Alcohol As Placebo

A week ago I had dinner with a respected drug policy expert who disapproves of drug legalization because he sees big negative externalities from alcohol use, and expects legalizing other drugs to make that worse. Which makes some sense. But the picture changes once one realizes that alcohol’s disruptive effects are mostly in our heads:

We Brits believe that alcohol has magical powers – that it causes us to shed our inhibitions and become aggressive, promiscuous, disorderly and even violent.

But we are wrong. In high doses, alcohol impairs our reaction times, muscle control, co-ordination, short-term memory, perceptual field, cognitive abilities and ability to speak clearly. But it does not cause us selectively to break specific social rules. It does not cause us to say, “Oi, what you lookin’ at?” and start punching each other. Nor does it cause us to say, “Hey babe, fancy a shag?” and start groping each other.

The effects of alcohol on behaviour are determined by cultural rules and norms, not by the chemical actions of ethanol. There is enormous cross-cultural variation in the way people behave when they drink alcohol. … In … the vast majority of cultures, … drinking is not associated with these undesirable behaviours … Alcohol is just a morally neutral, normal, integral part of ordinary, everyday life – about on a par with, say, coffee or tea. …

This variation cannot be attributed to different levels of consumption. … Instead the variation is clearly related to different cultural beliefs about alcohol. … This basic fact has been proved time and again … in carefully controlled scientific experiments – double-blind, placebos and all. To put it very simply, the experiments show that when people think they are drinking alcohol, they behave according to their cultural beliefs about the behavioural effects of alcohol. …

Those who most strongly believe that alcohol causes aggression are the most likely to become aggressive when they think that they have consumed alcohol. … These experiments show that even when people are very drunk, if they are given an incentive (either financial reward or even just social approval) they are perfectly capable of remaining in complete control of their behaviour – of behaving as though they were totally sober. …

If I were given total power, I could very easily engineer a nation in which coffee would become a huge social problem. … I would restrict access to coffee, thus immediately giving it highly desirable forbidden-fruit status. Then I would issue lots of dire warnings about the dangerously disinhibiting effects of coffee. I would make sure everyone knew that even a mere three cups (six “units”) of coffee “can lead to anti-social, aggressive and violent behaviour”, and sexual promiscuity, thus instantly giving young people a powerful motive to binge-drink double espressos, and a perfect excuse to behave very badly after doing so. (more; HT Rob Wiblin)

Sometimes we want to behave well, and be around others who behave well, and sometimes we want to behave “badly,” and behave around others who behave badly. We also sometimes want to (often hypocritically) signal our disapproval of bad behavior, and pay costs to “do something” about it.

Our culture has coordinated to support all of these options, by coordinating to see alcohol and other “drugs” as inducing bad behavior. Clever eh? While we can signal our disapproval of bad behavior by opposing drugs, including their legalization, it is far less clear how much such actions actually reduce bad behavior. If we completely eliminated the symbolic items by which we now we identify situations where bad behavior is expected and tolerated, I expect we would quickly pick substitute symbols, and continue on with bad behavior. Because the fact is, much as we often want to signal disapproval of bad behavior, we nearly as often really enjoy behaving “badly.”

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  • PaulG

    Do you have a link to any of these studies she is talking about? I’m sure there is a cultural component to our reaction to alcohol, but to say you could basically engineer a violent reaction to just about any sort of food, drink or whatever sounds very strange to me. Alcohol has a specific chemical function after all. Following the logic could also lead me to conclude that because there is such a thing as a placebo effect any drugs effectiveness hinges on just that effect and nothing else.

    • tribsantos

      Yeah, I also missed links to the studies, something that has become pretty common on the internet, provided there are studies…

    • Simon

      Hi Paul – Robin Room is one of the giants – and he is also
      problematizing a bit in this one: http://www.robinroom.net/intoxbad.pdf

  • Thursday

    If I were given total power, I could very easily engineer a nation in which coffee would become a huge social problem.

    What a lot of blank slatist horseshit. No, you could never engineer a society where coffee had the same effects.

    There are other societies (such as Latin and Mediterranean cultures in particular, but in fact the vast majority of cultures), where drinking is not associated with these undesirable behaviours – cultures where alcohol is just a morally neutral, normal, integral part of ordinary, everyday life – about on a par with, say, coffee or tea.

    This is a great example of the bullshit you get when you ignore average genetic differences between racial groups. There is a clear correlation between the bad social effects of alcohol and the timeline of when it was introduced to a particular society. Scandenavians, Irish and Brits seem have it the worst in Europe, but Native North Americans have it even more bad. Mediterranean societies have had alcohol a lot longer.

