One Bourbon, One Scotch, One Beer x3. And then one other thing, too.
September 26, 2014 9:04 AM   Subscribe

Washington Post's Wonkblog, leveraging data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and economics and public policy professor Philip J. Cook's "Paying the Tab" looks at how much Americans drink. 30% of Americans don't drink at all. Another 30% consume fewer than one drink per week. To be in the top 10% of American, you'd need to drink the equivalent of 74 drinks per week, every week, or a little over 10 drinks per day.
posted by 2bucksplus (159 comments total) 18 users marked this as a favorite
 
I don't buy it. 10% of Americans admit to 74 drinks per week? Every week? No chance.
posted by roomthreeseventeen at 9:10 AM on September 26, 2014 [10 favorites]


1 in 10 Americans are hardcore alcoholics with consistent access to booze? That sounds somewhat suspect.
posted by Artw at 9:11 AM on September 26, 2014


My grandfather allegedly drank at least a six-pack every night at and after dinner. He rather unsurprisingly died of cirrhosis of the liver, which at least according to the CDC was the 10th-highest cause of death for men in the US as of 2001.

I can believe these statistics. Alcohol is a hell of a drug.
posted by zombieflanders at 9:16 AM on September 26, 2014 [7 favorites]


Most Americans probably don't drink that much liquid in a week.
posted by Foosnark at 9:16 AM on September 26, 2014 [11 favorites]


It's 10 percent of people who drink regularly, not of all Americans. Or at least that's my understanding of the study.
posted by miyabo at 9:17 AM on September 26, 2014 [3 favorites]


74 drinks/week is the average for the 10th decile, not the minimum. That is, some people in the top 10% drink fewer than 74 drinks/week, and some drink more. Probably much more.
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 you'd still be below-average among those top 10 percenters.
Based on other figures in the article, their definition of "one drink" seems to equate to 1/4 bottle of wine. (Note that this is quite a bit more alcohol than the standard "unit" used in the UK and elsewhere.) Combined with the above sentence, this means that you need somewhere above 56 drinks/week to break into the top 10%. At >8 drinks/day, that still seems like quite a feat to sustain for any length of time...
It's 10 percent of people who drink regularly, not of all Americans. Or at least that's my understanding of the study.
That can't be true, because the study found that 30% of the population don't drink at all, and another 10% have only about 7 drinks per year.
posted by mbrubeck at 9:21 AM on September 26, 2014 [4 favorites]


It's 10 percent of people who drink regularly, not of all Americans. Or at least that's my understanding of the study.

In that case, 40% of people who don't drink regularly don't drink at all.
posted by mochapickle at 9:21 AM on September 26, 2014 [11 favorites]


I don't buy it. 10% of Americans admit to 74 drinks per week? Every week? No chance.

That's 10 per day, which, with hard liquor and free time isn't that hard to get to. Seeing the wreckage several of my uncles have left in their wake, I am not surprised that some people can do this very well.

And my uncles are apparently indestructible. They reach levels of drinking I could never hope to attain to and have for decades. How they have lived well into their 50s and 60s, I just don't understand. They have discovered immortality, and they squander it on on drinking and living in utter squalor.
posted by Pogo_Fuzzybutt at 9:22 AM on September 26, 2014 [9 favorites]


It's 10 percent of people who drink regularly, not of all Americans. Or at least that's my understanding of the study.
I don't think that's right. At least, that's not how the little infographic thingie has it. It has the bottom three deciles not drinking at all, and the top decile drinking 73 drinks a week.

I wonder if part of it has to do with size. For me, as a small woman, ten drinks sounds like really a whole lot of alcohol. But if you're a 250-pound guy, it's not as much, not even taking into account that alcoholics build up a tolerance.
posted by ArbitraryAndCapricious at 9:23 AM on September 26, 2014 [1 favorite]


Watch the regulars sitting at your local bar. They routinely put away that much in a night, every day of the week.
posted by Dip Flash at 9:23 AM on September 26, 2014 [4 favorites]


Among my nuclear family (mom, dad, brother) both my dad and my brother drink at least that much. They go through a case of beer a day. There's 4 of us. So thats 50%.

If you met them in person, it wouldn't even occur to you that they drink that much. They're both highly functional. They're rarely really drunk. Its just that they have a beer in their hand, all day. All day. The article says they need to drink 10 beers a day. 10 beers? Easy. It might be less than that during the week but they more than make up for it on the weekends.
posted by vacapinta at 9:23 AM on September 26, 2014 [11 favorites]


10 drinks? I drank that much a day. Then I would take a nap. Then I would drink that much a night, too. Every day/night. For *years.*

It's not impossible, but it does take practice, free time, and an income (though not necessarily yours). Lots of people do it. Lots are doing it right now. I know this.
posted by Gilbert at 9:28 AM on September 26, 2014 [27 favorites]


Based on other figures in the article, their definition of "one drink" seems to equate to 1/4 bottle of wine.

I think a normal pour is five glasses per bottle, which may not have much relationship to standard alcohol units.

I would love to see comparable charts for the UK and other European countries.
posted by Dip Flash at 9:29 AM on September 26, 2014 [1 favorite]


The top 10 percent of American drinkers - 24 million adults over age 18 - consume, on average, 74 alcoholic drinks per week.

Wow, that's appalling. And scary, if any of them are driving afterward, which you know some have to be.

Interesting that they used 18 as the cutoff, too, given that the legal drinking age in the U.S. Is 21. Looking at those 18 and over means you are going to include partying college students in your statistics. They could be helping that 10% skew so high.
posted by misha at 9:34 AM on September 26, 2014


I was talking about this yesterday with a friend of mine and the thing that boggled our mind was the notion of how much more you're consuming calorically as well. You're essentially eating a second dinner depending on your delivery system of choice. I couldn't sustain that many more calories without a drastic lifestyle change. How do people who do this not gain huge amounts of weight? Skipping meals? Very active lifestyle a la construction worker?
posted by Carillon at 9:35 AM on September 26, 2014 [1 favorite]


How do people who do this not gain huge amounts of weight?

I assume many of these people do gain huge amounts of weight.
posted by roomthreeseventeen at 9:36 AM on September 26, 2014 [8 favorites]


And many eat no other dinner.
posted by OmieWise at 9:37 AM on September 26, 2014 [12 favorites]


One of the divers on the sea urchin boat I worked back in the day drank almost a suitcase of Meister Brau per day.

Eighteen to twenty cans of beer. Per day. He'd wake up, crack open a warm one, and keep going all day from there. Now consider that he spent half of that day on the bottom prying urchins off of rocks, and it's doubly impressive.

That guy had a lot of problems.
posted by notyou at 9:43 AM on September 26, 2014 [8 favorites]


And many eat no other dinner.

This is pretty much how my father has gotten the majority of his calories for the, er, decade or so?

74 drinks sounds like a lot, until you live with a hardcore alcoholic. 10 drinks/day is definitely achievable, especially in terms of hard liquor.
posted by kalimac at 9:43 AM on September 26, 2014 [5 favorites]


My dad drank 10 drinks a day, easily, for most of his adult life. He held down good jobs and maintained good health for most of that time. Alcoholics are really good at what they do. Until they're not, obviously. He died at 60 and the last few years were grim. But many of them can keep it up for a long time before the shit truly hits the fan.

What is startling to me is not that some people are drinking 10+ drinks a day but how many of those people there are. Not good.
posted by something something at 9:45 AM on September 26, 2014 [6 favorites]


That's two bottles of wine a day. A beer an hour from 2 pm until midnight. What surprises me is how surprised many of you are.
posted by MrMoonPie at 9:57 AM on September 26, 2014 [26 favorites]


"One consequence is that the heaviest drinkers are of greatly disproportionate importance to the sales and profitability of the alcoholic-beverage industry," he writes writes. "If the top decile somehow could be induced to curb their consumption level to that of the next lower group (the ninth decile), then total ethanol sales would fall by 60 percent."

wow.
posted by philip-random at 9:59 AM on September 26, 2014 [48 favorites]


How do people who do this not gain huge amounts of weight?

Some of them are soldiers. This was absolutely typical drinking activity for a lot of the guys I knew while I was in.
posted by corb at 10:04 AM on September 26, 2014 [1 favorite]


How does that affect the transition once they're out corb? I imagine it doesn't make it any easier.
posted by Carillon at 10:07 AM on September 26, 2014 [2 favorites]


A beer an hour from 2 pm until midnight.

