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Jay R. Brooks on Beer

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Inflating Binge Drinking Statistics

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binge-barney
The biggest problem with binge drinking statistics is that the definition keeps changing. Over the last few decades it’s gone from somewhat vague to an increasingly narrow definition. Each change in the definition increases the number of binge drinkers. It’s not that more people are binge drinking necessarily, but that more people fall under the definition as they lower it and lower it.

At the bottom of an NPR story, Binge Drinking: A Big Problem, Especially For The Prosperous, there’s a strange little video about binge drinking put together by the CDC. In it, they reveal some disturbing ways of looking at what it means to binge drink.

The most recent way our government defines binge drinking is “[f]our or more drinks within a few hours for a woman and five or more for a man.” That actually narrows yet again, as recently as the last few years it’s been “five or more drinks in a row,” which tends to imply more speed. Adding “within a few hours” means even drinking at a leisurely pace makes you a binge drinker. I wrote more about this shift last year in a post, Inventing Binge Drinking.

The CDC video further claims that “half of all alcohol consumed by adults in the US is binge drinking.” Wow, that’s pretty remarkable, especially if you consider that according to the DOJ only 54% of adults drink alcohol. We’re now a nation of binge drinkers. You’d think a society where 1 in 2 people drinking is on a bender would be more noticeable. But look out your door or window and unless there’s a car alarm going off, it’s more likely you’ll hear crickets and birds chirping, not the devastation implied by that alarming factoid.

They also claim “1.5 billion episodes of binge drinking” take place each year in the U.S. That’s 5 for every man, woman and child in the country, or 6.25 times for every adult. If we assume the DOJ’s statistic that 46% of adults don’t drink alcohol, then that’s 11.6 for every adult who does imbibe, or nearly once a month. That’s a lot of benders. Or is it? Is having five drinks less than once a month really an alarming societal problem? I go to a beer dinner probably at least once a month and most are at least five courses. That makes me a binge drinker, but I’m hardly a danger to society because of it. Clearly, for some individuals persistent binge drinking is a serious problem, but the people who fall into that category represent a very small minority of all drinkers.

Toward the end of the NPR article, they have this to add.

The problem, though bad, isn’t a lot worse than it used to be. In 1993, the CDC says, about 14 percent of adults had gone on drinking binges. But as Dr. Thomas Frieden, head of the CDC put it, “Because binge drinking is not recognized as a problem, it has not decreased in 15 years.”

That’s a pretty glaring inconsistency. On one hand, the CDC claims that “half of all alcohol consumed by adults in the US is binge drinking” but only “14 percent of adults had gone on drinking binges.” But my favorite howler is the statement that “binge drinking is not recognized as a problem.” What planet is he living on, because neo-prohibitionists and the health, university and government research communities, not to mention all the treatment and addiction businesses that stand to make more money if the problem keeps increasing, have been screaming about the perils of binge drinking as long as I’ve been an adult, and probably longer. And the hue and cry has only increased in recent decades. But this just serves to prove that binge drinkers aren’t born, they’re created … by statistics.

But wait, it gets worse. According to the CDC video, the NIAAA now defines binge drinking as “consumption that raises blood-alcohol content to .08%.” That’s right folks “binge drinking” and being “drunk” are now exactly the same! Then they go on to say that binge drinkers are “14 times more likely to drive drunk.” Duh, if you define binge drinking as getting drunk, then that’s a self-fulfilling statistic, isn’t it? But it’s pretty alarming that a government agency’s standard for binge drinking is simply drinking enough to raise your BAC to 0.08%.

Other interesting tidbits include that statistic that 70% of binge drinkers are 26 or older and that 80% of binge drinkers are not alcoholics. Of course they’re not alcoholics if all they have to do to binge drink is get drunk once. And if most are legal adults, why the insistence later in the video to maintain 21 as the minimum age of consumption?

Naturally, they propose all the same old chestnuts to “fix” the problems they just created by inflating the statistics. Nothing new is ever proposed. Of course, none of the proposals ever work, either, wherever they’ve been implemented. Here’s the CDC recommendations.

  1. Increase alcohol taxes
  2. Close places that sell alcohol, reducing their number
  3. Close the remaining outlets earlier
  4. Enforce the laws that prohibit underage drinking

But by continually widening the net and artificially adding to the number of people that are considered binge drinkers, it lessens the chances of actually helping the people who truly do need help. All they do is increasingly demonize alcohol manufacturers and criminalize law-abiding people. It’s as if all of the organizations that are anti-alcohol or who make their money from addiction, be it through treatment, medications or whatever, need to keep the issue a dangerous one and have to keep it just bad enough so the money keeps flowing. So it becomes a game of creating the perception of effectiveness while the problem remains perpetually, and conveniently, elusive.

Biting the Hand That Feeds You

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This has has me seriously steaming mad. As you may know, October is Breast Cancer Awareness Month. The brewing community, particularly locally, has done much to help that cause and raise money for breast cancer research and treatment. Marin Brewing has been putting on the Breastfest for ten years now, and the annual beer festival was specifically created to benefit breast cancer awareness. As a side note, Marin County inexplicably has one of the highest rates of breast cancer in the country.

Natalie Cilurzo, co-owner of Russian River Brewing in Santa Rosa, goes all out every October with their All Hopped Up For the Cure campaign to raise money for the cause. For the last few years, they’ve decorated the brewpub in pink and auctioned a pink Vespa. It’s a cause that’s very personal to her and she spends a lot of time and energy on it every year.

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That’s just the Bay Area. In Atlanta, there’s a Beer 4 Boobs beer festival. There are similar breast cancer charity events at breweries and in the form of beer festivals all over the country. Boulder, Colorado has one at Boulder Beer Co. and the Lost Abbey in San Diego sponsored an event along with White Labs. The Ladies of Craft Beer also held a “Beer for Boobs Brunch” at Denver’s Freshcraft restaurant. And that’s probably the tip of the proverbial iceberg.

