Drink? Drink! Drink ...
A non-shaming, realistic look at what alcohol is, what it does physically and emotionally to the humans consuming it, and its effects on society at large, Professor David Nutt’s Drink?: The New Science of Alcohol + Your Health covers a lot of ground without leaving you behind in either Science 400 class or the opposite: boring you like a basic brochure. His point seems to be, “What’s the level of drinking that will make me feel good but allow me to function well too?” I’ve read much quit lit and nonfiction about alcohol, diatribes concerned with over-drinking, and drunk-to-sober memoirs, and this scientific look with just enough personality is like reading The New Yorker review of a big dry book you would never actually read but are interested in. Extra points for being English and the many examples of pub life, pints, lagers, and cider. Cheers.

Wendy Ward
http://wendyrward.tumblr.com

So when I first saw this book I thought it was going to be more about the psychology around drinking and how it related to genetics. However, going over the book a little bit and even just through the table of contents this book made me feel almost guilty even for the small amount of drinking that I do. Was a little disappointed.

David Nutt is an English neuropsychopharmacologist, meaning he studies drugs that affect the brain. Of which alcohol is a big, bad one.

He was fired, or asked to resign, from his position as a government drug advisor for saying on primetime radio “that alcohol was the most harmful drug in the UK. At that time alcohol wasn’t even allowed to be considered a drug by the UK Advisory Council on the Misuse of Drugs – the ACMD – despite every scientist in the country knowing that it most certainly was a drug.”

He returns to this point that got him in trouble, asserting that neither the government nor the alcohol industry wants it classified as a drug, but from his perspective as a scientist examining alcohol’s affects on the brain’s neurotransmitters, that status is indisputable.

Drink? is a collection of information about some of alcohol’s neurological and other physiological effects, as well as data about the harm its use — even in alarmingly small amounts — can have on our behavior and lives. Plus the striking big picture impact: “In the US, drinking costs $249 billion a year of which $28 billion are health care costs and $23 billion from crime.”

There’s a lot of fascinating information and data here, but it’s mostly written like an extended heath department pamphlet. It’s undeniably important, but could it be any…drier (pun intended; I’m sorry.)

It’s sometimes just lists of statistics and data. Nevertheless, I still highly recommended it if you’re interested in the topic, and as a resource (plus it’s not very long so it’s not a massive time commitment). I’m especially interested, having come at it from multiple angles over time, both the weird feelings and treatment by those around you when you don’t drink, and later self-medicating with alcohol, as well as seeing its powerful and uncomfortable effects on and control over people I’ve been close to. So regardless of whether it’s the juiciest read or not, I wanted to learn from it and I did. If you feel similarly, it’s helpful.

He identifies there being a marketing push that “has altered our perception” of the way we consume alcohol, including its ubiquity in “every part of our lives” — he lists social bonding, drinking to close business deals, to celebrate births and commiserate deaths. Like I mentioned with this book, this is an area I want to know much more about and I can’t seem to find an in-depth resource for it.

There is a somewhat scary element, like when he writes that “Years before any health issues show up, alcohol is already affecting very organ and system of your body, including your brain. And there are more subtle changes happening too, “affecting health, sleep, work performance, skin, fitness, and sex life.” Or that “the safe limit of alcohol, if you applied food standards criteria, would be one glass of wine a year.” And to stay below the acceptable food standard risk for cancer in particular, you could consume “a maximum of two standard drinks a year.” Fuck.

His main message is that he doesn’t want you “to throw alcohol down your throat without thinking.” He argues for being conscious of what you’re drinking and why, and that drinking should be a “positive, active pleasure rather than a reflex and habit, or something you’ve always done, or self-medication for stress or anxiety.” And to understand what amount of alcohol makes sense for you in terms of your personal risk-benefit analysis. On this basis, I think this is a must-read for any drinker, whether you consider yours problematic or not.

