Promoting Positive Drinking: Alcohol, Necessary Evil or Positive Good? - Alcohol, Necessary Evil or Positive Good?

Written by Stanton Peele

Before Prohibition in the United States and from the 1940s through the 1960s, drinking alcohol was accepted and valued as was perhaps even excessive drinking. Musto (1996) has detailed cycles of attitudes towards alcohol in the United States, from the libertarian to the prohibitionistic. We can see the view of drinking and even alcohol intoxication as pleasurable in American film (Room, 1989), including also the work of such mainstream and morally upright artists as Walt Disney, who presented an entertaining and drunken Bacchus in his 1940 animated film, Fantasia. Television dramas in the 1960s casually depicted drinking by doctors, parents, and most adults. In the United States, one view of alcohol—the permissive—is associated with high consumption and few restraints on drinking (Akers, 1992; Orcutt, 1991).

Most drinkers throughout the Western world view alcohol as a positive experience. Respondents in surveys in the United States, Canada, and Sweden predominantly mention positive sensations and experiences in association with drinking—such as relaxation and sociability—with little mention of harm (Pernanen, 1991). Cahalan (1970) found that the most common result of drinking reported by current drinkers in the United States was that they "felt happy and cheerful" (50% of male and 47% of female nonproblem drinkers). Roizen (1983) reported national survey data in the United States in which 43% of adult male drinkers always or usually felt "friendly" (the most common effect) when they drank, compared with 8% who felt "aggressive" or 2% who felt "sad".

Alcohol May Be Good or Bad

Of course, many of those sources for the goodness of alcohol also drew important distinctions among styles of alcohol use. Increase Mather's full view of alcohol was outlined in his 1673 tract Wo to Drunkards: "The wine is from God, but the Drunkard is from the Devil." Benjamin Rush, the colonial physician who first formulated a disease view of alcoholism, recommended abstinence only from spirits, and not wine or cider, as did the early temperance movement (Lender & Martin, 1987). It was only in the middle of the 19th century that teetotaling became the goal of temperance, a goal that was adopted by AA in the next century.

Some cultures and groups instead accept and encourage drinking, although they disapprove of drunkenness and antisocial behavior while drinking. Jews as an ethnic group typify this "prescriptive" approach to drinking, which allows frequent imbibing but strictly regulates the style of drinking and comportment when drinking, a style that leads overwhelmingly to moderate drinking with a minimal number of problems (Akers, 1992; Glassner, 1991). Modern epidemiologic research on alcohol (Camargo, 1999; Klatsky, 1999) embodies this view of alcohol's double-edged nature with the U- or J-shaped curve, in which mild to moderate drinkers display reduced coronary artery disease and mortality rates, but abstainers and heavier drinkers show depreciated health outcomes.

A less successful view of the "dual" nature of alcohol consumption is embodied by ambivalent groups (Akers, 1992), which both welcome alcohol's intoxicating effects and disapprove (or feel guilty about) excessive drinking and its consequences.

Alcohol and the Integrated Lifestyle

A view consistent with that in which alcohol may be used in either a positive or a negative fashion is one that sees healthful drinking not so much as the cause of either good and bad medical or psychosocial outcomes but as a part of an overall healthful approach to life. One version of this idea is embedded in the so-called Mediterranean diet, which emphasizes a balanced diet lower in animal protein than the typical American diet, and in which regular, moderate alcohol drinking is one central element. In line with this integrated approach, crosscultural epidemiologic research has shown that diet and alcohol contribute independently to coronary artery disease benefits in Mediterranean countries (Criqui & Ringle, 1994). Indeed, one can imagine other characteristics of Mediterranean cultures that lead to reduced levels of coronary artery disease—such as more walking, greater community supports, and less stressful lifestyles than in the United States and other temperance, generally Protestant, cultures.

Grossarth-Maticek (1995) has presented an even more radical version of this integrated approach, in which self-regulation is the fundamental individual value or outlook, and drinking moderately or healthily is secondary to this larger orientation:

"Troubled drinkers," i.e. people who both suffer from permanent stress and also impair their own self-regulation by drinking, only need a small daily dose to shorten their lives considerably. On the other hand, people who can regulate themselves well, and whose self-regulation is improved by alcohol consumption, even by a high dose, do not manifest a shorter life span or a higher frequency of chronic illnesses.

Drinking Messages and Their Consequences

Never Drink

The proscriptive approach to alcohol, characteristic for example of Moslem and Mormon societies, formally rules out all alcohol use. Within the United States, proscriptive groups include conservative Protestant sects and, often corresponding to such religious groupings, dry political regions. If those in such groups drink, they are at high risk for drinking excessively, because there are no norms to prescribe moderate consumption. This same phenomenon is seen in national drinking surveys, in which groups with high abstinence rates also display higher-than-average problem-drinking rates, at least among those who are exposed to alcohol (Cahalan & Room, 1974; Hilton, 1987, 1988).