April 7th, 2012

James Joyner reacts to a list of putative signs of problem drinking that includes a question about drinking alone:

I often drink alone because I’m often alone. Or, at least, don’t have other adults around. I like to drink. I like to be alone. So, quite often, I do them simultaneously.

When my colleagues and I wrote the Treatment of Drinking Problems we did not include drinking alone as a sign of having an alcohol problem. The folklore holds that drinking alone betokens a drinking problem, but we couldn’t find any systematic evidence that alcoholics drink alone any more than do non-alcoholics.

If “alone” means drinking with people around whom you don’t know personally, then every solitary airline passenger who orders a drink (and many do) is “drinking alone”; That doesn’t mean they have a problem. If “drinking alone” means simply drinking away from the physical presence of any other people, then a group of alcoholic regulars at the same bar are not drinking alone; that doesn’t mean they don’t have a problem.

I suspect drinking alone got its reputation because of the sort of experience described by the eminent Professor Thorogood:

Every morning just before breakfast
I don’t want no coffee or tea
Just me and good buddy Wiser
That’s all I ever need
‘Cause I drink alone, yeah
With nobody else
Yeah, you know when I drink alone
I prefer to be by myself

But the critical variable here isn’t the aloneness, that’s an outcome of drinking in the early morning when very few non-alcoholic people drink. So it makes more sense for drinking problem screening scales to get to the nub by asking “Do you need a drink or two to get yourself going when you wake up?”.

Other alcoholics drink alone because they become so unpleasant when drunk that everyone avoids them. But again in that case it would make more sense for screening questions to get to the point — “Do you do things when drinking that upset other people?” — rather than focusing on the loose correlate of drinking alone.

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18 Responses to “Drinking Alone Does Not Necessarily Mean You Have a Drinking Problem”

  1. Katja says:

    I had read his article, too, but what mostly stood out to me was actually this paragraph:

    I enjoy having a beer or glass of wine with dinner. But I’m in excess of 200 pounds and metabolize alcohol quickly, so I can have a drink early in the meal and be well under the legal limit before getting behind the wheel. Similarly, I quit drinking well before leaving a bar or party if I’m going to be driving home.

    My understanding is that impairment due to alcohol begins long before you reach the legal limit and that even a single glass of beer or wine can noticeably impair your cognitive functions for hours. The CDC seems to agree:

    Legal limits do not define a level below which it is safe to operate a vehicle or engage in some other activity. Impairment due to alcohol use begins to occur at levels well below the legal limit.

    • Keith Humphreys says:

      Katja, AFAIK this is certainly true for driving, even a blood alcohol level one half of the legal limit makes a driver much more prone to accidents.

      • Brett Bellmore says:

        Problem is, lots and lots of things which are perfectly legal “impair” driving, in the sense of departure from perfect conditions. Gotta draw a line someplace, we can’t demand that people be in perfect condition, trained and rested, before they step behind the wheel.

  2. Katja says:

    So … I guess in order not to derail the discussion I should probably also write something more on point? (Sorry, it’s Saturday morning here and I wasn’t fully awake when I wrote the above.)

    I suspect that part of the assumption here is that a lot of people don’t really drink alcohol aside from parties and such.

    I’ve never been much of a fan of alcoholic beverages myself (though I don’t mind them) and have only ever had the occasional glass of wine when I was more or less coaxed into it (“to be social”) [1]. I do wonder how many people drink alcohol merely because it’s the expected thing and not because they enjoy it (in moderation) or to overcome shyness or for medical reasons or whatever. I really only noticed for myself when I was pregnant the first time and felt kinda relieved that I could turn drinks for a reason and without feeling like I was being anti-social. I do wonder how much alcohol is an acquired taste, like dark chocolate (which some people love and others hate).

    That could help explain how drinking alone can be seen as a signifier for alcohol problems regardless of whether there’s an actual scientific basis for it.

    [1] My husband, on the other hand, can’t stand the taste of alcohol at all and has no problem being very explicit about it.

    • Keith Humphreys says:

      The pressure to drink almost everywhere in the UK, and on US college campuses, is unbelievable. You’d think people were committing a crime against the community by *not* imbibing.

  3. I remember long ago talking with an alcoholic, abstinent at the time, who said he hAd liked the social aspects of drinking. “I liked going to bars — buying rounds, joking, shaking the dice cup, the whole thing. I’d stay till closing. Then I’d go home and DRINK.”

  4. Byomtov says:

    Joyner’s comment about drinking alone applies to me as well. I’m a loner. I often eat alone. I like wine with dinner. So what?

  5. Mark Kleiman says:

    Seems to me that “Don’t drink alone” can be a useful personal rule, even if drinking alone isn’t a “sign” of anything, for someone for whom a commitment to drink only in company reduces either the frequency or the intensity of heavy-drinking experiences. Of course that doesn’t mean that going out with the boys to get sh*t-faced at the bar is a healthy practice.

    As to the “impairment” question, of course people are somewhat impaired below the legal limit. The question is “How much?” Driving home after dinner for a 200-lb. man who has had one drink early in the meal might raise his risk of an accident by 10%, from what is after all a very low baseline. Even at the legal limit of .08, the relative risk is roughly a factor of 2 or 3. But all that means is that driving a mile at .08 is about as risky as driving three miles sober. If one isn’t shockingly risky, neither is the other.

