Soni Kassam (3:09)

He's also the author of the New Science of Alcohol and your Health. David has been studying drugs and its effects on the brain for more than 50 years. He spent two years at the National Institutes of Health in Washington, D.C. and advised the UK government on drug policy. But then he got sacked in 2009 for publicly declaring that alcohol is more harmful to people in society than illegal drugs like LSD and Ecstasy.

David Nutt (3:45)

There was no relationship between the harms of drugs and whether they were regulated by law or not.

Soni Kassam (3:53)

In fact, on a Friday night, as many as 70% of people in UK emergency rooms are drunk.

David Nutt (4:01)

Beyond the health costs, there are policing costs, and they're very present because they occur at the time people are drinking. And then on top of all that, you've got the sum of lost opportunity costs from hangovers. In fact, hangovers cost more to the British economy than both the policing costs of drunkenness and the health harms of alcohol.

Soni Kassam (4:23)

All of that the ER visits the police calls lost productivity stems from one tiny molecule. So what is it about alcohol that keeps us coming back? Let's start with the basics and a few numbers to set the stage. Roughly a third of the world's adults drink alcohol. In the US and much of Western Europe, that number climbs to about 7 out of 10. So what is is alcohol. At its core, alcohol is a simple molecule made of carbon, hydrogen and oxygen. It's produced when yeast breaks down sugar by fermentation, like in rotting fruit, leaving behind a liquid that can fuel engines or a night out. Alcohol affects many different neurotransmitters in our brain. If you're anxious, it calms you. If you're tired, it perks you up. If you're overstimulated, it slows you down. It's incredibly versatile and that makes it appealing, though generally not at first.

David Nutt (5:37)

What's perplexing about alcohol is the fact that when people start drinking, they usually don't like it. Alcohol itself is very bitter. If you put alcohol in the tongue of a dog, it'll wince and run away and not come back for more. And young people, when they're beginning to engage in drinking, find the same, which is why they often put alcohol into lemonade.

Soni Kassam (6:04)

But eventually, our brains learn a powerful trick linking the bitter smell and taste of booze with the warm buzz that follows. That's how we acquire the taste for it.

David Nutt (6:20)

Over time, eventually, that taste or smell begins to induce the pleasure that they later get when the alcohol gets to their brain.

Soni Kassam (6:33)

So we know drinking can feel good. It can also wreak havoc on your body and health. So we asked David to take us on our journey from first first sip to drunken stupor to the hangover. The Next morning.

David Nutt (6:49)

So what happens when you're an old man like me who's acquired the ability to drink? Well, I'm just going to open a bottle of whiskey for you now, and I'm going to smell it. And the smell already induces in my brain memories of pleasant experiences with whiskey. I sip my whiskey and immediately I get a tingling sensation in my tongue and in the back of my throat. And that also tells my brain this is the real thing. This isn't just a smell of whiskey, this is the taste of whiskey. And the alcohol in the whiskey is activating my taste receptors in my tongue and also activating some sensory receptors in my throat. And they together are going into the same part of the brain as where the smell went. And they're beginning to tickle up those parts of the brain which remember the pleasure of drinking. Then the alcohol molecules float down, roll down into my stomach, and then they get absorbed in my stomach and my duodenum.

Soni Kassam (7:57)

That's the first part of your small intestine where it then heads to your liver.

David Nutt (8:02)

And then in the liver, some of them get broken down into a substance called acetaldehyde.

Soni Kassam (8:08)

The acetaldehyde compound is also what causes us to turn red, to get flushed. It also happens to be a carcinogen.

David Nutt (8:17)

But most of them get through there and get up into my brain. An alcohol gets in the brain very easily. It crosses the blood brain barrier, the protective barrier of the brain brain very, very quickly.

Soni Kassam (8:33)

That's because it's such a small molecule. It takes just five or ten minutes to start feeling a pleasant buzz.

David Nutt (8:41)

And the first effect of alcohol is to enhance the neurotransmitter gaba, the calming transmitter in the brain.

