tag:theconversation.com,2011:/us/topics/drunkenness-23111/articlesDrunkenness – The Conversation2023-10-26T12:31:10Ztag:theconversation.com,2011:article/2158892023-10-26T12:31:10Z2023-10-26T12:31:10ZTo better understand addiction, students in this course take a close look at liquor in literature<figure><img src="https://images.theconversation.com/files/555246/original/file-20231023-15-kxsfnv.jpg?ixlib=rb-1.1.0&rect=23%2C31%2C5152%2C3383&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Characters in books can teach lessons about addiction.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/open-book-and-glass-of-white-wine-in-sunlight-royalty-free-image/1219727594?phrase=wine+literature&adppopup=true">Nataliia Shcherbyna via iStock/Getty Images Plus</a></span></figcaption></figure><figure class="align-right ">
<img alt="Text saying: Uncommon Courses, from The Conversation" src="https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=375&fit=crop&dpr=1 600w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=375&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=375&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=471&fit=crop&dpr=1 754w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=471&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/499014/original/file-20221205-17-kcwec8.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=471&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em><a href="https://theconversation.com/topics/uncommon-courses-130908">Uncommon Courses</a> is an occasional series from The Conversation U.S. highlighting unconventional approaches to teaching.</em> </p>
<h2>Title of course:</h2>
<p>Alcohol in American Literature</p>
<h2>What prompted the idea for the course?</h2>
<p>I got the idea for the course when I was writing a chapter on the temperance movement in American literature for my doctoral dissertation. I ended up reading a lot of fiction and poetry about alcohol and the anti-alcohol movement. I thought it would be fun to teach a class that <a href="https://www.academia.edu/12903259/_Temperance_Novels_and_Moral_Reform_in_Oxford_History_of_the_Novel_in_English_Oxford_UP_2014_">surveyed American literature through a booze-themed lens</a>. </p>
<p>Since alcohol affects and disables people regardless of gender, sexual orientation, race, ethnicity or class, it is easy to find literature about the impact of alcohol from many points of view. </p>
<h2>What does the course explore?</h2>
<p>I pair my course with a medical doctor who teaches a course on the <a href="https://www.verywellmind.com/addiction-4157312">biology of addiction</a>. In the biology course, students learn about the <a href="https://www.verywellmind.com/addiction-overview-4581803">biological and physiological effects</a> of diseases of addiction, <a href="https://www.verywellmind.com/substance-use-vs-substance-use-disorder-whats-the-difference-6385961">substance use and abuse</a>, dependency and recovery.</p>
<p>The core curriculum at John Carroll University requires students to take paired courses from different departments that are linked together. A colleague who teaches biology courses approached me about linking my alcohol class to her addiction class. Students must take both of our courses during the same semester. The combined courses give students both a scientific and literary view of addiction. </p>
<p>Students read fiction, poetry and drama about many aspects of alcohol and other addictive substances: celebrating them, struggling with them, even prohibiting and regulating them. Students compare the literary representations of substance and alcohol abuse with medical descriptions and impacts. For example, when my class reads Kristen Roupenian’s viral short story “<a href="https://www.newyorker.com/magazine/2017/12/11/cat-person">Cat Person,</a>” we talk about the role of alcohol in reducing inhibition when casually dating.</p>
<h2>What’s a critical lesson from the course?</h2>
<p>My goal is for students to come to a better understanding of how alcohol influences literature. They learn how some writers portray the way alcoholism further marginalizes minorities. For example, characters in <a href="https://fallsapart.com/">Sherman Alexie</a>’s “<a href="https://bookshop.org/p/books/the-lone-ranger-and-tonto-fistfight-in-heaven-20th-anniversary-edition-sherman-alexie/12459512?ean=9780802121998">The Lone Ranger and Tonto Fistfight in Heaven</a>” are enrolled members of the Spokane Tribe of Indians. They live on the reservation and have great difficulty finding or keeping a job. Many characters suffer from intergenerational trauma, poverty and a pervasive addiction to alcohol. </p>
<p>For their final project, students must pitch a movie that offers a compelling plot with relatable characters. The storyline must be backed up by a deep understanding of the science of disease and addiction. </p>
<h2>What materials does the course feature?</h2>
<p>• “<a href="https://tinhouse.com/book/night-of-the-living-rez/">Night of the Living Rez</a>,” by Morgan Talty, explores addiction and poverty among the Penobscot Nation.</p>
<p>• “<a href="https://www.hemingwayhome.com/store/p/the-sun-also-rises-softcover">The Sun Also Rises</a>,” by Ernest Hemingway, is a classic novel set in 1920s Paris about a set of heavy-drinking American ex-pats dealing with the trauma of World War I.</p>
<p>• We visit <a href="https://karamuhouse.org/">Karamu House</a>, the U.S.’s oldest continuing African American theater, to watch a performance of “<a href="https://www.dramatists.com/cgi-bin/db/single.asp?key=6301">Clyde’s</a>,” a popular play by Lynn Nottage that is set in a truck stop sandwich shop that employs the recently incarcerated.</p>
<h2>What will the course prepare students to do?</h2>
<p>Students can be better advocates for their own personal health, and the health of others, if they understand how addictive substances affect their minds and bodies. Pre-health students in particular get a general introduction to medical issues related to addiction and how American authors have long portrayed booze. </p>
<p>For example, Frances Watkins Harper’s “<a href="https://www.literaryladiesguide.com/full-texts-of-classic-works/the-two-offers-by-frances-watkins-harper/">The Two Offers</a>,” written in the 1850s, is believed to be the first short story ever published by an African American woman. It is a temperance story that encourages young women not to marry a drunkard, highlighting the antebellum Black community’s concerns about sobriety and domestic well-being, in addition to freedom.</p>
<p>The course hones students’ critical reading and writing skills while challenging them to think about the role of alcohol, substance abuse, sobriety and recovery in their lives and in American culture.</p><img src="https://counter.theconversation.com/content/215889/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Debra J. Rosenthal does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>This course beckons students to examine how alcoholic beverages are portrayed in books by American authors.Debra J. Rosenthal, Professor of English, John Carroll UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1374752020-04-29T19:04:30Z2020-04-29T19:04:30ZElephants get drunk because they can’t metabolize alcohol like us<figure><img src="https://images.theconversation.com/files/331555/original/file-20200429-51495-1x6f3d1.jpg?ixlib=rb-1.1.0&rect=14%2C0%2C3244%2C2438&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Scientists had assumed that elephants could not become inebriated because of their size.</span> <span class="attribution"><span class="source">(James Higham)</span>, <span class="license">Author provided</span></span></figcaption></figure><p>Anecdotes about wild animals seemingly getting drunk after eating rotting fruit are widespread. </p>
<p>There are stories about <a href="https://doi.org/10.3758/BF03333758">African elephants eating the overripe fruit of the marula tree</a> (incidentally, Amarula Cream liqueur is made from the same plant). There was that <a href="https://www.bbc.com/news/world-europe-14842999">moose in Sweden that got stuck in a tree</a> after eating too many rotting apples. And the vervet monkeys of St. Kitts, whose fondness for sugar and possibly alcohol, drives them to steal drinks from tourists.</p>
<p>Chimpanzees even make tools, in the form of leaf sponges, <a href="https://doi.org/10.1098/rsos.150150">to access the fermented sap</a> that collects in containers hung from tapped raffia palms in Guinea. </p>
<p>Despite the popularity of these stories in the public imagination, they have often been dismissed as myths. Scientists concluded that it would be unlikely for elephants to eat enough fermented fruit to get drunk <a href="https://doi.org/10.1086/499983">because they are so large</a>. </p>
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<figcaption><span class="caption">A BBC report on vervet monkeys stealing alcoholic drinks from tourists in St. Kitts.</span></figcaption>
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<p>I am a molecular ecologist and anthropologist who studies digestive adaptations of animals. My colleagues and I just published <a href="https://doi.org/10.1098/rsbl.2020.0070">a new study in the journal <em>Biology Letters</em></a> on genetic variation related to ethanol metabolism. We found that these conclusions may have been premature and stories about elephants, and other mammals, becoming inebriated from eating rotting fruit may well be true.</p>
<h2>Too big to get drunk</h2>
