The Antidote to Alcohol Abuse: Sensible Drinking Messages - Sensible Drinking Messages

Written by Stanton Peele

Reeducating Our Culture

We in the United States have ample positive models of drinking to emulate, both in our own country and around the world. We have all the more reason to do so now that the federal government has revised its Dietary Guidelines for Americans (32) to reflect the finding that alcohol has substantial health benefits. Beyond such official pronouncements, there are at least two crucial contact points to reach people with accurate and useful instruction about drinking.

Positive socialization of the young: We can best prepare young people to live in a world (and a nation) where most people do drink by teaching them the difference between responsible and irresponsible drinking. The most reliable mechanism for doing this is the positive parental model. Indeed, the single most crucial source of constructive alcohol education is the family that puts drinking in perspective, using it to enhance social gatherings in which people of all ages and both genders participate. (Picture the difference between drinking with your family and drinking with "the boys.") Alcohol does not drive the parents' behavior: it doesn't keep them from being productive, and it doesn't make them aggressive and violent. By this example, children learn that alcohol need not disrupt their lives or serve as an excuse for violating normal social standards.

Ideally, this positive modeling at home would be reinforced by sensible-drinking messages in school. Unfortunately, in today's neotemperance times, alcohol education in school is dominated by a prohibitionist hysteria that cannot acknowledge positive drinking habits. As with illicit drugs, all alcohol use is classified as misuse. A child who comes from a family in which alcohol is drunk in a convivial and sensible manner is thus bombarded by exclusively negative information about alcohol. Although children may parrot this message in school, such an unrealistic alcohol education is drowned out in high-school and college peer groups, where destructive binge-drinking has become the norm (34).

To illustrate this process with one ludicrous example, a high-school newsletter for entering freshmen told its youthful readers that a person who begins to drink at age 13 has an 80 percent chance of becoming an alcoholic! It added that the average age at which children begin to drink is 12 (26). Does that mean that nearly half of today's children will grow up to be alcoholic? Is it any wonder that high-school and college students cynically dismiss these warnings? It seems as though schools want to tell children as many negative things as possible about alcohol, whether or not they stand any chance of being believed.

Recent research has found that antidrug programs like DARE are not effective (8). Dennis Gorman, the Director of Prevention Research at the Rutgers Center of Alcohol Studies, believes this is due to the failure of such programs to address the community milieu where alcohol and drug use occurs (18). It is especially self-defeating to have the school program and family and community values in conflict. Think of the confusion when a child returns from school to a moderate-drinking home to call a parent who is drinking a glass of wine a "drug abuser." Often the child is relaying messages from AA members who lecture school children about the dangers of alcohol. In this case, the blind (uncontrolled drinkers) are leading the sighted (moderate drinkers). This is wrong, scientifically and morally, and counterproductive for individuals, families, and society.

Physician interventions: Along with bringing up our children in an atmosphere that encourages moderate drinking, it would be useful to have a nonintrusive way to help adults monitor their consumption patterns, i.e., to provide a periodic check on a habit that, for some, can get out of hand. Such a corrective mechanism is available in the form of brief interventions by physicians. Brief interventions can substitute for, and have been found superior to, specialized alcohol-abuse treatments (25). In the course of a physical examination or other clinical visit, the physician (or other health professional) asks about the patient's drinking and, if necessary, advises the patient to change the behavior in question so as to reduce the health risks involved (16).

Medical research worldwide shows that brief intervention is as effective and cost-effective a treatment as we have for alcohol abuse (2). Yet so extreme is the ideological bias against any alcohol consumption in the U.S. that physicians are afraid to advise patients about safe levels of drinking. While European physicians routinely dispense such advice, physicians in this country hesitate even to suggest that patients reduce their consumption, for fear of implying that some level of drinking can be positively recommended. In an article in a prominent U.S. medical journal, Dr. Katharine Bradley and her colleagues urge physicians to adopt this technique (5). They write: "There is no evidence from studies of heavy drinkers in Britain, Sweden, and Norway that alcohol consumption increases when heavy drinkers are advised to drink less; in fact it decreases."

So much for the fear that people cannot be trusted to hear balanced, medically sound information about the effects of alcohol.

Can We Turn a Temperance Culture Into a Culture of Moderation?

In the uneasy mix of ethnic drinking cultures that we call the United States of America, we see the bifurcation characteristic of a temperance culture, with a large number of abstainers (30%) and small but still troubling minorities of alcohol-dependent drinkers (5%) and nondependent problem drinkers (15%) among the adult population (19). Even so, we have a large culture of moderation, with the largest category (50%) of adult Americans being social, nonproblem drinkers. Most Americans who drink do so in a responsible manner. The typical wine drinker generally consumes 2 or fewer glasses on any given occasion, usually at mealtimes and in the company of family or friends.

And yet, still driven by the demons of the Temperance movement, we are doing our best to destroy that positive culture by ignoring or denying its existence. Writing in American Psychologist (28), Stanton Peele noted with concern that "the attitudes that characterize both ethnic groups and individuals with the greatest drinking problems are being propagated as a national outlook." He went on to explain that "a range of cultural forces in our society has endangered the attitudes that underlie the norm and the practice of moderate drinking. The widespread propagation of the image of the irresistible dangers of alcohol has contributed to this undermining."

Selden Bacon, a founder and long-time director of what became the Rutgers Center of Alcohol Studies, has graphically described the perverse negativism of alcohol "education" in the U.S. (3):

Current organized knowledge about alcohol use can be likened to...knowledge about automobiles and their use if the latter were limited to facts and theories about accidents and crashes.... [What is missing are] the positive functions and positive attitudes about alcohol uses in our as well as in other societies.... If educating youth about drinking starts from the assumed basis that such drinking is bad [and]...full of risk for life and property, at best considered as an escape, clearly useless per se, and/or frequently the precursor of disease, and the subject matter is taught by nondrinkers and antidrinkers, this is a particular indoctrination. Further, if 75-80% of the surrounding peers and elders are or are going to become drinkers, there [is]...an inconsistency between the message and the reality.