1. Alcohol abuse? It’s in the blood (22/12/94)
2. Drink, and be merry (8/6/95)
3. Let’s all drink to lower alcohol prices (30/7/98)

1.
Padraic P. McGuinness, “Alcohol abuse? It’s in the blood,”
The Sydney Morning Herald, December 22, 1994, p. 10.

We are already getting the usual series of earnest warnings about the use of alcohol at the Christmas season and grave comments about the indecency of overindulgence. But drink, and drunkenness, are really an essential element of most of the social rituals of the societies which celebrate Christmas, and other drugs or stimulants of various kinds are integral to the different non-Christian cultures — from tobacco, through marijuana to opium. Few if any societies have ever existed where some recourse has not been had to mood-altering drugs, for religious and celebratory purposes.

But as important, they have played a vital social role.

This social role is usually overlooked or minimised, when it is not explicitly attacked, by those who disapprove of drugs and, in particular in our society, alcohol. These are usually people who have discovered some substitute, whether it be religiosity, self-hypnosis, neurotic disorder or obsession. It is probably far more appropriate for our society to use alcohol, and overindulge in it on special occasions, than to espouse any of these inferior substitutes. The thrust of pharmacological research ought to be to find an effective alternative which escapes ill-effects.

However, as an article in a recent issue of the English weekly New Scientist (“I’m relaxed, you’re drunk,” by Gail Vines, December 10) points out, the social rituals involving drink (it is really necessary to stop using the word alcohol in this context, since different forms of alcoholic drink have different social functions) are sometimes even more important than the drink itself. This is illustrated by the remarkable phenomenon of apparent drunkenness on the part of total abstainers who participate in the social bonding and rituals of drinking. Not only can such people display all the external signs of drunkenness, they actually feel and behave as if they were intoxicated in the same way as their companions. (Probably they feel a bit better in the mornings, though.) It is obvious enough that social drinking and drunkenness have an important, even essential, role in our society. The office Christmas party is just one occasion for ritual drinking of a kind in which few people indulge at other times of the year. It clearly has an important bonding function. So do other kinds of party and communal drinking. The way in which men come together in the pub, or in similar drinking places, varies a lot within any society — the riotous behaviour of young men drinking when away from home, or in places like a beer festival, can often become revolting enough. In England and Scotland the “lager louts” are identified by the more respectable as somehow different from (and worse than) the “rugger-buggers” who soak themselves in traditional “real”, strong, warm beer. There is an enormous number of social gradations and distinctions involved in drinking.

Thus in Australia it is an interesting phenomenon that as men see themselves moving up the social scale in business they are likely to begin substituting spirits for beer, and of course drinking wine at meals more often. Some people never use pubs, but indulge in quite heavy wine drinking at dinner parties or conjoin with marijuana use. Women’s social drinking patterns vary widely among social and occupational groups and differ from men’s. Women drinking solely with other women often drink more heavily than in mixed company, and different types of drink. All kinds of drinking are constrained partly by economic factors, but much more by social factors.

Different societies have quite different attitudes to drinking and drunkenness. Thus one of the questions Japanese parents often ask their prospective son-in-law is, “Can he hold his drink?” The rules as to what a subordinate can permissibly say to a boss when they are both in their cups are quite different to those we are used to. In every society the rules about drinking are very different.

Thus in France, middle-class attitudes strongly endorse wine-drinking, but in moderation, and drinking more than a few glasses at meals is frowned on.

But France is still one of the heaviest imbibers in the world of wine and spirits on a per capita basis, and beer drinking, especially of strong Belgian and German beers, is becoming more common even outside the traditional areas like Alsace. The United States endorses communal spirits drinking much more than most other countries of Europe), and ordinary people are likely to frown on drinking wine with meals while accepting spirits — unless of course they eschew alcohol altogether in extreme reaction to its overuse. In Hong Kong the done thing in sufficiently wealthy circles is to drink cognac with meals and not much at other times. But in rural China, as the writings of Lu Hsun among many others testify, heavy drinking in communal places was always common.

All this suggests that most of the anti-alcohol education campaigns are misdirected, even more than those against drugs which do not have such fundamental and ill-understood social as well as psychological functions.

It is clear that to continually preach about the evils of drink, as of those of tobacco, does have some effect on patterns of consumption. It mainly affects the behaviour of the bien-pensant middle classes. But it is clear that the more preaching there is directed against the young and those of low class status, the more they drink and smoke. This is because there are very strong social pressures involved — not just peer pressures, but a whole conception of how they relate to other people and especially their own immediate groups. Merely to adopt the posture of the wowser will cure nothing — it is in fact likely to make social drinking worse and increase the consumption of alcohol.

It is also clear that most medicos have a naïve and unsophisticated understanding of the role of drinking. They see the extremes, the casualties — often those who have found social support inadequate, and have indulged to an increasing degree in solitary drinking. (Usually the worst kind, since it often involves a high intake of spirits). They understand little of the social role of drinking. There is a genetic element in abuse of alcohol, but social rules tend to keep this under control in close-knit societies.

