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A look at the problem and nature of alcoholism around the world

Sociologists, anthropologists, historians, and psychologists, in their study of different cultures and historical eras, have noted how malleable people's drinking habits are.

If one can't detect the difference between drinking in this setting, or at Jewish or Chinese weddings, or in Greek taverns, and that in Irish working-class bars, or in Portuguese bars in the worn-out industrial towns of New England, or in run-down shacks where Indians and Eskimos gather to get drunk, or in Southern bars where men down shots and beers--and furthermore, if one can't connect these different drinking settings, styles, and cultures with the repeatedly measured differences in alcoholism rates among these same groups, then I can only think one is blind to the realities of alcoholism.

Ways of drinking and of thinking about drinking are learned by individuals within the context in which they learn ways of doing other things and of thinking about them--that is, whatever else drinking may be, it is an aspect of culture about which patterns of belief and behavior are modeled by a combination of example, exhortation, rewards, punishments, and the many other means, both formal and informal, that societies use for communicating norms, attitudes, and values.

Potentially, each individual is linked, directly or indirectly, to all members of his or her culture.

The Alcoholics of the Animal World

A Social Explanation, Aldine, Chicago, 1969, p. Thus, how we learn to drink and continue to drink is determined most by the drinking we observe, the attitudes about drinking we pick up, and the people we drink with.

In this booklet we will explore the relationship between cultural assumptions and educational messages about alcohol and the likelihood that people will drink in ways that are harmful to themselves or others. One popular approach to reducing drinking problems is to reduce the overall amount of alcohol a society consumes. However, it is remarkable how little correspondence there is between the amount of alcohol consumed per person in different societies and the problems this alcohol consumption generates.

In a comprehensive study of alcohol consumption patterns and outcomes in European and English-speaking countries, none of the 10 countries with a history of Temperance movements showing a concern with the destructive consequences of drinking had as high a per capita alcohol consumption as any of the countries without Temperance movements.

In cultures where ambivalent attitudes toward drinking prevail, the incidence of alcoholism is also high.

A population that drinks daily may have a high rate of cirrhosis and other medical problems but few accidents, fights, homicides, or other violent alcohol-associated traumas; a population with predominantly binge drinking usually shows the opposite complex of drinking problems. A group that views drinking as a ritually significant act is not likely to develop many alcohol-related problems of any sort, whereas another group, which sees it primarily as a way to escape from stress or to demonstrate one's strength, is at high risk of developing problems with drinking.

The solitary drinker, so dominant an image in relation to alcohol in the United States, is virtually unknown in other countries. The same is true among tribal and peasant societies everywhere.

Whereas the French soldiers could be allowed to forage freely, the British soldiers, when they encountered alcohol, could be expected to drink to unconsciousness. Yet others were coming in not at all disgusted. Our soldiers could not resist wine. Modern epidemiological and sociological research consistently documents these cultural differences.

Using DSM-III, an international team led by John Helzer discovered the following remarkable differences in alcohol abuse rates among different cultures, including two native Asian groups: There is about a fiftyfold difference in lifetime prevalence between these two samples and Shanghai, where the lowest lifetime prevalence of 0. For as long as American epidemiologists have measured drinking problems, they have found clearcut, significant, and persistent group differences.

It is notable that the groups with the lowest incidence of alcohol abuse, the Jews and Italians, have a the lowest abstinence rates among these groups, and b especially the Italians the highest consumption rates.

Two sociologists searched for Jewish alcohol abusers in an upstate NY city in the belief that alcoholism rates among American Jews had risen. Instead, they found an astoundingly low rate of 0. George Vaillant, studying inner-city ethnic men in Boston over a 40-year period, found that Irish-Americans were 7 times as likely to develop alcohol dependence as Italian-Americans--this despite the Irish-Americans having a substantially higher abstinence rate.

A sociologist who reviewed 17,500 arrest records in New York's Chinatown from 1933 to 1949 found that not one arrest noted public drunkenness. An anthropological study," pp. There are also clear and distinct differences in alcohol abuse rates by socioeconomic status.

