Moderate drinking is good for you. Except when it’s bad for you

Just three months ago the highly regarded and influential publication the British Medical Journal stated that moderate drinking was good for our hearts and that even heavy drinking lowered our risk of a heart attack. Good.

Last week the same British Medical Journal announced that moderate drinking is bad for our brain and causes a steep decline in mental functioning. Bad.

To the dedicated drinker – and this country could take dedicated drinking as our specialist subject on Mastermind – these findings provoked a Sophie's Choice dilemma. Heart or brain? Do we really need both?

The dilemma is compounded because “moderate” and “heavy” drinking are highly subjective and nuanced terms in this country.

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Even the Government is confused. As it stands, under HSE guidelines you can go into a pub in Dundalk and happily knock back 21.2 units of alcohol, content in the knowledge that you are in "the low risk of harm from alcohol" category.

Travel a few miles north into Newry, though, and your moderate Dundalk drinking now becomes "heavy" drinking – as in the UK you can only have 14 units of alcohol if you want to remain a paid-up member of the "low risk of harm from alcohol" club.

Bring your own pyrex jug

The term “unit” here is problematic. Unless you’re the type of person who carries a pyrex unit measuring jug around with them, a unit is 10ml or 8g of pure alcohol, which is roughly equivalent to 250 ml of 4 per cent strength beer, 76ml of 13 per cent wine or 25ml of 40 per cent spirits.

Good luck with your HSE unit and millilitres/grams calculations when ordering a round this Saturday night.

But most every country has their own version of what a unit represents, along with their own version of what “moderate” and “heavy” drinking entails.

In Russia, up until just six years ago, they didn't even bother classifying beer as alcohol – on the basis that anything containing less than 10 per cent alcohol was considered a foodstuff. At the same time, then-president Dmitry Medvedev was stating that the country's chronic alcohol problem could be solved if people switched from vodka to wine.

But then again it was just over 10 years ago when our then minister for justice, Michael McDowell, announced the cure for Ireland’s drink problem was the introduction of Parisian cafe bar style venues wherein if we just ordered a salade niçoise and read some Sartre in between the rake of pints, we’d be grand.

The amount of conflicting, contradictory and barely sane advice or recommendations about alcohol consumption is now such that leading scientists say this is a problem that needs treating in itself.

Just move country

A major international study published in the journal Addiction found that the variation between stated safe alcohol consumption levels among countries was so great that they could only conclude that if a person was worried they had a drink problem, they should just move to a country where their drinking would fall under the "safe" category.

The underlying problem here is bringing actuarial style figures – units, measurements, percentages etc – to bear on a potent, culturally sanctioned drug.

This country’s already much discussed Public Health (Alcohol) Bill, which was shelved last year, is now being resuscitated.

The HSE is calling for “a reduction in the per capita consumption from the current 11.46 litres of pure alcohol per person per year to 9.1 litres of pure alcohol per year”. This is a ridiculously random statement. There’s no explanation given why 11.46 litres of pure alcohol per year is bad and 9.1 litres of pure alcohol per year is desirable. They’re only looking at quantity here. There’s a panoply of variables missing.

There is little evidence regarding the impact of any guidelines in changing health behaviours (price increases are different). For one, the guidelines keep changing (the bar keeps getting lowered) and second, the figures are impossibly impractical – who on earth knows how many litres of pure alcohol they consume per year?

Rate my gargle

Then again, maybe the HSE will release an App for our phones so we can diligently enter in our litres and units consumed every time we raise a glass/bottle to our lips – while also factoring in our height, weight, gender, body mass index, amount of food consumed that day before drinking, whether we are predisposed to addictive behaviour, and a lengthy questionnaire about the state of our mental health.

Alcohol abuse is not an accountancy exercise. Give the same amount of alcohol to two different individuals and you will see two different reactions. Your “heavy” drinking may be my “moderate” drinking.

And how is “low-risk” drinking defined anyway? First, there is a stunning lack of international agreement on what it constitutes, but the mangled consensus seems to be that “low-risk” drinking gives you less than a 1 per cent chance of dying from an alcohol-related condition.

You'd get more sense out of Paddy Power if you presented them with your weekly drink tally and asked them to bet on how long you will live.

The language and numbers need to go. The new alcohol Bill needs to ask not how much/how often we drink or even why we drink – not that you’d get an honest answer to either.

To hell and back

Irish people are capable of travelling forth to the most wretched place on earth (Holyhead) to get a drink on Good Friday; in more extreme “rock-bottom” cases we will even sit through a play at the Abbey on Good Friday for the sake of the few scoops at the interval.

The alcohol Bill need only ask one question: what effect does alcohol have on us?

Words written by the journalist John Aitch in 2009 about this dysfunctional governmental preoccupation with litres and units (which many people just regard as personal target figures anyway) should be read by everyone involved with our new alcohol Bill:

“Why do they waste their time and ours on this nonsense? Statistics, advice, guidance, warnings, threats and general interference don’t do much more than irritate everyone, since those who choose what they drink don’t need to hear it and those who are in denial about their drinking can’t or won’t hear a word said against it.

“Has it never occurred to politicians to ask those who have accepted that they drank too much why and how they cut down or stopped? They might learn that the sherry-sipping grandmother who had reached the point of drinking against her own will had a habit that was affected not one jot by the unit size of her glass.”