It’s well-sourced and cited, but when it’s not I was left wondering. Like this: “Most of us have some level of social anxiety, and alcohol removes our fear and inhibitions.” For me, this is entirely true. But I’m curious about the broad assumption. Of course alcohol lowers inhibitions, but do most of us really have some level of social anxiety? On the one hand, I’m relieved at being less alone; on the other, I’m suspicious just based on a lifetime of observation.

The bottom line, much as we don’t like to hear it, is that “no level of drinking is actually beneficial to health.” I suspected as much. He goes into a lot of detail around this which I appreciated and find valuable, because as he notes, “everyone who drinks loves to read all the reasons why it’s a good idea, right?” And they love to parrot these, but the reality is that research shows that “any protection (by red wine against stroke, for example) would be more than cancelled out by the negative effects.”

It also contained a fascinating look at how many lives have been saved, albeit controversially, by raising the federally mandated drinking age in the US to 21 in the 1980s — something I found Europeans constantly marveled at, since most European countries sell beer and wine from age 16. He says it’s credited with saving hundreds of thousands of live in road accidents, since “Young people’s driving is much more impaired by a given level of alcohol.”

One section I loved and wished I’d heard about a long time ago was the prevalence of problematic drinking among expats. This happened to me and every single one of my close expat friends, yet I had no idea it was a widespread occurrence, I thought it was just us, which now seems ridiculous. For factoids like that, I found this very helpful and I think anyone with questions or issues around consumption would be likely to find some kind of answer or direction for pursuing further research here.

And it has actionable sections, like in how to deal with people who badger you about not drinking, providing some helpful statements. Sadly, one of these is a reminder of the advice that “No is a complete sentence.” Which bums me out that some people are so aggressively uncomfortable with non-drinkers that you have to use the same words as when dating an asshole. Drinking culture fascinates me for this reason, and this is a good step in learning more about it, if a bit clinical.

Also interesting: the author owns a wine bar in London, despite having lost a job for refusing to compromise on acknowledging the dangers of alcohol and insisting it be classified as a drug. I sense some curious cognitive dissonance, although again, his main message is to be conscious of what, why, and how you’re drinking and adjust your ideas of moderation even lower, not to abandon it completely. Whether it’s realistic and achievable for most, I’m not sure.

Everyone should read this book! It clearly tells us the science behind drinking and leaves the choice to imbibe or not in your own court. I thought it was wonderful and objective.

Alcohol is everywhere. In fact, 80 percent of adults consume it, but only about one-fifth of us get into trouble with it. The challenge is that we now have scientific proof that alcohol is the most harmful drug there is. Yet we still drink anyway because it’s socially acceptable. It’s also legal and accessible. And, unless we start to face severe consequences as a result of our drinking, giving it up entirely isn’t going to change anytime soon.

In Drink?, neuropharmacology professor David Nutt shows us the evidence from the latest studies on alcohol. And why we might want to reconsider our relationship with it. After all, alcohol impacts our health, our sleep, our emotions and our productivity. And that’s if we drink moderately.

Nutt tells us how drinking affects our bodies—from the first sip through the hangover. He also addresses topics such as hormones, mental health, fertility and addiction.

Yet, despite the harmful effects, Nutt doesn’t insist on abstinence. In fact, he fesses up to owning a wine bar with his daughter and partaking in drinking himself. For those reasons, I cannot get on board with giving this book rave reviews. Especially because it so clearly demonstrates that we shouldn’t be using this drug. I don’t quite get the logic.

Professor David Nutt, famously sacked following his comments on alcohol, has pulled off the impossible. He has written a scientifically rigorous, yet readable, book on drinking and alcohol. It is comprehensive, weaving together the science behind alcohol’s effects on the body, the mind and, most importantly, life. The title, “Drink?”, poses the question and then answers it through a series of chapters devoted to all the facets involved when you consider a widely consumed, potent drug. What makes this book stand out is the absence of judgement of those who choose to drink. Nutt provides the information on the harms and the benefits. It is so well-rounded he devotes two chapters to moderate drinking and ways to drink some but still stay in the same, personal, margin that drinkers set for themselves. Strong recommendation. Belongs in any library’s collection as well as the bookshelf of anyone who drinks alcohol, in whatever amount.

