Evolutionary Hangover or 21st Century Social Ingredient: Beverage Alcohol v Neo-Prohibitionism
There is context to the role of alcohol consumption in our human evolution: historical, sociological, anthropological, neurological, epidemiological, and psychological. Context that matters, and – despite organised efforts over millennia to stamp out alcohol consumption – explains why it continues to play a societal role.
The neo-prohibitionist movement seems on a roll these days in Canada. Since the temperance-dominated Canadian Centre on Substance Use and Addiction’s Final Report (misleadingly called “Canada’s Guidance on Alcohol and Health” – it is nowhere close to being approved or adopted as Canada’s official policy), at least one public scare campaign has been launched.
Last August, the CCSA tested the public mood by issuing its draft “Guidelines” for severely-curtailed alcohol consumption by Canadians of legal drinking age. It raised questions, including: What precisely is the public health problem for which this dramatic solution is proposed? Recent StatsCan data show Canadians consumed less per capita in 2022 than 2021, and international comparative studies show Canada’s consumption rates are within internationally recommended number of drinks per week (average of nationally established drinking guidelines in several peer countries over a decade).
The CCSA authors have succeeded only in serving up an alarmist and incomplete picture of the causal connections between drinking and disease, and drinking and mortality (“years of life lost” or YLL in some models). The authors also fail to provide a scientifically defensible answer to just how much health risk a person faces when drinking 9 to 11 drinks per week (the present guidelines, established in 2011), since the report ignores critical factors like family history, diet, smoking, weight, exercise or consumption patterns.
On the back of CCSA’s final report in January 2023, public transit ads popped up around Metro Vancouver called The Proof. Produced by the BC Cancer Agency and funded by the BC Ministry of Health, they claim that Alcohol Causes Cancer, and that two drinks per day doubles your risk of developing “cancers of the head and neck”. Which cancers? Doubles from what level?
A close examination reveals that risk elevation for some cancers start – and remain – at exceedingly low levels, and which may be better explained by other factors. In the words of Professor Dan Malleck, a medical historian specializing in drug and alcohol regulation and policy, “For example, the report states that your risk of larynx cancer increases by 100 per cent after 3.5 drinks per week, but it doesn’t tell you that larynx cancer was diagnosed in only 0.0197 per cent of Canadians and is largely related to smoking.” (Toronto Life interview March 9, 2023)
Claims such as these are made on the basis of no new peer-endorsed Canadian or international research, and the alarmist language about relative risk deliberately provokes fear rather than providing the individual Canadian the tools to assess his or her absolute risk from low to moderate drinking.
As Edward Slingerland says in his outstanding book Drunk, “We can do better than this.”
First, Canadians should take a deep breath and step back from panicking about the implications of our habits - assuming of course that they’re moderate in the first place. Merely shifting the framework (unilaterally and without scientific basis) of what counts as a “safe level of consumption” doesn’t suddenly make average Canadians borderline alcoholics.
Second, we should remember that there is context to the role of alcohol consumption in our human evolution: historical, sociological, anthropological, neurological, epidemiological, and psychological. Context that matters – a lot – in understanding most Canadians’ relationship with alcohol as consumers, particularly wine as it embodies facets of the good life: conviviality, enjoyment of meals, and celebration of life’s major events. Context that matters historically, and – despite organised efforts over millennia to stamp out alcohol consumption – explains why it continues to play a societal role.
Evolutionary Hangover?
Beyond the realms of epidemiology, cardiology, public health policy and ethics (note that Canadian and international specialists in each field have publicly criticised the CCSA’s effort), there is a glaring absence in the CCSA report of any research on social or psychological benefits of moderate drinking. Fortunately, these have been widely studied, and many do pass critical scientific examination. Inconveniently for the CCSA authors, who would have us believe that alcohol consumption is a severe 21st century problem, regular enjoyment of alcohol is a lived experience for many individuals, across cultures and throughout much of settled human history.
Which begs an evolutionary question, brilliantly examined by Edward Slingerland, Professor of Philosophy and author of the book Drunk: Why do we drink in the first place, if it is so harmful to our health? He traces the history of alcohol production (and presumably consumption!) from 7000 BCE in China through modern-day Georgia and Iran (Mesopotamia), through Greece and Armenia in about 4000 BCE, and in modern-day Britain, Australia, South and Central America from about 3000 BCE.