Again, this suggests that lower abstinence rates and higher consumption levels are not themselves the source of drinking problems. Drinking patterns in the U. The Southern and Mountain regions of the country, with their "dry" traditions, have high levels of both abstinence and individual excess. These differences in problem rates, however, are apparent only among men. It has recently been argued that drinking practices and problems in the United States are heading toward a regional convergence.

The evidence given here, however, contradicts the convergence thesis. According to the latest national survey data, the wetter and drier sections of the country continue to have markedly different rates of abstention and per-drinker consumption. Alcoholics Anonymous World Headquarters has compiled AA group membership data in countries around the world.

In 1991 the last year for which data were keptthe western country with the fewest AA groups per capita was Portugal, with 0.

  • In spite of the enormous human and monetary resources employed in this educational approach, it has not been effective;
  • The context chosen by the drinker or thrust on him or her by peers defines the social and physical environment he or she will encounter while intoxicated and thus the constellation of environmental risks.

The highest was Iceland, with almost 800 groups per million. Drunken aggression is commonly observed in some cultures and settings in the United States. Worldwide, however, such behavior is typically quite rare, even among people who drink a great deal.

  1. Alcohol consumption is expressed in terms of the average daily consumption of pure alcohol.
  2. Of these groups, the southern Baptists have the highest drinking pathology probability rate. Again, a fairly clear answer has emerged.
  3. The small percentage of the population whose reported average daily consumption is in excess of 4 ounces a day is probably drunk for some period of time most days of the year.

Numerous anthropological studies demonstrate that alcohol-related violence is a learned behavior, not an inevitable result of alcohol consumption. Alcohol as a drug can be viewed as an enabler or a facilitator of certain culturally given inebriate states, but it cannot be seen as producing a specific response pattern among all human beings who ingest it.

  • Quantity and Frequency Current knowledge of drinking practices rests heavily on general sample surveys of households in the general population;
  • Although we have stressed observations of the impermanence of drinking practices over individual drinkers' lifetimes, it is clear that in the short run, at least, drinking practices do have some inertia;
  • These regulations may or may not be enforced, however;
  • The priest comes into the house;
  • But Table 8 shows how much each portion of the drinking population contributed to people who have problems associated with drinking;
  • And when the researchers looked at patterns of drinking, macaques that lived alone tended to drink the most.

An Anthropological View of Ethanol as a Disinhibitor," pp. He found that men get drunk either occasionally or often in 46 of these 60 societies. But, he found men involved in drunken brawls a look at the problem and nature of alcoholism around the world only 24 of the societies.

So, in a worldwide sense, it seems that alcohol-related aggressive behavior -- as measured by male involvement in drunken brawls -- is about as likely to be present as it is to be absent. There is no verbal or sexual aggression, no destruction of property, no drunken homicide or suicide.

On the contrary, drinking is a time for cordiality and easy social interaction that are rare in other times of their lives.

Or, conceivably, the blood alcohol levels could even be in inverse relation to expressions of aggression if we compare beer in taverns to martinis at business luncheons or at cocktail parties. Its use is associated with sociability and the enhancement of pleasure. Few, if indeed any, major alcohol-related problems are thought to arise from the consumption of wine. Wine is deemed most appropriate for consumption at home, usually during mealtime -- which, it should be noted, is yet another drinking occasion that has been related to moderate alcohol intake.

In colonial America, alcohol was viewed as benign and even as a blessing. Drinking and occasional drunkenness were tolerated as part of everyday life--the workplace, elections, social gatherings.

Antisocial drinking, on the other hand, was held in check by strong social sanctions. At that time inebriation was not associated with violence or crime; only rowdy, belligerent inebriation in public places was frowned upon. Control was also exercised through informal channels.

One Massachusetts minister insisted that a public house be located next to his own dwelling so he could monitor tavern traffic through his study window. If he observed a man frequenting the place too often, the clergyman could go next door and escort the drinker home.