Wow! I really learned quite a bit from this book about the effects of alcohol on your mental and physical well-being. I considered myself fairly well-informed on the topic prior to reading this book, but was amazed at how little I actually understood about how regular, immoderate drinking can impact your health from the cellular level. The author did an amazing job of simply giving the information in a clear way that was not filled with jargon and that did not carry the message of "stop drink you loser". The author provides the information and allows the reader to make the decision that is best for them, but boy you really can't unknow this stuff after learning about it! The only slight "complaint" that I have about the book is that it is written by a British author who clearly had a UK readership in mind with his frequent mentioning of pubs and use of the metric system when discussion alcohol portions. He does address the U.S. readership as well though and alcohol use is a universal issue, so it doesn't cause any difficulties in understanding the content. I would highly recommend this title for those who are interested in learning factual information about the short-term and long-term effects of alcohol use and tips for moderating their use should they choose to do so.

Did you know nearly 88,000 people in the US die annually from alcohol-related causes? And did you know that alcohol is the third leading preventable cause of death in the US? Well..Neither did I!
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Drink? The New Science of Alcohol and Health is the most comprehensive evaluation of alcohol that I’ve ever read. David Nutt explains how alcohol affects individuals on a chemical, physiological and psychological level. He details what happens in your body from the moment you take your first drink of the night, to the morning after when you’re experiencing that dreadful hungover. And it is deep!
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This book forced me take a honest look at my own drinking habits. About midway through the first chapter I began thinking about alcohol consumption in a way I’ve never thought about it before. As I read page after page I started to ask myself some heartfelt questions...Do I drink too much? Is there a recommended amount of alcohol I can consume without causing harm to my body? I’m telling you, this book raised so many questions. Yet, it provided so many answers.
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I wasn’t the least bit bored while taking in all the facts. Yes, there is a lot of information. But, Professor David Nutt a doctor that was once the UK government chief drug advisor, successfully spoon fed the hard core facts in a way that was easy for me to digest. His breakdown of the topics are precise and practical. I breezed through the book effortlessly.
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Some of the topics discussed are, how alcohol causes accidents, aggressive behaviors and health issues. He talks about about alcohol and hormones, quality of life, children, relationships and so much more.
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It also contains some really good pointers on how to scale back on consumption. One suggestion he gives is to keep a drink journal. I like this idea a lot.
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The timing of this book’s release couldn’t be at a better time. While a lot of people in the world are using alcohol to help cope with these scary and uncertain times, it’s important to know how your favorite adult beverage could be affecting your life.

I requested a copy of this book because I have recently decided to stop drinking and have been reading many related books. This looked like it would offer a very scientific approach and I was interested in learning even more.

I am completely torn over this book. One on hand, I really loved the scientific evidence, facts, and research that made the argument to stop drinking so much stronger for me. However, Professor David Nutt decided to have this “cool guy” approach where he is going to tell you how awful alcohol is but do not worry, he will not judge you and he will even help you to continue drinking! It felt so contradictory to present evidence on how horrible alcohol is and then turn around and give the impression that it is a risk worth taking. I can imagine that Nutt did not think he would be received as well if he suggested no alcohol consumption at all, but it felt cowardly to back down like that.

