Using a log splitter to perform surgery and other thoughts on alcohol regulations

My August piece for Palate Press, up today, reviews some of the recent literature on what alcohol restrictions do for public health. I’d hoped, when I first logged in to PubMed, for one of two things. 1. Three or four reviews showing that placing restrictions on alcohol reduces consumption by “everyday” drinkers but doesn’t change heavy drinkers’ behavior. 2. Three or four reviews showing mixed evidence for whether anti-alcohol regulations improve public health that still argued in favor of those laws because all drinking is bad drinking.

What I found is the latter, sort of. Medical research is never as simple as you’d like it to be. Drinking can do bad things to people, and restricting when and where it can be sold reduces how much people drink… probably, most of the time, it seems. For researchers who dismiss alcohol as a health hazard and won’t see it for anything else*, that’s enough.

My argument is this: instead of chasing down exactly when, where, and how regulating alcohol sales might reduce deaths by liver cirrhosis or drunk driving accidents or domestic violence, let’s spend our resources on finding better strategies altogether. Drinking isn’t the problem, whether you’re considering just human health or (thinking more thoughtfully) human well-being in general. Heavy drinking — the kind people do to escape from other problems in their life or, less often, the kind people do out of ignorance for the harm it does — is the problem. We’re doing surgery with a log splitter by trying to decrease problem drinking by decreasing all drinking. There are better ways. Education. Better server training. Encouraging social pressure. Addressing the underlying social ills with which alcohol abuse tends to be associated, such as family instability. And my favorite: working, however slowly, on changing the prevailing American culture of alcohol-as-drug to one of wine and beer as food, and spirits as drugs with appropriate ceremonial and ritual functions**.

*Or for researchers who adopt that prohibitionist perspective for the sake of winning grants from misguided and uncritical public health organizations, though I’m inclined to think that most researchers have at least a little (and sometimes a lot of) personal investment in their work and its implications.

** Ceremonial and ritual taken broadly. Sipping whisky with your mates in the pub on Saturday night is ceremonial; it invokes a particular kind of social bonding and communication and creates and demarcates the space in which that happens.

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