<p>When scientists claimed that elephants could not become inebriated from eating rotting fruit, they based those claims on a simple calculation that included the amount of ethanol that’s in marula fruit, how quickly humans break down ethanol and the body size of elephants. So they basically considered how much marula fruit it would take for us to feel intoxicated and then scaled up for an elephant’s size. </p>
<p>However, there is one fatal flaw in this logic — it assumes that elephants are able to break down ethanol as quickly as humans do. Research suggests that this assumption might not be true. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/331552/original/file-20200429-51466-bcmuct.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/331552/original/file-20200429-51466-bcmuct.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/331552/original/file-20200429-51466-bcmuct.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/331552/original/file-20200429-51466-bcmuct.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/331552/original/file-20200429-51466-bcmuct.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/331552/original/file-20200429-51466-bcmuct.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/331552/original/file-20200429-51466-bcmuct.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/331552/original/file-20200429-51466-bcmuct.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">We have long been fascinated by anecdotes about elephants becoming inebriated from eating rotting fruit.</span>
<span class="attribution"><span class="source">(James Higham)</span>, <span class="license">Author provided</span></span>
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<p>Humans are quite special in our ability to metabolize ethanol quickly. One of the enzymes involved in breaking down of ethanol, alcohol dehydrogenase class 4, encoded by the gene ADH7, has a variation that makes us <a href="https://doi.org/10.1073/pnas.1404167111">40 times faster at metabolizing ethanol</a> than other primates. </p>
<p>This change evolved around 10 million years ago in our common ancestry with gorillas and chimpanzees, long before we intentionally started fermenting beverages (which began no earlier than <a href="https://doi.org/10.1007/s10816-011-9127-y">12,000 years ago</a>). The change might be an adaptation for feeding on fruit, especially after switching to a terrestrial lifestyle, where we probably <a href="https://doi.org/10.1073/pnas.1421566112">encountered more fallen fruit</a>. Overripe wild fruits and nectars can have <a href="https://doi.org/10.1093/icb/44.4.315">surprisingly high ethanol contents</a>, similar to some pale ales!</p>
<h2>Elephants are lightweights</h2>
<p>So, if humans have an especially fast ethanol metabolism, can we really compare other animals simply by adjusting for body size? To know more about the abilities of other mammals to break down ethanol, <a href="https://doi.org/10.1098/rsbl.2020.0070">we compared the ADH7 gene across 85 mammals</a>. </p>
<p>We found that most of them not share the variation for faster ethanol breakdown, and that many mammals did not even have a functional ADH7 gene, including African and Asian elephants. Even mammoths, an extinct elephant relative, did not have one. What the mammals that lost the ADH7 gene have in common is that they don’t regularly eat a lot of fruit: their diets are comprised of grass (cows, horses, sheep and goats) and other foliage (beavers, elephants) or meat (dogs, sea lions, whales and dolphins).</p>
<p>Now, ethanol metabolism is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3756590/">a complex process</a> that involves several steps and a number of different enzymes, so it’s possible that elephants have another way of breaking down ethanol. But it’s very unlikely that the efficiency with which they can do this is comparable to that of humans. Simply scaling up for body size does not accurately predict whether elephants can become intoxicated from eating old marula fruit.</p>
<h2>In human company</h2>
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<a href="https://images.theconversation.com/files/331511/original/file-20200429-51485-pkz85h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/331511/original/file-20200429-51485-pkz85h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/331511/original/file-20200429-51485-pkz85h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/331511/original/file-20200429-51485-pkz85h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/331511/original/file-20200429-51485-pkz85h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/331511/original/file-20200429-51485-pkz85h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/331511/original/file-20200429-51485-pkz85h.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/331511/original/file-20200429-51485-pkz85h.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Aye-ayes in Madagascar are known to feed on the nectar of the traveller’s palm.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/nomissimon/15382959344/in/photolist-q6SSAM-qo97kB-q6U9Mv-q6SRJr-q6LrA9-pryh5a-qogaxf-qo9jDz-q6Ty6P-qm3Lqd-q6M9rN-prkFSY-q6M7Qb">(nomis-simon/Flickr)</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
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<p>Humans do have some company among other mammals who share the same or similar changes to their ADH7 gene. What they tend to have in common is that they eat a lot of fruit or nectar. For example, the aye-aye, a primate that is found on Madagascar, is known to drink the nectar of the traveller’s palm, which is <a href="https://doi.org/10.1098/rsos.160217">speculated to be fermented</a>. </p>
<p>Fruit bats, like flying foxes or the cave nectar bat, that eat nothing but fruit and nectar might also be better at breaking down ethanol. This might be an important adaptation — as you can imagine, being inebriated would be especially bad news for a flying mammal. </p>
<p>The diets of mammals are wondrously diverse and so are their digestive systems and adaptations. Instead of extrapolating from humans and anthropomorphizing animal metabolism, we need to consider the evolutionary history of each species and their diets.</p>
<p>All of those stories about drunken animals? There might be some truth to them after all.</p><img src="https://counter.theconversation.com/content/137475/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mareike Janiak receives funding from the Leakey Foundation, the Wenner-Gren Foundation, and the Alberta Children's Hospital Research Institute. </span></em></p>Elephants don’t have the enzyme that allows humans to metabolize alcohol. This means that anecdotes about elephants getting drunk from rotten fruit may very well be true.Mareike Janiak, Postdoctoral Scholar in Primate Genomics, University of CalgaryLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1163162019-05-02T11:42:45Z2019-05-02T11:42:45ZStreet drinking, fly-tipping and nuisance neighbours: who experiences anti-social behaviour?<figure><img src="https://images.theconversation.com/files/272207/original/file-20190502-103049-1e429kp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Anti-social. </span> <span class="attribution"><span class="source">J Walters/Shutterstock</span></span></figcaption></figure><p>For some people who repeatedly experience or witness anti-social behaviour it can have a devastating affect on their lives. A new report from the Victims’ Commissioner for England and Wales has <a href="https://victimscommissioner.org.uk/published-reviews/anti-social-behaviour-living-a-nightmare/">called it a “living nightmare”</a>. Findings from our ongoing research were included in the Commissioner’s report and they help to explain who is experiencing anti-social behaviour and in what context. </p>
<p>Anti-social behaviour is <a href="http://www.legislation.gov.uk/ukpga/2014/12/contents/enacted">defined</a> in UK law as “conduct that has caused, or is likely to cause, harassment, alarm or distress to any person”. This might include, for example, nuisance neighbours, street drinking, fly tipping or evidence of drug use. The latest figures from the <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/bulletins/crimeinenglandandwales/yearendingdecember2018">Crime Survey for England and Wales (CSEW)</a> suggest that 37% of those who responded to the survey had experienced or witnessed some form of anti-social behaviour in their local area in the year ending December 2018 – the highest percentage since this data was first collected. </p>
<p>The <a href="https://www.ons.gov.uk/surveys/informationforhouseholdsandindividuals/householdandindividualsurveys/crimesurveyforenglandandwales">CSEW</a> is widely considered to be the <a href="https://www.cambridge.org/core/journals/legal-information-management/article/choosing-and-using-statistical-sources-in-criminology-what-can-the-crime-survey-for-england-and-wales-tell-us/BBCB2D03249DC8C7CAFBA16D4B8C2FBD">best source </a> of victimisation data internationally. Conducted since 1981, the survey collects information on experiences of crime and anti-social behaviour, and other contextual information on victims, such as their household and where they live. </p>
<p>Respondents are asked if they have experienced or witnessed anti-social behaviour within a 15-minute walk of their home in the previous 12 months, how often the incidents happened, and what happened next. In our analysis of data on anti-social behaviour from the CSEW, we found that five key themes emerged. </p>
<h2>Repeated behaviour</h2>