The control of unhealthy drinking must take account of the social roles and institutions which support it, and which are supported by it. The discovery of healthy but powerful alternative drugs ought to be high on the research agenda in order to help those who tend to drink for psychological reasons. This would do more good than all the preaching in the world. But changing the social and celebratory, indeed the religious, role of communal drinking is a much more difficult issue in the long run. Meanwhile, enjoy your Christmas overindulgence — you’ll be a better Christian than the wowsers.

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2.
Padraic P. McGuinness, “Drink, and be merry,”
The Sydney Morning Herald, June 8, 1995, p. 14.

Accumulating evidence that drinking wine is beneficial to health is clearly disturbing those professionals devoted to the study of alcohol and drug abuse, who are convinced that alcohol in virtually any quantity and form is dangerous and harmful. They are fearful that any break in the solidarity of opposition to alcohol will encourage its use and especially its overuse.

Among the opponents of both tobacco and alcohol use it is generally accepted that taxation is an effective way of reducing consumption of these substances, and high taxation is justified both by the costs imposed by smokers and drinkers on the community and by the beneficial health effects of reduced consumption. There is indeed some evidence that both high taxation and outright prohibition can reduce consumption — thus prohibition of alcohol in the United States did reduce alcohol consumption, and heavy taxation of alcohol and tobacco does decrease the consumption of the taxed substances.

However, the effects of taxation are not nearly so clear. Perhaps a few comparative studies would help to determine the effects of such policies. In the US, it is clear that there were some benefits from Prohibition — but the costs in terms of poisoning, disrespect for the law, the growth of criminal bootlegging, and the accompanying criminal milieu of alcohol consumption, were immense. A less extreme case which I have recently observed is that of Finland. There alcohol and tobacco taxes are extremely heavy, and consumption in bars and restaurants is penalised by very high mark-ups on top of this. Far from reducing the rates of alcoholism and smoking, these appear to be much higher than in countries where taxes are lower. The visibility of heavy drinking and drunkenness, and heavy smoking, in the streets and bars of Helsinki is greater than in central Sydney or Melbourne.

This is only one part of a great deal of evidence that official anti-smoking and anti-drinking propaganda, even when backed by heavy taxes and restrictions, can often have a counter-productive effect. It is clear, for example, that smoking among teenagers, especially teenage girls, is increasing in Australia despite all the propaganda against it. Similarly, the overuse of alcohol among the young in increasing disturbingly.

The evidence on restrictive regimes with respect to tobacco and alcohol, as with many other drugs which are illegal, is that while aggregate consumption might be reduced, there are perverse effects among a proportion of the population such that they become heavier users and abusers, and suffer disproportionate damage. Surely, this ought to provoke some fundamental rethinking on policies towards taxation and restriction on use, as well as on the kind of education which might reduce consumption. Smokers and drinkers are clearly not the same across the whole spectrum, and while higher prices will cause some to act rationally by substituting other purchases, others will cut down on their consumption of even essentials like food and clothing in order to try to maintain their alcohol or nicotine intake.

This suggests that if the policy-makers were really concerned with the welfare of the smokers and drinkers they would consider other than draconian and puritanical measures. It is obvious, for example, that the physiology of addiction is ill-understood. Any drugs which might substitute less harmfully for alcohol and nicotine are denied general availability — the only alternatives offered are the very inferior drugs of religion or canting puritanism. The long history of alcohol use in Europe, and of tobacco use in the Americas, and of other substances elsewhere, is strong evidence of a deep psychological need among at least a proportion of humanity for some kind of mind-altering substances.

Nor is it clear just how harmful alcohol and nicotine are. A lot of the social and medical problems seems to be associated with the forms in which they are ingested. The recent widely reported Copenhagen study suggested that there were very definite health benefits from the drinking of wine, particularly red wine, even in quantities considerably greater than those generally recommended by the medical critics of alcohol.

There are two important aspect of this. First, there is growing evidence on the virtues of red wine from the point of view of heart and arterial health. It is now well-known that in certain areas of France where there is a heavy intake of fats, there are remarkably low levels of cardio-vascular disease, and the evidence points to the regular intake of red wine as the explanation.

However, the puritans might argue they would be even healthier if they cut down on both fats and wine. Perhaps, but it is certain that the quality of life would be worse.

Second, what happened in Copenhagen was like a controlled experiment — as a result of the lowering of the relative price of wine as a result of lower taxation following Denmark’s entry into the European Community, Danes did not drink less alcohol, but they changed its form, with wine becoming a much greater proportionate source, as against spirits and beer, of the alcohol intake.

There was a substantial beneficial health effect across the board, not only cardio-vascular.

This suggests that the people who are now agitating for higher wine taxes because of the excessive consumption of cheap wine in Australia are barking up the wrong tree. The alternatives to cheap alcohol can be much worse — like methylated spirits or petrol-sniffing. Instead, there is a case for adding vitamin B to the cheapest forms of wine, including fortified wines, as well as beer, since many of the health problems associated with excessive drinking are the result of malnutrition. The wowsers deliberately try to confuse the issue by insisting that in such a case the additives should go into bottled table wine of all qualities — they cannot bear the idea of anyone having any fun.