And a beer an hour will not get you drunk. One beer even chugged will not get even a smallish adult to 0.08, and no matter what size you are you'll completely metabolize it in about 40 minutes.

Alcohol calories cannot be stored as fat. They are burned preferentially, so if you're eating a lot of carbohydrates those will be stored as fat but you probably won't notice the difference unless you were exercising enough to burn off the carbs anyway.
posted by localroger at 10:07 AM on September 26, 2014 [3 favorites]


I have several coworkers who drink on that scale while holding down demanding white collar technical jobs. They do it entirely outside of working hours, too, which takes extra dedication.

Compared to the abstainers I must look like a drinker, but I am pretty sure I've never had ten drinks in a day in my life.
posted by Dip Flash at 10:10 AM on September 26, 2014


Leonard Cohen once remarked that he knew when to go back to the Mount Baldy monastery when he found his two bottles of red wine after a concert weren't enough anymore.
posted by bonehead at 10:11 AM on September 26, 2014 [5 favorites]


wow.

And this is why I don't find it difficult to believe the conspiracy theories that booze companies don't want us to legalize pot.
posted by Drinky Die at 10:13 AM on September 26, 2014 [17 favorites]


And a beer an hour will not get you drunk.

At least with strong micros it wil for me. That's about the pace I'll drink beers when out with friends, and even with food one per hour has a serious cumulative impact. (And I'm over 6' tall; as noted above the impact is a lot greater for a small woman.)

The real heavy drinkers I know mostly drink lighter beers or hard liquor, I assume to be able to meter their intake more precisely over many hours of drinking.
posted by Dip Flash at 10:17 AM on September 26, 2014 [3 favorites]


Carillon: How do people who do this not gain huge amounts of weight?
My understanding is that alcohol impedes the uptake of vitamins, so some of these people are staying skinny through nutritional starvation.

Here's a link that mentions alcohol inhibits fat absorption and thereby impairs absorption of some vitamins.
posted by IAmBroom at 10:18 AM on September 26, 2014 [2 favorites]


I've been involved in several studies that tracked alcohol consumption, these numbers are very much in line with what I've seen before. And seconding what some others have said about alcohol being the main source of calories for some people.

Much as I love a good craft beer I do harbor resentment against the microbrewing renaissance for all the crazy high alcohol beers that don't fit the usual visual aid we use with patients. When your weird IPA has more ABV than malt liqour it makes my already messy data even less reliable. Sigh.
posted by Wretch729 at 10:19 AM on September 26, 2014 [5 favorites]


Man, no matter how hard I try, I'm never in the top 10% of anything.
posted by neroli at 10:21 AM on September 26, 2014 [33 favorites]


How does that affect the transition once they're out corb? I imagine it doesn't make it any easier.

You're right. Removed from a culture that embraces and in some cases enables alcoholics, they enter civilian life and become just "drunks." Without easy access to DDs, a lot of them get DUIs. It's become a maladaptive coping mechanism now and is actually pretty terrible.
posted by corb at 10:22 AM on September 26, 2014 [7 favorites]


I know many folks who always have a cup of coffee / tea / beer / spliff in hand. Aside from those who abstain completely, the correlation between functionality and level of consumption is weak at best.

Drinking a lot isn't the problem (except when it comes to your liver). Drinking too much is the problem.
posted by poe at 10:22 AM on September 26, 2014 [1 favorite]


Interesting that they used 18 as the cutoff, too, given that the legal drinking age in the U.S. Is 21. Looking at those 18 and over means you are going to include partying college students in your statistics. They could be helping that 10% skew so high.
posted by misha at 12:34 PM on September 26


I'm dubious that partying college kids could skew the number that high. If you imagine binge drinking four nights a week to fifteen drinks, that still doesn't get you to 74 drinks a week. Drinking that much takes everyday commitment to constant drinking. I think the number is being skewed by seriously ill alcoholics; that number certainly contains some college students, but I don't think the stereotypical partying college kid is drinking anywhere close to that amount.
posted by Bulgaroktonos at 10:25 AM on September 26, 2014 [5 favorites]


Drinking a lot isn't the problem (except when it comes to your liver). Drinking too much is the problem.

It is a good thing then that people who have a couple are excellent at making precise judgements.
posted by srboisvert at 10:30 AM on September 26, 2014 [3 favorites]


I know many folks who always have a cup of coffee / tea / beer / spliff in hand. Aside from those who abstain completely, the correlation between functionality and level of consumption is weak at best.

I don't think that's true at all. If functionality means that you don't die or don't kill anyone, that's a pretty low bar. If you're having 74 drinks per week, that's not functioning as an adult, sorry.
posted by roomthreeseventeen at 10:31 AM on September 26, 2014 [4 favorites]


Alcohol calories cannot be stored as fat.

Whaaaaaaat?
posted by Justinian at 10:39 AM on September 26, 2014 [8 favorites]


For a 6 month period before I went into the Navy, I was a cashier at 24 hour convenience store working the night shift. There was a man how showed up just after 6 AM every day to buy a 6 pack of talls and a fifth of whiskey. He had a weird smell that I can only guess is what you smell like when your liver has failed and you continue to drink like a fish.
posted by doctor_negative at 10:41 AM on September 26, 2014 [4 favorites]


I'm wondering what the curve looks like within that decile. Does it replicate the same steep curve or does it level off at some point? I'm wondering what the average consumption is for the top 1 percent, if the average for the decile is the equivalent of two bottles of wine a day.

Also, I'm kind of surprised that alcohol advertising isn't worse than it is, and why they bother to advertise to average drinkers at all. From a practical standpoint, they should all be trying to get the alcoholics to switch.
posted by tavella at 10:41 AM on September 26, 2014 [3 favorites]


poe: Drinking a lot isn't the problem (except when it comes to your liver). Drinking too much is the problem.
And when it comes to cancer - alcohol is a Class 1 carcinogen. Even using an alcohol-based mouthwash increases your chance of oral cancers.

And your judgment, which adults vitally depend on at irregular and unpredictable intervals.

Basically, there's no meaningful distinction between "drinking a lot" and "drinking too much." And, since there are both social and health advantages in light consumption, but some social and health disadvantages begin at the first sip, there's no simple dividing line for anyone.

---

A dear friend of mine was a high-functioning drunk. High-functioning, until he decided the best way to handle a problem was to kill himself - an idiotic decision that I can't help thinking (knowing a few more details than I'm willing to put on the internet) was encouraged by his drinking.

Another dear, high-functioning drunk friend is currently destroying everything he used to hold dear; clearly no longer high-functioning.

Drinking more than a little is risky, at the least. I do it. I know it's risky. I know I'd probably be healthier drinking less - and I'm not an alcoholic, by any reasonable standard.
posted by IAmBroom at 10:43 AM on September 26, 2014 [5 favorites]


In the UK, ten drinks is just a good night out. Sometimes you lovely Americans do seem rather prissy about booze. ;-)
posted by Decani at 10:44 AM on September 26, 2014 [8 favorites]


and I'm not an alcoholic, by any reasonable standard.

I don't think the word alcoholic has anything to do with volume of how much you drink. It's if you can stop drinking that delineates that.
posted by roomthreeseventeen at 10:45 AM on September 26, 2014 [1 favorite]


To be in the top 10% of American, you'd need to drink the equivalent of 74 drinks per week, every week, or a little over 10 drinks per day.

Holy shit!

I often find conversations online about alcohol involving Americans seem to express strange ideas about what is "a problem," but I had no idea that 10% of Americans were drinking 10 or more drinks a day. Every day. That's actually a lot of people.
posted by Hoopo at 10:47 AM on September 26, 2014 [3 favorites]


Between coffee, water and beer I still don't drink 74 drinks a week. I can honestly say I can't imagine what it must be like to want to drink alcohol (or anything for that matter) quite that much.
posted by tommasz at 10:48 AM on September 26, 2014


In the UK, ten drinks is just a good night out. Sometimes you lovely Americans do seem rather prissy about booze. ;-)

I don't think that's what's going on here -- I routinely have more than ten drinks and consider that a good night out. I don't do it every night.
posted by Mrs. Pterodactyl at 10:48 AM on September 26, 2014 [4 favorites]


It certainly explains why alcohol ads are generally 1. colorful and entertaining, 2. sell a fantasy. If you're going to drink 12 beers/a bottle of booze today anyway, may as well be the ones that transport you to Mexico, or reinforce your manliness, or whatever.
posted by 2bucksplus at 10:49 AM on September 26, 2014


It certainly explains why alcohol ads are generally 1. colorful and entertaining, 2. sell a fantasy. If you're going to drink 12 beers/a bottle of booze today anyway, may as well be the ones that transport you to Mexico, or reinforce your manliness, or whatever.


