What’s The Difference Between Drinking For Pleasure And Drinking For Relief? Dr. Charles Knowles Reveals The Difference

Natalie MacLean
May20th

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Introduction

What’s the difference between drinking for pleasure and drinking for relief? How does your body’s early reaction to alcohol predict your long-term risk of developing alcohol dependence? How do some people drink heavily for years without developing the same dependence that others struggle to escape?

In this episode of the Unreserved Wine Talk podcast, I’m chatting with Dr. Charles Knowles, author of Why We Drink Too Much: The New Science of Alcohol.

You can find the wines we discussed here.

 

Giveaway

Three of you are going to win a copy of Charles Knowles’ new book, Why We Drink Too Much: The Impact of Alcohol on Our Bodies and Culture.

 

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Highlights

  • When does alcohol shift from a social choice into biological dependence?
  • Why can people with alcohol dependence end up drinking more for relief than for pleasure?
  • How do certain environments become powerful craving cues?
  • Why is being able to drink heavily without hangovers considered a major risk factor?
  • Why do some people experience alcohol as intensely stimulating rather than merely relaxing?
  • How did long-term studies of teenagers predict future alcoholism?
  • Why is there still no meaningful genetic test for alcohol dependence?
  • What behavioral signs can reveal a heightened vulnerability to problematic drinking?
  • Why does alcohol dependence often appear in highly driven professions?
  • Why does Charles believe that people with alcohol dependence can never safely return to drinking?
  • What convinced Charles that he could never drink again?
  • Why does Charles believe recovery depends on changing thinking patterns?

 

Key Takeaways

  • What’s the difference between drinking for pleasure and drinking for relief?
    • Addiction really has two aspects to it. One is that pure addiction of the deep desire to have something because of reward. And the other is relief. And when you cross the line as I did into alcohol dependence when you’re drinking for relief. You’ve carried that negative reinforcement that you may have started because you had ADHD and because you were bored or unhappy or other things, now into a thing where changes in your brain lead to such an unpleasant feeling when you stop drinking that you need more alcohol to relieve that. Once that is established, as it was, and you asked me about this earlier, that’s my early 30s, standing in front of the fridge. That was the first real indicator that I had crossed the line. I’m afraid my personal opinion on this, I think borne out by others, is once that line is crossed, the end is inevitable.
  • How does your body’s early reaction to alcohol predict your long-term risk of developing alcohol dependence?
    • There are a group of people who are properly intolerant to alcohol who will almost never develop a problem with alcohol because it’s a deeply unpleasant experience to drink. Then there’s probably a group of about 10% of the population who really don’t like drinking, they just don’t like the experience. And the other end of the spectrum, there are people who are highly tolerant of it, as I was, who can drink a lot without falling over. In all the years I drank, I can always make it home. You know, I never had injuries and things from it. Then the second aspect of this is alcohol related stimulation. And this is where some of the other mice experiments come in, our drinking champion mouse. So whereas some people are slowed by alcohol and sort of sit in the corner looking a bit miserable. Other people are highly stimulated by alcohol and makes you more likely to be preferring to drink and puts you in a high risk. And there are cohort studies like the San Diego cohort study ran for 35 years that took teenagers who were alcohol naive, gave them a measured amount of alcohol, and looked at how stimulated they were and how they felt, and the ones that were most stimulated and had the most subjective pleasure from the experience went on to have the highest risk 30 years later of being alcoholic.
  • How do some people drink heavily for years without developing the same dependence that others struggle to escape?
    • People who had problems with alcohol were constantly fidgeting and tapping their feet and I think probably what he was observing was the overlap with ADHD and hyperactivity. I see it in AA meetings all the time, the people tapping and things, and a sort of intensity of approach to the drink are sort of things that you can look at now. Over and above that, the amount consumed and regularity of consumption has a weak correlation with that. Obviously people who drink very little are at very little risk of developing a problem. The opposite is not, however, true that people who drink a lot are roughly dispersed across the spectrum. So drinking a lot does not equate well with dependence. There are many people who drink a lot, who are completely neutral around alcohol. And in fact, I met many of them. I know people who can drink six months of the year and not drink other six months of the year, and these would drink with the best of them. That was not my experience. I drank much less than these people but I found it very difficult to stop.

 

About Charles Knowles

Michael Finnerty is a cheesemonger, journalist, and author based in both London, UK, and Montreal. After almost 30 years of success and acclaim working for the CBC, BBC, and The Guardian, he found joy and a new life selling cheese at London’s iconic Borough Market. Mike has a weekly column on Pénélope on Radio-Canada, works part-time at Global Montreal, but for most of the year, you can find him slinging cheese with the other mongers. Critically acclaimed, The Cheese Cure is his first book.

 

Resources

 

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Transcript

 

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