My own mother died from breast cancer when I was only 22, nearly thirty years ago. I’ve lived virtually my entire adult life without the comfort and counsel of my mother so it’s pretty personal to me, as well. As a result, I’m quite proud that the brewing community is so supportive of a cause that’s near and dear to me and many of my friends.

But apparently I shouldn’t be proud of that. In fact I should be ashamed of it. That’s what Angela Wall of Breast Cancer Action in San Francisco said on MSNBC yesterday. And it wasn’t just an offhand remark, it was the considered position of her organization. They even put up a prepared graphic with the same quote, but from Executive Director Barbara Brenner telling me a second time how ashamed I should be that the brewing community might try to help her cause.

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This reminds me a bit of when Anheuser-Busch put water in plain white beer cans with only their logo and where the water came from and then sent them to Haiti to help with earthquake relief. The Marin Institute had the temerity to chastise them in a press release for putting their logo on the cans and, wait for it, sending out a press release about it. I wrote all about that in Let No Good Deed Go Unpunished.

This is the same thing. But there’s a couple of ways to look at her problem with alcohol companies raising money for breast cancer. First — for purposes of discussion — let’s assume that alcohol does indeed cause breast cancer. The Marin Institute has this hokey idea of “charge for harm” where they believe that whatever “harm” is caused by people drinking alcohol should have to be paid for by the companies who make it. It’s a specious argument, but again — just to talk about it — let’s say that they’re right. Wouldn’t the industry actually paying money for their supposed harm be a good thing, exactly what their critics think they should be doing? That they’re raising money for breast cancer should be seen as a good thing, shouldn’t it? If they think the alcohol industry is causing the problem, then this should be exactly what the industry should do. But they don’t, do they? They think the industry shouldn’t be doing that, and they think they shouldn’t be trying to make a profit either.

Wall claims that “trying to sell alcohol to promote breast cancer awareness” is “shameful” because alcohol also carries a risk of breast cancer. But that makes no sense. Does she think for that reason alone, alcohol companies should simply just go out of business and stop making their products? Obviously, that would harm the economy and put thousands out of work. And of course, not everyone who drinks will get breast cancer. So presumably she’d prefer that the alcohol companies simply not raise money for her cause, but that seems counter-intuitive since it’s money that funds research into finding a cure for breast cancer. But since no one’s going to stop making alcohol just on her say so, I honestly don’t understand why she’d turn down money that might actually help find a cure if it didn’t come from the “right” source.

I would very much want there to be a cure for breast cancer found, if for no grander reason than I hope no one else has to go through losing their mother at a young age. I’m sure many people feel that way, and a number of them probably also work in the alcohol field. Some of them are my friends. But here Wall is telling me we should be ashamed of feeling that way because we work in the alcohol industry. I have to say, that pisses me off but good. I don’t think I’ve ever felt so conflicted about wanting to help a cause but feeling deeply offended and insulted by some of the people and organizations involved in it.

But perhaps the most telling part of the interview was when the MSNBC reporter remarked that one alcohol company had donated $500,000 to breast cancer awareness causes and then she asked a simple, direct question of Wall. “Do you think that money should be given back?” Wall hems and haws, but refuses to give a yes or no answer, indeed never really even addresses the question. Clearly, she’s not giving the money back. But the brewing industry, we’re the hypocrites?

On a post at their Think Before You Pink blog about this MSNBC appearance, they state that “[w]hile we do believe that the media focuses too heavily on lifestyle (diet and exercise, for example) in discussion of breast cancer risk, it’s irresponsible for companies to encourage people to ‘drink year round for breast cancer.'” So what Breast Cancer Action is saying is that they don’t like the media or how it covers breast cancer, but they’re still willing to use it when it suits them by appearing on it to further their agenda and get their message out. So I ask again, it’s the alcohol industry who’s being hypocritical by raising money for breast cancer?

One other quite strange argument made by Angela Wall for why alcohol companies should not be raising money for breast cancer was that it was no longer necessary. She said. “I don’t think anybody in this country is unaware of breast cancer in this month.” Oh, really? I guess we’re done with this issue, no more awareness or money is needed, the fight is over. Good job everybody, you can go home now. Of course, then why bother to keep designating October as Breast Cancer Awareness Month? If their work is done, why bother? You get the feeling she really hates us, if she’d go so far as to try and convince people that whatever money we raise isn’t even necessary. But I guess we should be getting used to that. Being in the alcohol industry is increasingly like being the fat kid at model camp. Everyone feels like they can make fun of us and attack us because, you know, we’re fat after all.

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The basis for Breast Cancer Action’s outrage is the results of one new study in the Journal of Clinical Oncology that “found drinking alcoholic beverages, including wine, beer and liquor, may increase risk of breast cancer recurrence, particularly among postmenopausal and overweight and/or obese women.” That’s as reported in a story in Food Consumer, which also cherry picks a few other studies which show similar risks. But that’s not exactly the whole story nor is this exactly as settled as they’d like you to believe, not by a long shot. While studies do indeed appear to show an increased risk of breast cancer in women, at least one done by Kaiser Permanente shows that it’s the amount that matters, the higher the intake the greater the risk, meaning moderate drinking has less risk.

Still others show just the opposite. For example, a 2008 study at the Universidade do Porto, Porto, Portugal showed that Compounds in Beer and Wine Slow Breast Cancer Cell Growth. Still another suggests that “xanthohumol found in hops [has] the potential to lower the risk of prostate cancer, [and] researchers believe it could also reduce breast cancer risk in a similar manner — by binding to the receptors on breast cancer cells and blocking the effects of estrogen which stimulates the growth of certain types of breast cancer.” That’s about the discovery that xanthohumol is a Cancer-fighting agent found in beer.

In a fact sheet about the relationship between Alcohol and the Risk of Breast Cancer at Cornell University, there’s this sage advice:

Researchers have reported that women who consume light to moderate amounts of alcohol have a decreased risk of developing and dying from cardiovascular disease. Since more women are affected by and may die from cardiovascular diseases than breast cancer, the recommendations regarding alcohol and breast cancer may seem to contradict the reports regarding cardiovascular disease. The 1996 Guidelines on Diet, Nutrition and Cancer Prevention from the American Cancer Society suggest that most adults can drink, but they should limit their intake. Given the complex relationship between alcohol consumption and different diseases, any recommendations should be based on information about all health risks and benefits.