The information would have been so much more powerful if he would have just stuck to the narrative that “no level of alcohol is safe” for consumption, which is a direct quote. Instead he acts as if it is worth it to consume *some* alcohol and even presents BENEFITS to drinking. He admits that there are no health benefits to drinking, but having an entire chapter dedicated to the social benefits is just giving people the excuse they need. He acts as if we should all relish the feelings of community and connection we have while drinking together, making it seem more important than protecting our health. Social benefits would be irrelevant if we all made the healthy choice to stop drinking and learned to connect with each other in ways that are more meaningful. I worry that people are going to forget all of the incredible information that should persuade them not to drink and instead only remember the one chapter about how socially beneficial alcohol is.

I just felt so disappointed every time he contradicted himself. For instance, he explains how alcohol impairs the decision making and judgement part of the brain, often leading to why people binge drink even when they do not want to. Then later he explains how you should come up with a system to limit yourself to a *safer* amount of drinks, even though the more you drink the less you can control your decisions… He seems to be setting you up for failure. I commend anyone who would want to start limit their drinking and think his tips would be helpful if that was your next step, but he ignored how addictive alcohol is here and acted as if you could easily adapt to these new rules. Rather than giving people tips on how to keep drinking, I would have appreciated a narrative more on how your life will improve if you give up drinking. I wouldn’t consider this a self-help book, and instead of trying to help in one small chapter I think he should have focused on presenting the evidence as a way of waking up society to the harmful effects of alcohol, a drug that we celebrate.

Another contradiction throughout: He suggests you should only drink two drinks a day as a safe amount but also admits that even one drink a day will increase your risk for cancer and a couple of drinks a few times a week will raise your risk of premature death by 20%. I just did not like the mixed messaging approach. I loved all of the evidence he used to explain why alcohol is so bad for us to consume yet wasn’t happy with the message he chose to pair with this evidence.

Besides that, I really liked his view on addiction. I agree with his stance that is unfair to blame people who become addicted to a legal substance and recognizing that their intention was not to become addicted. I also liked how he makes clear that you do not have to be craving alcohol or be unable to stop drinking in order for it to kill you. No matter what level you drink at, it is going to harm you.

I also liked how he advocated for prioritizing the treatment of alcoholism and I supported how he admonishes politicians and society for viewing alcoholism as a failure of will rather than a failure of the brain. With other things I have read, I really like this approach of looking at addiction. He definitely does not blame anyone for drinking and I am on board with that attitude, just not with his lack of enthusiasm for quitting alcohol altogether. I also liked how he called out the alcohol industry:

“The alcohol industry knows alcohol is a toxic substance. If it were discovered today, it would be illegal as a food product. The safe limit of alcohol, if you applied food standards criteria, would be one glass of wine a year.”

Overall, there was so much great information; I saved countless quotes. If the author had taken a different stance, I personally would have enjoyed it more but if you are someone looking for the facts about drinking and are interested in cutting back on drinking this book will give you plenty of reasons to.

“Drink?: The New Science of Alcohol and Your Health” is an informative read by Professor Nutt about the physiological effects of alcohol on the body. Nutt is a British neuropsychopharmacologist who specializes in drugs that effect the brain.

This book is insightful about the effect alcohol has on the human body without being preachy. I found it fascinating and answered a lot of questions I had about the effects alcohol has on anxiety, depression, and insomnia.

I’ve read 6 thrillers this month, 3 gripping stories of literary fiction, and this one. Guess which one I read cover to cover in one sitting??? I did not see that coming! This is excellent. I’m someone who drinks semi-regularly and I was interested in the effects and current research. I’m not necessarily shocked by any of the information, but it was very enlightening. I will definitely reconsider my consumption in the future. I love how this didn’t come across as preachy, holier than thou. There were lots of good bits of research written in a way that was easy to understand. I appreciated the author’s careful balance of anecdotes with scientific studies. All in all, a great book for anyone interested in alcohol.

This is a fantastic book that goes in depth into alcohol and what it does to every single organ in our body, as well as our lives. I think if more people read this before they started drinking instead of being told how wonderful a few glasses are for us, they might never start.