I don't so much think those are the people those ads are aimed at.
posted by kagredon at 10:50 AM on September 26, 2014 [2 favorites]


I am also having a hard tome believing this. For one thing:
These figures come from Philip J. Cook's "Paying the Tab," an economically-minded examination of the costs and benefits of alcohol control in the U.S. Specifically, they're calculations made using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) data.

I double-checked these figures with Cook, just to make sure I wasn't reading them wrong.
But what if Cook read them wrong? The link to the NESARC just goes to some kind of newsletter containing none of this data. Where is the actual study these numbers came from?
posted by Sys Rq at 10:54 AM on September 26, 2014 [1 favorite]


I don't so much think those are the people those ads are aimed at.

Yeah. I have said this on metafilter before, but I work for a large wine wholesaler with a strong portfolio of excellent wines from all over the world, and Richard's Wild Irish Rose is one of our very highest volume brands. When's the last time you saw that advertised on television?
posted by something something at 10:54 AM on September 26, 2014 [3 favorites]


Jeez Louise. I'm not going to claim never to have had ten drinks in a night, but the next morning I was not capable of doing anything except sitting in a darkened room watching the world spin around me. Like I said, I'm a short woman, but if I had ten drinks a night every night, I would not be doing anything with my life except drinking alcohol.
posted by ArbitraryAndCapricious at 10:54 AM on September 26, 2014


Get down with the working class -- hang with some construction workers, roofers, road crews, people in the trenches. Also, musicians in bars. In the 80's, everyone I knew consumed every day, a personal six-pack in an evening was normal, more or less. I didn't always drink that much on a weeknight, but I could get going at 10 or 11 on a Saturday morning, and carry on until I was being tossed out of a bar at closing time 13 or 14 hours later. You drink steadily all day on a saturday, and you can do some damage to your wallet. Sunday was hair of the dog time, though I usually laid off by 7 or 8 so I could get one night's sleep.

I was not unusual. I had a whole cadre of friends who more or less blew me off when I stopped partying. Some of them are dead, some of them are sober, and a few stalwarts are still at it.
posted by Devils Rancher at 10:54 AM on September 26, 2014 [4 favorites]


If they’re using the CDC definition, 1 drink = 0.6 oz alcohol. Much like the difference between a portion and a serving size, what many people think of as “a drink” can easily contain 1.5–2 standard drinks worth of alcohol.
posted by nicepersonality at 10:55 AM on September 26, 2014 [2 favorites]


Viral hepatitis and certain metabolic diseases such as iron overload (hemachromatosis) can also cause cirrhosis; it is possible to see cirrhosis in a teetotaler so a person with cirrhosis isn't necessarily lying when they state that they don't drink. Sometimes it's just bad luck.
posted by Renoroc at 10:55 AM on September 26, 2014 [2 favorites]


if I had ten drinks a night every night, I would not be doing anything with my life except drinking alcohol.

Hi! 35-year-old me waves from 1998. That's where it got to, eventually, once I'd worn myself out. The body can take it for a while and some people are stoically determined to bulldoze through any hangover, but it takes its toll.
posted by Devils Rancher at 10:56 AM on September 26, 2014 [4 favorites]


For me, the only way I'd be able to drink 10 drinks a night is if I did it every day as part of a serious effort to develop/maintain my tolerance. I'm a pretty small woman and with my current low tolerance, I think 10 drinks would come close to killing me. Certainly I'd be in the land of blackouts and bad decision-making. As it is, I drink maybe once a week or less and the result is that 2-3 drinks in and I'm a happy camper. 4-6 drinks, and it's whoops I should probably go home now.
posted by misskaz at 11:01 AM on September 26, 2014


I'm between the eighth and ninth decile of drinkers. Nowhere close to those in the tenth. Holy crap, those people are dedicated to their passion in life! I wonder if this is why my writing career hasn't taken off. I must be between the eighth and ninth decile in terms of dedication to my craft. (I'm not making any dubious connections here between alcohol consumption and writing, only making an analogy.)
posted by ChuckRamone at 11:02 AM on September 26, 2014


30% drink nothing at all? I wonder how much overall public health would improve if those people all had one glass of red wine per day. I can't believe that in 2014 so many people are damaging their health by abstaining from alcohol!
posted by 1adam12 at 11:04 AM on September 26, 2014 [16 favorites]


Speaking as a small lady who has been a problem drinker in the past (doing a lot better now, yay!), a lot of people in this thread are really underestimating the effects of tolerance.
posted by kagredon at 11:05 AM on September 26, 2014 [10 favorites]


If they’re using the CDC definition, 1 drink = 0.6 oz alcohol. Much like the difference between a portion and a serving size, what many people think of as “a drink” can easily contain 1.5–2 standard drinks worth of alcohol.

In the U.S. apparently a shot (like, at a bar in a shot glass) is 1.5 oz which is already over two portions of alcohol.
posted by 2bucksplus at 11:06 AM on September 26, 2014


a shot (like, at a bar in a shot glass) is 1.5 oz which is already over two portions of alcohol.

The CDC definition is based on pure grain alcohol. Most hard liquors are 40% or 50% alcohol by volume.
posted by localroger at 11:07 AM on September 26, 2014 [2 favorites]


For those expressing disbelief at the 74 drinks figure and to follow-up on what nicepersonality said, yes, when the CDC or NIAAA say "one drink" they mean a "standard drink." A forty of malt liqour (~7% alcohol) is 4.5 drinks. To get to 74 drinks a week you only need just under 3 forties a day, and that's abstaining on Sundays! (74/4.5/6=2.74) That's not at all uncommon. Five or six tallboys of bud a day will also get you there.
posted by Wretch729 at 11:08 AM on September 26, 2014 [4 favorites]


Ha! I remember the last alcohol thread, where certain MeFites were insisting 12 drinks a week was too high, if not proof of alcoholism.

I've noticed that sinne 25, my drinking as become more variable, but trending less. Seventy-four/week isn't shocking, but I doubt I've ever had even half of that in my heaviest years.
posted by spaltavian at 11:09 AM on September 26, 2014


Right, localroger, good point.
posted by 2bucksplus at 11:09 AM on September 26, 2014


I'm a light drinker, averaging just under 1 drink per day. I'll usually make a cocktail or have a beer when I get home from work. So I have a relatively low, but sustained level of consumption.

The way I get through events like PAX or Comic Con without OMG HUGE CROWDS panic attacks is to stay pleasantly sauced the whole time. Not drunk, just slightly buzzed. 10 drinks a day, spread out over a 12- or 18-hour period, is certainly doable, and without ill effects the next day.
posted by xedrik at 11:09 AM on September 26, 2014


The CDC definition is based on pure grain alcohol. Most hard liquors are 40% or 50% alcohol by volume.

What? No, it's not.

1.5-ounces or a “shot” of 80-proof (40% alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whiskey).
posted by kagredon at 11:10 AM on September 26, 2014


I'm a light drinker, averaging just under 1 drink per day.

According to this chart, you are in the top 40% of drinkers.
posted by roomthreeseventeen at 11:11 AM on September 26, 2014 [3 favorites]


Oh, wait, there was confusion with people referring to the 0.6 oz figure that is based on "pure" alcohol. Makes sense now.
posted by kagredon at 11:12 AM on September 26, 2014


kagredon, that's exactly what I said. 1.5 ounces of 40% content liquor is equal to about 0.6 ounces of pure grain alcohol. It's the same definition.
posted by localroger at 11:12 AM on September 26, 2014 [3 favorites]


Not drunk, just slightly buzzed. 10 drinks a day, spread out over a 12- or 18-hour period, is certainly doable, and without ill effects the next day.

