Alcohol Abuse Can be Reduced
by David J. Hanson, Ph.D.
The substance of ethanol is invariant around the world. What does vary greatly across time and place are the beliefs and attitudes that people have about it, their behaviors in relation to it, and the consequences of their consumption of it.
Important for both alcohol policy and alcohol education is the fact that in many groups and societies most people drink, they often drink frequently and daily, yet they experience few alcohol problems. Such groups familiar to most people include Jews, Italians, Greeks, Spaniards, and Portuguese. There are three major keys to the success of such groups. 1
- First, alcohol is viewed as a neutral substance. It is seen neither as a poison that seduces its victims nor as a magic elixir that transforms people into what they would like to be. What is important is how alcohol is used, and that is what determines whether it is good or bad.
- Second, such groups provide two options, each of which is equally acceptable morally and socially. One option is to abstain from alcohol. The other option is to use alcohol in moderation. What is totally unacceptable is the misuse of alcohol by anyone, anytime, for any reason.
- Third, people learn to drink alcohol sensibly and they do so from an early age in the home. They learn appropriate drinking behavior from their parents, whose good model of behavior they emulate. If they over-imbibe, they do so in the safe environment of the home where they can be guided to correct behavior. They don't learn to drink at university, in a fraternity house, in the military, or other environments.
It is clear that alcohol policies and education that fail to distinguish the use of alcohol from the abuse of alcohol, that stigmatize alcohol as a poison, that stigmatize those who consume it at moderate levels, that accept intoxication as an excuse for otherwise unacceptable behavior, or that attempt to prevent young people from consuming any amount of alcohol are not likely to be successful.
The single most effective way that parents can reduce alcohol abuse among their children is to be good role models by using alcohol sensibly. What parents do is much more important than what they say. It is important to remember that in the long run parents are even more inﬂuential than are peers. 2
Policies should not focus on the substance of alcohol but on how it is perceived and consumed. Of course, policies that fail to recognize the equivalent amount of alcohol in standard drinks of alcohol beverage are likely to mislead people inadvertently.
To a large degree, what we think is more important than what and how much we drink. This can be seen in many ways at the group and societal level. 3
A standard drink is:
- A 12-ounce can or bottle of regular beer
- A 5-ounce glass of dinner wine
- A shot (one and one-half ounces) of 80 proof liquor or spirits such as vodka, tequila, or rum either straight or in a mixed drink.
People in Europe and North America commonly believe that intoxication causes disinhibition and throughout those areas it sometimes leads to "disinhibited" behavior. Intoxication provides a convenient "time out" during which time people can do those things which they ordinarily would not be free to do. '"That was not I, but the alcohol." The desire for such an excuse may actually motivate intoxication. 4
However, in some societies people do not believe that intoxication disinhibits, and in those societies intoxication does not lead to disinhibition. Examples include the Yuruna of South America, 5 the people of Vicos in the Peruvian Andes, 6 the Camba of eastern Bolivia, 7 the Aritama of northem Columbia, 8 the people of Ifaluk Atoll in the Caroline Islands, 9 the Takashima of Japan, 10 and the Mixtec of Mexico. 11 In all of these societies, people become highly intoxicated, often to the point of passing out, but they never ever become disinhibited.
Targets of Aggression
The acceptable targets of aggression during intoxication vary from group to group. Women are never subject to aggression by intoxicated husbands among the Cuna of Central America, 12 but they are likely to be assaulted by intoxicated husbands among the Ainu of northern Japan. 13
Children are never assaulted by intoxicated parents among the Chamula of the Central American highlands. 14 Drinking spouses sometimes assault each other among North Americans, who almost never assault their parents.
Among the Maori of New Zealand, drinking occurs at drinking sessions or at drinking parties. The amount of alcohol consumed is comparable at both. However, at drinking sessions people tend to become drowsy and relaxed. But at drinking parties, they tend to become happy and noisy, violence is quite common, there is a sexual undertone, and behavior is usually egocentric and self-enhancing. 15
Among the Taira of Okinawa there is no aggression when men and women drink together. But when men drink alone, quarreling and even brawling sometimes occurs. When the Tecospans of Mexico drink among themselves, violence never occurs. However, when they drink with others, disputes, conﬂict and ﬁghting are common. 16
The Chippewa of Minnesota distinguish between "white drinking," characterized by relative decorum, and "Indian drinking," characterized by loud boisterousness and frequent aggression. White drinking behavior typically occurs when drinking in white bars and Indian drinking typically occurs in Indian bars. A white anthropologist reported that "Chippewa acquaintenances, unexpectedly meeting the author in an Indian bar, have dropped Indian drinking behaviors and assumed white drinking for the course of the conversation." 17
Such differences in behavior may sound surprising, but how many Europeans or North Americans behave the same way when drinking at a wedding reception as they do when drinking at a New Year's Eve party?