Soni Kassam (8:53)

Gaba, that's gamma aminobutyric acid, if you're curious. It's a key part of how we regulate our central nervous system.

David Nutt (9:02)

And by enhancing gaba, we take away tension, we relax people and we allow them, if they want, to socialize, and most of humans do want to socialise, to socialize more efficiently. It's easier to engage in eye contact, it's easier to laugh when the other person's laughing, etc.

Soni Kassam (9:26)

It also gives us more confidence to actually talk to that attractive stranger at the bar. Though the science is mixed on whether it actually gives us beer goggles, the idea that other people seem more attractive after you've had a few drinks.

David Nutt (9:42)

Then, as I drink another drink, another five, ten minutes later, the alcohol levels in the brain rise and then they begin to release other neurotransmitters. They begin to turn on the dopamine system. And the dopamine system gets you high. It makes you louder, makes you more animated, can make you irritable and aggressive. It can make you more lecherous.

Soni Kassam (10:05)

One of the reasons some people binge alcohol, why they crave more, is because of dopamine. It feels so good. And there's another reason. A similar amount of alcohol also releases.

David Nutt (10:18)

Endorphins, the so called runner's high. Well, they're also a large part of the drinker's high. Alcohol releases endorphins. Endorphins get you high. They're pleasure chemicals like dopamine, but it's a different kind of pleasure. It's a warmer, more intimate pleasure. But endorphins also like dopamine, run the risk of producing some kind of dependence. And then if you carry on drinking, you begin to get into an area where there are serious issues in the brain. Because when blood alcohol levels rise to about twice the drink driving limit, then you begin to block the glutamate system in the brain. The glutamate system is the on switch of the brain. It's the brain neurotransmitter which makes you do things. It's critical to everything. It's critical to all movement, to all perception, and to all memory.

Soni Kassam (11:28)

So alcohol affects your brain in three big ways. First, it increases gaba, which, which slows down brain activity. That's why you start to feel relaxed and why you might slur your words or lose coordination. Then it boosts dopamine, which makes you feel confident, talkative, maybe even invincible. But too much dopamine can make you mean and aggressive. And then finally, the booze blocks glutamate.

David Nutt (11:56)

And if you block glutamate, you can't lay down new memories. And that's why people who drink excessively end up having amnesia. They call it blackouts.

Soni Kassam (12:09)

Blocking the glutamate system is also responsible for another unpleasant part of drinking. The hangover the next day, where you feel tired, headachy, nauseated and thirsty.

David Nutt (12:22)

In hangover, you have too much glutamate. The brain is overactive. And that's why some people have fits during alcohol withdrawal. That's why you get what we call hangxiety.

Soni Kassam (12:34)

You have to pee a lot because the hormone that controls urination, called vasopressin, is out of whack. So you pee out more water than you take in, causing dizziness and headaches. You're also hungover because you slept terribly at first. Your sleep is extra deep.

David Nutt (12:55)

People often Wet the bed because they're so deeply asleep that they don't wake up when they need to pee.

Soni Kassam (13:01)

But then your sleep is disrupted. So overall the quality of your sleep is bad as you enter hangover. So alcohol makes you feel looser, happier and social, or it can make you feel sadder, angrier and sloppier. But it's also poison and the health effects are numerous.

David Nutt (13:22)

As well as being a very promiscuous pharmacological agent, alcohol is also a very promiscuous toxin. In fact, it's hard to find any organ in the body that alcohol doesn't damage.

Soni Kassam (13:36)

It's probably the leading cause of high blood pressure in those without kidney disease.

David Nutt (13:43)

It's associated with stomach ulcers because it's a toxin and it erodes the stomach lining. It's associated with both cirrhosis of the liver and liver cancer because it's a toxin. And the acetaldehyde in particular damages and inflames the liver. It's associated with brain damage and that comes in part from the toxicity due to the hyperexcitation from the glutamate drive in the brain, which is compensatory to intoxication with alcohol. And it also comes from brain damage from being drunk and falling over and being beaten up and driving your car into a wall, etc.