<p>First, certain types of anti-social behaviour are more common than others. These include street drinking or drunken behaviour – which accounted for 11.5% of those who reported experiencing or witnessing some form of anti-social behaviour. Other common behaviour were the category of youths, teenagers or groups “hanging about on the streets” (9.5%), inconsiderate behaviour, such as repeated use of fireworks or people throwing stones (7.1%), and anti-social behaviour related to vehicles, such as inconvenient parking or speeding cars (5.1%).</p>
<p>Second, we also found that certain types of anti-social behaviour were more prone to repetition, including environmental nuisances – such as litter, fly tipping or dog fouling – as well as begging, behaviour related to vehicles, and people using or dealing drugs. </p>
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<p>As the graph above shows, for the majority of the types of anti-social behaviour that we analysed, more than half of those experiencing or witnessing the behaviour, did so at least once a month. This highlights the repetitive and persistent nature of much anti-social behaviour. It also underlines the importance of not viewing incidents in isolation, a point echoed in the Victims’ Commissioner’s report.</p>
<p>Third, certain people and households are more likely to experience anti-social behaviour – and this varies depending on the type of behaviour. Those more likely to witness street drinking or drunken behaviour, for example, tend to be younger, white people with educational qualifications. They also tend to have lived in a terraced house or flat in an urban, income-deprived, higher-crime area for more than 12 months.</p>
<p>Those more likely to witness youths, teenagers or groups hanging about, also tend to be younger with educational qualifications. However, they tend to have a household income of more than £30,000 and have lived in a flat in an area with higher-income deprivation for more than 12 months. Having said this, the households who are more likely to experience anti-social behaviour are not necessarily the same as those who report the highest impact on their quality of life.</p>
<h2>Quality of life</h2>
<p>Fourth, we found that nuisance neighbours and out of control or dangerous dogs are the types of anti-social behaviour that have the greatest impact on quality of life. The <a href="https://s3-eu-west-2.amazonaws.com/victcomm2-prod-storage-119w3o4kq2z48/uploads/2019/04/ASB-report.pdf">report</a> from the Victims’ Commissioner presents a number of case studies illustrating the devastating impact anti-social neighbours can have on a person’s life. One victim, for example, said: “The stress and sleep deprivation he caused wrecked my mental and physical health.”</p>
<p>The CSEW provides a more accurate picture of the extent and nature of crime and anti-social behaviour than data records of police incidents do. The final evidence our analysis showed was that approximately 31% of incidents of anti-social behaviour are reported to the police, local authority or to a housing association or private landlord.</p>
<p>While it’s still unclear why so few incidents are reported, one potential reason, highlighted by victims interviewed in the Victims’ Commissioner <a href="https://s3-eu-west-2.amazonaws.com/victcomm2-prod-storage-119w3o4kq2z48/uploads/2019/04/ASB-report.pdf">report</a>, could relate to issues regarding the 101 non-emergency phone line which costs 15p per minute. While victims are encouraged to call 101, rather than the free 999 service used to report crime, often they can face long delays.</p>
<p>In relation to crime, the CSEW reveals a variety of reasons why <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/adhocs/007750reasonsfornotreportingcrimetothepolice2016to2017crimesurveyforenglandandwales">some victims don’t report incidents to the police</a>, including that they felt the incident was too trivial, that the police couldn’t do anything, or that they dealt with the incident themselves. It’s possible the same reasons could apply to anti-social behaviour.</p>
<p>Understanding who is most likely to experience anti-social behaviour can inform interventions to prevent the recurrence of incidents and the accumulation of the harms it causes. At a time when many organisations’ resources are stretched, it makes sense to focus efforts where they are most needed: towards victims of potentially high harm, repeated and persistent anti-social behaviour.</p>
<p>Our findings also highlight the diverse nature of anti-social behaviour. They suggest that an approach involving a range of partners including the police, local authority, housing associations, landlords, businesses, the National Health Service and the voluntary sector, is needed to develop and implement effective responses.</p><img src="https://counter.theconversation.com/content/116316/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Becky Thompson has received funding for this research from the Economic and Social Research Council (ESRC) (project reference: ES/P001556/1). The research upon which this article is based was funded by the ESRC (project reference: ES/P001556/1). Previous, related research was also funded by the College of Policing, Higher Education Funding Council for England and Home Office Police Knowledge Fund. </span></em></p><p class="fine-print"><em><span>Andromachi Tseloni has received funding for this research from the Economic and Social Research Council (ESRC) (project reference: ES/P001556/1). The research upon which this article is based was funded by the ESRC (project reference: ES/P001556/1). Previous, related research was also funded by the Home Office, College of Policing and Higher Education Funding Council for England Police Knowledge Fund. </span></em></p><p class="fine-print"><em><span>James Hunter has received funding from the Economic and Social Research Council (ESRC), Innovate UK, the Home Office, College of Policing, and Higher Education Funding Council for England. Research upon which this article is based was funded by the ESRC (project reference: ES/P001556/1).</span></em></p><p class="fine-print"><em><span>Nick Tilley received funding for this research from the Economic and Social Research Council (ESRC). </span></em></p><p class="fine-print"><em><span>Puneet Tiwari received funding for this research from the Economic and Social Research Council (ESRC). </span></em></p>New analysis reveals the most common types of anti-social behaviour, and who the victims are.Becky Thompson, Senior Lecturer in Criminology, Nottingham Trent UniversityAndromachi Tseloni, Professor of Quantitative Criminology, Nottingham Trent UniversityJames Hunter, Principal Lecturer in Public Policy, Nottingham Trent UniversityNick Tilley, Principal Research Associate, Department of Security and Crime Science, UCLPuneet Tiwari, Lecturer in the School of Social Sciences, Nottingham Trent UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1131302019-03-14T11:45:58Z2019-03-14T11:45:58ZBaby boomers are increasingly more likely to risk drink-driving than millennials<figure><img src="https://images.theconversation.com/files/263433/original/file-20190312-86678-1bsocxy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">shutterstock</span></span></figcaption></figure><p>“Baby boomers”, all now over the age of 50, have shown the <a href="https://www.bmj.com/content/358/bmj.j3885">fastest rise in rates of alcohol and drug misuse</a> over the past 15 years – and this is playing out on Britain’s roads.</p>
<p>At first glance, the latest data on reported <a href="https://www.gov.uk/government/collections/road-accidents-and-safety-statistics">accidents and casualties on public roads</a> in England and Wales is little more than a general update. There are the standard statistics on drink drive accidents and casualties using roadside breath testing. There is also data on blood alcohol levels for accidents involving deaths from drink driving. In 2017, there were just under 171,000 casualties from reported road traffic accidents. This was 6% lower than in 2016 – making it <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/744077/reported-road-casualties-annual-report-2017.pdf">the lowest level on record</a>.</p>
<p>But more revealing data comes from the <a href="http://www.crimesurvey.co.uk/en/SurveyResults.html">British Crime Survey</a>. <a href="http://www.crimesurvey.co.uk/en/SurveyResults.html">The Survey</a> looked at self-reported driving by people who think that they have been over the legal alcohol limit at least once in the last 12 months. Between 2010 and 2018, there was a reduction of nearly 50% in the proportion of people aged 16 to 19 who took this risk. For people aged 50, it fell by only 11%. </p>
<p>The same survey also provided data on the proportion of people reporting driving under the influence of drugs over the previous 12 months – which paints a very different picture. Although there was a reduction of 61% for 16- to 19 year-olds over the past ten years, the reduction for baby boomers was a staggering 98%. </p>
<p>A likely explanation for the comparatively larger reductions in people willing to take the risk of drug driving compared with drink driving may be a change in the law over the past four years. Until 2015, there were no defined limits for individual controlled drugs when bringing charges against someone suspected of drug driving. This changed in 2015 through the introduction of <a href="https://www.legislation.gov.uk/ukpga/1988/52/section/5A">Section 5A of the Road Traffic Act</a>. This set an upper limit for the level of specific controlled drugs in a driver’s blood. </p>