Many of us know some of the harms of excessive alcohol, but this book was much more in depth and full of insights without being too preachy or boring. Good writing. I watched two of my uncles die a slow death from alcohol and never understood how anyone could get to that point. This book explains that well without calling it a failure of will or to categorize drinkers in the many negative way people do these days.

I really love how the book addresses not just dependence, but the physical and psychological cravings and desires as well. It explains the toll alcohol takes on our body and mind even when we think we can completely control it. I love that it isn’t judgmental, and even isn’t completely saying to give it up but offers suggestions on how to cut back if that’s what you choose.

I wish this book was a required reading. A lot of lives and livelihoods could be saved. Highly recommended for anyone who thinks they drink too much and would like to stop, for anyone who wants to understand someone who drinks too much, or for anyone who just wants to understand the many impacts drinking has on not just the person drinking, but friends and families too. The writing was good. A book with such depth and insight, and even Science, could easily become boring, but this was very interesting.

Drink?
by Professor David Nutt
Pub Date: 22 Dec 2020
read courtesy of http://netgalley.com

I realize this has turned into more of a critique than a book review. You may just want to read the first three and last three of the following paragraphs if you want the short version of my review.

Labeled as "self-help," this book is then presented a little backwards. The beginning is the "why" alcohol does what it does, and the second half is the "how" one can reduce or eliminate alcohol use. By the time I got through the "why," I was almost uninterested in the "how." Granted, one might never read the "why" section if they get through the "how" section, since the self-help portion is the reason one would obtain the book in the first place. However, I was more impressed, and less confused, by the self-help section, so I'm glad I persevered.

Read the introduction; it contains some of the 'truths' about alcohol. "Marketing has altered our perception," "...its's absurd that coming of age should still be about alcohol," and "Would you take a new drug if you were told it would increase your risk of cancer, dementia, heart disease, or that it would shorten your life?"

Chapters 1-5 are the "why" - chemistry and biology - and chapters 6-10 are the "how" - psychology and sociology.

WHY: Chapters 1-5
There were a number of places in the book where I questioned whether Professor Nutt's statements were opinion or fact. These were the places I expected to see citations, like throughout the rest of the book, but where documentation for an assertion was lacking. For example, Professor Nutt's use of words like 'slight,' 'possible,' 'seems,' 'I think,' and 'some' caused me to search for citations to determine the research behind the associated statements, but the citations just as often weren't referenced. One example is "...the number of people living with it [alcoholic dementia] is expected to triple by 2050." THAT'S a statistic that requires a citation!

Irrelevant to which part of the book some of his suggestions appeared, a few concerned me. Although one section is subtitled, "Hangover Cures: What's the Evidence," implying he's presenting information and not recommendations, since this is a self-help book, I might assume that most readers aren't processing the "What's the Evidence" portion of the heading and merely focusing on the promise of "Hangover Cures."
For example, in number 2 he describes beta blockers and ends that paragraph with, "Whether they do more than that, I'm not sure." It's irresponsible to leave it at that; do beta blockers for a hangover do more good? More harm? Not enough 'evidence,' Professor Nutt.

Although one shouldn't expect 100% definitive guidelines, I'm bothered by some contradictions. At one point he says, ""...don't drink at all - because there are no health benefits" and "...no level of drinking is actually beneficial to health." However, one whole chapter (8) is about "The Social Benefits of Alcohol." Granted, health and social benefits are different, but he expounds in so many places how alcohol provides social benefits, which others can argue can positively affect health benefits. He concludes that "...But if you want the sociability benefits alcohol brings, it's a different story. In that case, you need to decide what risks you want to accept...." Teeter-totters go in both directions; he implies that the benefits of alcohol abstinence and social drinking have an inverse relationship, so one has to choose, to "balance out the pleasure you gain." Further into the book he says, "...that the amount of alcohol optimal to provide the protection ["partial protective effect on cardiovascular health - The Lancet"] appears to be very low - about one unit a day." So there are some health benefits; he just wants us to know "...that the benefit to the heart does not outweigh all the other risks of alcohol...." And remember the reference to alcoholic dementia above? Later in the book, he says, "...low levels of alcohol consumption - that is between one and ten drinks a week - reduced the risk of dementia. In fact, it appears that being teetotal may raise your risk of dementia...." He also includes "...a 2017 review [that] concluded that light to moderate drinking does reduce the risk of diabetes," and that report IS cited.