Intoxicated Behavior Can Change Over Time
Genetic differences cannot explain group differences in intoxicated behavior because it often changes over time. For example, among the Papago people of southern Arizona, men would traditionally drink heavily, vomit, drink heavily again, vomit again, and continue in such a cycle of behavior but always behaved themselves. However, life in conservation work camps beginning in 1933 and military service in World War Two brought the Papago into close contact with whites and their concept that alcohol disinhibits and that it provides an excuse for otherwise unacceptable behavior. By the end of that war, many Papago men had become disinhibited drinkers. 18
On the other hand, the Tahitians of the South Paciﬁc originally drank heavily and became violent after being introduced to alcohol by sailors and traders. Now they drink heavily but are not violent when intoxicated.
Intoxicated Behavior Can Change Quickly
Many people in Europe and North America have been in situations in which intoxicated people suddenly ﬁnd that they must conduct themselves in a sober manner and do so. For example, upon observing an automobile accident, they may telephone for an ambulance, direct trafﬁc as needed, administer ﬁrst aid, and otherwise provide needed assistance.
Intoxicated Behavior Tends to Operate "Within the Limits" Set by Society
The Lepchas of the Himalayas are inordinately preoccupied with sex, which is the most common topic of conversation and they are highly promiscuous. However, they rigidly prohibit incest and punish it by death. Lepchas include within the incest taboo sexual relations with blood relatives for nine generations on the father's side and four on the mother's, plus a large number of distant relatives by marriage. However, no matter how intoxicated they become, Lepchas never violate the taboo. Even while intoxicated, they operate "within the limits" set by their society. 20
Historians have provided numerous examples of this phenomenon from the early relations between native peoples and European settlers of North America. It was common for indigenous peoples to observe that settlers used alcohol as an excuse for otherwise unacceptable behavior. However, when native Americans went beyond the limits permitted by settlers, they often suffered catastrophic consequences. Afterward, the natives would behave in an apparently disinhibited manner when intoxicated, but would rarely go beyond the established acceptable limits; they had learned that to do so was to invite disaster. 21
Conclusion I: Societies have the type of intoxicated behavior that they permit.
Psychological studies shed additional light on the "think drink" phenomenon, whereby what we think about what we drink influences what we experience. 22
Laboratory research has demonstrated that when alcoholics are instructed not to drink for a number of hours (veriﬁed by breath tests) and then are given a placebo "drink," they experience relief from physical and mental distress. However, when such subjects are given alcohol which they falsely believe is not alcohol, they continue to experience distress. 23
This phenomenon may explain anecdotal reports of alcoholic priests who are no longer drinkers but who consume communion wine with no triggering of any addictive mechanism: they believe that they are drinking is no longer actually alcohol.
Research has also demonstrated that men who falsely believe that they have been drinking alcohol become less anxious in social situations. On the other hand, women who falsely believe that they have been consuming alcohol become more anxious in social situations. 24
Carefully conducted double-blind laboratory research has demonstrated that men who falsely believe that they have been drinking alcohol become more aggressive. However, they become relatively less aggressive when they think they are drinking only tonic water but are actually drinking tonic water and alcohol. 25
Men tend to become more sexually aroused from viewing erotica when they falsely believe that they have been consuming alcohol, arousal being indicated by means of a strain gauge to measure penile tumescence. Women report feeling more aroused from viewing erotica when they falsely believe that they have been consuming alcohol. However, a measure of vaginal blood ﬂow demonstrates that they are physically becoming less aroused. 26
Clearly, what people think can be more important than what they drink. This leads to conclusion II: Societies have the type of intoxicated behavior that they expect to have.
Combining the ﬁrst two conclusions leads to the ﬁnal conclusion: Societies have the type of intoxicated behavior that they expect and that they permit. Of course, what societies expect and what they permit are closely related.
We need to accept the wisdom of the ancient Chines proverb, roughly paraphrased: Drinking problems are not the fault of alcohol but of people and their society.
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