that excessive consumption in the states is certainly not a new thing. So who knows? Maybe the stats are true.
I note that another commenter is pointing out that addicts will enjoy these articles because it tells them they are normal. Beats me what normal is. Are we supposed to all agree on a definition here? Is it okay to bring up what some of the stats and historians are saying about alcohol consumption in a non-judgmental way without either having to endorse or condemn it?
Some anthropologists believe that the natural state
of man up until a hundred years or so ago was
intoxication, it just wasn't spelled out as clearly
in the literature, mainly because it wasn't unusual.
There's quite a bit of literature out there about this. What I haven't seen a lot of—and would be interested in learning more about—is the seemingly simultaneous occurrence of the proliferation of coffee houses and the Enlightenment in Europe.
It would make a ton of sense to me that trading in a constant state of inebriation for a caffeine buzz might make for better productivity.
There are all these cases today of sizable percentages of the population being pre-dispositioned to do things that currently make no sense. ADHD is one. Is ADHD a defect? Or an adaptive response that is no longer needed? Or just a different kind of personality maturation pattern?
Perhaps heavy alcohol inebriation was needed when you worked 35 years barely staying alive, then died of measels. Perhaps it's part of intelligence -- some addiction researchers are now saying that addicts are actually "over-learning" the stimulus-response associated with drinking.
Like I said, beats me. But it is fascinating -- even more so if there is 10% of the population who are adults and presumably mostly feel they have no problem while the rest of us think they do. Obesity is developing along similar lines -- except the 10 percent are going to end up being the folks who aren't fat!
Personal anecdotes are great, and I congratulate anybody on overcoming something that they've identified as a problem. But when we're talking 10 percent of the population? There's something else at work here; something that has developed over eons across populations worldwide. Fascinating stuff.
IIRC, a lot of it was credited to the difficulty of getting pure drinking water. Fermented beer (with considerably lower ABV than we're used to) was much safer to drink than water from a river that everyone upstream had been throwing their trash into.
Another interesting historical comparison is that for much of the history of civilization, drinking water was mostly contaminated and unsafe to drink. So people drank beer and wine instead. Granted, most of the time it was watered wine or "small" beer, but yeah, most people must have been somewhat buzzed all the time.
I read a book about John Wilkes, the 18th century English politician, and apparently it was not uncommon for people in those circles to drink four or five bottles of wine a day... Ben Franklin was another famous lush, as was Winston Churchill.
There's a lot of bizarre puritanism going on in American culture these days...
Come visit Australia to see a real history of drinking. The British colonists ran out of pound notes, and chose rum as the national currency. Then an argument about distilling rights led to a coup d'etat.
The article is misleading. You don't need to drink 74 drinks per week to be in the top 10 percentile. 74 drinks is the average of all those in the top 10 percentile and not the lower boundary.
I don't think it says that. The author points out that upon entering the top 10 percentile, "you'd still be below-average among those top 10 percenters." PS. Send my regards to Watson!
The article says: "But in order to break into the top 10 percent of American drinkers, you would need to drink more than two bottles of wine with every dinner." And according to Watson that's 10 drinks ;-) (http://www.rethinkingdrinking.niaaa.nih.gov/default_wine.asp)
Right. so two bottles of wine is 70 per week. and you would need to drink MORE than that(let's say, by about 40% of a bottle/week) to crack the top 10 :)
> After Prohibition, beer makers were actually forbidden from putting alcohol content information on their labels. They finally sued for the right to do so in 1987.
That's amazing. I come from a country where content labeling is mandatory. When I'm in the US I tend to prefer beer that is labelled for its content (or styles I know are closer to 5% than 9%), because I like to know how much I'm drinking. It seems strange to me that the conclusion about labeling is "people will use labels to buy more alcohol for the same money" and not "people will use labels to help them make responsible decisions".
Well, it's obviously path-dependent. The US has fairly strict labeling laws now, but you can probably imagine the arguments for not allowing alcohol content to be advertized could be part of a compromise when you're emerging from a period of prohibition. I vaguely recall the debate at the time that the law was changed, and it was accompanied by the expected amount of hand-wringing.
I agree, its hard to find decent non cheap beer (PBR, Coors, Bud, etc) that has lower alcohol content, it seems. Even on the West Coast, where we have tons of microbrews available in seemingly every store.
