A quick and topical video about what it means to be in control of one's decisions as it relates to alcohol.

https://www.tiktok.com/@bbcnews/video/7295729395971427616

What I've heard of alcoholics describe as a lifelong urge that has to be suppressed every waking moment not to drink that first drink or that will result in a complete lack of control/.../. — Hanover

I think this is an American thing, although made popular via 12 Step philosophy.
It has that American black-and-white, all-or-nothing thinking in it. There is a culturally specific element in how people will interpret their urges.

It's not as if Native Americans, for example, who have extremely high rates of alcoholism, are just weak willed. It's part of their genetic response to the substance.

Do you know of any actual large-scale longitudinal studies that offer evidence of this genetic predisposition?

Obviously, there is a lot of alcoholism (and other forms of drug abuse) among Native Americans. But when considering the circumstances in which they tend to live, substance abuse is no surprise. Many live in a nightmare of a situation, in reservations, like in leper colonies, cut off from the rest of the world, with systemic racism against them, poverty as a background, dependent on state support.
Anyone, regardless of one's genetic predisposition, when placed in such grim prospects would struggle, and be more vulnerable to substance abuse.

Almost everyone who tries alcohol for the first time finds it disgusting, and the first time being drunk is also not necessarily pleasant. But social pressure makes you do it more and more, and allow it to become a pleasurable habit. — Skalidris

There is an explanation that nobody likes their first sip of alcohol, or coffee, or the first puff from a cigarette. These are acquired tastes. It takes deliberate effort to override one's body's natural negative response to them. And it's this deliberate effort to override one's body's natural negative response to a substance or activity that bonds the person to that substance or activity.

My thread was mostly about why we keep on feeding these habits as it promotes escapism and gives less importance to meaningful social interactions.

It seems the crucial element here is in deliberately overriding one's intuitive impulses. This is what becoming "civilized" or "cultured" comes down to, for better or for worse.

For example, when your first impulse is to tell someone "God, you're ugly in that dress!" and you stop yourself, that's an example of deliberately overriding your impulse, and in turn, you're going to be perceived as "cultured".
But it seems this pattern extends to other things as well, such as alcohol.

Some people instantly find alcohol pleasurable, from the fist drink. Many people will tell you that on drinking, it was the first time they felt normal or had a sense of wellbeing. — Tom Storm

But perhaps at that point they had already lost their "drug virginity" to something else.
For example, they have already abused other substances that induce a slight buzz, such as sugar or coffee. Or glue or paint thinner. The stuff many children have been fed in modern times is pretty much setting them up on the course of substance abuse; with all that sugary fizzy drinks and sugary or fatty foods, they are already in a state of buzz. Then they quickly move over to energy drinks with lots of sugar and caffeine. By the time they begin to consume alcohol, they are already seasoned substance abusers, so it's no wonder they like it. (And then easily move on to other drugs.)

Using substances may well be a path some people adopt to manage significant trauma or anxiety disorders.

But this is a maladaptive approach.

Using substances may well be a path some people adopt to manage significant trauma or anxiety disorders.

But this is a maladaptive approach. — baker

That’s one way of classifying it. On the other hand, substance use can make life more bearable and prevent suicide. Many former users have told me it was substance use that helped them to cope with unbearable pain. But in the end they also had to overcome substance use. Using helped them get by for a time.

It is the result of genetics. As the study notes, generally, 50% of the cases of alcoholism are inherited. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3603686/ — Hanover

Okay. But whether a genetic predisposition will express itself depends also on environmental and other factors.

I'm cautious of blaming "genetics" for anything, because blaming "genetics" tends to be a way to absolve the blamer for any responsibility for how they treat the blamed.


All in all, alcohol use and abuse is a very complex topic. So discussing it isn't merely about alcohol, but also about many preconceived notions with which people approach talking about alcohol and social and psychological topics in general.

So my question to you is: do you think that it is the case for alcohol? That it is mostly genetics and there isn't much we can do about it. — Skalidris

It's about how we talk about it, isn't it?

If someone comes to the discussion with the conviction that "everyone is solely responsible for themselves", then such a person will favor such explanations of alcoholism that are in line with that (e.g. "some people just have weak wills"). While someone who believes in the overwhelming power of genetics will just shrug their shoulders and perhaps hope for some medication that can override the genetic defect.
And so on.

I think this is an American thing, although made popular via 12 Step philosophy.
It has that American black-and-white, all-or-nothing thinking in it. There is a culturally specific element in how people will interpret their urges. — baker

It's not black and white at all really in that they never claim you're recovered. It's just the basics of things like Alcoholics Anonymous. It's an ongoing program.

