The ancient ruins of Göbekli Tepe, in what is now Turkey, date back at least 10,000 years. Its megaliths – large hand-hewn stone pillars weighing between 10 and 20 tonnes apiece and dragged from nearby quarries – are considered the oldest ever discovered and pre-date the beginnings of settled agriculture in the Middle East’s Fertile Crescent. This site, in what is called “the Cradle of Civilization,” must therefore have been built by nomadic tribes who didn’t even live or farm there year-round. Why would anyone go to so much effort to build something they could only use part-time? To get roaring drunk, says Edward Slingerland.
Göbekli Tepe plays a central role in Slingerland’s fascinating 2021 book Drunk, which charts the significance of alcohol throughout humanity’s development. “It is a very powerful and important site,” says Slingerland, a philosophy professor at the University of British Columbia, in an interview. “We know there was no agriculture at this point. But these hunter-gatherers undertook the back-breaking labour required to build this essentially useless monument. Why?”
Clues to its true purpose can be found in chemical traces discovered in vats and storage basins around the area suggesting they were used to ferment beer. For this reason, Göbekli Tepe is held as proof of the “beer before bread” theory of human development – that people got together to share intoxicating beverages before they figured out how to bake bread or perform other more traditional markers of civilized behaviour. It was, according to Slingerland, an ancient brewery and religious centre meant to facilitate “epic, blowout feasts, accompanied by dramatic rituals, all of it likely fuelled by generous quantities of booze.” And that was to its builders’ great advantage.
Slingerland’s provocative thesis is that alcohol is not just delicious and delightful (we’ll get to that shortly), but also offers distinct advantages to groups who can harness its best properties. “Cultures that figured out how to use alcohol effectively were able to outcompete cultures that didn’t,” he asserts, pointing beyond Turkey to Israel, China, Africa and Europe for additional supporting evidence on the key role played by alcohol in spurring human progress. And these effects, he argues, are just as powerful today as they were millennia ago. Drunk thus offers a stout defence for imbibing often – with gusto and without regret. “Beyond the obvious pleasure that it brings, alcohol has real functional benefits for individuals and cultures,” he says. “This is why its use has persisted for so long.”
Today, however, that ancient track record is under attack.
The Story So Far (Or Half Of It)
Last month the Canadian Centre on Substance Use and Addiction (CCSA) released its Guidance on Alcohol and Health offering Canadians its latest advice on how much they should drink. In short – not a drop. This new advice, funded by Health Canada, is meant to update Canada’s current Low Risk Drinking Guidelines, released in 2011, that recommend up to 15 drinks per week for men and 10 for women. These figures are notable for acknowledging the interplay between the health risks and health benefits of moderate alcohol consumption, as well as the social component to how we drink. Now the CCSA wants to replace that sensible advice with an ideal amount equal to zero. “The risk of negative outcomes begins to increase with any alcohol use,” it states. And anything more than two drinks per week for men and women poses “a significant increased risk of harms to self and others.” These parsimonious recommendations have been widely criticized for an excessive emphasis on very small health risks and selective use of supporting evidence, all of which is detailed in Part I of this two-part series.
The ultimate impact of the CCSA’s new report, which also includes a call for new national alcohol labelling requirements, remains unclear. Ottawa has paid for the report, but not yet officially accepted its recommendations. Asked about next steps, a Health Canada spokesperson replied via email that, “The Government of Canada is currently reviewing the Final Report, and will continue to engage with Canadians, including key stakeholders such as the CCSA, to inform our government’s work to address harms and risks associated with alcohol use.”
There is, however, much more to a proper debate about alcohol than just looking at harms and risks. As Slingerland observes, the CCSA’s new report “is presented solely through a medical lens and is solely about risk mitigation. But from a pure risk mitigation perspective, I probably shouldn’t drive – because every time I get in my car the chance of an accident increases. Yet we still drive because the benefits outweigh the risks.” The same holds true for alcohol. Focusing exclusively on whether the increased chance of liver cancer or tuberculosis (TB) from drinking is big or small misses a much larger picture. “There are definite benefits to alcohol use that need to be weighed against the risks,” he says. “And that isn’t happening in these new recommendations.”
Missing from the CCSA’s Puritanical risk table calculations are a host of positive and countervailing factors arising from moderate alcohol consumption. These entail all of Slingerland’s historical arguments as well as other frequently overlooked mental health and lifestyle issues. This includes the welcome role of booze as a tool for combating the modern scourge of loneliness and social isolation plus the great pleasure many people derive from simply savouring a fine wine, beer or liquor in pleasant company. Together these factors are arguably far more relevant to everyday Canadians’ overall wellbeing than a two one-millionth percent increase in their chance of dying from TB. Yet none of this is included in the new drinking guideline recommendations. In essence, the CCSA has chosen to tell Canadians only half the story. Here’s the rest of what you need to know about tipping a glass.