As the other two comments have pointed out, craft brewers are starting to make "session" brews that are lower alcohol in general, including "session IPAs" which are hoppier than normal low-alcohol beers but are still closer to 5% than 9%.
I can see a daily drink or two (realizing that the 'or two' does make a difference) as what should be a normal high end, but the top 10%? Wow, I'd imagine that drinking a dozen or so drinks a day would quickly ruin your health-obesity, liver problems, run ins with the law, etc.
It seems like in the US there really isn't that much of a nationwide culture of moderate drinking-drinking being the thing you're only supposed to do on non work nights or for celebratory occasions. I think controlled moderate drinking (the glass or two of booze a night) tends to be looked down upon as being one step away from being in the gutter.
But that's just my own opinion, bashing our somewhat prudish society.
How to explain it? is it an addiction that grows slowly, or is it a consequence of people being dissatisfied with their lives. I also wonder if cannabis, when fully legalized, will replace alcohol as our "drug of choice".
It's a cultural thing. Especially heavy drinkers tend to exist in a bubble where all the people they regularly socialize with are also regular drinkers and enable each other.
It's a spiritual disease. You are correct in speculating that one addiction can be switched with another - cannabis, pornography/hookers/affairs, heavier drugs. The bad part is, unless one surrenders, if a person is a bona fide addict, their full blown illness will drive them to depression, unmanageability, prison... possibly suicide.
The good news is, if one surrenders, he or she can suspend the progress of the disease.
I really don't think a cannabis addiction can be classed as the same life ruining addiction that alcohol is. Maybe because of it's legality it can ruin lives but the parent was specifically talking about after it became legalized.
The following is a troublesome statement to me about pot that I didn't know until now:
"Smoking marijuana is more dangerous than smoking cigarettes, experts say. The tar in joints contains a much higher concentration of the chemicals linked to lung cancer compared with tobacco tar. And smoking marijuana deposits four times more tar in the lungs than smoking an equivalent amount of tobacco, according to the National Institute on Drug Abuse."
It's important to know that there are alternative ways to consume cannabis. One is to ingest it (which may not be as convenient as smoking), an other one is vaporization. Vaporization offers a very similar experience to smoking without the health risks associated with combustion (it's still not known if it's totally safe though).
One thing we can expect with legalization is that consumers will be better informed about those alternatives.
That's a clever bit of scaremongering, if you do the math. Marijuana smoke is more dangerous than an equivalent amount of tobacco smoke, but a typical marijuana user consumes far less than than the typical cigarette smoker. Nobody (or almost nobody) has a pack-a-day weed habit.
For a few years I drank so infrequently that across a year my weekly average would be below 0.25 drinks/week, but I wasn't a "never" drinker. There might be a difference between people who literally never drink (recovering alcoholics, lifelong teetotalers) and those who do drink, but who do so so infrequently that their average would round down to 0 depending on the question asked.
This article doesn't define what a "drink" is. It also says:
> Do you drink a glass of wine with dinner every night? That puts you in the top 30 percent of American adults in terms of per-capita alcohol consumption. If you drink two glasses, that would put you in the top 20 percent.
Which, in context, is weakly linking "glass of wine equals one drink".
England talks about alcohol units. One unit is, for example, 125 ml of wine with an ABV (alcohol by volume) of 8%. Even though wine is recently getting weaker it's tricky to find wine as weak as 8%. 13% is more typical. If someone poured you 125 ml of wine at a meal you might think they'd made a mistake. Try it yourself now to see how small it is. 175 ml or 200 ml are more normal serving sizes.
200 ml at 13% is 2.6 units. Two of those is 5.2 units.
So, really, people need to learn how much alcohol they're drinking. You get the health benefits from alcohol when you drink one unit per day; risks start to rise after that. Being teetotal appears to be as harmful as drinking maybe 5 to 6 units per day, even when corrected for people who are teetotal because of health history.
Basic statistics: just because the average in the top decile is 74, that doesn't mean everyone in the top decile drinks 74. The top 5%/1%/0.1% who drink way more than 74/week (15/day? 20/day?) can counter-balance the 5-8/day crowd.
To give another example: the average top decile Facebook employee has a net worth over $33 Million. That seems high, but that's because that net worth is highly skewed - in fact, I assumed only Mark Zuckerberg's wealth was distributed equally among FB's ~10k employees, and that everyone else has $0. The figure $33 Million is meaningless.