Exactly. Of course women should make individual decisions based upon their family history and/or other personal factors, but making a pronouncement for everyone is wrong. The overall positive effects of moderate alcohol consumption have to be weighed against individual risk factors. For example, total mortality is effected positively by moderate alcohol consumption, that is numerous studies and meta-studies have shown that people who drink in moderation will most likely live longer than people who abstain completely or who regularly binge drink. And that’s taking into account both the negative and positive risks and rewards.

So the Breast Cancer Action’s outrage seems to avoid looking at the big picture and instead focuses all it’s enmity at one individual study. I’m not saying it shouldn’t be concerned by that study, but to not factor in any other and to use that to shout at organizations trying to help their cause is unbelievably obnoxious and off-putting.

Wall also claims that alcohol represents the “only proven link between food and breast cancer.” Hmm, let’s break that down. That’s a pretty declarative statement for something as complex as the relationship between cancer and alcohol and how the body processes it. That there are studies that seem to show an increased risk of breast cancer and others which show just the opposite suggests that a definite link has hardly been “proven.” But perhaps more annoying is her saying that it’s the only food that increases the risk of breast cancer. Dietary fat also appears to be linked. “International findings suggest that breast cancer rates are minimal in countries where the standard diet is low in fat (particularly animal fat). It is known that fat cells play a role in estrogen production, especially in postmenopausal women. Therefore, being overweight may contribute to risky estrogen exposure in such individuals.” According to WebMD:

The link between diet and breast cancer is debated. Obesity is a noteworthy risk factor, and drinking alcohol regularly — more than a couple of drinks a day — may promote the disease. Many studies have shown that women whose diets are high in fat are more likely to get the disease. Researchers suspect that if a woman lowers her daily calories from fat — to less than 20%-30% — her diet may help protect her from developing breast cancer.

So if being obese puts you at risk for breast cancer and eating food is what causes you to become obese, I’d say that food played a pretty direct role there. And let’s not forget that earlier this year, Breast Cancer Action similarly chastised one of their own, Susan G. Komen For the Cure, for partnering with KFC in “Buckets For the Cure.” Characterizing themselves as “the respected watchdog of the breast cancer movement,” one of their problems with the KFC partnership was that it exploited “breast cancer and [would] do the most harm in low income communities that are already disproportionately affected by health issues like obesity and diabetes, as well as breast cancer.” They went all out against them on their Think Before You Pink blog. Maybe not a direct reference to food, but they’re certainly linking food, obesity and breast cancer with KFC’s new pinkwashing campaign to “raise money for breast cancer” is half-cooked!

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Obviously, this story really pushed my buttons. Breast Cancer Action essentially is trying to invalidate the hard work of friends of mine who are sincerely trying to help find a cure for breast cancer and who have raised a lot of money in support of that cause. More than that, they’ve insulted those people for their sincere efforts. Quite frankly, I think they should be ashamed of themselves.

You can watch the entire story for yourself from MSNBC below.

Some Additional Thoughts: Since this post went online a few days ago, I was actually surprised to see that a lot of people shared my anger and frustration over this and similar experiences people have had. After reading the comments along with some experiences I’ve had with other charities, I’m really starting to believe that there’s now a “charitable industrial complex,” that these behemoth charities have become big business in their own right. And from what some of you have written, and from what I’ve seen, it appears that, like many big corporations, much of the profits go to the people who run them and only a little goes to shareholders, or in this case to the actual charitable cause itself. They seem to have become more about the money than the well-intentioned passion to do something about an issue that led to their formation. That’s a deeply disturbing trend.

Second, another thought occurred to me about how Breast Cancer Action was wrong to insult the alcohol community for their efforts. In the video from MSNBC, the piece opens by singling out Mike’s Hard Lemonade and Chambord for having programs designed to benefit breast cancer awareness. But what they didn’t ask was why? There are lots of worthy causes any company could choose to support. It’s possible it was just a calculated decision to ensnare more female drinkers, but there could be another, more personal, reason, too. All of the people in the brewing industry I know who do a lot for breast cancer, do so because breast cancer has touched their loves at some point. That’s why I’m passionate about the cause, and I suspect that that’s not an uncommon feeling. So it’s at least possible, I’d say even plausible, that Chambord decided to support breast cancer awareness because someone in the company or someone close to the company had breast cancer or knew someone who did. With so many available causes, people tend to pick the one that’s personal to them. My family tends to support Autism charities for the simple reason that our son Porter is autistic. I’d say that’s a pretty typical response. I’d be willing to say most charities are supported by the people who have been effected most by the diseases or issues at the heart of any particular charity.

According to the American Cancer Society, “[b]reast cancer is the most common cancer among women in the United States, other than skin cancer. It is the second leading cause of cancer death in women, after lung cancer. The chance of a woman having invasive breast cancer some time during her life is a little less 1 in 8. The chance of dying from breast cancer is about 1 in 35.” So that’s a lot of people and suggests that a large percentage of the population have been touched by breast cancer, either directly or indirectly. So I think it’s entirely likely that Chambord may have started their breast cancer awareness campaign precisely because someone in the company had an experience with breast cancer and wanted to do something about it. Perhaps it was to honor a loved one’s memory or perhaps to celebrate a survivor. We don’t know because Breast Cancer Action didn’t even bother to ask before lashing out at them for trying to do a good deed. As far as I can tell, they just assumed an evil intent but never asked the simple question “why.” My guess is they don’t actually care what the answer is, and asking it may have stopped their own quest for attention and publicity and donations.

Mayor’s Veto Stands, No SF Alcohol Tax For Now

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After San Francisco Supervisor John Avalos asked for a week’s postponement, his attempt to override Mayor Gavin Newsom’s veto of the proposed ordinance imposing an alcohol tax in the city failed today. The Chronicle is reporting that, as many expected, Avalos was unable to find the vote he needed to override Newsom’s veto two weeks ago.