Creativity, Community and Culture
Slingerland’s book musters considerable biological, anthropological and archaeological evidence in distilling how successful civilizations came to recognize and seize the advantages of alcohol. He calls these attributes the three Cs: creativity, community and culture.
Since creativity was central to the evolutionary success of thin-skinned and relatively weak homo sapiens many millennia ago, Slingerland posits that groups with access to this liquid imagination-booster tended to come up with better solutions to problems than those that didn’t.
It all starts in the brain. As humans grow to adulthood, the brain’s pre-frontal cortex, which regulates executive functions such as rational thinking, planning and delayed gratification, becomes fully formed and dominant. “This makes us grown-ups,” observes Slingerland. “But it also makes us less creative.” Alcohol relaxes the control exerted by the pre-frontal cortex and allows humans to temporarily become more imaginative and child-like. “Throughout history, you see alcohol associated with thinking creatively and spontaneously,” he notes, offering ample scientific as well as poetic examples to bolster his point. Odes to Dionysus, the Greek god of wine, figure prominently, as does brain mapping and patent filing. Since creativity was central to the evolutionary success of thin-skinned and relatively weak homo sapiens many millennia ago, Slingerland posits that groups with access to this liquid imagination-booster tended to come up with better solutions to problems than those that didn’t.
Because ethyl alcohol triggers the release of endorphins in the body, it also makes you feel good and lowers your natural defences. For this reason, drinking figures prominently in bringing people together and allowing them to interact. The 2,000-year-old Latin phrase in vino veritas, (“in wine, truth”) reflects the ancient wisdom that alcohol acts as a sort of truth serum and trust enhancer. Slingerland again offers numerous examples demonstrating this booze-fuelled sense of comity, from Viking treaty-making to elaborate Pacific Island kava rituals where drinking forms a precursor to cooperation. “Intoxicants allowed humans to overcome the challenges of moving from small to large-scale societies,” he says. “As soon as you see people organizing in any coherent way, there is always alcohol there.” That exhausting megalith haul at Göbekli Tepe can be considered early proof of this concept.
Over time, alcohol has additionally come to play an important role in defining national and regional cultures, which further builds community and resilience. The French are known for their love of wine, Germans for foamy lagers and Japanese for saké. The same goes for Christian communion as well as other religious customs around the world. These habits, often associated with elaborate ceremonies, create an important sense of cohesion. Today, alcoholic customs are so deeply embedded in Canadian life that you might easily overlook them. Yet we instinctively bring a bottle of wine as a hostess gift, raise our glass to toast significant occasions and buy a beer for an opponent after a night at the curling rink. “The cultural weight of alcohol is hard to ignore,” says Slingerland.
Beyond his three Cs, Slingerland’s book also examines some much older reasons behind humanity’s long relationship with alcohol. This includes evolutionary physiologist Robert Dudley’s famous “drunken monkey” theory. Dudley posited that successful primates learned to prefer ripe, often fermented, fruit that had fallen on the ground over unripe fruit still hanging on trees or vines. Because ground fruit is higher in calories, such a choice made good, competitive sense. That it also left the chimps feeling slightly buzzed likely opened pleasure centres in the brain that linked the sensation of being drunk to practical decision-making over the course of evolution.
In making his claim on the necessity of alcohol, Slingerland does not ignore its many well-established health risks – all of which the CCSA eagerly and repeatedly promotes. The bigger point, the UBC philosopher points out, is that alcohol use has persisted for so long despite its many obvious disadvantages of increased liver disease, addiction and reckless behaviour like duelling, bar fights and, in modern times, drunk driving. For every ancient poet extolling the virtues of vino, there are examples like Alexander the Great, who made many of his worst military decisions while hammered and basically drank himself to death at age 32.
Nonetheless, the persistence of alcohol’s popularity, and the repeated failure of moralizing crusaders and governments around the world to prohibit its use, all speak to its fundamental role across time as a useful, it not vital, tool. Slingerland notes even currently abstemious cultures such as Islam or the Mormon church reveal a long history of alcohol use upon closer inspection.