If you're doing that every day, you're doing serious damage to your body, no matter if you notice it the next day or not.
posted by roomthreeseventeen at 11:12 AM on September 26, 2014


It certainly explains why alcohol ads are generally 1. colorful and entertaining, 2. sell a fantasy. If you're going to drink 12 beers/a bottle of booze today anyway, may as well be the ones that transport you to Mexico, or reinforce your manliness, or whatever.
posted by 2bucksplus at 1:49 PM on September 26


I don't think serious alcoholics are the ones responding to this kind of advertising. The guys I see at the 7/11 buying Steel Reserve at 7 AM don't seem like they're doing it because they think it will make their lives colorful and fun. Those ads are probably mostly aimed at teenagers, honestly.
posted by Bulgaroktonos at 11:13 AM on September 26, 2014 [4 favorites]


According to this chart, you are in the top 40% of drinkers.

Only if you're defining "drinkers" as including "people who don't drink at all".

If you're doing that every day, you're doing serious damage to your body, no matter if you notice it the next day or not.

xedrik specifically said he was not doing it every day.
posted by kagredon at 11:14 AM on September 26, 2014 [2 favorites]


Right, not every day, just for the con weekend. And I'm not doing 10 drinks a day then, I'm saying it's certainly doable.
posted by xedrik at 11:16 AM on September 26, 2014


The NESARC data seems to be buried deeply enough in the census website that I can't quickly find it, but some of it is also hosted by the NIAAA here.
posted by Wretch729 at 11:18 AM on September 26, 2014


1adam12, I don't know, but I'm in that 30%. I quit drinking when I developed NASH (at about age 23 or so) to avoid putting any additional stress on my liver. It's possible that the health benefits would outweigh the effects on my weakened liver but as I disliked red wine when I did drink, I haven't been too interested in finding out. (White wine, amaretto, and vodka were my poisons of choice in the day.)

I doubt I'm alone in being in a health position where the benefits have to be weighed against the problem. Add in former alcoholics who do not feel they can imbibe at all, and you've got a reasonable chunk of people for whom it probably would not be a net improvement.

And frankly, compared to all the other horrible crap I do to my health, abstaining from red wine is waaaay down on the list.
posted by Four Ds at 11:19 AM on September 26, 2014 [1 favorite]


As a recovering alcoholic, the top 10% didn't surprise me at all; what did surprise me were the 30% teetotalers.
posted by Halloween Jack at 11:20 AM on September 26, 2014 [11 favorites]


I thought 1adam12 was kidding. Not drinking is infinitely better than indulging, even if red wine might be good for cardiac health. (And I'm a drinker)
posted by roomthreeseventeen at 11:21 AM on September 26, 2014 [1 favorite]


That drink size definition is really important. It changes everything. Conversationally I would say I have around 3 drinks a day, usually two cocktails and a glass of wine with dinner. But if the standard drink definition is 1.5oz of liquor, well my Manhattan recipe would qualify as around 2 drinks, so now we're talking "five drinks" a day, which would be around 35 in a week - let's say 45 to 50 to allow for extra drinks while out with the guys on the weekend. Suddenly that 74 in a week doesn't sound as hard to reach.
posted by dnash at 11:22 AM on September 26, 2014 [3 favorites]


Of the 30% who are non-drinkers, I assume a large percentage who are recovering alcoholics or who have health problems that preclude alcohol use.
posted by coldhotel at 11:26 AM on September 26, 2014 [2 favorites]


Don't forget religious reasons. It could be an underrepresented group on metafilter but a number of the patients I see don't drink or restrict their drinking because of religious reasons.
posted by Wretch729 at 11:30 AM on September 26, 2014 [1 favorite]


That chart is freaking me out. I don't think of myself as a heavy drinker, but this week's consumption (one beer on Sunday, two beers at bar trivia on Wednesday, and one cocktail with dinner on Thursday) already puts me in the eighth decile for consumption.

Yikes.
posted by evidenceofabsence at 11:34 AM on September 26, 2014


Well not exactly roomthreeseventeen. There was recently a study that showed teetotalers died younger than those who were moderate drinkers. It's not quite clear to say not drinking is infinitely better than indulging. It's a complicated system but not even close to say that it is so cut and dry.
posted by Carillon at 11:37 AM on September 26, 2014 [2 favorites]


Don't forget religious reasons. It could be an underrepresented group on metafilter but a number of the patients I see don't drink or restrict their drinking because of religious reasons.
posted by Wretch729 at 2:30 PM on September 26


Yeah. Growing up in the South, religious (or heavily religion influenced cultural) reasons are the first thing I assume when someone doesn't drink, because basically no one over 40 in my dad's side of the family drinks because they were all raised to think that drinking was a sin.

Actually, growing up in the South, I mostly thought there were alcoholics and teetotalers, I didn't really discover social/healthy drinkers until I left.
posted by Bulgaroktonos at 11:39 AM on September 26, 2014 [2 favorites]


Of the 30% who are non-drinkers, I assume a large percentage who are recovering alcoholics or who have health problems that preclude alcohol use.

Don't forget religious reasons.


There are also plenty of people who just don't like drinking.
posted by evidenceofabsence at 11:39 AM on September 26, 2014 [4 favorites]


xedrik specifically said he was not doing it every day.

Yeah, but if you actually read is comment, you don't get to shame him about it!
posted by spaltavian at 11:43 AM on September 26, 2014 [4 favorites]


Holy crap! I'm feeling pretty good about my beer consumption now.
posted by brundlefly at 11:44 AM on September 26, 2014


The standard US drink is 0.6 ounces of alcohol, so yes, that makes it 1.5 ounces of 80 proof liquor. Most martinis in bar/restaurants that are not mixology-oriented (e.g. steakhouses, chains and the like) use 4-5 ounce martini glasses, so a martini ends up being close to around 2.5 drinks. A short glass with ice is more around 1.5 - 2 drinks.

Basically, if you want bang for buck alcohol, you get a martini and see it filled to the brim.

A 750mL bottle of wine at 14% alcohol has 5.83 drinks, so half a bottle is a little under 3 drinks and a glass of wine (assuming 1/4) a little under 1.5 drinks.

15 drinks would basically mean a glass and a half of wine everyday. You drink more than that, then it looks like you're in the top decile.

Basically, if you drink regularly you are in the top decile, so that 74 number, as an average, needs to be broken down because it sounds like there is a minority in the top decile with really high numbers pulling the average forward.

This doesn't say anything about binge drinking, which would include anyone starting around the eight decile. It would be interesting to see the split between bingers and regulars for the top 30%.
posted by linux at 11:46 AM on September 26, 2014 [3 favorites]


Wow. I'm in the 7th or 8th decile and I would consider myself a light drinker. A single 16oz microbrew per week is enough to put one in the 7th decile. Having 3 on a Friday night will move you into the 8th decile.

But the more I think about it, the more likely that seems. I don't drink much, compared to my peers. But I sure as heck drink a lot more than the (non-alcoholic) members of my family over the age of 50 do. They will typically have a glass of wine at a wedding, and never touch the stuff otherwise. And my family is not particularly religious, I suspect more conservative families drink even less.
posted by zug at 11:46 AM on September 26, 2014 [2 favorites]


Speaking as a small lady who has been a problem drinker in the past (doing a lot better now, yay!), a lot of people in this thread are really underestimating the effects of tolerance.

Yeah. When I was in the Army I was in the top 10% for a while - three or four large mixed drinks every evening would be a normal night, not even a spree.

Now if I drink a glass of wine I get buzzed.

Tolerance is real but must be arduously maintained.
posted by corb at 11:49 AM on September 26, 2014 [2 favorites]


linux not sure what you're seeing but the article says to break into the top 10% you'd need to drink two bottles of wine a night not a glass and a half.

"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 you'd still be below-average among those top 10 percenters."
posted by Carillon at 11:50 AM on September 26, 2014


It's unclear where the demarcation lies for these averages, since the ninth decile is around 15.
posted by linux at 11:54 AM on September 26, 2014


to break into the top 10% you'd need to drink two bottles of wine a night not a glass and a half

Put this way, I know people who do this. They are very wealthy and successful people, too, approaching a very luxurious retirement. But one of them is a bit of an emotional basketcase. Most people in my family like to drink and get a bit buzzed, but we have a lot of difficulty keeping up with these 2 when we visit. I suppose I could see it.
posted by Hoopo at 12:01 PM on September 26, 2014


The top decile sounded shocking until I read this discussion and thought about it a second time.

It's the bottom deciles that are far more shocking. 50% of Americans have less than four drinks per month. This explains so much about this country. Maybe people would be a bit more relaxed if they started having a glass with dinner.
posted by kanewai at 12:02 PM on September 26, 2014 [9 favorites]


There are also plenty of people who just don't like drinking.