    ————————–

    None of this is to say there is no social component to these problems, nor is it totally implausible that people will do things they wouldn’t otherwise do, knowing that they can use drunkenness as an excuse for their behaviour. But that is mostly because people know the genuine disinhibiting effects of alcohol.

    Honestly, when I read this kind of article, I have to seriously wonder if the author has ever gotten drunk in their whole life.

    • http://www.gwern.net gwern

      Why not? We have, inadvertently, done much the same thing for sugar (https://en.wikipedia.org/wiki/List_of_common_misconceptions#Nutrition.2C_food.2C_and_drink), which isn’t even active. So what happens when a caffeine-naive person (remember that caffeine tolerates fast and heavily), loaded with all sorts of cultural cues and stereotypes and false beliefs, gets hit with a big dose of No-Doz?

      • Thursday

        Permit me to repeat myself:

        I have to seriously wonder if the author has ever gotten drunk in their whole life.

      • Ham Nox

        It happens all the time in Utah. It’s Hilarious.

    • Andrew Breese

      EXACTLY, Thursday! On all points.

      It’s apparently a cloyingly small step from merely speculating whether one candidate factor (placebo, say) could somehow explain huge swaths of reality…to seriously thinking that it just does.

      Diversity across the world, especially in sensible patterns, is evidence of actual causative differences across the world. Diversity should not first make us imagine arbitrary chaotic non-causes.

      • Michael Vassar

        I’m pretty sure Robin’s largely right here, but he’s missing a major point.

        The idea of ‘self control’ is not well understood. It’s not that coherent, because there’s no unified ‘self’. Alcohol doesn’t ’cause’ bad behavior, but it reduces the activity of mental pathways that prevent ‘bad behavior’, which makes it easier for people to engage in it when they want to. It’s not that being drunk causes some activity. It’s that being drunk enables people to activate patterns of behavior other than those they are accustomed to.

    • Steven

      Not to troll, Thursday, but for the love of all that’s holy: If you’re speaking about a subject in the singular, use “his” or “her,” never “their.” You’ve made some very cogent arguments here and you’re ruining them needlessly, in particular because you repeated it incorrectly.

      • BJnDaBear

        Steven, comma abuse is a serious problem in our culture. Step off and let real professionals handle this. You have been warned.

  • http://www.gwern.net gwern

    There’s a similar placebo effect for testosterone. From the review article of testosterone I link, quote & discuss in http://lesswrong.com/lw/84i/social_status_testosterone/

    Folk wisdom holds that testosterone causes antisocial, egoistic, or even aggressive behaviors in humans. However, the correlational studies discussed above already suggest that this simple folk view probably requires revision [34,56]. A recent placebo-controlled testosterone administration study found support for the idea that the testosterone-aggression link might be based upon ‘folk’ views: individuals given placebo who believed they had been given testosterone showed less fair bargaining offers compared with those who believed that they had received placebo, thus confirming people’s stereotypes about the behavioral effects of testosterone.

  • Doug

    You can definitely see a similar affect with cocaine. Andean cultures who have consumed it for thousands of years from the coca leaf view it basically the same way that we do caffeine. Western cultures though view it as a violent, disinhibited, addictive, powerful neuro-stimulant. And accordingly they behave that way.

    And it’s not related to a genetic European vs Andean component as Thrursday suggests. We know this because 100+ years ago when first introduced, cocaine was viewed as a daily energy enhancer, good for slogging through a big workload or academic focus. Much the same way we view energy drinks like Red Bull today. Accordingly that’s how people from that culture acted while intoxicated.

    • Thursday

      You’re being somewhat disingenuous.

      From Wikipedia:

      “The leaves of the coca plant contain several alkaloids including cocaine;[1] in fact, they comprise the sources for cocaine’s chemical production, though the amount of cocaine in the leaves is so small, around 0.4%,[1][2] that in order to make a gram of cocaine, 250 grams of coca leaves would be needed.[3][4] A cup of coca tea prepared from one gram of coca leaves contains approximately 4.21 mg of cocaine (cocaine benzoylmethylecgonine, a crystalline Ray Ellis tropane alkaloid).[5]”

      http://en.wikipedia.org/wiki/Coca_tea

      • Doug

        A single average sized “line” of insufflated cocaine is about 30 mg. Someone drinking 4 glasses of coca tea or chewing 1/4 oz of coca leafs, which is not uncommon in Andean cultures, is consuming on the order of the moles of cocaine as a typical Western powder recreational user.

      • Thursday

        1 g of “cocaine” off the street with about 30% actual cocaine = 300 mg cocaine

        300mg/4.2mg per cup of tea = 71 cups of tea!