A Sober Heart is a Lonely Hunter
In addition to understanding the many historical benefits of alcohol, it is also necessary to consider more fully what would happen if the CCSA’s plan to convince Canadians to cut back consumption to two drinks or less per week was actually successful. Doing so requires adopting a more liberal definition of public health than is currently the fashion.
A 2020 study on healthy lifestyles in JAMA Internal Medicine lists the four best personal habits for avoiding chronic disease in people aged 40 to 75, they are: avoiding obesity, not smoking, staying active and drinking moderately.
“We in public health typically only care about things we can measure,” says Kiffer Card, a social and behavioural epidemiologist in the Faculty of Health Sciences at Simon Fraser University in Vancouver. “That’s why we are so concerned about the prevalence of heart disease, liver disease or cancer. But this makes it difficult for us to discuss things that are more difficult to measure, like happiness or pain.”
As we already know, consuming ethanol releases endorphins that allow people feel better about themselves and others. As Card notes, this “happiness” effect makes it easier to make new friends and form social bonds. Such an effect is not trivial, and can be particularly important for people with social anxiety or who are introverted. Within limits, as the amount consumed increases, so does the strength of these connections. “Alcohol plays a really outsized role in facilitating social bonding among humans,” he observes. “It is not lost on me that university is a time when most people make a lot of lifelong friendships. It also tends to be a time of intense, if not excessive, drinking.”
Card considers alcohol’s social bonding properties to be of great significance to public health given the physical and mental toll that loneliness and social isolation are taking on modern life. Research in the American Journal of Public Health estimates the mortality risk of being in the highest category for social isolation as second only to smoking, and far in excess of the risks from high blood pressure, obesity or high cholesterol. “Not having close intimate relationship is one of the most important predictors of longer-term mortality,” says Card. “People are often surprised to discover the impact loneliness can have on your health.”
There is an ample supply of recent medical evidence demonstrating the role moderate drinking can play in promoting social activity and thus improving overall good health. A 2020 study on healthy lifestyles in JAMA Internal Medicine lists the four best personal habits for avoiding chronic disease in people aged 40 to 75, they are: avoiding obesity, not smoking, staying active and drinking moderately (up to two drinks per day for women and three for men). In a study published in the BMC Public Health journal last year, Danish researchers found “higher psychological well-being in individuals with moderate alcohol consumption.” These results reflect an interplay of biological and social factors, the study reported, noting that cultural norms encourage interaction and discourage over-consumption. In essence, well-adjusted people tend to enjoy having a few drinks with friends, along with other healthy habits.
Like Slingerland, Card is at pains to acknowledge the grave medical implications of alcohol abuse. But both academics worry that the CCSA’s single-minded focus on physical disease misses the bigger story about the positive effects drinking has on socialization. “The recommendations fail to capture the complete picture of how people live their lives and the role played by alcohol,” says Card.
Card is lead researcher on a new federally-funded program seeking to develop Canadian Social Connections Guidelines. The goal is to offer people practical advice on how to live a healthy social life and, when complete, will be the first such guidelines in the world. While not explicitly intended as a critique of the CCSA’s restrictive drinking rules, Card admits his project could have a corrective effect by encouraging a more holistic view of moderate alcohol use that recognizes benefits as well as risks. “Social health is not a side piece to public health,” he stresses. “It is the core of what public health should be concerned about.” If the CCSA’s two-drink-per week limit causes lonely Canadians to stay home more often because they have fewer opportunities to socialize, that “might be causing even greater harms. The new guidelines risk creating a stigma around something that is natural and very important.”
Skål! A 2020 Danish study published in BMC Public Health found “higher psychological well-being in individuals with moderate alcohol consumption,” and noted that cultural norms work to discourage over-consumption. (Source of photo: Pexels)
Card’s vision of public health as a pursuit concerned with the public’s whole health – including the size of their social networks and general sense of wellbeing – rather than merely regarding them as medical lab rats to be herded, poked, locked-down and scolded as changing scientific advice dictates, seems a novel and refreshing concept, especially given recent experience with Covid-19. Almost as refreshing as an ice-cold lager.
My Third Place Sells Beer
“It began as a rebellion against mainstream beer,” Mark Heise boasts. Heise is explaining the origin of Rebellion Brewery in Regina, Saskatchewan, which he opened in 2014 and now includes a range of award-winning beers plus a lively bar and kitchen; an expansion to Saskatoon is also in the works. Rebellion is among the 1,200 craft breweries that now blanket Canada in locales big and small. “Our industry has seen massive growth over the past ten years,” says Heise. Such growth reflects a dramatic shift among Canadian beer drinkers to abandon corporate suds for the greater range of specialty products offered by smaller locally-owned producers. Beyond the substantial economic effects of this democratization in beer production, it’s also releasing plenty of endorphins.