Yup. The appeal is largely lost on me. (I'm probably somewhere in the sixth decile; I've probably had about 12 drinks in the past year.)

FWIW, the study that chart is citing was published in 2006, based on data from 2001-2002.

Across the population of those 18 and older, 17.28% had never had a drink in their lives, and an additional 17.28% were not lifetime abstainers but hadn't had a drink in the past year.

There is way, way more data on the archived version of the original site, particularly in the "Data Reference Manual," and I don't have time to sift through it just now.
posted by Shmuel510 at 12:03 PM on September 26, 2014 [1 favorite]


And this is why I don't find it difficult to believe the conspiracy theories that booze companies don't want us to legalize pot.

It's pretty interesting to think about. I'm addicted to beer, but when I smoke pot that addiction center of my brain is somehow inhibited. Marijuana actively makes me not drink beer, or even find beer especially appealing. I wonder if studies have been done about this.
posted by naju at 12:05 PM on September 26, 2014 [2 favorites]


Are non-drinkers statistically more likely to engage in alternative vices? Seems pretty likely to me, gotta chill out somehow. Smoking? Over-eating? Pills or other drugs? Sex? Knitting?
posted by Drinky Die at 12:06 PM on September 26, 2014 [2 favorites]


Drinking 10 drinks in an evening isn't hard; I've been at plenty of dinner parties where people were consuming 1-2 bottles of wine each over the course of it, and you don't have to get particularly drunk even if you aren't a heavy drinker with a liver to match. A drink or two while people are socializing before hand, several glasses during dinner, another with dessert, then several hours of people hanging out glass in hand at the table, talking. It's even easier with mixed drinks, since most of them contain the equivalent of 2-3 drinks -- drink 4 or 5 over the course of a party, and you are there.

So I guess I can picture that there is a group of people to which alcohol is fundamentally their entire social life or hobby. But the percentage that fits that is a little terrifying.
posted by tavella at 12:15 PM on September 26, 2014


It's really hard to talk about "too much" in terms of # of drinks. I can drink a single bomber of a 9.5% double IPA and be feeling REALLY good and not in any condition to make serious decisions. Double bonus, because then it's like "what? I had about 2 pints, what's the big deal." I think there's an ABV war going on among craft/micro brewers and it really does change how we approach this question. It's another way we get to be "in denial" about a serious problem, maybe.
posted by naju at 12:25 PM on September 26, 2014


It certainly explains why alcohol ads are generally 1. colorful and entertaining, 2. sell a fantasy. >
Those ads are probably mostly aimed at teenagers, honestly.


yeah, I'm pretty sure it's common knowledge in the beer marketing biz that young men (women, too?) tend to decide what their lifelong beer of choice will be by the time they're twenty-two, and then stick to it. Bud for life. Miller for life. Coors for life -- whatever.

So yes, the marketing is almost entirely aimed at that sort of fratboy fantasy of good times, hot babes, exotic locales ...
posted by philip-random at 12:28 PM on September 26, 2014 [2 favorites]


Are non-drinkers statistically more likely to engage in alternative vices? Seems pretty likely to me, gotta chill out somehow. Smoking? Over-eating? Pills or other drugs? Sex? Knitting?

Based on a very quick skim of the data, it looks like it's the other way around: drinkers are more likely to smoke than non-drinkers. They didn't track knitting.
posted by Shmuel510 at 12:29 PM on September 26, 2014 [4 favorites]


What shocks me more about this chart than the 10-drinks-a-day people is that as someone who has maybe a couple drinks a night on weekends, I am already drinking more than 75% of Americans. And I'm small and female and certain people on this very website can confirm that I'm pretty hilarious to watch after just one or two drinks.
posted by capricorn at 12:39 PM on September 26, 2014 [5 favorites]


Tolerance is real but must be arduously maintained.

It's a double-edged sword, too--people who are pushing into the top decile are likely also facing withdrawal symptoms if they don't drink daily (not necessarily full-blown DTs, but definitely insomnia, irritability, cravings, etc.)
posted by kagredon at 12:47 PM on September 26, 2014


I have spent periods of time hanging out at bars several nights a week (with varying degrees of actual drinking) and while the 10% number is surprising, I definitely can think of lots and lots of regulars who are well up into those numbers, and hold down perfectly good jobs during the day. They have to - drinking out isn't cheap.

Now, I'm on heavy-duty meds (the kind where I have to get liver function tests every other month) for arthritis, and I suspect none of the bottles of whiskey in the cabinet will get finished in my lifetime if I don't somehow acquire assistance. My girlfriend weighs 95 pounds and gets a hangover from half a drink, so she's right out, too. I look at all the data about how moderate drinking is healthy and just have to sigh. But I don't really miss the barfly lifestyle, either.
posted by restless_nomad at 12:51 PM on September 26, 2014


I think Americans obsess over numbers like these too much.
posted by jeff-o-matic at 12:52 PM on September 26, 2014 [2 favorites]


drinking water before during and after drinking alcohol goes a long way to proper buzz maintenance. It's something I wish they would teach in schools. If you aren't allowing your alcohol to double as a hydration device you can regulate it pretty damn effectively.
posted by any major dude at 12:53 PM on September 26, 2014 [4 favorites]


Carillon:
"There was recently a study that showed teetotalers died younger than those who were moderate drinkers. It's not quite clear to say not drinking is infinitely better than indulging. It's a complicated system but not even close to say that it is so cut and dry."
Was it the one referred to here and here?

It is interesting... according to those findings moderate drinkers outlive heavy drinkers and both outlive non-drinkers on average.

If I had to guess it would have something to do with reduced stress levels.

Either way... tonight's whisky night and our little tasting society managed to obtain a bottle of the latest Ardbeg Supernova. So, wheeeee!
posted by Hairy Lobster at 12:55 PM on September 26, 2014 [1 favorite]


What shocks me more about this chart than the 10-drinks-a-day people is that as someone who has maybe a couple drinks a night on weekends, I am already drinking more than 75% of Americans. And I'm small and female

As a dude who is 6'4" and 220, I'd have to drink 2-3 times what you do to get the same level of snookered. The average person is half my size. There is something ridiculous about applying the same consumption standards on both 5'0 110 lb women and 6'4" 220 lb men.

My wife likes to give me crap about my beer drinking - I'm gonna print out this chart and show her, that once again, my lifetime habit of underachieving is paying dividends.
posted by Pogo_Fuzzybutt at 12:59 PM on September 26, 2014 [3 favorites]


Maybe, I was talking in part about this FPP.
posted by Carillon at 12:59 PM on September 26, 2014


Hairy Lobster: Was it the one referred to here and here?

From the Time link:
The sample of those who were studied included individuals between ages 55 and 65 who had had any kind of outpatient care in the previous three years.... One drawback of the sample: a disproportionate number, 63%, were men.
That raises a flag for me. The high proportion of men tells you immediately that the sample is badly skewed. The limitation to people who visited outpatient care throws the results right out for me.

Anecdotally, both of my (teetotalling) parents went for stretches much longer than three years during that age range without a hospital outpatient visit. (I believe that it has been a few decades for my mother.) The same was true, I suspect, for many of their teetotalling fellow church-goers; the hospital didn't become a place to visit until their 70s.

An outpatient visit is a sign that something has gone out of control. Maybe your doctor sent you over because he's worried and thinks you need blood tests. Maybe you had an accident. Etc. The teetotallers I've known mostly don't start slipping out of control like that until well after 65 years of age.

So I, myself, am taking the study with a grain of salt.
posted by clawsoon at 1:19 PM on September 26, 2014 [1 favorite]


Remember, in some of these studies showing teetotalers dying younger, there are serious confounders. For example, in the sample of non-drinkers, you may have many former alcoholics who cannot take a single drink anymore. Also, it often contains a bunch of folks who cannot drink alcohol for health reasons - because of a bad liver, kidneys, whatever. Bottom line, many of the non-drinkers can be in poor health compared to drinkers. Also, some non-drinkers may simply not be able to afford drinking - and being poor or of a lower economic status is strongly correlated with worse health outcomes, lack of health insurance, higher stress, worse lifestyle etc. By contrast, those who are moderate drinkers, particularly wine drinkers, are of a higher socio-economic status and their generally better health is a reflection of that fact, rather than the wine consumption; they are also healthy enough to drink - and often more physically active (there's a correlation with higher alcohol consumption and physical activity).