In the last two weeks Avalos has spent his time on more political gamesmanship, questioning the mayor’s right to veto, despite the question having been answered by the court in 1986. No word yet whether he’ll now take the vote to the people, something he claimed to be considering after the mayor’s veto. Only time will tell, but I doubt we’ve heard the last of this issue. This sure is one dead horse, but I’m sure he’ll find a way to keep beating it.

Family Dining Leads To Responsible Drinking

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It’s not often I agree with the neo-prohibitionists but last month the National Center on Addiction and Substance Abuse (CASA) released the findings of their sixth annual Importance of Family Dinners survey. And guess what, kids who eat with their parents at family dinners are less likely to develop bad habits like binge drinking, smoking or drug use. It’s one of those studies I characterize as “duh studies,” because the results are so obvious. Do we really need a survey to tell us that being engaged with our children is better than being alienated from them? At any rate, Medical News Today, has the story of this year’s survey.

The first one was conducted in 2003, and based on their survey concluded that “teens who have dinner with their families five or more nights in a week are 32 percent likelier never to have tried cigarettes (86 percent vs. 65 percent), 45 percent likelier never to have tried alcohol (68 percent vs. 47 percent), and 24 percent likelier never to have smoked pot (88 percent vs. 71 percent). This also led to CASA creating a holiday, Family Day — A Day to Eat Dinner with Your Children (September 27) and it’s one that I support and list on my calendar database of holidays.

But here’s my one quibble and where we part company — it’s always something, right? — these same organizations that celebrate family are the same groups that also have pushed to make it illegal for parents to give their own children a taste of alcohol in the home, believing they know better. For example, California just added civil penalties to the criminal ones for giving alcohol to a minor in the home. In theory, I’m not allowed to teach my own children about alcohol when I, as their parent, believe it’s appropriate. The best I can do is model responsible behavior by my example of drinking in moderation and trying to cast doubt on the propaganda they’ve been receiving at school literally since kindergarten that’s mandated by the state and with “learning” materials from MADD.

These same groups also have pressured state alcohol regulators to not allow kids at beer festivals, though wine tastings are usually just fine. They claim to love family and want kids to not engage in what they believe to be dangerous behaviors, at least while they’re minors, but at the same time want to deny parents the tools and resources to educate their own children about those dangers. They don’t want kids even seeing adults drink, even though it’s legal for adults to do so and it would allow children to see their parents drink responsibly, thus showing by example how the majority of Americans consume it. It would model good behavior and act as a balance to negative stereotypes, showing that drinking can be part of a healthy adult lifestyle. Showing both the positive and the negative stereotypes would teach kids they have a choice, that drinking doesn’t have to lead to destructive behaviors if done responsibly.

We already know what happens when they’re not permitted to learn that lesson. They go off to college or out in the world and, on their own for the first time, binge drink or worse. And who can blame them? If they’ve seen no positive drinking examples and only know the propaganda they’ve been brainwashed with since elementary school, what else should we expect?

I agree that families should be engaged, that parents should be involved with their kids and especially their teenagers. But as long as parents are handicapped by misguided anti-alcohol advocates who think “just say no” is a valid approach or think kindergarten is an appropriate age to begin teaching kids about drinking and driving, then nothing will change. Real change has to begin at home, with the family, and that also has to include modeling positive behavior and freeing parents to make decisions about their own children.

I see the negative effects of the propaganda every time my six-year old daughter reminds me beer is a drug and I have to, yet again, explain to her that it’s okay for Daddy and other adults to drink it. Either they can’t be bothered to explain the difference between legal alcohol and drugs or she’s too young to grasp the concept. Either way, it’s not working. When Porter was her age, he came home from the “Red Ribbon Week” lectures chiding us for using cold medicine because it was a drug, and “all drugs are bad.” That’s the message he got. But that’s what happens when zealots are allowed to shape the policy and parents are cut out of the decision-making process for raising their own children.

The Most Dangerous Things & The Duckworth Scale

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Over the weekend I was perusing a book I picked up during my last trip to England, The Book of General Ignorance, a trivia book based on a British TV show, QI, which stands for Quite Interesting. There’s a whole series of QI books, and I was drawn to it initially because Stephen Fry was involved, and I’m a big fan of his work. One of the entries I read recently was entitled “What’s three times more dangerous than war?” It was the first sentence that leapt out at me. “Work is a bigger killer than drink, drugs or war.”

Many anti-alcohol organizations begin their press releases, policy papers, etc. with the eye-catching statistic that alcohol-related deaths account for a higher number of deaths than another kind. But this seems to fly in the face of that. It claims that “around two million people die every year from work-related accidents and diseases, as opposed to a mere 650,000 who are killed in wars.” While I might quibble with the adjective “mere,” it’s clear that far more die at work or in war than from alcohol. You can read the entire entry on the bottom of page 69 through Google Books.

Of course, some recent studies insist that two million die worldwide each year due to alcohol-related causes. Still others insist it’s involved in 1 in 25 deaths, which would mean that if it were really 2 million, then total world mortality for a given year would be 50 million. According to the UN, about 62 million people die each year. In the World Health Organization’s top 10 causes of death worldwide, alcohol is not among them. In 2001, a study by the CDC claimed 75,754 deaths were attributable to alcohol, but added that “low consumption has some beneficial effects, so a net 59,180 deaths were attributed to alcohol.” I could keep going citing study after study with different results, because the way you structure the statistics leads to the ultimate results. And that’s why who does the study and/or their motives are so important. And that’s why you shouldn’t believe such statistics without finding out where they came from, not even mine.

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Somewhat off-topic, but quite interesting — at least to me — is the statistics behind the QI’s pronouncement of what’s safe and what’s dangerous were based on The Duckworth Scale, a “scale for assessing the risks involved in various activities” created in 1999. It takes its name from its creator, Dr. Frank Duckworth, a retired statistician. The scale is logarithmic, like the Richter scale for earthquakes. It grades one’s risk of death from activities ranging from washing up to playing Russian Roulette. It starts at zero for living on planet earth for a year, to a maximum of eight for certain death.