Soni Kassam (14:16)

It's associated with multiple cancers like colon, breast and pancreatic.

David Nutt (14:21)

Alcohol also damages the heart. High levels of alcohol essentially kill the heart. People get heart failure and die as a result of the heart just packing up. It has a particularly deleterious effect on the testes and reproduction. It can cause men to become to develop breasts because it changes the hormonal balance in the liver. It impedes fertility in women, and worse than that, it is the leading cause of fetal damage in utero. Fetal alcohol syndrome causes more damaged children than autism and fragile X and down syndrome put together. And that's because it's a toxin to the developing embryo.

Soni Kassam (15:05)

That's all the long term damage. It can also kill quickly. About a third of all fatal car crashes in the US involve drunk drivers. And about 11,000 people die each year in drunk driving crashes, according to the U.S. department of Transportation. It's also strongly linked with domestic violence, assaults and murder. So after knowing all the harm alcohol causes, why do any of us drink?

David Nutt (15:33)

I think the reason alcohol has survived in human society for as long as we know of human society is because it is the social drink.

Soni Kassam (15:50)

What alcohol does to civilization, that's In a moment.

1440 Topics Narrator (15:57)

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Soni Kassam (17:10)

Humans have been drinking booze for thousands of years. Some say it's what led to civilization itself. But if it's so harmful to our bodies, why didn't evolution knock it out? Anthropologist and professor Edward Slingerland thinks he has the answer.

Edward Slingerland (17:31)

Cultures see alcohol as a source of inspiration.

Soni Kassam (17:37)

Edward is a professor of philosophy at the University of British Columbia and the author of How He Sipped, Danced and Stood Stumbled our way to civilization. So with Edward as our next guide, let's start at the beginning. And the beginning is a very long time ago. 10 million years ago, the thinking goes, one of our primate ancestors starts eating.

Edward Slingerland (18:02)

Some fruit, fruit that had fallen off of trees and was fermenting a bit and just naturally contained a bit of alcohol.

Soni Kassam (18:09)

It's bubbly, fizzy, and gives this primate a buzz. That's because around this time, the primate develops a mutation that metabolizes ethanol. Why? Well, fruit has a lot of calories and alcohol has a distinct smell you can detect from far away.

Edward Slingerland (18:27)

And so the idea was smelling ethanol and being attracted to it and being able to track down its source in the jungle was adaptive because it allowed us to find find these high calorie rewards, this fermenting fruit.

Soni Kassam (18:42)

By the way, it's not just primates. Some birds and even fruit flies can metabolize alcohol. By the time humans come along in our evolutionary timeline, we already have the ability to process booze.

Edward Slingerland (19:01)

We have artistic representations of people drinking that are 20,000 years old.

Soni Kassam (19:08)

For a long time, researchers believed humans invented agriculture for food and then learned they could turn crops into beer. But in recent decades, some researchers say that story might be backwards.

Edward Slingerland (19:22)

Maybe people were motivated to start cultivating grains because they wanted to make Beer. They wanted to make more and better beer, and not because they wanted bread.

Soni Kassam (19:33)

Edwards says there's a lot of data that supports this. It seems like the first crops humans planted were chosen because of their ability to affect your mind, not provide nutrition.

Edward Slingerland (19:44)

So if this is true, and there's a lot of converging evidence for it, there's a very literal sense in which intoxication led to civilization. Our desire to get intoxicated actually motivated us to start civilization in the first place. And then later on, we were like, oh, you could eat this stuff too.

Soni Kassam (20:05)

Over thousands of years and all over the world, there's evidence of humans drinking alcohol. Vessels show up in ancient Chinese tombs, often as some of the most important items buried with the dead. And the ancient Greeks held drinking parties called symposia, where they discussed philosophy and poetry. But they watered down their wine to beer. Like strength, the function of that is.