Bottom line: careful with statistics and drawing far-going conclusions from epidemiological studies. It is entirely possible that the teetotalers dying earlier are a statistical artifact that has little bearing on alcohol consumption.
posted by VikingSword at 1:36 PM on September 26, 2014 [11 favorites]


There is something wrong with the data here. If the 10 drinks thing were true, the population with alcohol use disorders would be more than *triple* the government's other estimates of it, which come from the National Household Survey on Drug Use and Health and find that about 7 million adults over 12 have either alcohol dependence or abuse (DSM 4 defined).

Now, NHSDUH does not survey homeless people or prisoners, but it cannot be the case that there are 17 million homeless or incarcerated alcoholics!
posted by Maias at 2:13 PM on September 26, 2014 [1 favorite]


DSM-IV and AA don't define alcoholism or alcohol abuse / dependence based on the specific number of drinks consumed.
posted by krinklyfig at 2:22 PM on September 26, 2014 [1 favorite]


And a beer an hour will not get you drunk.

and you can't get pregnant from only having sex once, right?
posted by caddis at 2:38 PM on September 26, 2014 [1 favorite]


Basically, if you drink regularly you are in the top decile, so that 74 number, as an average, needs to be broken down because it sounds like there is a minority in the top decile with really high numbers pulling the average forward.

It is looking a lot like the income distribution in the US, where it doesn't do much good to talk about the top ten percent since the top one percent (and even more the top 1/10 of one percent) dominate the inequality measurements. Breaking out that top ten percent of drinking is likely going to paint a different picture that is both horrifying at the very top and reassuring below that.

I definitely can think of lots and lots of regulars who are well up into those numbers, and hold down perfectly good jobs during the day. They have to - drinking out isn't cheap.

I go out just often enough and know just enough bar owners to have learned that a lot of the serious, hardcore drinkers have special arrangements to cut the costs. Some arrange to keep their own bottles behind the bar, others just get comped a certain percentage of the time, and some do things like sign over their checks and just drink for the month on that knowing that it may not really cover the actual bill. The article talked about how dependent the alcohol industry is on the top ten percent of drinkers; I'd bet that bars are even more so -- lots of people swing by the store for a bottle of wine for a dinner party, but no one stops by the bar to buy five glasses of wine to go for a party.
posted by Dip Flash at 2:48 PM on September 26, 2014 [2 favorites]


One of the interesting findings from the garbology (archaeology of modern landfill) studies is the discrepancy between what people will admit to drinking and what their garbage shows they actually drank. Here's an image I use in my intro archaeology class based on research by garbologist William Rathje. The columns are consumption of beer/week: self reported to an interviewer vs. what their garbage showed.

Note how many people will deny drinking any beer at all when asked by a door to door interviewer.
posted by Rumple at 2:48 PM on September 26, 2014 [15 favorites]


I'm just collecting litter and recycling it!
posted by Drinky Die at 2:58 PM on September 26, 2014


let us never forget the trashbooze incident
posted by kagredon at 3:03 PM on September 26, 2014 [3 favorites]


it's true that DSM doesn't define alcoholism by amount of drinks consumed, but by any measure, 10 drinks a day qualifies for an "abuse" diagnosis and most likely for "dependence" because it is ongoing use despite negative consequences (you can't be drinking at that level without consequences).

it's simply not the case that 24 million people are doing so, or else we'd have higher cirrhosis rates etc.
posted by Maias at 3:04 PM on September 26, 2014


the beer thing could be confounded by secret teenage drinkers and/or the surveyed person not really paying attention to her (typically) husband's consumption levels while not drinking herself though. of course, there's definitely some under-reporting on drinking and drug taking in these surveys, but it is not as extreme as you typically think.

also, six pack of beer v. more than six pack isn't the best cut off.

there's other data on self reported drug use which finds that it is more accurate than you would think, so long as the people really do believe the results are confidential.
posted by Maias at 3:10 PM on September 26, 2014


it's simply not the case that 24 million people are doing so, or else we'd have higher cirrhosis rates etc.

Cirrhosis is usually the end result of decades of heavy drinking. I suspect most of the people who would comprise that 24 million either (a) eventually moderate or entirely cut out their intake, or (b) die some other way (suicide, accident, overdose, general poor health) before cirrhosis could catch up with them.
posted by kagredon at 3:11 PM on September 26, 2014


And a beer an hour will not get you drunk.

and you can't get pregnant from only having sex once, right?


No need to be a jerk about it. Don't take my word for it. And there are many other such calculators, all of which agree. Some are even provided by police departments.

For a 180 lb person one beer is worth immediate BAC about 0.03, and you burn it off in 40 minutes. If you are drinking one an hour you cannot get drunk. Science says so!

If you start at noon it is quite possible to kill a 12-pack of Budweiser before bedtime without ever becoming drunk enough to notice, much less too drunk to drive.
posted by localroger at 3:30 PM on September 26, 2014 [5 favorites]


I'm pretty sure I'm in the top percentile, as I'm 'a coupla cocktails and a spliff/pax after work' practitioner, but I'll tell ya what, my AC/DC fandom has me with my thoughts in check today. Malcolm Young is such a great, underrated rhythm guitarist & songwriter, and now he is severely debilitated by alcohol-induced dementia. Crank 'Powerage' and go ahead and pour that whole Carlsberg on the concrete.
posted by mctsonic at 3:47 PM on September 26, 2014


Just noticed -- that calculator uses a different weight-based calculation for burnoff which contradicts what I've read before, so on that calculator you can in fact get drunk on a beer an hour if you weigh less than 140 pounds. But even at 120 lb you can put away a beer every 90 minutes pretty much forever.
posted by localroger at 3:51 PM on September 26, 2014


Mea Culpa on "all of which agree" LOL.
posted by localroger at 3:54 PM on September 26, 2014


But even at 120 lb you can put away a beer every 90 minutes pretty much forever.
Hmm. That means that in order to drink 72 beers a week without getting drunk, I would need to spend 15 hours every day drinking. I would start drinking at 8 in the morning and have a drink every hour-and-a-half until I went to bed at 11.
posted by ArbitraryAndCapricious at 3:59 PM on September 26, 2014


Smoking? Over-eating? Pills or other drugs? Sex? Knitting?

Videogames. I know Commander Shepard better than I do some of my cousins. (In my defense, I have a lot of cousins.)
posted by Halloween Jack at 4:03 PM on September 26, 2014 [1 favorite]


Sounds like you have a plan! Gotta get on it ArbitraryAndCapricious if you wanna get on the drinking podium :).
posted by Carillon at 4:05 PM on September 26, 2014


Yeah AAC. For a particular consumption level there is a SHARP weight limit (probably, as the site warns, varying a bit for different people) below which you apparently don't completely metabolize each drink. The last site I looked this up on said it was pretty much 40 minutes for anybody, because basic metabolic energy demands aren't really much less for a lightweight person. That calculator had the light person going to 0.06 instead of 0.03 immediately after a drink but still keeping steady at a rate of one drink an hour.

In any case I know I can drink one beer an hour without getting drunk because I weigh nearly 200 lb and I've paced myself at that rate according to the instructions.
posted by localroger at 4:07 PM on September 26, 2014


Also the claim repeated by several people here that you are inevitably damaging yourself if you drink a lot but slowly doesn't really bear up to scrutiny. If you're maintaining a modestly elevated BAC but not letting it get ridiculous and keeping yourself hydrated, it's really a stretch to insist that damage is being done comparable to binge drinking.

The mechanism in the liver which metabolizes alcohol to acetaldehyde and then clears the acetaldehyde exists for a reason, because it is used in natural metabolism even if you never touch ethyl alcohol. As long as you're not subjecting it to acute high levels and allowing the toxic acetaldehyde to build up (the basic cause of hangovers) there's no reason to assume cumulative damage is occurring.

Just as you can lift a thousand pounds of beanbags from the floor to your desktop one beanbag at a time without difficulty, but if you try to lift them all at once you're going to hurt yourself.
posted by localroger at 4:13 PM on September 26, 2014 [2 favorites]


The study that showed people drinking > 6 drinks a day still died less often of cardiovascular diseases than abstainers controlled for former problem drinkers iirc.
posted by grubby at 4:26 PM on September 26, 2014 [1 favorite]


For a 180 lb person one beer is worth immediate BAC about 0.03, and you burn it off in 40 minutes. If you are drinking one an hour you cannot get drunk. Science says so!