The Duckworth Scale

  • 8.0 Suicide Russian roulette (six bullets)
    Jumping off Eiffel Tower
    Lying in front of Flying Scotsman
  • 7.2 Russian Roulette (one game)
  • 7.1 Continuing smoking cigarettes (male aged 35 – 40 a day)
  • 6.9 Continuing smoking cigarettes (male aged 35 – 20 a day)
  • 6.7 Continuing smoking cigarettes (male aged 35 – 10 a day)
  • 6.4 Deep sea fishing (40 year career)
  • 6.3 Rock climbing over 20 years
  • 5.5 Accidental falls (new born male)
    Lifetime car travel (new born male)
    Dying while vacuuming
    Dying while washing up
    Dying while walking down the street
  • 4.6 Murder (new born male)
  • 4.2 Rock climbing (one session)
  • 2.0 Riding fairground rides (100 times)
  • 1.9 100 mile car journey (sober middle aged driver)
  • 1.7 100 mile flight
  • 1.6 Destructive asteroid impact (in the life-time of a new born male)
  • 0.3 100 mile rail journey

Those are the only ones I could find on the scale, but I’d love to see where more activities fall on the scale. Has anyone seen a more comprehensive list?

Calling The Brew Kettle Black

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In an irony apparently lost on the Marin Institute, their latest missive to the faithful accuses Big Alcohol of doing “anything” to protect their business. The exact headline is Big Alcohol will do anything to avoid paying for alcohol-related harm. This is related to the industry’s recent support of California Proposition 26, which is attempting to close the loophole created by the California Supreme Court that allows “fees” to be imposed under certain conditions with just a majority vote rather than the 2/3 vote required for ordinary taxes. This has led to a spate of taxes pretending to be fees being imposed throughout the state. The proposition seeks to expose those hidden taxes and subject them to the same standard as any other taxes.

As I wrote before in Trash Talking Prop 26, this proposition was not started by the alcohol industry, or even the oil or tobacco industries, but was a grassroots effort sponsored by the California Chamber of Commerce and the California Taxpayers’ Association, and is supported by nearly sixty chambers of commerce and tax organizations. There is also support from trade organizations in a wide range of businesses and industries. It wasn’t until August that alcohol donations were made and that’s a significant point the Marin Institute is conveniently ignoring. It was at that time that “every company who makes alcohol, distributes alcohol and sells and serves alcohol realized they were under attack by the Marin Institute, who was pushing [San Francisco supervisor John] Avalos and supplying him him with all the resources for the test case to add a new tax to alcohol in San Francisco. That’s when most of us even became aware of Prop 26. Before that, I’d wager, hardly anyone in the alcohol industry had paid it much attention. When you’re being attacked, you tend to defend yourself.”

So at a minimum, the Marin Institute is mis-characterizing Prop 26 and at worst is using the results of its own actions to claim that the alcohol industry will go to great lengths to “avoid paying for alcohol-related harm.” But first of all, the notion of “alcohol-related harm” is something that the Marin Institute made up themselves. Alcohol companies, like any business, are simply trying to protect themselves from having to pay more taxes. This is something every company in every industry would do, in fact has to do, indeed is mandated to do by their corporate charter. Shareholders would be right to revolt if they didn’t take those steps. That the Marin Institute is using this very reasonable and understandable reaction to being attacked by the Marin Institute to paint the industry as going too far is more than a little hypocritical as it shows the lengths that they will go to in bending reality to their service. The rest of the missive also misstates what the proposition is really about, further showing how far they’ll go to further their agenda. If that’s not the pot calling the brew kettle black, I don’t know what is.

Beer Drinkers Are Normal, Study Derisively Claims

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In yet another hatchet job by the National Institute on Alcohol Abuse and Alcoholism, a new study they sponsored declares “Alcohol Consumers Are Becoming The Norm,” as if that’s a bad thing. The longitudinal study using data almost two decades old from the NIAAA’s 1991-92 National Longitudinal Alcohol Epidemiologic Survey and the 2001-02 National Epidemiologic Study on Alcohol and Related Conditions was conducted by researchers at the UT Southwestern School of Health Professions. The results are being be published this month in Alcoholism: Clinical and Experimental Research, a journal of the National Council on Alcoholism and Drug Dependence. To say the study is most likely biased, without even having to look at it, is something of an understatement.

The press release for the study begins with this eye-catching pronouncement. “More people are drinking than 20 years ago.” But that’s not correct. A more accurate statement would be that more people are drinking eight years ago than were doing so twenty years ago. Not quite as sexy, or alarming, but correct based on the actual data the study examined.

But really, even if true, if more people are indeed drinking today than twenty years ago, so what? The statement completely ignores context. We know mass-produced beer is down. We know craft beer is up. Couldn’t an equally valid explanation be that more people are drinking less, but better beer. That would mean more moderate drinking, which has shown to cause people to live longer than either abstaining or over-drinking. Shouldn’t that be considered be excellent news? But when the people studying the data owe their careers and paychecks to the study of “alcoholism,” it’s always bad news. The glass is quite literally, always half empty.

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Just look at how they define drinkers vs. non-drinkers. For purposes of the study, someone who has had twelve drinks of at least “0.6 ounces” in the last year is considered a drinker. That’s a total of 7.2 ounces in an entire year and you’re a “drinker.” That’s less than half a pint in a year, for chrissakes. Less than that and you’re a non-drinker. Talk about just saying no. But an increase in the number of people who’ve had less than a half pint is on the increase, apparently, and that’s cause for alarm? Are you kidding me? That would be laughable if lead researcher Dr. Caetano didn’t sound so serious. He thinks “that continuous monitoring of alcohol consumption levels is needed to understand better the factors that affect consumption. Monitoring also would help to detect as early as possible signs that rates of risky drinking behaviors such as binge drinking or drinking to intoxication may be increasing.” And he’s worried about people who’ve consumed as little as 7.2 oz. in one year. Is it just me, or is that the proverbial tempest in a pint glass?