I'm cautious of blaming "genetics" for anything, because blaming "genetics" tends to be a way to absolve the blamer for any responsibility for how they treat the blamed. — baker

It's not an all or nothing proposition, but it's just obvious that people react differently to different chemicals. Pollen has no effect on me, but it does my wife, for example.

Genetics doesn't absolve the person of anything. Some use genetics to argue inferiority, for example.

But anyway, how people choose to weaponize information has no bearing on the question of what the facts are, and the facts are that some react in an addictive way to intoxicants and others don't.

It's for that reason that I don't think this really is a philosophical difference as much as it is a physiological difference. — Hanover

To me, it is primarily a philosophical difference. To me, asking a drinker "How did you convince yourself that drinking alcohol was worth it?" makes perfect sense. It took me a while to learn not to actually ask such questions.

Because it's not at all just about the physiological differences, but about a person's willingness to override the intuitive reaction they have to something.

This is almost verbatim from a conversation with a female acquaintance: "I hate high heels. My feet hurt in them. ... But what can one do. Women must wear high heels."

Clearly, she has such a philosophy of life that enables her to override the pain; whereas some women don't. While both groups of women experience wearing high heels as painful.

This is almost verbatim from a conversation with a female acquaintance: "I hate high heels. My feet hurt in them. ... But what can one do. Women must wear high heels."

Clearly, she has such a philosophy of life that enables her to override the pain; whereas some women don't. While both groups of women experience wearing high heels as painful. — baker

The enjoyment of wearing high heels at the expense of the pain of the high heels is not at all equivalent to the desire a heroin addict experiences for his drug. That should be obvious from the fact that the heroin addict will steal from his loved ones, break into homes, hold up stores, share infected needles, lie, cheat, and destroy every one of his relationships, and sleep in dark alleys with needles in his vein in order to get his fix.

The finest rehab facilities and the most oppressive of prisons have not eliminated drug abuse.

Anyway, watch this 50 second video:

https://www.tiktok.com/@bbcnews/video/7295729395971427616

This is almost verbatim from a conversation with a female acquaintance: "I hate high heels. My feet hurt in them. ... But what can one do. Women must wear high heels."

Clearly, she has such a philosophy of life that enables her to override the pain; whereas some women don't. While both groups of women experience wearing high heels as painful.
— baker

The enjoyment of wearing high heels at the expense of the pain of the high heels is not at all equivalent to the desire a heroin addict experiences for his drug. — Hanover

I'm talking about overriding one's initial negative response to something that is socially desirable, and having a philosophy for doing so. Like my high-heel wearing acquaintance who would rather not wear high heels, but does so because she is convinced that a woman must wear high heels (and she is able to put this into words).

You have a negative initial response to alcohol. Yet unlike so many other people who also have a negative initial response to alcohol, you don't override this initial negative response and so you don't drink. In contrast, many people do drink, despite their negative initial response to alcohol. My assumption is that they do have a philosophy for doing so, although I haven't heard it stated directly (unlike my high-heel wearing acquaintance). It is also my assumption that people who don't override their initial negative response to something socially desirable also have a philosophy for this.

Do you know why you don't act in accordance with the social expectations around drinking alcohol?

The finest rehab facilities and the most oppressive of prisons have not eliminated drug abuse.

Possibly because they are aiming to eliminate the wrong thing.
Being "in control" of one's substance use is the easier part; "being in control" of one's emotions and one's existential predicament is the hard part. Unless infinite health and wealth could be guaranteed, one's existential predicament is always going to loom large. Whole religions and other ideologies are built around trying to deal with the existential predicament. Not very successfully, apparently.

Anyway, watch this 50 second video:

https://www.tiktok.com/@bbcnews/video/7295729395971427616

I've watched it the first time you posted it and I've been wanting to comment on it.
What Perry is saying here is a stance that I describe as "typically American". The other man, Hitchens, has a stance that I find to be more representative of the culture I am from. I've known heavy drinkers, but even they would never say a thing like "I'm in control only of my first drink. If I have the first drink, I can't stop." It's normal here for people to drink, and to stop at some point. They can be all wobbly already, but still say, "Alright, that's enough", and they stop. And this can be a regular pattern, lasting for years. Of course, adherents of 12-step philosophy will say that these people are then "not really alcoholics".

The way a person's substance use and abuse and their thinking about this use and abuse are shaped has possibly a lot to do with the culture they live in. American culture tends to be black-and-white, all-or-nothing, so it's no surprise that an American-cultured person says things like "I'm in control only of my first drink. If I have the first drink, I can't stop." It's not alcoholism that gives one tunnel vision; it's tunnel vision that gives one things like alcoholism.