Way back above it was noted that people talk in terms of "one beer" but these days beers vary enormously in alcohol percentage (or in other words, in how many standard alcohol units they contain). The standard beer selection in my local grocery store and nearby bars will vary from under three percent to more than ten percent -- that's a big spread. (They also vary in size, which adds more complication, too.)

So I can get WAY too buzzed to drive drinking my heavy duty IPAs, but could easily stay soberish drinking Bud Lites all afternoon. Either way I'm drinking "one beer per hour," but it's not at all the same alcohol consumption.
posted by Dip Flash at 4:43 PM on September 26, 2014




Cirrhosis is usually the end result of decades of heavy drinking. I suspect most of the people who would comprise that 24 million either (a) eventually moderate or entirely cut out their intake, or (b) die some other way (suicide, accident, overdose, general poor health) before cirrhosis could catch up with them.

The people who age out by moderation, which are a majority of those with alcohol problems, tend to be binge drinking college students, who might drink 20 on a weekend, but don't drink daily. Half of all people with alcohol problems have ended them by age 35.

We'd have a higher rate of alcohol-linked suicides, accidents and OD's if these numbers were right. I'm willing to believe that there are far more heavy drinkers than the household surveys suggest, but I don't think they are off by a factor of 3. And I don't think it's likely that millions of people are drinking 10 a day for any significant period of time—or even getting up to drinking 10 a day for any significant time period— without having serious problems. Again, it's quite possible that there are more people who are functional heavy drinkers than the NHSDUH finds, but I don't think it's likely that the numbers are that far off.
posted by Maias at 5:14 PM on September 26, 2014


The mechanism in the liver which metabolizes alcohol to acetaldehyde and then clears the acetaldehyde exists for a reason, because it is used in natural metabolism even if you never touch ethyl alcohol. As long as you're not subjecting it to acute high levels and allowing the toxic acetaldehyde to build up (the basic cause of hangovers) there's no reason to assume cumulative damage is occurring.

On the contrary if we're talking about this beer an hour all day sort of drinking there's not much to support this reasoning. Certainly while non-daily binge drinking turns out to be fairly hard on the brain due to rebound excitotoxicity, and is probably worse for other organs than was once thought, it's not particularly associated with cirrhosis - only truly chronic intake is. It's entirely possible and not unlikely that constantly elevated enzyme activity and sustained exposure to alcohol metabolites (not necessarily at extreme levels) can set in motion processes that without sufficient recovery time eventually cause permanent damage. I don't know what research has been done on say ten drinks throughout the day versus ten after 6pm but I absolutely would not put my money on the former being "safe" even if it's not as bad.

Some people can drink outrageous amounts for a long time and not *inevitably* experience these consequences, because that's because some people are inherently much more resistant to these processes than others.

None of this is to deny that there is a level which has a neutral or positive impact on health for most people. But by definition I wouldn't call that "a lot."
posted by atoxyl at 5:36 PM on September 26, 2014 [1 favorite]


I found this pretty shocking too but then I did the math and despite considering myself only a moderate drinking, my 5 liters of wine per week is actually 34 drinks and I'm a lightweight who generally limits my consumption to the hours of 9pm to midnight. So I guess I can see how someone with a higher alcohol tolerance and more time to drink could easily double my intake.
posted by Jacqueline at 6:12 PM on September 26, 2014


grubby: The study that showed people drinking > 6 drinks a day still died less often of cardiovascular diseases than abstainers controlled for former problem drinkers iirc.

But was that the same study mentioned above which only included people between 55 and 65 who visited a hospital outpatient department in a three-year period?

You're gonna get a bunch of unusually frail teetotalers in the sample that you're basing your conclusions on if that's the case, no matter how much correction you do for socioeconomic status and former problem drinking. The study of beer is at least as difficult as the study of breast milk, and you need better controls than this to prove much of anything.
posted by clawsoon at 6:24 PM on September 26, 2014


It always seems to surprise people in these threads that people who do studies have actually realized that correlation and causation aren't the same and can do things to account for that.
posted by Justinian at 6:48 PM on September 26, 2014 [3 favorites]


As folks have pointed out above "a drink" is kind of a nonsense definition, and the drink you get at a bar may be anywhere from half of the alcohol of "a standard drink" to 3x the alcohol.

I did the arithmetic in the article and what the text calls "a drink" is about the CDC standard of 0.6oz of hard alcohol. The text talks about 1.5oz of hard liquor (45ml, or about 18ml of pure alcohol), a quarter bottle of wine (185ml, or about 26ml of pure alcohol), or "a beer" (350ml, or about 18ml of pure alcohol). The wine number is an outlier, I calculated that as 1/4 of a bottle of 14% wine. I think the "standard drink" is more like a fifth of a bottle of 12% wine, which also works out to about 18ml of pure alcohol, so the text seems a bit off by here but not by so much as to invalidate the point.
posted by Nelson at 6:58 PM on September 26, 2014


Justinian - take a look at that breast milk study to see how hundreds of professional, well-trained, well-motivated researchers working over a couple of decades can try and fail to properly account for confounding factors. (In the recent correcting paper, they compared siblings and discovered that the beneficial effects of breast milk - apparently proven in study after study which used all the best statistical tools to account for confounding factors - mostly disappeared.) Getting a paper published is a lot easier than taking all the complications into account, especially when you're dealing with problems getting the most basic data you need, as Rumple points out above.
posted by clawsoon at 7:01 PM on September 26, 2014 [1 favorite]


I have several coworkers who drink on that scale while holding down demanding white collar technical jobs. They do it entirely outside of working hours, too

Damn, the AD admins at my work were the same. I used to call them "sport drinkers".
posted by yoHighness at 7:06 PM on September 26, 2014


It's entirely possible and not unlikely that constantly elevated enzyme activity and sustained exposure to alcohol metabolites (not necessarily at extreme levels) can set in motion processes that without sufficient recovery time eventually cause permanent damage.

Well it's possible but there's no more reason actually a lot less reason to believe that than to believe that alcohol is a useful drug with powerful positive effects. All drugs are, of course, dangerous if you overuse them, even aspirin -- which as George Orwell once taught us was a drug of abuse in its turn.

For my part, I drink about a liter of wine every day. I've found it's my safe minimum dose. If I stop I don't develop any of the symptoms of alcohol withdrawal (it's a distinct syndrome which appears immediately). But within a couple of weeks I develop a host of other symptoms, all of which are known side effects of diabetes and correlate with highly elevated blood sugar measurements.

There are no other diabetes drugs that can keep my blood sugar levels controlled the way a combination of diet and my liter of wine a day do. I've researched them all and tried the few, especially Metformin, that showed some promise. All sent me back to the liquor store.

Actually, there is one other option, microdose insulin. Besides being a massive pain in the ass and brutally expensive one screw-up can kill you right now if there's nobody around to revive you from a hypo. I'll take my chances with the alcohol.

Earlier this year I developed a problem I know I inherited from my father and grandfather, both of whom were teetotalers and had heart attacks at the age of 61 -- my very own 85% clogged left anterior descending coronary artery. I figured it out due to suddenly always-massively-elevated blood pressure in December 1993 and I'm now the owner of a spiffy new stent thanks to catching it early.

I was a bit worried about explaining the alcohol thing to my cardiologist but he took me quite seriously and deliberately selected blood pressure drugs for me that don't interact with alcohol. (They work great.) In the followup after my angiogram he said my heart is completely healthy, my other arteries mostly clear, now on the 10 mg of Lipitor he prescribed my total cholesterol is 120 and my triglycerides 70, and I am usually the healthiest person in his waiting room.

I have been drinking regularly at this level for about 20 years. According to the bloodwork my liver and kidney function is completely normal. Sorry, but I tend to favor the theory that alcohol has been demonized. All drugs are toxins and all toxins are drugs, and while alcohol may be a toxin for others for me alcohol seems to be the only drug that keeps the "pre-" in my pre-diabetes.
posted by localroger at 7:11 PM on September 26, 2014 [5 favorites]


But was that the same study mentioned above which only included people between 55 and 65 who visited a hospital outpatient department in a three-year period?

It's not just one study that shows alcohol use reduces heart disease. The article linked in this FPP points to an AMA-published meta-analysis of thirty-four “well-designed prospective studies” encompassing over a million individuals. And that was just one of several sources for the article.
posted by mbrubeck at 7:58 PM on September 26, 2014 [2 favorites]


I once knew a guy who had a long commute, about an hour or so. He would leave work every day, stop at the local gas station, and buy a cold six-pack. The six pack would be finished by the time he got home.