    • kathleen says:

      “Even at the legal limit of .08, the relative risk is roughly a factor of 2 or 3. But all that means is that driving a mile at .08 is about as risky as driving three miles sober. If one isn’t shockingly risky, neither is the other.”

      I question the validity of such an equivalency-it violates common sense. It also has the drinker choosing to subject others on the road to his/her choice of assuming the increased risk being meted out to them without their consent. It may well be true that a drinker will have no accidents for many of their trips, but they are creating unsafe conditions for others by their very presence, an ethical lapse on their part.

      I rarely drink and have a healthy liver etc., but one glass of wine has sufficient effect on me that it will keep me from driving, so I never drink at all when I know I’ll need to drive (and I don’t drink more than one glass anyway).

      Too many people believe they’re still sufficiently sober to drive when an actually sober observer can easily tell that they’re not: starting to slur words, a bit of stumble to their step, laughing inappropriately; I can only imagine how they’d do on a response-time test. Drinkers are in no condition to judge their impairment, but since they’re impaired they will deny this basic fact and decree that they’re perfectly fine to drive.

      It only gets worse as they get older and lose what tolerance to alcohol they once had, but still measure out the drinks the same as ever. It is one of the more tedious parts of dealing with aging parents, that I finally had to tell my father that I do not ride in cars with drivers who have been drinking at all, including him, regardless of the fact that he still views himself as THE driver. Of course he takes this as a grave insult.

      I think that light drinking is far safer done at home, alone or not, unless one ALWAYS uses a taxi or has a real designated driver. Anyone who has trouble keeping it to light drinking while alone has a bigger problem and should probably not be drinking at all, no matter where they are.

    • Byomtov says:

      Mark,

      Relative risk of what?

      Any accident? Injuring someone?

      I’m also curious as to how the risk increases as BAC increases. I’m not being argumentative here. These are actual questions.

  6. Brett Bellmore says:

    Actually, that equivalency is simple math. To put it another way, the difference between a driver sober, and at the legal limit, is no greater than the difference between a really good driver, and a mediocre, but still good enough to have a license, driver. It’s within the range of acceptable variation.

    And that’s where the limit should be, of course, you don’t want it set so high as to permit shocking levels of impairment, or so crazy low that people can’t drive until the next day after they have a beer. We can’t require that people be at the top of their game, or call a taxi.

    Or rather, we could, but it wouldn’t make any sense, the cost/benefit ratio would be too high.

    • Keith Humphreys says:

      Two things are being mixed in this thread: The legal standard and the truth. No one has said the alcohol limit should legally be zero for driving, but a number have said that even low level consumption makes driving worse. From a public health viewpoint, the latter is worth repeating over and over so that everyone knows what risks they are taking.

      • Katja says:

        Yeah.

        I wasn’t trying to imply that James Joyner was a danger to other people, but he seemed to make the assumption that the legal limit is also a physiological threshold below which cognitive functions aren’t impaired.

      • kathleen says:

        It is also possible to get a citation for DUI when you are below 0.08 BAC (even if you’re over 21)*. The standard is whether you are impaired, and BAC is only once piece of that evaluation. Some people are too impaired to drive even with BAC under 0.08, and no once should rely on the number alone for that determination.

        Those who choose to drink any amount and then proceed to drive are taking a serious risk, because their perception of their own impairment is compromised. I would be overcome with guilt if I assumed I was not impaired by “just one” drink and so chose to drive and then ended up hurting someone-far simpler and safer to simply not drink and drive. YMMV.

        _______

        * California DMV (regarding drivers older than 21): “Even a BAC below .08% does not mean that it is safe or legal to drive.” (emphasis added)

  7. Joel says:

    I like to have a single beer when I get home and sometimes when I go out to eat. Sometimes I’ll also have a second beer later in the evening. And this is usually alone. I’m careful about my limits, have never gotten drunk, avoid getting close. So I don’t think “drinking alone” is a very good metric. Wild college partiers who drink more than almost anyone do it in big groups.

  8. Maggie says:

    If you don’t want people driving impaired, then forbid children in vehicles. I remember my Aunt driving down the road with one hand on the wheel, body turned sideways, smacking away at her two little brats in the back seat. Accident just waiting to happen. Maybe one drink would have settled her nerves!

  9. Maggie says:

    In re: Drinking alone. My mother was not a “drinker” per se. My father would come home and make a drink for each of them. My sister and I would be banished from the kitchen while they had their “adult time” to review the day’s events before sitting down to dinner. My father died at 67 and that practice died with him. However, on a winter’s evening my mother would get ready for bed and have a sherry, Kahlua, or Anisette as a nightcap. In her seventies and ALONE! ! ! After losing a spouse, many women find themselves drinking alone … it means nothing.

  10. Colin says:

    I recently saw an Irish TV advert for responsible drinking - it showed people being forced to drink by hands coming around from behind their backs. The message was simply “the right pace to drink at is your own”. Of course it’s not a good idea for alcoholics to “drink at their own pace”. But the general view seems to be that non-alcoholics would have no trouble in moderating their drinking if it weren’t for peer pressure. In the UK at least, we are very tolerant of the excessive drinker’s excuse that they were ‘just keeeping up’, but with drinking alone there is no such excuse and people are much more expected to stay in control. I get the impression that people don’t want to admit to themselves how much they like getting drunk for its own sake, so use the social setting to absolve themselves of responsibility.


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