In the drug counselling world there are many who disagree with AA and its model. They don’t care for the old term alcoholism and generally this term is not used in clinical settings unless they are AA run. SMART Recovery was set up as an alternative to AA and from what I have seen has better results. The disease model of addiction is gradually fading. People focus more on what triggers them to use alcohol or to gamble. Addiction need not involve substances. Plenty of material on line about all this.

You have a negative initial response to alcohol. Yet unlike so many other people who also have a negative initial response to alcohol, you don't override this initial negative response and so you don't drink. In contrast, many people do drink, despite their negative initial response to alcohol. — baker

The desire to look nice in high heels isn't as compelling as the desire the drug addict has for drugs. It's a matter of degree of such magnitude it's not really comparable. People are not dying of high heel wearing.

What Perry is saying here is a stance that I describe as "typically American". — baker

No it's not. Perry simply pointed out there is empirical evidence supportive of alcohol's measurable effect on people's personalities and Hitchens ignores the science in an effort to support his poliltical narrative. A typically American response is to do exactly as Hitchens has, which is to start with an opinion and end with that opinion no matter what if it challenges his worldview.

It's not much an issue for debate if you take science seriously. The question of whether addictive behavior is a product of physiology as opposed to sociology is easy enough to see by looking within certain family lines and gene pools. And then there are thousands of studies on mice that show exactly what I'm saying, which obviously controls for social pressures that might be faced by humans since mice don't feel those social pressures.

You can Google for these studies, or just click here: https://scholar.google.com/scholar?hl=en&as_sdt=0%2C11&q=addiction+studies+in+mice&btnG=

Of course, adherents of 12-step philosophy will say that these people are then "not really alcoholics". — baker

They absolutely don't say that. They never dictate who is an alcoholic and who isn't. https://aa.org.au/new-to-aa/frequently-asked-questions/

The disease model of addiction is gradually fading. — Tom Storm

For some, too late.

Plenty of material on line about all this. — Tom Storm

Of course.
Perhaps there'll even come a day when official psychology/psychiatry acknowledge philosophy as a valid approach to dealing with existential problems!

They never dictate who is an alcoholic and who isn't. — Hanover

I actually heard them say it.

And then there are thousands of studies on mice — Hanover

You've got to be kidding.

I actually heard them say it. — baker

Click on the website. It responds to your question.

You've got to be kidding. — baker

No, there actually are studies on animals that show the addictive quality of chemical substances, which control for social pressures related to the addiction, since animals aren't subject to human social pressures.

No, there actually are studies on animals that show the addictive quality of chemical substances, which control for social pressures related to the addiction, since animals aren't subject to human social pressures. — Hanover

I cancelled my subscription to rat psychology long ago.


(Tellingly, I couldn't even find a reference to "rat psychology" within five minutes of googling. "Rat psychology" is a derogatory term referring to an uncritical use of the findings in experiments on animals (often rats) to humans.)

The idea that different people react to different chemicals differently isn't revolutionary.

Perry simply pointed out there is empirical evidence supportive of alcohol's measurable effect on people's personalities and Hitchens ignores the science in an effort to support his poliltical narrative. — Hanover

Because the important thing is to be scientifically correct, even if this kills people, riiight.

It's better for a heavy drinker to think, "Once I've had the first drink I am powerless over my drinking and I will drink until I pass out". Because being scientifically correct is all that matters. Riight.

If that heavy drinker were to say to himself, "Who says that I have to keep drinking just because I've had a few drinks? I should at least try to stop" -- that would be an utter abomination in the eyes of science!!

that heavy drinker were to say to himself, "Who says that I have to keep drinking just because I've had a few drinks? I should at least try to stop" -- that would be an utter abomination in the eyes of science!! — baker

You can't will away an adverse reaction.

You can't will away an adverse reaction. — Hanover

But you can will to stop a bad habit.

For crying out loud, in that video with Matthew Perry, that other man was just giving him well-meaning common-sensical advice, not claiming to offer a scientific explanation.

When one sees another person in trouble, one doesn't tell them, "Oh yes, chances are you're doomed and science confirms it!"

When one sees another person in trouble, one doesn't tell them, "Oh yes, chances are you're doomed and science confirms it!" — baker

Yet if you have cancer, that is what they tell you, unless you're a proponent of medical professionals lying to patients.

In any event, alcoholism isn't a death sentence. There are many success stories, but I don't think those were achieved by telling alcoholics that their genetic disposition is the same as nonalcoholics.

If your genetic predisposition was towards acquiring melanoma, it would be good to know so you could be careful avoiding too much sunlight. Should you get melanoma, it would be accurate to say it was due to your choices, but also due to your genetics. Your predisposition made it harder to avoid, but telling you it is all your fault is just inaccurate.