<p>A report assessing the <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/609852/drug-driving-evaluation-report.pdf">impact of this change in law enforcement</a> found evidence of an improvement in awareness of the change in law enforcement among road users across all age groups. This appears to have been an even bigger deterrent to drug driving in older people. </p>
<h2>Cultural norms</h2>
<p>So why then are older drivers more prepared to risk drink driving than drug driving? Part of this may be the <a href="https://theconversation.com/having-lived-hedonistic-lives-the-baby-boomers-are-drinking-themselves-into-an-early-grave-64016">influence of cultural norms</a>, such as being exposed to high levels of advertising during their early years, but also to the increased affordability of alcohol. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/263435/original/file-20190312-86690-k45igb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/263435/original/file-20190312-86690-k45igb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/263435/original/file-20190312-86690-k45igb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/263435/original/file-20190312-86690-k45igb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/263435/original/file-20190312-86690-k45igb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/263435/original/file-20190312-86690-k45igb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/263435/original/file-20190312-86690-k45igb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Baby boomers’ drinking has been blamed for pushing alcohol-related deaths among women to the highest ever level.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>An upper legal limit of 80 milligrammes of alcohol per 100ml (also referred to as 0.08%) of blood was adopted across Europe over 50 years ago. Unlike the rest of Europe and Scotland, the rest of the UK <a href="https://www.bbc.co.uk/news/health-45572561">has not changed this legal level</a>. In Scotland, for example it is now 0.05%</p>
<p>In 2013, the National Transportation Safety Board in the US reduced the legal limit for blood alcohol <a href="https://www.safetylit.org/citations/index.php?fuseaction=citations.viewdetails&citationIds%5B%5D=citjournalarticle_565217_33">from 0.08% to 0.05%</a>. This resulted in an 11% decline in fatal alcohol-related crashes. </p>
<h2>Slow reactions</h2>
<p><a href="https://www.tandfonline.com/doi/abs/10.1080/15389588.2016.1194980">Even without drinking alcohol</a>, older people have slower reaction times and are less able to maintain a constant distance behind another car during driving simulation compared to younger people. </p>
<p>Older people are also more likely to experience the harmful effects of alcohol after drinking the <a href="https://www.cambridge.org/core/services/aop-cambridge-core/content/view/FA7BD9C2C3CF8E393BB25E1CD39DE8D8/S2056467800001468a.pdf/alcohol_misuse_in_older_people.pdf">same quantity of alcohol as younger people</a>. This is because of a reduced ability to remove alcohol from the bloodstream, as well as a higher likelihood of taking prescribed medication and having accompanying long-term health problems.</p>
<p>So should there be a lower legal blood alcohol level? Given that baby boomers are at increasingly higher risk of alcohol misuse and are more likely to take the risk of drink driving compared with drug driving, it may be the only direction of travel. After all, alcohol is a drug. And the sooner it’s treated like one, the better.</p><img src="https://counter.theconversation.com/content/113130/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tony Rao does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Baby boomers have shown the fastest rise in rates of alcohol and drug misuse in the last 15 years.Tony Rao, Visiting Lecturer in Old Age Psychiatry, King's College LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1036312018-10-19T10:13:21Z2018-10-19T10:13:21ZDrunk women convicted of assault treated harsher in sentencing than drunk men<figure><img src="https://images.theconversation.com/files/239308/original/file-20181004-52663-1xh7z7l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">How much have you had to drink?</span> <span class="attribution"><span class="source">graphbottles/Shutterstock</span></span></figcaption></figure><p>Women around the world tend to receive <a href="http://journals.sagepub.com/doi/abs/10.1177/0887403412466877">less severe sentences than men</a>. But my new research has found that <a href="https://academic.oup.com/bjc/article-lookup/doi/10.1093/bjc/azy041">women are twice as likely</a> as men to receive harsher sentences for assault offences when intoxication is a contributing factor.</p>
<p><a href="https://www.sentencingcouncil.org.uk/wp-content/uploads/Assault_definitive_guideline_-_Crown_Court.pdf">Sentencing guidelines</a> for assault published in 2011 set out that both alcohol and drug intoxication may aggravate an offence on the basis of its seriousness. However, any justification for this position is <a href="http://journals.sagepub.com/doi/abs/10.1177/1748895808093438">surprisingly absent in sentencing guidance</a>. The Sentencing Council also offers <a href="https://academic.oup.com/bjc/article-abstract/58/1/132/3056167?redirectedFrom=fulltext">little practical direction</a> on the extent to which alcohol intoxication should aggravate sentence outcomes, for whom, and in which contexts.</p>
<p>In my study, I analysed 30,861 sentences for assault offences detailed in the <a href="https://www.sentencingcouncil.org.uk/analysis-and-research/crown-court-sentencing-survey/">Crown Court Sentencing Survey</a>. This paper-based survey is completed by judges passing sentences in the Crown Court in England and Wales and collects information on the factors taken into account by a judge in working out the final sentence for an offender. The sentences I analysed were handed out by judges between the second quarter of 2012 and the end of 2014. </p>
<p>I found that intoxication increased the severity of sentences for both men and women – both in terms of the probability of a custodial sentence and the severity of the sentence. The probability of a women going to prison or attracting a more severe sentence for assault was still lower than for their male counterparts. But on average, where intoxication featured in an offence, the proportionate increase in probability of a custodial or more severe sentence was higher for women than for men.</p>
<p>Using an example of an offence of actual bodily harm, I found the probability of a custodial sentence was lower for women than for men – both when sober and intoxicated. But when intoxication was cited as an aggravating factor it didn’t have the same impact for male and female defendants. The aggravation – the increase in probability of a custodial sentence – applied by the judge was 13.4%, over twice that applied to male defendants at 5.7%.</p>
<p>There is evidence from around the world that women are <a href="https://www.press.uchicago.edu/ucp/books/book/distributed/W/bo22215221.html">judged more harshly</a> by sections of society for <a href="https://books.google.co.uk/books/about/Women_and_alcohol.html?id=TCMgAQAAIAAJ&redir_esc=y">their alcohol intoxication than men</a> and my findings seem to suggest that punishment is amplified in cases where women are drunk when committing an offence. </p>
<p>This is likely due to both criminal behaviour and intoxication violating traditional conceptions of womanhood. For example, men drinking and engaging in assaults may be seen as “boys being boys”, whereas <a href="http://www.academia.edu/2573801/Gender_and_Crime_in_Oxford_Handbook_of_Criminology_2012_">women might be expected to conform to different standards of behaviours</a> for both their drinking and violation of the law. In turn, this may impact sentencing decisions by some judges. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/239311/original/file-20181004-52695-1c3s28q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/239311/original/file-20181004-52695-1c3s28q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/239311/original/file-20181004-52695-1c3s28q.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/239311/original/file-20181004-52695-1c3s28q.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/239311/original/file-20181004-52695-1c3s28q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/239311/original/file-20181004-52695-1c3s28q.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/239311/original/file-20181004-52695-1c3s28q.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Women’s drinking is often viewed differently to men’s.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/group-party-people-men-women-drinking-126810821?src=iPfmPRj0qMRQJ03YhlAECg-1-0">Kzenon/Shutterstock</a></span>
</figcaption>
</figure>
<h2>Sentencing tensions</h2>
<p>Data underpinning the government’s recent <a href="https://www.gov.uk/government/publications/female-offender-strategy">female offender strategy</a> recognised that a higher proportion of women have alcohol misuse needs (35%) compared to men (20%) when assessed by offender managers and supervisors. This is also the case for drug misuse needs – 40% versus 37%. Addressing substance misuse problems is therefore one of seven identified priority areas in the strategy, with a particular focus on class A drug use, binge and chronic drinking. The strategy also points to evidence that a gender-informed approach that addresses the causes of women’s offending is more effective than a gender-neutral approach when it comes to rehabilitating female offenders.</p>