But wait, it gets better. Based on what any reasonable person would consider almost no drinking at all, he has the following recommendations.

“This suggests to us that a variety of public-health policies such as restrictions on alcohol advertising, regulating high-alcohol-content beverages, increasing taxes on alcohol, as well as treatment and brief interventions may be needed to reduce alcohol-related problems,” he said.

How? How does that suggest these draconian measures? To them, the “reasons for the uptick vary and may involve complex sociodemographic changes in the population, but the findings are clear: More people are consuming alcohol now than in the early 1990s.” But that’s not even true from their own findings. First of all, as I said before, this compares a study from 1991-92 to another one conducted in 2001-02. That was eight years ago, not “now” as he states. Then with such flimsy increases using as their base amount less than 8 oz. of alcohol consumed in an entire year, they think it’s appropriate to make recommendations calling for more regulation, higher taxes and more medical intervention. That’s completely absurd and utterly disproportional to the findings.

This seems so obviously an agenda in search of a study. The suggestions were already in place. It’s the same nonsense that neo-prohibitionist groups have been pushing for years. This study was just shamelessly shoe-horned into that agenda.

But again I think part of what bothers me about these type of studies is that they take the view that any drinking is bad, no matter how small or moderate. They don’t take into account the context of the drinking. Is it with food? Is it with friends over a long period of time? Is it a few times a week or all at once? Even the Federal government increased their recommendations of safe drinking from two to four drinks a day, assuming the weekly intake stays below their recommendations. And they’ve acknowledged the numerous studies that show moderate drinking is part of a healthy lifestyle and will also most likely mean you’ll live longer. But these anti-alcohol funded studies just add up the amounts people drink and say it’s all bad for you, no context necessary. It’s just self-serving propaganda. If an alcohol industry group had sponsored this, it would have been dismissed immediately. But anti-alcohol groups get no such scrutiny. Their studies are embraced by the medical community, such as Medical News Today, which ran the study’s press release as a news story almost verbatim. Also, Science Daily reprinted the press release as news, disclosing its source at the bottom, well after the average reader stopped reading it. They also provide a link to the press release and the original journal article, something that Medical News Today can’t be bothered to do.

Though the headline is Alcohol Consumers Are Becoming The Norm, the title of the study itself is Sociodemographic Predictors of Pattern and Volume of Alcohol Consumption Across Hispanics, Blacks, and Whites: 10-Year Trend (1992–2002), the headline bears very little resemblance to the study itself.

Here’s the abstract:

Keywords: Ethnicity; Race; Binge Drinking; Drunkenness; Intoxication; Whites; Blacks; Hispanics

Background:  There have been limited trend studies examining variations on the patterns of alcohol consumption among Whites, Blacks, and Hispanics in the United States. The current paper reports national trends in drinking patterns, volume of drinking (number of drinks per month), binge drinking, and drinking to intoxication among Blacks, Whites, and Hispanics over a period of 10 years and identifies sociodemographic predictors of these behaviors across the 3 ethnic groups.

Methods:  Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population.

Results:  Trends varied across different dimensions of drinking and ethnic groups. There were no statistically significant differences in the mean number of drinks consumed per month among men and women in any of the 3 ethnic groups between 1992 and 2002, but there was a significant rise in the proportion of current drinkers in both genders and in all 3 ethnic groups. Multivariate analysis indicated that, compared to Whites in 1992, Blacks and Hispanics did not increase their volume of drinking, but Whites did. Drinking 5 or more drinks in day at all did not increase between 1992 and 2002, but drinking 5 or more drinks at least once a month was more likely for all groups in 2002 compared to Whites in 1992. Drinking to intoxication at all was more likely among Whites in 2002 than 1992, but drinking to intoxication at least once a month was more likely among Whites and Blacks in 2002 than 1992.

Conclusion:  The only common trend between 1992 and 2002 across both genders and 3 ethnic groups was a rise in the proportion of drinkers. There was also a rise in drinking 5 or more drinks in a day (Whites, Blacks, and Hispanics) and drinking to intoxication (Whites and Blacks), but this was limited to those reporting such drinking at least once a month. The reasons for these changes are many and may involve complex sociodemographic changes in the population. It is important for the field to closely monitor these cross-ethnic trends in alcohol consumption.

I don’t see a reference to the headline, Alcohol Consumers Are Becoming The Norm, anywhere in either the press release or the abstract. Nothing in the abstract addresses normalization of any kind. After the headline, it’s never mentioned again. I don’t understand what it even means, becoming the norm? Alcohol has been consumed since the beginning of civilization. It hasn’t suddenly become anything. It’s been perfectly normal for adults to drink alcohol since at least 1933, when it became legal again in the U.S. It’s pretty hard to take the whole thing very seriously, when the headline itself is nothing but sensationalist propaganda.

Original AA Bible More Religious

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I’ve been somewhat suspicious of Alcoholics Anonymous for many years. I grew up with an alcoholic stepfather, and had some experience with AA when I was younger, which you can read about in an earlier post. One of my big issues has been the idea of powerlessness and giving yourself over to a “higher power.” Though AA has been careful to use the non-denominational “higher power,” it always felt like a thinly veiled religious god, and more specifically one of the monotheistic sky-gods (of Christianity, Islam and Judaism).

But the idea that you can’t rely on yourself, your own will, has always troubled me. I know it seems to work for a lot of people, but it never felt like a cure, just a lifelong band-aid over a wound that never heals because the wound itself is never even treated. And I know I’m not the only one. There are treatment centers in Japan whose patients are able to drink in moderation without immediately becoming “alcoholics” after one sip. And a controversial book last year by Harvard psychology professor Gene M. Heyman, Addiction: A Disorder of Choice, punched further holes in AA’s insistence of powerlessness in alcoholics.