In the early 21st century, cultures all over the world are making and drinking beverage alcohol. Slingerland explores historical, biological, and anthropological explanations for why we (still) drink, focusing on the amusingly-named hangover theory. This theory treats humans’ taste for alcohol as a relic: an adaptive part of our genetic makeup that served a purpose at earlier phases of evolution, but no longer. We may at one time have physically benefitted from (fermented) alcohol’s nutritional value, its disinfectant properties, and its enjoyable flavours, so goes the theory.
The hangover theory leaves the inquiring mind dissatisfied, in part because the helpful features listed above could have been performed just as well by alternative beverages or foods that don’t give you a buzz, or worse. If you want fruit, just eat ripe fruit, not the over-ripe kind turbocharged by ethanol. In other words, as cultures evolved, people should simply have found alternatives (especially after water treatment and refrigeration), and alcohol use would have become extinct. But it hasn’t.
21st Century Social Ingredient
Is it really an evolutionary mistake that we still drink alcohol? Slingerland says, “The use of intoxicants should puzzle us as much as religion does, and is similarly ripe for proper scientific examination.” (p. 37) Accordingly, he takes the reader through a dizzying (no pun intended) array of fields of scientific inquiry, laboratory experiments, and historical records to arrive at the conclusion that, despite obvious and devastating social and health harms from addiction and over-consumption, beverage alcohol does serve a purpose – to individuals and to societies.
His key observations (referencing peer-reviewed and meticulously-cited studies) are summarised in the following points:
· Our evolution as a species has led us to occupy a specific “ecological niche”, requiring us to deploy the Three Cs to survive and thrive: we are Creative, we are Cultural, and we are Communal. We would not have advanced very far (or perhaps at all) without deploying these three to great effect.
· On the communal facet and why alcohol is relevant, humans need to be cooperative to survive. The cognitive control centre in our brains (the pre-frontal cortex or PFC) governs our abstract thought, instrumental reason and cognitive control, and impedes cooperation, trust, and bonding. (For a classic example of these two warring sets of human motivations, look up Prisoner’s Dilemma studies).
· The temporary sidelining of the PFC after a glass or two enables us to enhance the Three Cs… “Intoxication is an antidote to cognitive control, a way to temporarily hamstring that opponent to creativity, cultural openness, and communal bonding”. (p. 104) It can also relieve social anxiety, especially among introverts. “Social enhancement” was the top reason given by survey respondents worldwide for their motives for drinking. (p. 198)
· Extrapolating to modern societies and referencing anthropological research, “a recognition that mood boosting and anxiety reduction at the individual level probably serve a broader social function of enabling humans to rub along better in the cramped, hierarchical confines of large-scale societies.” Alcohol is a tool for enhancing social solidarity, throwing off the fierce independence of the hunter-gatherer, and enabling stress relief as we cope with living in increasingly crowded, complex, urban-based societies. (pp. 121-122)
· “Collective invention” demonstrates creativity, and tends to happen when people gather, usually informally, often over a beverage. An economic study tested the proposition that communal consumption of alcohol is a driver of innovation: Prohibition in America. County-by-county data revealed that prohibition reduced the number of new patents by 15% annually in previously “wet” counties compared to previously “dry” counties. (pp. 168-9)
Risk/Reward Considerations
In other words, when consumed moderately, alcohol – crucially, fermented (not distilled) beverages in Slingerland’s historical account – can promote social bonding, and at a larger scale, community cohesion. In short, Slingerland posits, used in this way, for this purpose, alcohol indeed helped us “sip, dance, and stumble our way to civilisation” (subtitle of his book).
When we take into account this historical, social and yes, physiological context, take a deep breath and consider that individuals should continue to - without stigma implied by the CCSA authors - assess our own risk, not just from alcohol but across all aspects of life. Which risks do we wish to bear, for fulfilment and enjoyment, knowing the benefits and consequences?
As the International Scientific Forum on Alcohol Research sensibly summarises: “Some risk, therefore, needs to be accepted in our lives otherwise living is impossible. The benefit of drinking alcohol (in moderation) can be social engagement or a relaxation benefit which is not included in the CCSA risk models. In addition, the size of the risk needs some consideration. The risk in years of life lost (estimated and then modelled for the recommended 2023 Canadian guidelines) is estimated at 17.5 YLLS in 100 lifetimes [average 75 years] … which would be 64 days”.
That works out to an average person’s final year of life being shortened by less than 20%. Is it worth the risk, for a lifetime of enjoyment for many people? That’s for individuals and families to decide. It is not for neo-Prohibitionists to scare, guilt or implicitly bully Canadians into changing their habits. And it is not for the Government of Canada to passively allow them to peddle a biased agenda as public health “guidance”.
We can do better than this.
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