<p>Yet sentencing guidelines apply to both male and female defendants, and aim for equality of sentencing. While these guidelines are aimed at reducing bias, they may indirectly standardise outcomes in a way that is contrary to gender equality and the ideals of social justice. For example, criminologists in the US have suggested that the adoption of sentencing for a fixed time period rather than a range of time could bring about a corresponding “equalisation” of justice <a href="https://www.journals.uchicago.edu/doi/abs/10.1086/449263">resulting in higher female incarceration rates</a>.</p>
<p>These policy tensions are especially important as the UK government has made <a href="https://www.parliament.uk/business/committees/committees-a-z/commons-select/justice-committee/news/women-offenders-report-published/">limited progress</a> to meet recommendations about a proportionate, integrated criminal justice system for women, set out in the 2007 <a href="http://webarchive.nationalarchives.gov.uk/+tf_/http:/www.homeoffice.gov.uk/documents/corston-report/">Corston report</a>. </p>
<p>Intoxication remains a controversial part of the way sentences are handed out, and my research suggests judges’ decisions about its influence do not have a uniform impact on sentencing outcomes for men and women. Worryingly, the Sentencing Council has <a href="https://www.sentencingcouncil.org.uk/blog/post/sentencing-council-analysis-and-research-to-take-new-approach-in-2015">ended</a> the Crown Court Sentencing Survey which tracks data on this and other issues relating to differential sentencing for male and female defendants. It may want to consider issuing further guidance as to how intoxication ought to be applied in determining sentence outcomes for both men and women.</p><img src="https://counter.theconversation.com/content/103631/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Carly Lightowlers receives funding from UK based research councils for her work; although not for this study in particular.</span></em></p>New research found a disparity between the sentences women and men are given for offence when alcohol is an aggravating factor.Carly Lightowlers, Senior Lecturer in Criminology, University of LiverpoolLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1036212018-10-02T10:30:19Z2018-10-02T10:30:19ZInternational students on British drinking habits – ‘people don’t know when to stop’<figure><img src="https://images.theconversation.com/files/238672/original/file-20181001-195278-1ehvki.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">shutterstock</span></span></figcaption></figure><p>Of the <a href="https://www.universitiesuk.ac.uk/facts-and-stats/Pages/higher-education-data.aspx">2.3m students</a> starting courses at UK universities each autumn, well over 400,000 <a href="https://www.universitiesuk.ac.uk/policy-and-analysis/reports/Pages/international-facts-figures-2017.aspx">are international students</a> from non-UK countries. </p>
<p><a href="https://www.universitiesuk.ac.uk/facts-and-stats/Pages/higher-education-data.aspx">The scale and importance</a> of international students to the UK higher education sector is now well established. Yet we know very little about how students from non-UK countries experience and interact with the heavy drinking culture that predominates on and near many universities. </p>
<p>Many international students often come from cultures marked by moderation or abstinence around alcohol. And concerns have been raised that <a href="https://www.vice.com/en_uk/article/ne7e7m/international-students-on-what-shocked-them-most-about-british-uni">activities centred on alcohol</a> may exclude <a href="https://www.theguardian.com/education/2014/oct/13/-sp-meet-a-student-from-greece">international students</a>. </p>
<p>We’ve conducted <a href="https://doi.org/10.1177/1360780418761207">new research</a> to reveal the perceptions of British drinking cultures held by international students studying on postgraduate courses at a UK university. In focus groups and interviews, students from countries including Nigeria, the US, China, Turkey, Poland, Germany and Greece told us of their experiences of drinking culture at university. </p>
<h2>The British ‘like to drink’</h2>
<p>The <a href="https://study-uk.britishcouncil.org/living/culture-night-life">British Council</a>, and many city and university marketing teams, often promote the British pub as a safe and friendly leisure space in their bid to market studying in the UK to international students. The students we spoke to were aware of the iconic image of the British pub. They spoke of their desire to participate in what they saw as being an important part of British culture. Others spoke with excitement of being able to try British real ale and craft beer as a part of their experience of living and studying in Britain. </p>
<p>Having seen depictions of British pubs in television, film and, increasingly, social media, most international students were aware of alcohol consumption being important to British culture before they came to the UK. This prior perception was confirmed by their initial experiences on arrival. Our interviewees felt that getting drunk was an important part of British cultural life and reported being initially surprised that drinking to excess was <a href="https://www.tandfonline.com/doi/abs/10.1080/02614367.2011.633616">an expected part of university life</a>.</p>
<p>Despite these concerns, drinking alcohol was an important part of the social lives of many international students. Many had enjoyed their experiences of socialising in bars and pubs. For others, whose degree programme cohorts were predominantly fellow international students, the pub was a space in which they could view and interact with British culture and British people – such as non-student locals. </p>
<h2>Drinking cultures in contrast</h2>
<p>International students made ready comparisons with the drinking habits and attitudes of their own cultures. Many told us about how people drink alcohol and get drunk in their own cultures. But they contrasted this with the tendency of “going too far” and of “not knowing when to stop” that was perceived to be a major characteristic of British drinking culture. </p>
<p>That said, many interviewees had enjoyed learning about the practice of buying “rounds” of drinks, using “cheers” before drinking and the lack of table service in Britain. They saw this as a fun and a pleasurable part of getting to know local culture.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/238675/original/file-20181001-195266-1ox1bb1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/238675/original/file-20181001-195266-1ox1bb1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/238675/original/file-20181001-195266-1ox1bb1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/238675/original/file-20181001-195266-1ox1bb1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/238675/original/file-20181001-195266-1ox1bb1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/238675/original/file-20181001-195266-1ox1bb1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/238675/original/file-20181001-195266-1ox1bb1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">International students say they are shocked at the amount of booze consumed by Brits at university.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>As identified in <a href="https://www.tandfonline.com/doi/abs/10.1080/08870446.2011.617444">other research</a>, gender is an important feature of how students view drinking and drunkenness. Concern was expressed in our study about a perceived lack of control among some British women when drinking alcohol. Words such as embarrassment and shame were used by both male and female interviewees to define the boundary between fun, sociable drinking and excessive drunkenness. </p>
<p>Interviewees expressed surprise that public vomiting and urination or collapsing in the street were so widely tolerated and even in some cases expected and celebrated by British students. </p>
<h2>Finding the balance</h2>
<p>Most students felt capable of negotiating their involvement with student drinking culture by choosing times, spaces and styles of drinking that suited their own tastes. This involved a clear preference for drinking as part of other events such as eating a meal out with friends or watching televised sport in pubs. At social events where heavy drinking was the main activity, some would try to enjoy “one or two” drinks but leave once other people became noticeably drunk.</p>
<p>But while many students spoke of the pub as a welcoming and relaxed space for socialising with friends, bars and nightclubs were said to be intimidating places where they felt at risk of violence or harassment. Many students witnessed fights. </p>
<p>Female international students had particular concerns – several spoke of their strategies to stay safe when out at night. The avoidance of the streets at night due to a fear of potential violence or aggression was also highlighted in a previous study that looked at levels of <a href="https://doi.org/10.1080/03075079.2011.614940">racism experienced by international students</a>.</p>
<p>That said, UK drinking culture is changing. More than a quarter of young adults in the UK <a href="https://www.theguardian.com/society/datablog/2017/may/06/more-than-a-quarter-of-young-adults-in-the-uk-do-not-drink-alcohol-in-data">do not drink alcohol</a>.