I also questioned some of his assertions like, "...there are wards full of these kids," while talking about "acute alcoholic hepatitis" in young binge drinkers. Then he goes on to say, "However bingeing is not the reason behind most cases of alcoholic hepatitis...." He also provided no citation regarding the number of kids or the number of wards. There were also some judgmental statements peppered throughout the book. In one instance, Nutt says that he doesn't think people seeing their doctors for hypertension are being asked about their alcohol use, "...perhaps because many doctors drink too much themselves?" If that's not just a judgment, then where's the citation?

The British perspective came through a few times. For instance, in the section, "Major Ways Alcohol Affects Your Length of Life," I had to look up Professor Nutt's reference to Damien Hirst's sharks and cows with regards to Nutt's mention of formaldehyde. However, I was pleased that Professor Nutt was inclusive and did include science references to Asia and Africa along with Europe, the UK, and the USA.

I liked his discussion (and the reality check) of the arbitrariness of legal blood alcohol limits. He points out that for .079 and .081 "...is not that one is safe and the other dangerous, but that one if legal and the other is not." I also appreciated that he found a way to show how one's alcohol use affects others and not just one's self. He cites that the estimated prevalence of fetal alcohol spectrum disorders is 8 in 1,000 while the prevalence of Down's Syndrome is 1 in 1000. Perspective on preventable disorders is powerful. These type of discussions absolutely support his goal of an individual being "...able to work out how little you need in order to get the effects you do want."

HOW: Chapters 6-10
Early in the second half of the book, Professor Nutt relays some social the history of alcohol. One interesting part discussed how "...ancient Persians would only finally make a decision after the issue at hand had been discussed both sober and drunk," since being drunk brought out one's creativity. And though I knew alcohol was ancient, I didn't know that "It's only been in the last millennium that it has been banned by some religious groups, for example in Islam." [The irony isn't lost on this reader that modern "Persia" now Islamic.]

But sometimes he still spouts a factoid that he doesn't substantiate with a citation. I'd like to see the documentation of these assertions, Professor Nutt!
"...a view popular with conservative politicians, that addiction is fun and addicts enjoy getting drunk...."
"...conflation of morality and science happens in addiction more than any other branch of medicine."
"Drinking has become your hobby or the only way you socialize. This often happens with retirees or expats."
Professor Nutt does a much better job of citing some psychological aspects of why people drink, i.e., the self-help portion of the book. [Read the section on "Is Your Booze Buzz in Your Head?"] Later on he cites one study that "...showed that people drank lager 60 percent more slowly out of straight glasses than out of outward-curving (pilsner type) ones." Now that's interesting, don't you think? He also does a better job in this half of the book delineating when he is discussing fact or logic and not just opinion.

The best part of the book is headed, "How to Talk to Your Children about Booze." I can easily see this portion of the book being used with PTO/PTA groups. It was logical and could be easily implemented as a workshop program to support children and teens from succumbing to peer pressure, social norms, and advertising. While I did learn some things throughout the book, I'm not sure that much else is new or particularly persuasive that could convince an alcoholic to change their behavior; they'd just now be able to tell you why they are doing what they do.

And speaking of irony (which I did in the first ¶ of HOW: Chapters 6-10), his daughter runs a wine bar.

Excellent book about how alcohol affects your body and mental well-being. Very detailed and fact based but at the same time accessible to the average person to understand. Also included near the end is information on cutting down or stopping altogether and what to consider when making that decision.