Edward Slingerland (20:30)

That it gives the symposiarch the ability to control everyone's alcohol consumption. Because if things are flagging, if people are getting bored, if it's not going well, maybe I'll put a little less water in and make it stronger this time around. If people are starting to get sloppy and there's a little too much drinking going on, I'll put some more water when I pass it around. So it gave them a way to basically titrate the strength of what they were drinking so they could keep everyone at kind of an optimal blood alcohol content to get all the social creative bonding effects without going too far, but also without undershooting.

Soni Kassam (21:08)

So the ancient Greeks used booze to keep the conversation flowing. Others realized that drinking made people more creative. That's because booze turns down your prefrontal cortex. This is the part of the brain that helps with boring adult tasks like doing your taxes. Children don't have well developed PFCs, which is why they're bad at adult responsibilities, but good at doing things like mixing Barbies with Legos. But alcohol makes adults more like children in creatively productive ways.

Edward Slingerland (21:51)

This is why cultures see alcohol as a source of inspiration. The ancient Persians wouldn't make an important decision without getting drunk and talking about it first, because they wanted to completely explore the possibility space before they made a decision. We want to think about if there's something we're not considering or something, some factor we haven't taken into account. The only way you get that kind of broad view, kind of big flexibility of thought, is by turning down your cognitive control regions a bit.

Soni Kassam (22:22)

The Persians would then sober up and make sure they didn't decide something stupid.

Edward Slingerland (22:27)

It's similar to this kind of idea of, you know, write on alcohol but edit on coffee. You also want to check the. You want your sober mind to check the results of what your non sober mind came up with.

Soni Kassam (22:39)

In Edward's view. All this points to one key. Humans don't drink because of some evolutionary accident that gave us a taste for poison. We drink because it has real societal benefits.

Edward Slingerland (22:54)

One of them is definitely anxiety reduction.

Soni Kassam (22:56)

Being human is stressful. Once we developed agriculture, we started to live in dense villages and that brought social tensions.

Edward Slingerland (23:05)

And alcohol was arguably a tool for kind of calming those tensions down.

Soni Kassam (23:10)

Humans are also not always trustworthy. Booze helps with that too.

Edward Slingerland (23:16)

Everywhere around the world throughout history, anytime you have potentially hostile individuals sitting down to negotiate a war treaty or a marriage deal or some kind of trade deal, the alcohol comes out. And that's because it's reducing your ability to lie.

Soni Kassam (23:34)

Lying is hard on the brain. You have to hold in your brain both the truth and the story you're telling. Alcohol disrupts your cognitive control, so it's harder to keep it all straight.

Edward Slingerland (23:46)

When you're drinking alcohol, you're less inclined to lie. It's boosting endorphins, serotonin, it's making you feel good. It's actually making you more honest and more trustworthy.

Soni Kassam (23:58)

Its ability to act as a kind of truth serum, plus its way of making us less inhibited, more social, is a big reason why so many world changing meetings are held over drinks.

Edward Slingerland (24:10)

When Nixon went to China, he supposedly said, if we drink enough maotai, this distilled Chinese beverage, if we drink enough of this, there's nothing we can't do.

Soni Kassam (24:25)

So for most of human history, alcohol was used for gatherings, negotiations, reducing anxiety and boosting creativity. But for most of that history, alcohol was also relatively weak. When you make beer or wine the traditional way, there's a limit to how strong it can get. That's because alcohol is generally produced as a result of a war between bacteria and yeast. They are both trying to consume the same resource. In the grains, the yeast produces ethanol to kill off the bacteria. But at some point, the yeast reached their limit and shut down. So if you're making wine, pretty much the strongest you can get is about 16% alcohol by volume. Most beers back in the day were probably just 2 to 3% alcohol.

Edward Slingerland (25:12)

If you're drinking a 2 to 3% ABV beer, especially if you're doing physical labor or you're eating food, you can drink that all day long.

Soni Kassam (25:20)

So it was hard for our ancestors to get blackout drunk. That changed in the 1600s. This is when distilled spirits became common in Europe. Humans figured out how to separate the alcohol from water through evaporation and condensation and do it all at scale. Now, there was no limit to how strong a drink could be. Gins and tequilas could hit 90% ABV.