“Sober campuses” <a href="https://www.theguardian.com/commentisfree/2018/sep/27/students-british-booze-drinking-young-people">during fresher’s week</a> are becoming more prevalent, as are teetotal university halls. And many students are eager for advice on avoiding or moderating the <a href="https://theconversation.com/freshers-week-how-to-resist-the-pressure-to-drink-if-you-dont-want-to-103202?utm_source=twitter&utm_medium=twitterbutton">pressure to drink heavily while at university</a>. But only time will tell whether this is a trend that is set to remain.</p><img src="https://counter.theconversation.com/content/103621/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Public vomiting, urination and collapsing in the street are all things international students don’t see at home.Thomas Thurnell-Read, Lecturer in Cultural Sociology, Loughborough UniversityLorraine Brown, Associate Professor, Department of Tourism and Hospitality, Bournemouth UniversityPhilip Long, Honorary Visiting Research Associate, Bournemouth UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/808902017-07-17T03:59:15Z2017-07-17T03:59:15ZWe need more than just laws to ensure responsible alcohol service<figure><img src="https://images.theconversation.com/files/178360/original/file-20170716-14254-1g97jxj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">There is little evidence that training alone reduces the propensity for over-service of alcohol.</span> <span class="attribution"><span class="source">AAP/Alan Porritt</span></span></figcaption></figure><p>Australian law prohibits the sale of alcohol to drunk people. Despite the shifting sands of alcohol policy, <a href="http://www.legislation.vic.gov.au/Domino/Web_Notes/LDMS/LTObject_Store/LTObjSt7.nsf/DDE300B846EED9C7CA257616000A3571/70AC1BBE193EBF8BCA257B10001DF528/$FILE/98-94aa067%20authorised.pdf">Responsible Service of Alcohol (RSA) legislation</a> has remained a stalwart figure.</p>
<p>In Australia, RSA imposes mandatory training requirements for liquor industry workers to educate alcohol servers about signs of intoxication, when to refuse service, and the harms of over-service. Internationally, RSA training is considered a cost-effective strategy to reduce the sale of alcohol to drunk people.</p>
<p>However, <a href="http://www.sciencedirect.com/science/article/pii/S0140673616324205?via%3Dihub">there is little evidence</a> that training alone reduces the propensity for over-service. It may have some effect when coupled with penalties for sales to drunk people and strict enforcement.</p>
<p>Given the longstanding restrictions on the sale of alcohol to intoxicated patrons, it seems perplexing that public drunkenness remains a notable problem – especially when we consider that public knowledge about RSA in Australia appears to be extremely high.</p>
<p>In the <a href="https://www.globaldrugsurvey.com/the-global-drug-survey-2015-findings/">2015 Global Drug Survey</a> of alcohol and drug users, Australian respondents were overwhelmingly aware that it is illegal for bar staff to serve an intoxicated patron.</p>
<p>Awareness varied across states. South Australians were the least aware: 85.2% responded it was illegal to serve alcohol to a drunk person. Western Australians were most aware: 94.7% responded it was illegal.</p>
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<p>In spite of this high awareness, a large proportion of respondents also agreed that a drunk person would be served alcohol in Australian licensed venues.</p>
<p>Again, agreement varied across states. In New South Wales, 45% of respondents agreed that a drunk person would be served alcohol. More than 60% of Victorian respondents agreed a drunk person would be served – despite the practice being illegal.</p>
<p>These statistics seem to suggest that current RSA legislation is effective in increasing public knowledge about responsible alcohol service of alcohol, but it may not be effective in deterring public drunkenness or encouraging responsible drinking in Australian bars and nightclubs.</p>
<p>Perhaps more worryingly, these statistics may indicate some patrons buy alcohol even when they are intoxicated, putting bar staff at risk of monetary penalty. There is no penalty for the patron – only for the alcohol server and the venue.</p>
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<h2>Combining training with law enforcement</h2>
<p>In Australia, RSA was <a href="http://www.austlii.edu.au/cgi-bin/sinodisp/au/legis/nsw/num_act/placa1830n12395/placa1830n12395.html?stem=0&synonyms=0&query=new%20south%20wales%20liquor">first introduced in NSW</a> in 1830. Since then, it has been adopted across all jurisdictions.</p>
<p>In Australia, mandatory training is coupled with a legislative framework that imposes monetary penalties for the sale of alcohol to anyone who is unduly intoxicated. </p>
<p>Patrons are considered to be unduly intoxicated when their speech, balance, co-ordination and behaviour are noticeably affected, and there are reasonable grounds to believe it is due to alcohol and/or drug use. </p>
<p>In <a href="http://www.legislation.vic.gov.au/Domino/Web_Notes/LDMS/LTObject_Store/LTObjSt7.nsf/DDE300B846EED9C7CA257616000A3571/70AC1BBE193EBF8BCA257B10001DF528/$FILE/98-94aa067%20authorised.pdf">Victoria</a>, <a href="http://www.austlii.edu.au/au/legis/wa/consol_act/lca1988197/">WA</a>, <a href="http://www.austlii.edu.au/au/legis/tas/consol_act/lla1990190/">Tasmania</a>, and <a href="http://www.legislation.nsw.gov.au/inforce/8a197a07-ffb9-eceb-a956-ce6b1f11a313/2007-90.pdf">NSW</a>, it is also illegal for patrons to supply alcohol to another person or assist them in obtaining alcohol if the other person is intoxicated.</p>
<p>Penalties for over-service apply to licensees, managers and individual employees who serve alcohol to intoxicated patrons. </p>
<ul>
<li><p>Monetary penalties for licensees range from A$7,850 (Tasmania) to $63,075 (Queensland). </p></li>
<li><p>Employees who sell alcohol to drunk patrons can be fined anywhere from $1,500 (ACT) to $11,000 (NSW). </p></li>
<li><p>Monetary penalties for patrons who supply alcohol to intoxicated individuals range from $1,100 (NSW) to $7,850 (Tasmania).</p></li>
</ul>
<p>No states or territories impose jail time for the sale or supply of alcohol to intoxicated patrons. Despite long-existing legislation and the potential for heavy penalties, convictions are extremely rare.</p>
<h2>Australia compares favourably on knowledge and laws</h2>
<p>Compared to other countries, though, Australia appears to be performing well when it comes to alcohol and responsibility.</p>
<p>A <a href="http://bmjopen.bmj.com/content/5/12/e010112">recent paper</a> with respondents from 19 countries found Australians were <a href="http://bmjopen.bmj.com/content/bmjopen/suppl/2015/12/23/bmjopen-2015-010112.DC1/bmjopen-2015-010112supp.pdf">second only to New Zealand</a> in relation to knowledge about the illegality of serving drunk patrons.</p>
<p>The research found that in countries where public knowledge is highest, respondents are least likely to agree that a drunk person will be served.</p>
<p>While public knowledge is not enough to stop service to drunk patrons, perhaps informal regulation or self-regulation is enacted through public knowledge. People are less likely to attempt to purchase alcohol when intoxicated if they are aware of the law. And alcohol servers are less inclined to serve drunks if they sense patrons are aware of the legislation and may report their behaviour.</p>
<h2>Room for improvement</h2>
<p>However, the variation in responses between Australia’s states and territories suggests there remains room for improvement. </p>
<p>Focusing on further refinements to the content and delivery of RSA training is unlikely to be the answer. While evidence regarding the effectiveness of RSA training is mixed, there are core limitations of this approach that cannot be tackled through better training methods. </p>
<p>RSA training provides knowledge to servers about signs of intoxication. But these may be difficult to identify in a bar or club where lighting is poor, noise levels are high, and the interaction between bar staff and patrons is brief. </p>
<p>Given the liquor industry’s core business is the sale of alcohol, it’s easy to see why licensees and bar staff may be conflicted when it comes to refusing service. Such an action will likely result in loss of profit, and may lead to outrage or conflict from patrons. </p>
<p>Finally, any systematic approach to enforcement is likely to be resource-intensive and costly. Convictions are difficult to achieve: this requires proof the server was aware of the patron’s intoxication level.</p>
<p>This is not to suggest Australia should do away with its current RSA legislation. Instead, this approach should be coupled with public discussion that encourages people to take responsible for their own drinking behaviour, rather than placing the burden on servers to set drinking limits for patrons.</p>
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<p><em>This article was co-authored by Emily Kilpatrick, a masters student at the University of Queensland.</em></p><img src="https://counter.theconversation.com/content/80890/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jason Ferris is the chief biostatistican and part of the core research team in the Global Drug Survey.