“We like to call our public space a Taproom,” says Heise, who is also chair of the Saskatchewan Craft Brewers Association. “I think of it as a return to the pre-Prohibition days when there was a brewery in every community and they served as local gathering places.” Building this strong sense of communal spirit is crucial to the success and relevance of Rebellion, he notes. “We have local art for sale. We have local musicians performing. We host all sorts of local politicians’ events. This is where people talk politics.” As such, Heise argues his Taproom ought to be considered a “third place.” It’s not home. It’s not work. Rather it’s a neutral place where you can go to meet up with friends, bump into strangers or have important conversations. While Starbucks and other coffee shops have long claimed third place status for themselves, there is something far more attractive about a third place with beer on tap.
Surveying his establishment on a quiet Friday afternoon, Heise describes a wide variety of clientele in sight, including two young parents with a pair of toddlers enjoying a messy lunch and some old friends catching up after many years apart. ‘It would not be a good thing to lose all this,’ he adds determinedly.
The work of Oxford University psychologist Robin Dunbar further strengthens the connective value of beer in public places. Dunbar is internationally recognized for his work on social connections, including the famed “Dunbar’s Number” that proposes humans have a fixed capacity for close relationships (totalling approximately 150 acquaintances and five intimate friends). In 2017 Dunbar headed an academic study entitled Functional Benefits of (Modest) Alcohol Consumption which made use of surveys of British pub-goers along with other data exploring social health. Dunbar’s results revealed that “social drinkers have more friends on whom they can depend for emotional and other support, and feel more engaged with, and trusting of, their local community.” Further, “The social consumption of alcohol may thus have the same effect as the many other social activities such as laughter, singing and dancing that we use as a means of servicing and reinforcing social bond.” Does that sound like a dire health risk? Or more like something that doctors ought to be prescribing for anyone feeling a bit lonely or depressed?
And despite Heise’s claims to being “born a rebel,” he’s actually a big fan of the status quo when it comes to the existing recommendations of no more than 15 drinks per week for men and 10 for women. “I think the current guidelines have it right,” he says. “We are a human species, and we are meant to communicate and be together,” intuitively making the same argument as Slingerland, Card and Dunbar, but without their academic credentials. Surveying his establishment on a quiet Friday afternoon, Heise describes a wide variety of clientele in sight, including two young parents with a pair of toddlers enjoying a messy lunch and some old friends catching up after many years apart. “It would not be a good thing to lose all this,” he adds, reflecting on the broader impacts of a two-drinks per week maximum.
The Pleasure Principle
Another topic missing from any clinical debate over the medical risks of alcohol is the most obvious reason its use has persisted for so long – the immediate pleasure delivered by consuming wine, beer or liquor. Slingerland calls this the “hedonic” aspect of booze: that is, the inherent hedonism provided when sipping a fine Cabernet-Sauvignon or single malt whiskey. “It makes us feel good. It tastes good. And it goes so nicely with food,” he says. “We need to validate, rather than dismiss, the hedonic value of alcohol.” That such attributes are hard to quantify doesn’t mean the pleasure isn’t real. Or worth defending.
The lively and significant cultural aspects of alcohol are often most pronounced when it comes to wine. “Wine is meant to be enjoyed with food and in company,” extols Rob Taylor, director of policy and government relations at Wine Growers Canada. The congeniality embedded in the age-old culture of wine offers “social benefits that are good for your mental wellbeing and that derive from responsible alcohol consumption.” Sitting on a patio watching the sun set over a vineyard while finishing a great meal can further enhance the effect. But it goes far beyond pleasant imagery.
In many countries around the world, viticulture has profoundly shaped human geography and altered the very landscape. (Canada is a relative latecomer to this process). Many millions of people gladly ply their trade and owe their livelihood and sense of self-worth to tending, improving and marketing fermented grapes. For travellers, wine is often an opening topic of conversation with locals or even the reason for the trip – serving much the same role as sports does in other places. Some vine roots have supported grape-producing stocks for centuries and there are terroirs around the Mediterranean littoral that have been producing wine for over two millennia. Viticulture is thus a living definition of sustainability. But all this, of course, ultimately hinges on the continuing existence of drinkers and their willingness to buy another bottle. If a small cadre of public health officials manages to scare off future generations of wine lovers entirely with exaggerated claims of health risks, the entire economy and culture of wine could be lost forever.