Of course there are problems with excessive wine-drinking. The cask of cheap white in the fridge seems to have replaced for many house-bound women other drugs of dependence. But has their health worsened as a result? To say this, comparison would have to be made with other drugs they used hitherto, or would use if the price of wine increased. The comparison with no drug or alcohol use invalid, since that will not be the result of any current policy or price rise. Moreover, the minority of heavy wine drinkers are likely to have a much more inelastic price response than the average, and they are likely to cut down on wine costs.

In short, the health-effects of increasing taxes on wine could well be negative, making a substantial proportion of people in the community less healthy than at present. Of course it would be desirable for everyone to drink moderately, by why penalise those who do in the false hope of benefitting those who do not?

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3.
Padraic P. McGuinness, “Let’s all drink to lower alcohol prices,”
The Sydney Morning Herald, July 30, 1998, p. 13.

It’s important to keep alcohol out of the discussions of the GST. After all, the former is good for your health. HARD cases make bad law. They also make bad social and health policy. That is, just as the rule of law requires that principles be laid down which will not always suit the special circumstances of some individuals, so should equitable policy be designed for the majority rather than the exceptions or the worst cases. The really difficult and exceptional cases should be dealt with by ad hoc assistance.

The perception of problems by those in the professions devoted to health and social welfare is often distorted by the fact that they meet a skewed sample of the population, those who are in difficulties or in ill health, and they see the worst results of activities which most people deal with easily. Nowhere is this clearer than in the case of smoking, drinking, gambling and drugs generally.

With the impending attempt to yet again sell a goods and services tax to the electorate, the issue of alcohol taxation has once again risen to prominence — and as usual there are some of those who preach against the evils of alcohol who want to raise the taxes on drinking, rather than allowing them to fall. In particular it is being strongly argued that taxes on the cheapest wine, in casks, should be increased substantially so as to diminish their consumption for health reasons. Certainly there are numerous abusers of cask wine who suffer health problems as a result — but there are more users who do not.

There are social and health advantages in the availability of cheap wine and beer. One of them is the substitution of more harmful substances when the cost of the less harmful is too great. Methylated spirits drinking these days is rare, partly because cheap table and fortified wines are available. Petrol sniffing seems to be on the increase, but mainly in areas where cheap alcohol is not available. It may be that cheap alcohol is preferable to alternatives, given the inevitable human predilection for drugs in some form or another.

Unlike smoking, there is actually a health benefit in moderate drinking.

While there is a case for taxing alcohol sufficiently to pay for any additional health costs it imposes on the community, there also ought to be a credit for any contribution it makes to improving the general level of health. As with smoking, it is dishonest simply to add up all the real and supposed costs without taking account of the pleasure which individuals gain from the activity, and any benefits to the community. It may be that drinkers impose greater costs than smokers because of the effects of the excesses of some on their families, and the fact they are likely to live longer than smokers with greater costs to the community in their declining years. Those who both smoke and drink heavily are unlikely to impose a great burden on the community as a result of longevity.

Some of those concerned with the welfare of homeless people, especially those who have been ruthlessly shoved out into a “community” they cannot cope with by the rundown of appropriate institutions, like the former Callan Park (stolen from the mentally ill by the bureaucrats and educators), have pointed out that alcohol for many of the disturbed is a fairly effective means of self-medication as well as a consolation.

Some of the adverse health effects of heavy use of alcohol could be easily dealt with if it were not for the opposition of the wowsers. Thus it would make sense to add vitamin B supplements to standard beers and cheap fortified and cask wines. Mental deterioration suffered by long-term alcoholics is due to malnutrition and particularly vitamin B deficiency. But this has been opposed on the grounds that people might then think drinking was healthier (as it would be). Or it is demanded that all wines, no matter how expensive or carefully made, should be dosed, so affecting their quality. But good bottled wines are not the problem.

In any case, the long-term ill effects of alcohol may have been exaggerated. Of course, anyone who indulges heavily and continually will have health problems, but not necessarily mental ones. A study of Australian World War II veterans published last year in the British Medical Journal (June 7, 1997) compared a random sample of diggers, who had maintained a high rate of alcohol consumption all their lives, at two dates. They were administered a battery of standard neuropsychological tests and computed tomography in 1984 (at the average age of 64.3 years) and again nine years later.

The researchers concluded that “no evidence was found that apparently persistent lifelong consumption of alcohol was related to the cognitive functioning of these men in old age”. Nor was there any evidence of brain atrophy compared with non-drinkers or lighter drinkers. These conclusions were true even of the 21 per cent of the original sample assessed as drinking at the harmful level, even though this proportion had fallen to 9 per cent at the second date (when the average age was more than 73 years). The authors point out that their results are consistent with other recent studies of elderly drinkers’ brain function.

So, clearly the health arguments for increased taxation on alcohol, especially cheap wines and beer, are invalid in terms of mental function, and valid for physical health partly because the obvious public health measure of adding vitamin B supplements to the cheaper drinks is not taken. Naturally, it remains true that liver function will probably be affected, and in general drinking beyond two or three drinks a day is not recommended for anyone. But to increase the taxes on the simple pleasures of the poor on such flimsy grounds is contemptible.