Jason Ferris receives and has received financial support from the Australian National Health and Medical Research Council
(APP1089395, APP1122200), Australian Research Council (LP160100067, LP120100689, RFQ2009/30), Foundation for Alcohol Research and Education, Queensland Government, Criminology Research Council, Queensland Alliance for Environmental Health Science, Australian & New Zealand Association of Oral & Maxillofacial Surgeons, Tasmanian Department of Health and Human Services, The University of Queensland, Victorian Law Enforcement Drug Fund, Department of Health and Ageing, VicHealth, Australian National Preventive Health Agency.</span></em></p><p class="fine-print"><em><span>Adam Winstock is founder of the annual Global Drugs Survey.</span></em></p><p class="fine-print"><em><span>Larissa J. Maier and Renee Zahnow do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Responsible Service of Alcohol laws should be coupled with public discussion that encourages people to take responsible for their own drinking behaviour.Jason Ferris, Senior Research Fellow, NHMRC Postdoctoral Research Fellow, Institute for Social Science Research, The University of QueenslandAdam Winstock, Founder of the Global Drug Survey and Senior Lecturer, King's College LondonLarissa J. Maier, Postdoctoral Research Fellow, University of ZurichRenee Zahnow, Postdoctoral Research Fellow, Institute for Social Science Research, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/698792017-07-05T01:03:32Z2017-07-05T01:03:32ZDoctors and nurses can’t always tell if someone’s drunk or on drugs, and misdiagnosis can be dangerous<figure><img src="https://images.theconversation.com/files/171991/original/file-20170602-22797-icl539.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Even emergency department staff can have trouble telling if someone's intoxicated as clinical clues can mislead.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/159380372?src=OWQQcAH0BbqI0JnY4UHWWQ-2-85&size=medium_jpg">from www.shutterstock.com</a></span></figcaption></figure><p>Bob has arrived at the emergency department at 10am on a Tuesday after breaking several fingers slamming his hand in a car door. Bob is quite anxious; he speaks quickly and paces around. When asked to sit and explain what has happened, he provides an articulate account of events. A look at past medical records indicates Bob has recently been admitted to hospital for alcohol withdrawal. Bob’s blood alcohol concentration is 0.35% (or 0.35 grams per decilitre). For the average person, this could be fatal. But Bob is sitting upright with little outward cues he has been drinking heavily.</p>
<p>Now we turn to Bruce. Bruce stumbles up the street at 1am on a dark Saturday night. He loses his footing more than once and pauses multiple times as it seems he is struggling to avoid throwing up. Bruce’s speech is slurred and incoherent. Suddenly, he collapses in the street. When passers by check on him, they notice considerable cuts and bruises to his head. The man isn’t drunk; he was in a fight earlier that night and has a head injury.</p>
<p>These examples demonstrate “common sense” doesn’t always tell you who’s drunk and who’s sober. While slurred speech or lack of coordination might help, we cannot apply these cues in all circumstances.</p>
<p>These cues can be masked in people with high levels of tolerance to alcohol, or displayed by people who are not under the influence but have medical conditions with similar symptoms. For instance, both head injuries and <a href="https://www.diabetesaustralia.com.au/ketoacidosis">diabetic ketoacidosis</a> (when people have very high blood sugar levels in type 1 diabetes) have symptoms that mimic being drunk.</p>
<p>So what if Bruce, who seems drunk but is completely sober, turns up to emergency? Would staff have made the right diagnosis?</p>
<h2>Mistakes could be deadly</h2>
<p>Many of the issues surrounding correctly diagnosing someone with alcohol intoxication apply to correctly diagnosing someone who’s taken other drugs; mistakes could lead to illness and death.</p>
<p>The consequences of falsely identifying someone as intoxicated when they really have a life-threatening condition can be severe; they can receive the wrong treatment, or not receive treatment at all.</p>
<p>It is equally important to correctly identify intoxication with alcohol or other drugs, especially identifying the exact substance taken as some drugs can produce seemingly similar effects. Again, correctly identifying intoxication avoids giving medications incompatible with what the person’s taken.</p>
<p>While alcohol and drug testing (for instance blood or urine tests) is useful to determine intoxication objectively, their cost and time constraints may sometimes mean this is impractical. So, health care staff must accurately pick up on visual and verbal cues to tell if someone’s intoxicated or not.</p>
<p>But clinical suspicion alone may lead to missing a significant proportion of people who are intoxicated. In one study, trauma surgeons <a href="http://journals.lww.com/jtrauma/Abstract/1999/12000/Detection_of_Acute_Alcohol_Intoxication_and.27.aspx">failed to identify 23%</a> of patients who were acutely alcohol intoxicated.</p>
<h2>Why intoxication might be missed</h2>
<p>In one study that assessed emergency doctors’ and nurses’ knowledge of and attitudes to intoxication, <a href="http://www.sciencedirect.com/science/article/pii/S1755599X08000967">most (73.8%)</a> had not received specific training about drug and alcohol issues.</p>
<p>And as many people go to the emergency department with drug and alcohol related issues <a href="https://www.ncbi.nlm.nih.gov/pubmed/19378442">over the weekend or after hours</a> staff may not have enough time to interact sufficiently with each patient to pick up intoxication cues. </p>
<p>In some cases it may not be whether someone is intoxicated, but what they are intoxicated with that’s the issue. For instance, someone may have taken a <a href="https://www.ncbi.nlm.nih.gov/pubmed/25588018">novel psychoactive substance</a> (a designer drug) or more than one substance at once. These make it particularly difficult to spot and so provide the right treatment. </p>
<p>Bias may also play a role. In the <a href="http://journals.lww.com/jtrauma/Abstract/1999/12000/Detection_of_Acute_Alcohol_Intoxication_and.27.aspx">trauma surgeon study</a>, patients who the surgeons thought were dishevelled or of low socio-economic status were more likely to be falsely suspected of being drunk. And men were twice as likely as women to be falsely suspected of being drunk. But doctors were more likely to miss intoxication if patients were “well groomed”. </p>
<p>These issues are also relevant for first-responders as the ability for police, ambulance staff, and firefighters to correctly identify alcohol (and other drug) intoxication will influence how they approach and interact with people.</p>
<h2>How about the rest of us?</h2>
<p>So with these experienced and trained health workers potentially missing or misinterpreting the signs of intoxication, what chances do the rest of us have?</p>
<p>We might tell if friends and family are drunk because we know them sober so can compare their behaviours. If we try to tell if a stranger’s drunk, the context (such as a bar) might help, or it might be deceptive.</p>
<p>For drugs other than alcohol, we might know what our friends or family have taken. This information is vital for health professionals to know, so tell paramedics or other health workers so they can make the right treatment choices, even if this makes you feel uncomfortable. In the majority of drug overdoses police <a href="http://www.nuaa.org.au/wp-content/uploads/2014/03/police-overdose.pdf">will not get involved</a>.</p>
<h2>What we need to do</h2>
<p>It is astonishing how little research has been devoted to the topic of accurate detection of whether or not someone’s drunk or on drugs. We still can’t be certain people are receiving adequate training in this area, not only for individual substances but also if they have taken more than one substance.</p>
<p>How much someone’s taken and individual differences in how people respond to these substances also complicate the picture.</p>