The Stanton Peele Addiction Website

A special site for appropriate drinking was the colonial tavern, where as in church people of all ages met. It was like a public lecture hall and meeting place. Wedding parties, funerals, and even church services were held in the tavern. Children were regularly exposed to alcohol and taught how to drink. Many parents intended this early exposure to alcohol to accustom their offspring to the taste of liquor, to encourage them to accept the idea of drinking small amounts, and thus to protect them from becoming drunkards.

The 19th century saw the breakdown of the colonial consensus about alcohol and the rise of the temperance movement. In the 19th century the saloon was where middle class men went slumming, and where all men went to get away from their families. By the mid-1850s, many dry reformers were congratulating themselves on having destroyed the old consensus on drinking as a positive good.

The Reverend John Marsh. The result is the ambivalence toward alcohol we see in the U. This cultural ambivalence has been forged and reforged during each historical period, each social and economic upheaval, and each era of immigrant assimilation. The resulting negation of alcohol use has led to a curious worship of abstinence, which is little practiced and, when practiced, little respected. Toward a More Comprehensive Definition," pp.

  1. In the more usual case, however, the effects depend on such factors as the spacing of drinks, the drinker's size and weight, how recently he or she has eaten, his or her own hopes and expectations about the effects of drinking, and even the expectations and demands of the people present in addition to the amount consumed. No other element seemed capable of satisfying so many human needs.
  2. We have already stressed one reason for our interest in these issues.
  3. It has recently been argued that drinking practices and problems in the United States are heading toward a regional convergence.... These qualitative results also stand up when we look at data from national surveys conducted in 1967 and 1977.
  4. To a degree, this judgment can be usefully informed by empirical evidence on the frequencies and magnitudes of the various effects e.

Because our society's teachings are neither clear nor consistent, we lack unanimity of understanding; and where unanimity of understanding is lacking, we would argue that unanimity of practice is out of the question. Usually drinking is viewed as an important adjunct to sociability.

Almost as often, it is seen as a relatively inexpensive and effective relaxant, or as an important accompaniment to food. Its use in religions is ancient, and reflects social approval rather than scorn.

Most people in the United States, Canada, and Sweden, when asked what emotions they associate with drinking, responded favorably, emphasizing personal satisfactions of relaxation, social values of sociability, an antidote to fatigue, and other positive features.

No other element seemed capable of satisfying so many human needs. It contributed to the success of any festive occasion and inspirited those in sorrow and distress.

It gave courage to the soldier, endurance to the traveller, foresight to the statesman, and inspiration to the preacher. It sustained the sailor and the plowman, the trader and the trapper. By it were lighted the fires of revelry and of devotion.

Few doubted that it was a great boon to mankind. The drinking scene in the UK has undergone marked changes during recent decades. Public bars are now far more congenial and attractive to drinkers of both genders.

The British generally enjoy drinking, and recent legislation has attempted to increase the social integration of alcohol use and to discourage alcohol-related problems, but not drinking in itself.

Passover is a happy time. We are happy to be free. On the first and second nights we have a Seder. My whole family is there, singing and having a good time. Everybody drinks four glasses of wine. Shabbat comes once a week. It is a day of rest. It starts on Friday evening, when mother lights the candles.

Then daddy comes home and says the kiddush over the wine and challah. Next morning we all go to the synagogue.

  • What can be done is to outline the dimensions that are likely to be linked importantly to risks and benefits and report what is known about how the population is distributed across these dimensions;
  • A recent survey of drinking practices among U;
  • First, the aggregate pattern of alcohol consumption has been fairly stable over the first half of the 1970s;
  • The widespread propagation of the image of the irresistible dangers of alcohol has contributed to this undermining;
  • These differences in problem rates, however, are apparent only among men....

Back home again, we have a nice dinner and sing songs and take it easy. In the evening, when the three starts are out, daddy says the habdolah.