      • matt

        Doug, further to Thursday’s point, there is a substantial difference between snorting a drug and ingesting it. In the former case, all of the active chemical enters your blood stream in about 2-5 minutes, while when drinking/eating it takes 15-45 minutes, depending on one’s weight. When a drug is delivered in a more concentrated/efficient way, it will have stronger effects. This is one more piece of evidence that people doing this genre of study are probably unfamiliar with alcohol and drugs work. I think the “sugar high” debunking is instructive; it’s an open secret that no such thing exists. I’ve never had a sugar high, nor ever seen someone act differently after ingesting lots of sugar. On the other hand, some outrageous percentage of violent crimes (like 70%) are committed under the influence of alcohol.

  • Thursday

    Alcohol has similar behavioural effects on animals as on humans, though there is dispute over the exact mechanism:
    http://alcalc.oxfordjournals.org/content/40/5/373.full.pdf+html
    Placebo is not a factor with animals, though alcohol consumption alone may not produce certain specific behaviours without additional cues from the environment.

    • http://hanson.gmu.edu Robin Hanson

      “similar behavioral effects on animals” is not a good summary of that article.

      • Thursday

        I find your reply strange.

        When given alcohol, animals are observed to have increased aggression, impulsiveness and playfulness. Just like humans.

      • http://hanson.gmu.edu Robin Hanson

        Some example quotes:

        Low doses of alcohol have been found to increase aggressive behaviour in mice (Krsiak, 1976), increase or decrease aggression depending on whether confrontations took place in neutral or home cages. …

        During a competition between three dogs over a bone, low doses of alcohol increased aggression in subordinate dogs but reduced aggression in higher ranking dogs….

        Weitz (1974) found that alcohol increased fighting behaviour in pairs of male rats when electric foot shock was employed. In contrast, Tramill et al. (1980) found that low doses of alcohol decreased aggression towards a lever when single-restrained rats were shocked.

        Sometimes aggressiveness is increased, sometimes it is decreased. Just like in humans, right?

  • DK

    If I were given total power, I could very easily engineer a nation in which coffee would become a huge social problem.

    Jeez, Robin, are you willing to believe any crap as long as it sounds contrarian?

  • http://twitter.com/robsica Rob

    Check out Geoffrey Miller’s inspiring Comment to the target article of the latest issue of Behavioral and Brain Sciences, a bold call for sweeping reconsideration of drug use from a neuro-evolutionary perspective:

    “Optimal drug use and rational drug policy”
    http://tinyurl.com/cnft8lk

    • DK

      How can Miller (or, in fact, anyone who is aware of animals’ love for psychotropic drugs) write this: “In this view, our ancestors for millennia had been evolving endogenous psychoactive chemicals such as hormones and neurotransmitters to cope with the behavioral demands of prehistoric life. With the rise of agriculture, cities, divisions of labor, and legal monogamy,
      human life became more complex and frustrating faster than genetic evolution could track, so people turned to exogenous drugs to cope with civilization’s loneliness, monotony, oppression, anxiety, and chronic stress.”?

      Really? Rats drink ethanol because their civilization outpaced biological evolutionary changes?

  • http://hanson.gmu.edu Robin Hanson

    The author does not claim that alcohol has no specific biological effects. Rather the point is that many common social effects are not implied by those specific biological effects, but are instead due mainly to cultural expectations about use. Also, we know very little about what is possible with “total power” over society, so I certainly don’t know the author is wrong about what she could do with it.

    • Thursday

      The author does not claim that alcohol has no specific biological effects.

      Well, what she is saying is that alcohol has no biological effects that tend to cause specific large scale changes in behaviour. That quote about coffee is pretty hard to misread. It is also one of the most completely ridiculous things anyone has ever said.

    • Khoth

      Also, we know very little about what is possible with “total power” over society, so I certainly don’t know the author is wrong about what she could do with it

      Whereas the author is an expert on “total power” over society and knows exactly what she could do with it?

  • Thursday

    Alcohol doesn’t ’cause’ bad behavior

    We are all agreed that social and biological factors intermingle and that causation is complex.

    However, alcohol clearly would pass the “but for” criterion for causation.

  • Lorenzo Ruzzene

    Good point! I think this is another good reference:
    New Yorker, February 15, 2010, Annals of Anthropology
    Drinking Games
    How much people drink may matter less than how they drink it.

    • lemmy caution

      That new yorker article has a perfectly good explanation of what is going on with alcohol.

  • http://www.ciphergoth.org/ Paul Crowley

    FWIW I think it’s obviously true that there are negative externalities to the sale of alcohol and drugs. However I would have thought that’s an argument in favour of a Pigovian tax, not a ban. Especially when the bad consequences of such bans are so large.

  • axa

    i just remembered my 5th grade, long time ago. classroom was kind of a zoo: screams, fighting, jumping around without order, chaos =)

    could it be that this “beliefs” around alcohol allows adults to keep behaving like 5th graders???

    i don’t buy the idea yet, but i recognize it is pretty interesting.