<p>As there are a range of potential reasons why clinical suspicion may not be sufficient to detect intoxication (or rule out conditions that mimic intoxication), this suggests objective alcohol and drug testing may need to be more widely applied.</p>
<p>Knowing how to reliably assess intoxication will benefit the health services (correct diagnoses), first responders in general, and ultimately the community.</p><img src="https://counter.theconversation.com/content/69879/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lauren Monds is affiliated with NSW Health. </span></em></p><p class="fine-print"><em><span>Celine van Golde does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>We all know what a drunk person looks like, right? Wrong. Even health care workers can be confused.Lauren Monds, Research Fellow in Addiction Medicine, Research Officer in Forensic Psychology, University of SydneyCeline van Golde, Associate Lecturer in Forensic Psychology, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/512452015-12-20T19:55:56Z2015-12-20T19:55:56ZWhat’s happening to us when we get drunk?<figure><img src="https://images.theconversation.com/files/104036/original/image-20151202-14461-18b8gzf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Why does drinking alcohol cause us to lose our balance, our inhibitions and, in large enough doses, our lunch?</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/willposh/346605736/">Andrew/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>The Australian relationship with alcohol is complicated. It’s a colourful thread woven into the fabric of our society. </p>
<p>As a chemical, alcohol is a very simple molecule, but its effects on the brain are quite complex. And different people respond differently to alcohol in different situations.</p>
<p>Consumed orally, alcohol enters the bloodstream through the gastrointestinal tract. The amount that is absorbed varies from individual to individual depending on their <a href="http://rd.springer.com/article/10.1007/BF00566530">genetic make-up</a> and any medical conditions. It also varies depending on whether there is food in the gut, since this can reduce absorption into the bloodstream. </p>
<p>The size of the person and ratio between muscle and fat will also affect the rate at which the person’s blood alcohol concentration rises with consumption. Because alcohol is water-soluble, if two people weigh the same, the person with more muscle and less fat will have a lower blood alcohol concentration than somebody with more fat and less muscle after consuming the same amount of alcohol. </p>
<p>Once in the bloodstream, alcohol affects many of our body’s organs, but the nervous system (including the brain) is key in terms of behavioural effects. Alcohol acts as a central nervous system depressant. This means it slows down the rate at which brain cells and other nerves in the body communicate with one another. </p>
<p>Some people are surprised to find out alcohol is a central nervous system depressant since a low dose of alcohol can often lift one’s mood and act as a social lubricant. </p>
<h2>Low doses</h2>
<p>The reason alcohol acts as a social lubricant is because it reduces the functioning of the limbic system of the brain. The limbic system is responsible for producing emotions that drive anxiety and fear. As such, we tend to feel a little less socially awkward after a few drinks. </p>
<p>In addition, alcohol <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3593065/">reduces the functioning of the pre-frontal cortex</a> – the part of the brain responsible for higher-order cognitive processing (including reasoning and judgement). This leads people to be less inhibited and more impulsive after they have had a few drinks. </p>
<p>One danger of this reduction in inhibitions and impaired judgement is that people can sometimes consume more alcohol than they had originally intended.</p>
<h2>Higher doses</h2>
<p>As the dose of alcohol increases, so does the impact on the brain. Functioning of the pre-frontal cortex becomes further impaired such that people’s behaviour becomes even more uninhibited and judgement further impaired. Consequently, our behaviours are increasingly driven by the more primitive parts of the brain. Hence the potential increase in aggression and sexual prowess. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/104039/original/image-20151202-14444-1rgnp2g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/104039/original/image-20151202-14444-1rgnp2g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/104039/original/image-20151202-14444-1rgnp2g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/104039/original/image-20151202-14444-1rgnp2g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/104039/original/image-20151202-14444-1rgnp2g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/104039/original/image-20151202-14444-1rgnp2g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/104039/original/image-20151202-14444-1rgnp2g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/104039/original/image-20151202-14444-1rgnp2g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Things we wouldn’t do sober…</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/mrlerone/3101598061/">Toby Bradbury/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Alcohol also impacts on the cerebellum – the region at the back of the skull that co-ordinates muscle activity. Motor co-ordination increasingly becomes impaired as the dose of alcohol increases. Along with this comes the sensation of dizziness that can lead to nausea and vomiting. </p>
<p>High doses of alcohol also slow down the rate at which neurons communicate in the parts of brain that are essential for controlling our vital processes such as heart rate and breathing (the pons – part of the brainstem that directs messages to the cerebellum). </p>
<p>In an alcohol overdose, a person will stop breathing completely, causing death.</p>
<h2>Set and setting</h2>
<p>While the pharmacology of alcohol has a significant role in some of the subjective effects we experience from it, the influence of the environment that a person is drinking in and their pre-drinking psychological state cannot be underestimated. </p>
<p>In terms of setting, think about the difference between drinking at a wedding and drinking after a funeral. The pharmacology of the drug remains the same, but the setting has a major influence on the way we experience its effects. </p>
<p>Alcohol can exacerbate negative moods, so you should avoid drinking if you are not in a good frame of mind. The power of the mind is important here. People will begin to show minor signs of alcohol intoxication when provided with a placebo. </p>
<p>In studies where people are provided with a placebo they are told is alcohol, they are just as likely to want to engage in risky or sensation-seeking <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3893627/">behaviours</a>, feel <a href="https://www.researchgate.net/profile/William_George3/publication/11985518_Understanding_acute_alcohol_effects_on_sexual_behavior/links/00b7d517eb99d96290000000.pdf">sexually aroused</a> and <a href="http://www.researchgate.net/profile/Abigail_Rose/publication/232279776_Differentiating_the_Contribution_of_Pharmacological_from_Alcohol_Expectancy_Effects_to_Changes_in_Subjective_Response_and_Priming_Over_Successive_Drinks/links/0046351766b915b951000000.pdf">sedated</a>. This can partly be explained by conditioning, in which the body has a learned chemical response when exposed to a stimulus.</p>
<p>People’s expectations about the type of beverage they drink also affects their subjective experience. You might have been told that gin makes you feel depressed, so you feel more depressed after drinking gin. </p>
<p>So, this Christmas, drink only if you’re feeling festive and maybe switch out the gin for some eggnog.</p><img src="https://counter.theconversation.com/content/51245/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Stephen Bright receives funding from the Victorian Department of Health and Human Services</span></em></p>Chemically, alcohol is a very simple molecule; however, its effects on the brain are quite complex.Stephen Bright, Registered psychologist and sessional academic, Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.