Why that matters, I think, is for this reason. As Science-Based Medicine reminds us, that makes AA a faith-based treatment, not a scientifically sound method of treating anyone. They write: “Alcoholics Anonymous is the most widely used treatment for alcoholism. It is mandated by the courts, accepted by mainstream medicine, and required by insurance companies. AA is generally assumed to be the most effective treatment for alcoholism, or at least “an” effective treatment. That assumption is wrong.”

And there are plenty of other critics out there, such as Sober Without Gods, Stinkin’ Thinkin’ and this particularly interesting essay, I Was An AA Nazi, at When they tell you to ‘Keep Coming Back’, run for your life!!! Escape from Alcoholics Anonymous. And there’s at least two Yahoo groups, Escaping the Cult of AA and 12-Step Free. And that, I assume, just skims the surface. Reading some of those, AA comes off more like a cult than anything else. As many of its critics also point out, many former alcoholics replace their addiction to booze with an addition to AA or religion more generally. I realize many people will argue that the latter is safer and healthier than the former, but isn’t obvious that trading one addiction for another is no cure and does nothing to address any underlying causes?

Now, more evidence is coming to light that even the “higher power” dodge in AA wasn’t always there. As a recent article in the Washington Post reported, founder Bill Wilson’s original manuscript from before 1939, which is being published for the first time, shows that the original document was nakedly Christian in its tone. But before it was published, Wilson had a number of people help him edit his manuscript, and how to characterize religion in it became a hotly debated topic. Eventually all references to a specific god were generalized and changed so they could be essentially anything. That was a calculated decision.

According to the Post, “AA historians [whatever that means] and treatment experts say” claim the edits were made to “adopt a more inclusive tone was enormously important in making the deeply spiritual text accessible to the non-religious and non-Christian.” Frankly, that sounds like apologetics. The changes were largely semantical, the tone of the program remained deeply religious, only the names were changed so it could be claimed it was not. That allowed it to be spread farther and wider than if it had remained true to its roots, and I’m even willing to believe that in 1939 their heart was in the right place. The idea of religious freedom has been in our Constitution almost since the beginning, but we’ve been a mostly-Christian nation for the majority of our history. It’s really only been in recent decades that the promise of the First Amendment is beginning to be addressed and enforced.

But in 1939, they decided not to address the role of religion in treating addiction, instead opting to essentially try to hide its “spirituality” or at least tried to couch it in non-denominational platitudes.

But the crossed-out phrases and scribbles make clear that the words easily could have read differently. And the edits embody a debate that continues today: How should the role of spirituality and religion be handled in addiction treatment?

They also take readers back to an era when churches and society generally stigmatized alcohol addicts as immoral rather than ill. The AA movement’s reframing of addiction as having a physical component (the “doctor’s opinion” that opens the book calls it “a kind of allergy”) was revolutionary, experts say.

Maybe, but today AA’s Big Book (a.k.a. its “Bible”) has changed little since those initial edits. It’s remained almost exactly the same, only a few of the stories have been updated. But the world has not stayed the same as it was in 1939. People’s approach to religion has changed dramatically. We’re a more diverse nation spiritually than we were then, I’d wager, and more tolerant (I continue to hope) of other points of view. I’m sure AA seemed revolutionary at the time, 70+ years ago, but remaining the same while the world changed around it has turned it into an antiquated cult. Not to mention, much more has been learned about addiction, much of contradicting AA’s original premises and methods. And while some claim AA has incorporated these newer insights into the program, it seems to me it’s remained largely unchanged at its core. Certainly its bible has remained the same, as religious as the day it started.

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The 4th edition of AA’s Big Book, which is the most current, is available online.

A New Justification For More Beer Taxes

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rwjf
Ugh, here we go again. Three researchers at the University of Florida, led by epidemiologist Alexander C. Wagenaar, have just released a new study which they claim shows that raising alcohol taxes — in fact doubling them — will reduce consumption and cure society’s problems.

The study, Effects of Alcohol Tax and Price Policies on Morbidity and Mortality: A Systematic Review, is to be published in the November issue of the American Journal of Public Health, but was released online last week, as is common for academic journals.

As I don’t have the resources to buy a subscription to every related academic journal, I have to make do with the abstract and what other news outlets write about it. Here’s the abstract:

Objectives. We systematically reviewed the effects of alcohol taxes and prices on alcohol-related morbidity and mortality to assess their public health impact.

Methods. We searched 12 databases, along with articles’ reference lists, for studies providing estimates of the relationship between alcohol taxes and prices and measures of risky behavior or morbidity and mortality, then coded for effect sizes and numerous population and study characteristics. We combined independent estimates in random-effects models to obtain aggregate effect estimates.

Results. We identified 50 articles, containing 340 estimates. Meta-estimates were r=–0.347 for alcohol-related disease and injury outcomes, –0.022 for violence, –0.048 for suicide, –0.112 for traffic crash outcomes, –0.055 for sexually transmitted diseases, –0.022 for other drug use, and –0.014 for crime and other misbehavior measures. All except suicide were statistically significant.

Conclusions. Public policies affecting the price of alcoholic beverages have significant effects on alcohol-related disease and injury rates. Our results suggest that doubling the alcohol tax would reduce alcohol-related mortality by an average of 35%, traffic crash deaths by 11%, sexually transmitted disease by 6%, violence by 2%, and crime by 1.4%.

Those are some pretty specific promises and some pretty specific recommendations, something most academic papers assiduously avoid. To me that’s a red flag about the intentions of this study.

Science Daily covered the study in an article today (thanks to Richard S. for sending me the link) entitled Increasing Taxes on Alcoholic Beverages Reduces Disease, Injury, Crime and Death Rates, Study Finds. Obviously, I’m as predisposed to question such a study as the average anti-alcohol wingnut is to swallow it unquestioningly. And I confess something doesn’t smell right with it. My alky sense is tingling.