  • axa

    I used the children example cause children don’t need to be drunk to act accord the “drunkdard stereotype”

  • Anonymous

    In my experience, there’s something to it. It is hilarious to give a group of teenagers beverages that they think contains alcohol, when in reality, it doesn’t. Just do it. Watch their behavior. It’s really funny.

  • GregS

    Have you been talking to Mark Kleiman by any chance? It sounds very much like his position. It’s a position that there is no support for. Jeffrey Miron has pretty much debunked the idea that there are significant externalities due to drug use itself. I didn’t know any knowledgeable (I hesitate to say “credible”) drug expert took that position seriously until I heard Kleiman’s position.

    Under no reasonable set of assumptions about human behavior is drug prohibition a good idea. Are drugs especially harmful? If “no,” there’s nothing to argue about, because there is no danger. (And the answer is probably “no” for any recreational drug you’ve heard of.) If you answer “yes” to that question, you have to answer the next question: do people respond to unlikely hazards by avoiding them? If “yes” then people will mostly avoid drugs. If “no” then people will not respond to the small threat of a drug conviction. Kleiman and your friend are delusional if they believe they can engineer a legal system that punishes a large fraction of drug users (or seizes a large fraction of drugs as they are trafficked).

    Do these soft prohibitionists acknowledge that people respond to risks to themselves but still commit a lot of crimes against other people (that the activity is underpriced because of externalities)? If that’s the case, then it should be acknowledged that our legal system already “internalizes” these behaviors by making them criminal. A person who rationally responds to risk will avoid a substance that turns him into a murderer/rapist/thief; a person who does not respond rationally to risk will not respond to drug laws.

    This particular crowd of drug policy pseudo-experts are giving cover to one of the worst and most destructive domestic policies in existence. Don’t give them too much credit. This is an issue I’m willing to make a bet on at long odds; nothing bad will happen when we legalize drugs. None of the social pathologies the drug warriors predict will materialize. And violence will decline dramatically.

  • Dave

    Since this idea about alcohol is counter to prevailing ideas,this fact,the fact that it is counter to prevailing ideas is used to leverage or bolster the idea. This is a common thread in many of Robin’s posts.

    The usual problem with this is that it ignores contradictory information that is in the fund of knowledge. In this case it ignores the neuro- chemistry of rewarding substance that are thought to mediate addiction. You could never get people addicted to smoking straw or drinking mineral water.

  • GregS

    Robin: You should read “Saying Yes” by Jacob Sullum. What you say here about alcohol is true of pretty much all the drugs that are currently illegal. “This is Your Country On Drugs” by Ryan Grim tells pretty much the same story.

  • http://hertzlinger.blogspot.com Joseph Hertzlinger

    What drugs are associated with taking unsourced “studies” seriously?

  • William Blake

    I can only speak for myself when I say that having a few drinks does not make me aggressive or make me walk up to women and say “Want to root?” (root is Australian slang for “Screw”). It does however “loosen me up” and I find myself quite talkative with persons I may be too shy or timid to speak with otherwise. I found this out by performing my own double-blind test… In fact I was totally blind once I had reached my conclusion! ;)

  • ThePenileFamily

    Talk about sample size, my sample size is gigantic (joke). I can only talk about me, and what people have said about me.

    If drunk, then I am more open, more nice and less judgmental.

    There was only one situation where being drunk had led me to more aggressive VERBAL tendencies, but that is all.

    Out of all that time, one time, had shown me to be someone I’m not verbally. Every other time was a better me.

    I think all of this depends on the person. Social science is so hard to study and get real answers. I’m sure culture, DNA and the rest play a role, but I know many peeps who are not me that should not be drinking. On the flip-side, others should….

  • http://www.facebook.com/andreas.moser.blog Andreas Moser
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  • http://un-thought.blogspot.com/ Floccina

    I have to agree with Thursday.

  • Michael Wengler

    Thursday’s point about people talking about drugs and alcohol who have never been drunk is, in my opinion, a very good one. Especially if you are taking the position that the effects of alcohol are generally placebo, get yourself up to a 0.15% blood level at a party or a bar in a social situation.

    On the other side, the point that westerners use alcohol to lubricate sports-tribal violence and casual sex very well probably is convention. But I think it is convention that grew up around alcohol use because alcohol is particularly suited in its actual effects to supporting the enjoyment of these activities.

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  • Bromethius

    Alcohol is a fantastic performance enhancing drug right up until the point where it immediately becomes a harmful toxin that makes you make a fool of yourself. 
    http://www.squidoo.com/the-abcs-of-attraction

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