According to Spithoff, psychedelics and stimulants such as ‘MDMA (ecstasy), LSD and khat would all be much safer choices to accompany our social rituals, celebrations and everyday Canadian life.’ Switching out a pint of beer after a hockey game for a hit of ecstasy, or swapping the bubbly on New Year’s Eve for a mouthful of cocaine-like khat reads like a parody of public health advice. It’s not.
With that existential threat in mind, Taylor argues the CCSA should refocus its efforts on the small minority of Canadians who abuse alcohol through binging, and abandon its current efforts at frightening everyone else into abstinence. “Moderate consumption is part of a healthy and balanced lifestyle,” Taylor says. He points out Canada’s current drinking guidelines of no more than 15 drinks per week for men and 10 for women were created in 2011 in consultation with representatives from the domestic wine, beer and liquor industries. As such, they recognize the social context of drinking and enjoy a high degree of public acceptance; 83 percent of Canadians report they consume within the 15/10 limit. It also bears mention that many indicators of problem drinking in Canada, such as heavy drinking, under-age drinking and deaths due to drunk driving are at or near historic lows, suggesting most Canadians already have a good handle on any potential risks.
Unlike in 2011, however, the beverage industry was deliberately excluded from the CCSA’s recent consultation process. And the result was a teetotaling two-drink-per-week limit, which more than half of Canadians say they exceed. Presumably industry was shut out of the new guidelines because they couldn’t be trusted to discuss alcohol in strictly medical terms, and would insist on bringing up social contexts and the fact it tastes good. Efforts at mimicking the highly successful public health campaign against tobacco for alcohol (as explained in Part I) further necessitate casting local wine producers and beer brewers as the villains behind Big Booze. Yet as Taylor notes, the Canadian wine industry on its own has already developed a labelling and information system that offers wine drinkers all the details the CCSA claims are an urgent national necessity. Heise also lists the many ways he strives to “set a good example” with his own beer labeling and sponsorship programs. The risk of mistaking alcohol as Tobacco Round 2, warns Slingerland, is that “the new guidelines are so disconnected from reality that people will simply ignore them entirely.”
Our Finest Vintage LSD
A disconnect between public and medical opinions on drinking is certainly not a new phenomenon. Shortly after he took office in 2018, Ontario Premier Doug Ford liberalized many of the province’s Prohibition-era alcohol policies by relaxing bar hours, lowering minimum prices and allowing greater availability in grocery stores. The public response could be largely summarized as, “What took you so long?” The response from the public health community, on the other hand, was apoplectic. Some practitioners suggested it was time Canadians weaned themselves off the bottle altogether.
In response to Ford’s new policies, Sheryl Spithoff, a physician of Family and Community Medicine at the Women’s College Hospital in Toronto, argued in the Canadian Medical Association Journal that if Canadians insisted on using drugs in social settings, they should look beyond alcohol for comfort and safety. In addition to calling for higher taxes and reduced store hours to discourage drinking, Spithoff opined that psychedelics and stimulants such as “MDMA (ecstasy), LSD and khat would all be much safer choices to accompany our social rituals, celebrations and everyday Canadian life.” Switching out a pint of beer after a hockey game for a hit of ecstasy, or swapping the bubbly on New Year’s Eve for a mouthful of cocaine-like khat reads like a parody of public health advice. It’s not. But such is the enmity the public health establishment displays towards alcohol. Legal cannabis has similarly been hailed as a replacement for drinking. It’s not happening.
“Cannabis and psychedelics are definitely not substitutes,” advises Slingerland. Marijuana is notorious for the range of responses it elicits in users, from agitation to lethargy. And consumables can take hours to kick in. As for using LSD to combat social isolation, “It’ a terrible idea,” he says. “Psychedelics disconnect you from reality in such a powerful way and take a long time to wear off. Is anybody really going to pass around LSD at Christmastime when the family is visiting?” he asks. Set against its many competitors, alcohol is “the perfect drug,” Slingerland argues. It is simple to make and distribute. It can be consumed in easily controllable doses. Its effects are predictable, fast-acting, short-lived and generally consistent across users. Plus, it tastes great.
“Nothing else can fill the role played by alcohol,” says the author of Drunk. “Part of the reason I wrote the book is because public policy debate around alcohol has become so incredibly myopic. We’ve lost the larger historical, anthropological and scientific context for why we drink.” Adds Slingerland, “We have 20,000 years of experience with alcohol. If something better was going to take its place, it would have happened by now.”
Peter Shawn Taylor is senior features editor at C2C Journal. He lives in Waterloo, Ontario.
