Given the drinking is so disapproved an activity nowadays, what can be said about drunkenness? Harkening back to the Talmud (the Jewish holy book) admonition to Jews (a group known for moderate drinking since antiquity) that, on Purim, "You should drink until you don't know the difference between 'Cursed is Haman (an archetypal enemy of the Jews), Blessed is Mordechai'," Stanton here shows that there has always been a role for drunkenness, and there remains one. Recognizing some human urge for drunkenness gives public health a leg up in dampening its worst excesses. But, in any case, intoxication will always remain a regular part of human experience.

International Center for Alcohol Policies, Website: Invited Opinion, May, 2001 (reprinted with permission).

Stanton Peele
Morristown, NJ

Throughout history, in the United States and other societies, drunkenness has been accepted as ineradicable, even necessary and beneficial in some circumstances. Various cultures establish niches, sometimes referred to as "time-outs," that permit alcohol intoxication but at the same time limit and control it. This tolerance and quasi-approval are being withdrawn in the current atmosphere towards alcohol in the U.S. Something may be lost in this movement, however. Even in regards to preventing and remedying alcohol problems, an extreme intolerance for intoxication can be counterproductive because it ignores a reality, rather than softening its impact.

Once drunkenness was tolerated, even recognized as a social custom. Americans often regarded drunkenness in a bemused light. Recall that the Roman god of wine and revelry, Bacchus, was depicted as a merry drunk in the Disney feature cartoon Fantasia when it was originally released in 1940. This attitude has shifted radically in the last several decades.

The Persistence of Drunkenness

Although acceptance of or tolerance for drunkenness has largely evaporated, drunkenness has not disappeared. Indeed, it has actually increased among some populations — including American college students. Henry Wechsler, of the Harvard School of Public Health, has been studying binge drinking on U.S. campuses since 1993. Such drinking is commonplace — 44 percent had binged (5 or more drinks at a time for men, 4 or more for women) at least once in the prior two weeks in 1999. By 1999, furthermore, the percentage of students who frequently binged had increased significantly (to 23%). Among those who drink, a majority in 1997 (52%) said a major reason to do so was "to get drunk" — up from 39 percent in 1993.

There are other groups, times, and places where drunkenness is expected — for example, at pre-wedding bachelor parties. These all-male (and sometimes all-female) assemblages seem to feel it is obligatory to have one last binge before tying the marital bond. Other settings in which intensive or binge drinking may be required are marriage, birth, or death celebrations (such as the bouts that accompany the jazz processions following interments in New Orleans, or at Irish wakes).

The New Temperance — Public Health Versus Drunkenness

The U.S. is in one of its periodic cycles of disapproval of alcohol and drinking. That is, beginning in 1980, American alcohol consumption declined precipitously (a decline that has leveled off, but has not reversed itself, since the mid-1990s). Opprobrium is attached to heavy drinking across the board — including massive efforts to discover and resolve the sources of alcoholism, as well as to reverse heavy drinking among young people from adolescence through their twenties.

In this process, sometimes moderate social drinking is held out as a possible alternative — sometimes it is not. But the idea that sometimes drunkenness will occur and may even serve a function has disappeared. Today, to get drunk — ever — is to invite a negative diagnosis, and certainly disapproval. To put it another way, modern public health and public opinion generally recognize no positive role for drunkenness.

We can extend this point even further — American public health now focuses on drunkenness, whether occasional or otherwise, even more than on alcoholism. For instance, public health specialists point out, a large proportion of accidents and other negative drinking outcomes occur due to the occasional drunkenness of nonalcoholic individuals.

But these specialists have become so intolerant of drunkenness that they seemingly cannot accept that it will ever occur, or deal with it when it does. That is, in the field of drug abuse, public health has largely embraced an approach called "harm reduction." This model recognizes that illicit drug use — and abuse — will never disappear entirely, and that fallback positions are required to protect the health of those who continue to use these drugs, including those who are addicted.

The best-known of these approaches involves distributing clean needles to heroin addicts in order to prevent them from becoming infected with HIV. Alternately, addicts are switched to substitute drugs that they do not inject — methadone therapy is one example. These steps are taken not only for the benefit of the addict — public health improves when the spread of AIDS is curtailed.

But we seem not to be able to develop a similar approach for alcohol. Such an approach reckons that, although some people continue to drink excessively, they deserve to live and to be protected. Harm reduction techniques would include making sure that drunkards have sufficiently nutritious diets, or are protected from the elements, or can enter protected environments when they drink. A protected environment for drinking would also mean that drunks would not endanger others — most especially by driving drunk.

Today, these ideas seem impossibly radical — "Why encourage drunkenness?" the objection would be. Yet, in 1981, the prestigious National Academy of Sciences published a symposium on alcohol problems that called for making the world safer for, and from, drunkards as one approach to preventing alcohol problems. But, today, nothing that is seen to tolerate drunkenness has a chance even to be discussed, let alone to be adopted as public policy.*

(*Some might say that MADD — Mothers Against Drunk Driving — recognizes drunkenness will occur and suggests providing for alternate transportation home for those who have been drinking. Although this is in fact a harm reduction approach, MADD has become increasingly oriented towards preventing drunkenness itself, rather than protecting people from their own and others' drunkenness.)