That's sound statistics, but consider that that average value figures to over 10 drinks a day every day, and there's probably an upper limit on how much alcohol you can drink, even with an alcoholic's level of tolerance.
Salaries at Facebook are probably exponentially distributed, but if drinks per week were distributed that way, then the top 5%/1%/0.1% would become very dead, very quickly.
Interesting that junk food isn't mentioned. I bet that we could find quite a few examples of where the top consumers of classes of food products are having their health damaged more than the top consumers of marijuana.
Many Startup owners and entrepreneurs will be slightly scared about them getting in to alcoholism.
But lets get things straight.
I am "heavy" drinker in my opinion drinking on average 1,5 litre of whiskey a week. Is it a lot in statistics? No. Do I think its a lot? Yes. Do I have a problem? No. I can stop for a month without trying (doing a test every 3-4 months for 2 weeks just in case).
Alcohol helps to release stress. As old saying says - the very first time you will taste the vodka and you think its tasty - you have a problem pal. Serious problem.
Same with Whiskey or Gin.
Any strong alcohol will do actually.
Just use it as relaxing method, not substitute to happiness, and you will be good. Dont feel bad if you drink more alcohol than Yahoo statistics say. Just use common sense - anything in excess is harmful.
Is this self reported? How many people lie and say they don't consume any? Especially if they are religious and there religion forbids it. I know quite a few people who say they don't drink but I've seen them drink. They would even lie to themselves that they don't drink.
Jesus...even when I used to get absurdly hammered on the weekends in my late teens/early 20's at max I'd say that it worked out to 20-25 drinks (fri+sat night)...these guys are basically sustaining that rate through the entire week?
Been happily consuming up to 1 alcoholic drink per week for years now, still manage to go out and have a great time in bars and clubs, don't have to deal with being useless the next day or destroying my health.
Someone needs to get the NYTimes data visualization team to clean this up. Doesn't do the enormity of the number justice by folding the last column into four columns when the rest are a single column.
I have a drink maybe once in three months. I though I was unusual given so many people around me drive much more. Now I realize I'm closer to the medium.
On the data tab, the zip files unzip into a text file that is column based. The SAS convert program gives codes for those columns. Codes can be converted to questions using the code book tab.
I probably hit the 20-25 drinks a week mark with one to two 22 ounce craft beers a night during the week and maybe 3 on a Saturday.
I stock my beverage fridge like a Dr Dre video, but with good beer.
I love a good double/triple IPA. Having one makes me want another.
Of course on strong beer alone I could never hit 75 drinks. I'd be in the bathroom the whole time. In my distant past I had a buddy that would drink a twelver of bud light nearly every night. No thanks.
Actually, by strict adherence to HN rules the headline should be "Think you drink a lot? This chart will tell you." (Which IMO is a perfect illustration of why this is a stupid rule.)
That's not true. The rule calls for changing the headline when it is misleading or linkbait. "Think you drink a lot? This chart will tell you" is arguably bait because it uses the "you" trick and the "this" trick.
We certainly don't claim to apply the rule correctly all the time. We are, however, happy to be corrected. The best way to complain about a title on HN is to suggest a better one.
I haven't been keeping a list, unfortunately. I mostly become aware of it when a poster mentions that their original title was changed from <something descriptive> to <something else>. Is there a way to direct that to someone who can do something about it without coming off as a pest?
There's some amount of alcohol consumption that does not have much impact on health (especially short term).
Also, bars are only central to the social lives of Americans that go to bars. I don't know the numbers, but I'm sure the number of people who socialize at and around church is at least comparable to the drinking scene.
I realized at some point it was out of control and I couldn't stop. The details are as ugly as anybodys addiction story but to most everybody else I managed to externally look "fine".
I am the biggest contrarian and skeptic in the world, eventually sought out medical help and was referred to AA which I was very leery of.
But I did it and recently celebrated year 2 of sobriety along with a way to address the stress, fear, loneliness of startup life.
Not trying to hijack a data-thread into self-help but when I was out drinking I loved consuming these articles to feel like I wasn't the only one.
Having spent some time in AA there are are a LOT of developers, entrepreneurs, hackers that are working the program too, if you're struggling with the alcohol monkey like I was it's a safe thing to at least check out.