He gave me a ride one day in his car and it was absolutely full of beer cans. Like, the driver's footwell was empty but the rest of the car was just submerged in empties. It was incredible.

I can barely imagine being able to walk after drinking that much, never mind operate a vehicle.
posted by LastOfHisKind at 8:58 PM on September 26, 2014


I tried to find the actual data from the study. This link suggested the data is available at niaa.census.gov/data.html, but that seems to just be a very generic Census page. Any ideas?
posted by miyabo at 9:06 PM on September 26, 2014


I posted the link earlier.
posted by Shmuel510 at 9:22 PM on September 26, 2014


It feels weird that my 1 or 2 drinks a day, usually beer, puts me in the 8th or 9th decile.
posted by theora55 at 9:56 PM on September 26, 2014 [1 favorite]


I have been drinking regularly at this level for about 20 years. According to the bloodwork my liver and kidney function is completely normal. Sorry, but I tend to favor the theory that alcohol has been demonized. All drugs are toxins and all toxins are drugs, and while alcohol may be a toxin for others for me alcohol seems to be the only drug that keeps the "pre-" in my pre-diabetes.

I explicitly stated that some people can get away with drinking quite a bit, at least as far as the liver is concerned. You're doing what, six "standard drinks" a day? That's not all that extreme. The stat you see is that just 10-20% of heavy drinkers develop liver disease, keeping in mind that the bar for "heavy" is likely set pretty low, but it's almost certainly distinctly a minority of men who would at your level. You probably can't escape a bit of cancer risk but I have no problem believing it works out well for you. What I took issue with was the assertion about the risks of bingeing versus steady consumption, which I still believe to be inconsistent with what's known about what causes the most life-threatening harm in the people who *are* susceptible to harm from drinking. My position is neither that alcohol is without medical benefits in the right dose nor that you in particular are at great risk from the way you consume it.
posted by atoxyl at 9:57 PM on September 26, 2014 [1 favorite]


What's your liter of choice, localroger? Or do you change it up?
posted by zbsachs at 11:32 PM on September 26, 2014


mbrubeck, the meta-analysis mentioned in that article is available for free here, and it's worth a read. A couple of highlights:
A J-shaped relationship between alcohol and total mortality was confirmed in adjusted studies, in both men and women. Consumption of alcohol, up to 4 drinks per day in men and 2 drinks per day in women, was inversely associated with total mortality, maximum protection being 18% in women (99% confidence interval, 13%-22%) and 17% in men (99% confidence interval, 15%-19%). Higher doses of alcohol were associated with increased mortality.
Interestingly, it's better to be a European drinker:
In particular, maximum risk reduction was in the range 20% to 28% in European but 14% to 19% in US studies, and the protection extended up to 6 drinks per day in European but only up to 3 drinks per day in US studies.
However,
In studies that used as reference the category of no alcohol intake and excluded former drinkers, the protection was significantly lower.
So if you've always been an insufferable teetotaling asshole like me, moderate drinkers get less of a health advantage over you than if you stopped drinking later in life.

I'll admit to being skeptical of most "what you eat and drink affects your health in this way" studies, though. I have a sneaking suspicion that most of them are carried out with an unconscious desire to find a way to make poor people live longer without giving them more money or better healthcare. Just breastfeed, eat broccoli, drink red wine and eat the most expensive dark chocolate you can, and there'll be no need to give you Medicare; studies prove it.

I could be wrong in my suspicion, though.
posted by clawsoon at 12:21 AM on September 27, 2014


And here is a meta-analysis that supports my half-baked theorizing above:
We have provided recent evidence suggesting that a systematic error may be operating in prospective epidemiological mortality studies that have reported “light” or “moderate” regular use of alcohol to be “protective” against coronary heart disease. Using meta-analysis as a research tool, a hypothesis first suggested by Shaper and colleagues was tested. Shaper et al suggested that people decrease their alcohol consumption as they age and become ill or frail or increase use of medications, some people abstaining from alcohol altogether. If these people are included in the abstainer category in prospective studies, it is reasoned that it is not the absence of alcohol elevating their risk for coronary heart disease (CHD) but, rather, their ill health. Our meta-analytic results indicate that the few studies without this error (i.e., those that did not contaminate the abstainer category with occasional or former drinkers) show abstainers and “light” or “moderate” drinkers to be at equal risk for all-cause and CHD mortality.
I will admit that it's fun to be an instant Google expert.
posted by clawsoon at 12:37 AM on September 27, 2014 [1 favorite]


You absolutely cannot rely on guidelines about how much you can drink and be under the driving limit (or any other limit), because there is enormous variation between people, even when they are of similar size etc. I regularly administer breath tests to groups of people from 5 or 6 up to over 50 (where the required result is 0.0) and I have seen results for people who have gone drink-for-drink with each other the night before varying from 0.0 to .08.
posted by dg at 2:06 AM on September 27, 2014 [1 favorite]


Nobody in my immediate family drank, and not just because they were uptight Presbyterians. More than once I heard relatives remark that alcohol made them sick. I have found that drinks turn almost instantly into hangovers with no fun in between.

There must be a genetic component here. I understand thirst can be genetic so teatotaling must as well.

PS Full disclosure: I did have one great-uncle who returned from WW I alcoholic; he was considered a shocking aberration and died fairly young, and his drinking was blamed on the balloon corps.
posted by kinnakeet at 4:25 AM on September 27, 2014 [1 favorite]


What's your liter of choice, localroger? Or do you change it up?

Usually merlot, though I'll vary it sometimes, especially when I'm on the road and the usual go-to sources are unavailable.

I have found that drinks turn almost instantly into hangovers with no fun in between.

A lot depends on your liver's ability to clear out the metabolite acetaldehyde, which is genuinely and uncontroversially toxic. Antabuse works by deliberately breaking the function of acetaldehyde dehydrogenase so that acetaldehyde builds up quickly and stays in your system. If you naturally have difficulty clearing acetaldehyde then it would certainly be both unpleasant and dangerous to drink alcohol.
posted by localroger at 6:44 AM on September 27, 2014 [2 favorites]


What I took issue with was the assertion about the risks of bingeing versus steady consumption, which I still believe to be inconsistent with what's known about what causes the most life-threatening harm in the people who *are* susceptible to harm from drinking.

Bingeing is a bad idea with any drug, obviously. I believe a lot of the direct harm that alcoholics suffer is due to chronic acetaldehyde poisoning. It's not hard to avoid that, even with what some would consider heavy usage, but the stigma causes a lot of people to default to a binge and retreat cycle which is the worst of all possible worlds. It's easy to understand the attitude that if you have to drive 35 miles to get liquor you're not gonna just pick up a six-pack, but waking up with a hangover twice a week is probably a lot more unhealthy than drinking twice as much actual alcohol the way I do it.
posted by localroger at 6:54 AM on September 27, 2014 [1 favorite]


The US isn't a drinking culture, it's a speed culture.
posted by The Whelk at 10:05 AM on September 27, 2014


(also beloved cult actor Richard E. Grant is allergic to alcohol, lacking the enzymes to process it correctly - apparently even a single glass is enough to make him vomit.)
posted by The Whelk at 10:08 AM on September 27, 2014


which makes this performance all the more brilliant
posted by philip-random at 11:53 AM on September 27, 2014


For a 6 month period before I went into the Navy, I was a cashier at 24 hour convenience store working the night shift. There was a man how showed up just after 6 AM every day to buy a 6 pack of talls and a fifth of whiskey. He had a weird smell that I can only guess is what you smell like when your liver has failed and you continue to drink like a fish.

I just googled what a "fifth" was, just to make sure, and my eyes bulged when I saw that that means a 26 oz bottle.
posted by Theta States at 11:19 AM on September 30, 2014


From Substance -- The Truth We Won't Admit: Drinking is Healthy
The US public health establishment buries overwhelming evidence that abstinence is a cause of heart disease and early death. People deserve to know that alcohol gives most of us a higher life expectancy—even if consumed above recommended limits.
Via a recent deleted post by MartinWisse.
posted by filthy light thief at 11:43 AM on October 2, 2014 [1 favorite]


This non-deleted post that was discussed above linked to a reprint of that same article.
posted by mbrubeck at 2:16 PM on October 2, 2014


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