Edward Slingerland (25:46)

Even though it's still just ethanol, I think it should be considered a different drug. Most of the benefits that I talk about in the book come at a kind of mild inebriation level.

Soni Kassam (25:57)

Widespread distilled spirits has another big effect on world history. They're so strong, it's almost impossible for them to go bad. So as European countries became colonial powers, they realized they could trade the stuff for goods or slaves.

Edward Slingerland (26:14)

It turned alcohol into a commodity in a way that it never was before.

Soni Kassam (26:19)

It also turned alcohol into a much bigger problem. Think about it. Until recent centuries, drinking generally happened during social gatherings, complete with rituals that serve to slow you down. If you're someone who might be at risk of becoming dependent on alcohol, there were a lot of obstacles. First, the drinks were relatively weak. And then rituals stopped you from having too much too fast. In traditional Chinese banquets, you can't take a sip until someone makes a toast.

Edward Slingerland (26:56)

And you have to wait now and until another toast is made.

Soni Kassam (26:59)

By the way, a similar thing happens today. When you go to a bar with friends, we generally order beers in rounds. That stops one person from ordering too much too quickly. But all this is broken by the widespread availability of distilled spirits like vodka. Those can get you drunk in minutes. In the 18th century, London was flooded with cheap gin.

Edward Slingerland (27:28)

It was called the gin craze. It broke down families, it created orphans, it killed people.

Soni Kassam (27:34)

It then spread to North America. Men would head to saloons after work to drink, then come home and abuse their wives and kids. This is what sparked the temperance movements in the 19th and 20th centuries.

Edward Slingerland (27:46)

The early Prohibition activists, they wanted to close down saloons, they wanted to close down these gin consuming places. And I don't think really wine or beer was on their radar.

Soni Kassam (27:58)

This culminated in Prohibition in the US in the 1920s and early 30s, drinking was banned nationwide. But Edward thinks there's a reason it didn't last.

Edward Slingerland (28:09)

I think with the Prohibition movement, people realize when we get rid of alcohol, we've gotten rid of something that was actually useful.

Soni Kassam (28:17)

We want a drug that calms our social anxiety, acts as a truth serum, and makes us more creative.

Edward Slingerland (28:24)

No one yet has invented a drug that can do everything that alcohol can do, but doesn't have any of the downsides.

Soni Kassam (28:36)

Prohibition ended in 1933, but it had some lasting unintended consequences. For one, it helped normalize drinking at home, drinking alone. Add to that the rise of the suburbs after World War II. Workers began commuting long distances by car.

Edward Slingerland (28:55)

And then if you want to drink, you're drinking alone at home or drinking at most with your family and not having those kind of broader social interactions that we used to have when human life was more focused around pubs and coffee shops and trattoria and things like that.

Soni Kassam (29:12)

All of this distilled spirits drinking alone magnifies the negative effects of alcohol and divorces it from many of the positives humans have known. Alcohol can create dependence for centuries, but it didn't really become a widespread problem until the advent of gin and other distilled spirits and when humans started consuming booze at home. Today, it's estimated that about 7% of the world's population lives with alcohol use disorder. It develops for a few reasons. Some try to dull pain and depression. Some get addicted to the endorphin and dopamine hits. And a third group becomes dependent on it to treat social anxiety. All of this brings us back to alcohol and our health. It's no secret drinking can wreak havoc on our bodies. We talked earlier about all the harm it causes. But wait a moment. Isn't alcohol supposed to have some health benefits too?

David Nutt (30:13)

So why is it that the French, who eat as much or more fat than we do, suffer fewer heart attacks, even though they smoke more and exercise less?

Soni Kassam (30:23)

This is the late Morley SAFER. Back in 1991, introducing one of his most famous stories on CBS's 60 Minutes. He was reporting on the so called French paradox. For all the butter and cigarettes they consumed, why were the French having far fewer heart attacks?