Having not seen the full article, I’m left wondering exactly what the “50 published research papers containing 340 estimates” means. What is being “estimated?” It reads like it’s the supposed harm that’s being estimated, because I can’t for the life of me understand how you could ever say there’s definitive causation for such a complex relationship as the price of something to “other misbehaviors,” or indeed any of the laundry list of issues the researchers believe are caused by people drinking alcohol. In my experience at looking at these studies, any event in which there was alcohol present is usually sufficient to consider the incident alcohol-related, but that’s nowhere near the same as having been caused by the alcohol. And so these statistics tend to be inflated and, consequently, misused.

But the key insight into the study came in the very last paragraph of Science Daily’s coverage of the study, where they reveal that the funding for the study came from the notorious Robert Wood Johnson Foundation (RWJF), the godfather of neo-prohibitionist groups. The RWJF funds many other neo-prohibitionist groups, and also sets the national agenda in the anti-alcohol community. That they funded this, and other similar studies, suggests that the answer preceded the study, that is it was designed to support their agenda, its conclusions a fait accompli.

To me this also explains professor Wagenaar’s statement. “Results are surprisingly consistent.” Of course, they would be if you’re looking for a correlation. The same team did a similar study in 2007, Raising Alcohol Taxes Reduces Deaths, Study Finds where they examined alcohol-related deaths in Alaska after beer taxes were raised in the state. That study was also funded by the RWJF. Predictably they found the correlation they were looking for, but this is playing with statistics for incredibly complex relationships. Their simple conclusions seem absurd. They ignore any underlying causes for alcohol abuse or suicide or anything else, for that matter. As almost every study like this I’ve ever seen, “alcohol-related” is a thinly veiled attempt to paint any alcohol use, however responsible or moderate, as dangerous and life-threatening. Beer is not a syringe of heroin, despite these same groups’ attempts to portray it that way.

Mark my words, we’re going to see this study used by groups all over the country in renewed efforts to raise beer taxes in state after state. But the only thing I remember happening when the federal excise tax on beer was doubled in 1990 was a loss of jobs and long term economic harm visited on the brewing industry. I don’t recall seeing any victory parties by the anti-alcohol groups once that doubling cured all the problems they previously ascribed to alcohol. They went right on complaining about all the supposed damage caused by the industry. That’s a real world example of what they want to do having none of the outcomes this new study claims would occur under the exact same conditions.

1 In 5 Americans Driving After Drinking

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The National Highway Traffic Safety Administration (NHTSA) released the results of their latest National Survey of Drinking and Driving Attitudes and Behaviors, done in 2008.

That headline grabbing statistic, that one in five have driven after drinking (actually within two hours of drinking) is not about driving “drunk,” but simply after having had any amount of alcohol. That seems a little alarmist and misleading. If I have one beer with lunch and then drive, I’m included in that statistic even though at my size and appetite, it’s unlikely I’m anywhere near 0.08% BAC. It makes for a great headline, but that’s about it. It’s also the statistic featured on the home page for this survey. Here’s the abstract from the NHTSA.

One Out of Five Are Drinker-Drivers

Twenty percent of the public 16 and older had in the past year driven a motor vehicle within two hours of drinking alcohol. About two-thirds of these, or 13% of the total population 16 and older had done so in the past 30 days. The survey produced an estimate of 85.5 million past-month drinking-driving trips, up from 73.7 million trips in 2004 and reversing a declining trend in such trips since 1995. More than three-fourths (78%) of the trips were made by males.

Those who reported driving within two hours of drinking in the past year tended to be more frequent drinkers than did other drivers who drink but do not drive afterwards. More than one in four (28%) drinking drivers usually consumed alcoholic beverages 3 or more days a week, compared to 10% of drivers who drink but do not drink and drive. While few 16- to 20-year-olds reported drinking and driving, those that did averaged 5.7 drinks per sitting during the times they drink alcohol (inclusive of all drinking occasions, not just drinking and driving). For 21- to 24-year-old drinking drivers, their average alcohol intake was 4.2 drinks per sitting. The average number of drinks dropped sharply again for 25- to 34-year-old drinking drivers (3.0), then declined more slowly across ensuing age groups.

But when you look at this same statistic since 1993, when the first survey was taken, it’s been almost exactly the same, changing no more than a percentage point or two in nearly twenty years. The point is that all of the efforts to lower the standard of what it means to be drunk, the scare tactics and increased penalties have done little to change people’s behavior.

As for people driving after meeting our arbitrary definition of being drunk, that’s roughly 17.2 million people (in the last year) or about 8%. That’s more like one in twelve. And though I couldn’t find a companion chart for this stat since 1993, I’d be willing to guess it’s been similarly static.

I should say at this point — though I shouldn’t have to — that I don’t think people should get drunk and drive, so please don’t write and accuse me of that. I’m simply questioning the statistics and the effectiveness of current policy based upon them. As I’ve written before, I tend to think that all that lowering the standard of intoxication from 0.1% to 0.08% has accomplished is to criminalize more people while doing nothing to stop the true problem drinkers from driving.

To me, the real scandal is that not one organization that’s against drunk driving is actively lobbying for a mass transit system that actually works in the U.S. It seems to me that the most obvious way to curb drunk driving is provide an alternative. If history has taught us anything, it’s that we can’t effectively stop people from drinking alcohol. It was illegal for thirteen years, and that didn’t stop anyone. And if this recent study shows us anything, it’s that, right or wrong, people still drive after drinking despite years of increasingly criminalizing that behavior. In short, what we’re doing now isn’t working. Isn’t that obvious?

Many people who want to lower the BAC even further note that in Europe it’s often 0.05% or even lower. But what they fail to point out is that in every country in Europe I’ve ever visited, there are real, viable alternatives to get around using public transportation. But we’re a car country thanks to the actions of the oil and automobile companies in the last century, when they bought up and dismantled public transportation systems. Not to mention the greatest corporate giveaway in history is the public highway system. Imagine how expensive cars would be if the automobile companies had to build the roads, too, like railroads did. So if we want to use Europe as a model, then we have to build an effective public transportation system here, too. And that would have all kinds of positive benefits beyond reducing drunk driving. So let’s get on that.

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You can read the whole survey, in three parts at the NHTSA website, where you can download the pdf’s.