I have always enjoyed drinking alcohol, something which is rather at odds with my job as an addiction psychiatrist. When I first started this work, I gave up alcohol completely for several months, largely due to the horror of witnessing the devastation it can cause. I also wanted to prove to myself that I could—how could I ask others to stop drinking if I couldn’t? I didn’t feel any better or worse, and eventually I let myself drink again, but the easy pleasure of my youthful drinking was gone.
I am now a unit-counter, a drink-controller, and I am very hard on myself if I fail to stick to my own rules. I watch other people with an eye of suspicion, and envy those who either drink, or don’t drink, with abandon. For me, and for many others, drinking and guilt walk hand-in-hand.
But sometimes I wonder, if I ditched the guilt and self-monitoring, would I really drink any more? The truth is, I doubt it. Modern life is filled with so many instructions—and apps—telling us how we should live, that it’s quite hard to listen to our own minds and bodies, which are often best at telling us when we’ve had enough. And this leads me to a further thought—can drinking ever actually be good for you?
I don’t mean in terms of the oft-quoted health benefits of red wine; as I think most people know, that is largely wishful thinking. Instead, I mean more in terms of happiness and connection, or fulfilment. Humans have been drinking alcohol for millennia and have always sought substances that change their mental state in one way or another. Even our morning coffee does this. A substance like alcohol, which is so consistently sought after, must surely provide something positive.
At its best, alcohol can be a source of social cohesion. It can help us to interact, make new friends and even find romantic partners. The pleasure of drinking—sensibly—with others should not be denied, and neither should it be tainted by guilt. We must never forget the problems caused by alcohol—both to individuals and society—but neither should we lose sight of the joy it can bring.
The anthropologist and evolutionary psychologist Robin Dunbar has researched these potential benefits. He suggests that they may relate to the triggering of the endorphin system. But one in five adults in the UK don’t drink at all, and there are, of course, many other ways to trigger our endorphins, such as exercise. We don’t need to drink, but many of us do. I’ve spoken to lots of people with alcohol use disorders, both friends and patients, and one thing strikes me: for them, it’s never enough. Most of us quickly tire of drinking, and usually turn down that last one, but for some people this is almost impossible. It’s as if their reward pathway has been mis-set, as if it never says stop and just carries on shouting for more. I often ask my patients: what do you enjoy about drinking? Many of them look at me, uncomprehending. After alcohol has ripped their lives apart there is often no pleasure left. But for others, there is still some joy in drinking, and understanding that can be vital to making changes.
It must be hard to admit to enjoying something that you think you shouldn’t, perhaps even more so when it’s hurting you or the people you love. I’ve heard so many non-drinkers ask blankly about someone with alcohol problems: why can’t they just stop? But this can be a harsh and unforgiving question. Personally, I consider myself enormously lucky that I can stop because, if I couldn’t, I would not be able to continue drinking and would have to stop completely. But perhaps the truth is that I have never enjoyed it enough—that alcohol dependence may be a consequence of liking alcohol far too much, or of finding that it relieves pain far too well, at least at the start. Later it causes its own pain.
A cool glass of wine with a friend is the epitome of joy for me, but it’s just as much about the friend, and the end of the day, and relaxing. I would never advise someone else to drink, but neither would I promote universal abstinence. The pandemic has made life harder for many of us, with people less able to see each other, and there’s no doubt that some are drinking more to relieve boredom and depression, and perhaps to fill the gaps caused by social isolation. Hopefully 2022 will bring more happiness to all of us. For those of us who drink, we will enjoy it in moderation. Drink when your mood is good, drink with friends and stop as soon as it no longer makes you happy. I think that works for me.
