Alcohol and Health: Despite the controversy, abstinent countries have the biggest health problems

Alcohol and Health: Controversy Continues. Nigel Barber. Psychology Today, Mar 21 2019. https://www.psychologytoday.com/intl/blog/the-human-beast/201903/alcohol-and-health-controversy-continues
Abstinent countries have the biggest health problems.

Excerpts:

We often hear how many people die of alcohol-related diseases. Such research considers the only pathology and ignores the possibility that alcohol has health benefits. Such benefits appear to be enjoyed mainly by the affluent.

In an earlier post, I argued that very damaging drug use is selected against. The best example of this is the phenomenon of genetic alcohol intolerance in Asian populations that had been bedeviled by excessive alcohol use thanks to the easy availability of homemade rice wine (1).

Learning also matters. Tobacco use declines via social learning once its adverse health effects become widely known (2). Why would so many people drink alcohol if it is so bad for health?

Alcohol Use and Adaptation

Alcohol is consumed in most countries and by over 40 percent of the population in countries around the world. Recent research, published in Lancet, found that any level of alcohol consumption increases morbidity and mortality from alcohol-related diseases.

Many scholars argue that this is another case of human behavior going badly off the rails in modern societies that are very different from ancestral environments to which we are supposedly adapted (2).

Yet, this picture of human limitations may be excessively bleak. Humans and other mammals are a great deal more adaptable to their current environments than this approach suggests. Moose growing up in locations where wolves are extinct loose all fear of their ancestral arch enemy.

Humans are more flexible than other species and quickly learn to avoid foods and drugs that are harmful, including highly addictive drugs such as tobacco (2).

Alcohol has complex health effects and there may not be a simple linear effect of increasing alcohol consumption undermining health as the Lancet study concludes.

The U-shaped Function

Research on cardiovascular disease found that there is a U-shaped relationship between illness and alcohol consumption (3). This means that people who drink unusually little have worse health than those who consume a moderate amount whereas heavy consumption is associated with a heavy health cost.

These findings are inconsistent with the conclusion that alcohol in any amount is harmful.

Yet, there is a way in which the contradiction could be resolved. Even if alcohol is always toxic, its use in moderate amounts could have beneficial effects for health if (a) it facilitates social interactions and thereby reduces isolation and increases bonding and social support and (b) the beneficial consequences outweigh the toxicity costs.

Hence wealthy people consume more alcohol than average but also enjoy much better health and longevity than poorer segments of the population.