David Nutt (30:42)

The answer to the riddle, the explanation of the paradox may lie in this inviting glass.

Soni Kassam (30:50)

Red wine specifically. As soon as the story aired, wine sales in the US soared 40%. And for more than two decades, moderate drinking of wine became seen as healthy. If that seems too good to be true, well, Dr. David Nutt says more.

David Nutt (31:08)

Recent research has shown that the French paradox comes from living in the south of France where there's lots of sunshine, high levels of vitamin D, you have an diet rich in polyunsaturated fats, you have a very healthy diet, and you probably have a more relaxed lifestyle as well.

Soni Kassam (31:26)

Over the past decade, research has stripped any luster of health from wine and other alcoholic drinks.

David Nutt (31:32)

Some of you may be surprised to hear me say that there is no proven physical health benefits from alcohol.

Soni Kassam (31:40)

In fact, the pendulum has swung the other way. The World Health Organization now says there is no safe amount of alcohol. Health authorities around the world are revising their recommendations. Canada, for instance, now recommends no more than two drinks per week. David Nutt says if alcohol were discovered today, based on what we know now, regulators would be unlikely to allow more than one glass of wine per year. These new warnings are breaking through Generation Z. Today's teens and 20somethings are drinking a lot less than older generations, like 20% less than millennials. That's for a lot of reasons, but health is a big one. Despite all the risks, both of our experts continue to drink in my moderation. About 10 years ago, David Nett and his daughter opened a wine bar in West London. The same man who called alcohol the most harmful drug in the UK also owns a wine bar.

David Nutt (32:48)

People often ask me, you know, do you still drink knowing all this? And I say, yes. And the reason I drink is because I enjoy drinking. I enjoy the social experience of drinking alcohol. But I have changed my drinking a lot over the last decade, partly due to the understanding that the safe limits of alcohol are lower than we thought before, and partly because we have an alternative.

Soni Kassam (33:12)

David has been developing an alcohol substitute called Sentia that has some of the brain boosting effects of alcohol, like the relaxed, sociable buzz, but without all the negatives. And for Edward Slingerland, the anthropologist, despite all all the downsides, alcohol has been a net positive for society. And a big part of that is how it enhances us socially.

Edward Slingerland (33:36)

Ethanol is dangerous for your physical health. So is loneliness. Loneliness is incredibly dangerous. And it's something kind of understudied. So if you stay home and you don't go to the pub, maybe you're sparing your liver and you're sparing yourself that ethanol exposure. What are you losing when you don't have those social connections? If you told me you can never again have a cool climate, Chardonnay from the Santa Cruz Mountains. You'll never taste that taste again, but you'll live an extra month. I'd rather take the Chardonnay, just maybe.

Soni Kassam (34:15)

Drink it in moderation. So what have we learned? Alcohol is a paradox. For centuries, humans have grappled with alcohol's dual nature. A force for social bonding and a cause of deep harm. It's something we turn to for comfort, connection and creativity. But it's also something that can silently erode our health, our relationships, and our sense of control. Even today, as we understand more about its effects on our bodies and minds. Alcohol still holds a powerful place in society. Whether or not we choose to drink is a personal decision. But for those who do, maybe the real challenge lies in how, when and why. So maybe next time you pick up a glass, remember, it's not just about the buzz. It's about the people you're with, the moments you share, and having the wisdom to know when to put it down. Thanks for listening to 1440 explores. I'm Soni Kassam. Make sure to follow the show and leave a review on Spotify, Apple or wherever you listen to your podcasts and let us know what you think@podcastoin140.com while you're at it, start your learning journey with us at join140.com subscribe to our free daily and weekly newsletters on world affairs, business and finance, society and culture, and much more. 1440 explores is a production of Rhyme Media for 1440 Media. This episode was produced by Dan Bobkoff and Kim Naderfin Pietersa. It was found fact checked by Sanam Skelly. Our sound designer is Jay Cowett. The executive producer at Rhyme is Dan Babkoff, and the executive producers at 1440 are me and Drew Steigerwald. See you next time.