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Health, Science, Environment

Commentary: The wages of abstinence are death

This article first appeared in the St. Louis Beacon, Sept. 9, 2010 - Finally, some encouraging news. While wading through the seemingly endless litany of wars going badly, economies gone south, broken dreams, busted marriages and what Charles Bukowski once called “the routine tales of ordinary madness,” I came across a glimmer of hope, thanks to a report published by Time/CNN. Turns out drinkers — even heavy drinkers — tend to outlive their teetotaling counterparts.

Psychologist Charles Holahan of the University of Texas at Austin conducted a mortality study of 1,824 persons aged 55 to 65, who were classified as either “heavy drinkers,” “moderate drinkers” or “abstainers.” Twenty years later, 41 percent of moderate drinkers had died, as had 60 percent of heavy drinkers. But more than 69 percent of the unduly sober had departed this mortal coil.

Researchers have consistently found that moderate drinkers tend to live longer than those who do not partake. The standard response to this finding from Alcoholics Anonymous was that the abstinence sample included dried-out drunks who had already irreparably damaged their health before going sober.

To control for this possible source of error, Holahan studied only non-drinkers who had never drank regularly. He defined moderate drinking as routinely consuming 1 to 3 drinks a day and heavy drinking as 4 or more drinks daily.

His findings for moderation basically confirmed what was already known, although the 28+ percentage point lower mortality rate was a dramatic confirmation. The outcome for heavy drinking, however, was wholly unanticipated and is remarkable for several reasons.

When doctors cite the health benefits of alcohol, they stress moderation — usually recommending a glass or two of red wine daily. That sounds good in the exam room but often doesn’t translate well at the tavern. What self-respecting saloonatic is going to consider his thirst quenched after two glasses of wine?

Just as tardy husbands who stopped after work for “a beer” tend to underreport their actual consumption, respondents often minimize the amount they imbibe when talking to researchers. Psychologists have long noted that people generally try to paint a favorable picture of themselves, even when completing anonymous surveys.

When sitting face to face with a stranger in a clinical setting, confessing to an “occasional cocktail” sounds a lot better than “I drink like a fish.” It is thus a fair bet that some portion of the “moderate” sample would be more accurately classified in the less flattering “heavy” category.

The mortality rate among heavy drinkers is even more remarkable in that boozers are at far greater risk of calamity than the population at large. Due to their impaired abilities and judgment, they have a bad habit of falling down stairs, off balconies and over unseen coffee tables. When they drive, tragedy is always a distinct possibility.

They also run higher risks of cirrhosis of the liver, and cancers of the mouth and esophagus. Further, they are more likely to become involved in physical altercations with fellow sots and are also more likely to smoke. For all of that, they still die at a rate 9+ percentage points below that of the chronically sober.

The obvious conclusion to be drawn from these numbers is either that a.) alcohol consumption is beneficial to health or, b.) people who are genetically prone to long life are also predisposed to drink. As there is no known evidence to support the latter, the former would seem the more reasonable explanation.

Ironically, the politically incorrect finding that heavy drinking is healthier than abstinence was probably itself a by-product of political correctness. By setting the standard for heavy drinking at 4 drinks, researchers unwittingly lumped a lot of social drinkers in with genuine, hard-core alcoholics.

The brick-layer who puts a dent in a six-pack of beer after a long day of manual labor and the guy who can’t hold a job because he drinks a couple of quarts of vodka daily are two very different people and are likely to have very different health outcomes. Yet, the study considers both to be “heavy drinkers” and analyzes their mortality rates accordingly. Had researchers included a “super-heavyweight” division, I suspect the health benefits of over-indulgence would have disappeared.

Moderate alcohol consumption appears to benefit the circulatory system, as drinkers exhibit lower incidence of heart disease than those who abstain. I suspect there’s another advantage to drinking that researchers often ignore but any barroom practitioner would immediately recognize: It’s fun.

Comparing the effects of a primary ingredient in beer, ale and whiskey to the moral edification of reading Paradise Lost, the poet Houseman observed, “…malt does more than Milton can to justify God’s ways to man.”

The world’s a rough place and nobody gets out of it alive. Getting away from your cares for a while, relaxing with friends and laughing at life’s absurdities are good for the soul. Maybe that’s why alcoholic beverages are often referred to as “spirits.”

Most regular drinkers know their limits. They’ve learned from cruel experience that although a few drinks can facilitate a good time, a hangover is anything but. And once you get past the college years, puking on your shoes is generally not considered to be a satisfactory conclusion to a night on the town.

Like any adult choice, the decision to imbibe involves risks and rewards. As for me, I usually follow the lead of the late W.C. Fields who is said to have remarked, “Everybody has to believe in something — I believe I’ll have a drink.” Cheers.

M.W.Guzy is a retired St. Louis cop who currently works for the city Sheriff's Department. His column appears weekly in the Beacon. 

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