Alcohol can do good as well as damage

From a speech by Bruce Charlton, the lecturer in psychology at Newcastle University, made during a debate at Kings College, London

From the public health perspective, alcohol is pretty much a bad thing. Alcohol has, of course, great potential for harm. The dangers of alcohol have been extensively documented in the statistics of road accidents, violence, suicide and disease.

From the public health perspective, alcohol is pretty much a bad thing. Alcohol has, of course, great potential for harm. The dangers of alcohol have been extensively documented in the statistics of road accidents, violence, suicide and disease.

The good effects and opportunities that result from increased happiness, creativity, sociability, and human fulfilment in general are simply not a part of the public health calculus, since these aspects are private, subjective and incalculable.

Alcohol is probably the most powerful of widely available psychotropic drugs. More accurately, it can be regarded as several drugs, since its effects vary between people and according to dose. In high doses, alcohol produces intoxication, stupor, coma and eventually death. In lower doses, its effects may be benign and life-enhancing. Alcohol is not just a drug, since it is a flavouring element in some of the most enjoyable foods and drinks: beer, cider, wine, whisky and so on. And people often drink alcohol not for its medicinal properties but to become intoxicated as a positive objective in its own right - intoxication being a delirious state of brain impairment. At best, intoxication may provide a kind of happy holiday from the real world - albeit short-lived, and followed by that holiday in hell we call a hangover.

But aside from its effects in flavouring and as a pleasurable intoxicant, there are at least three serious reasons for taking alcohol as a psychoactive drug. Alcohol may be used as a hypnotic agent, in other words to promote sleep. Second, some people take alcohol as a kind of "antidepressant" or psychological pain-killer. The third use is as an anti-anxiety agent - to reduce shyness, increase confidence and lubricate social intercourse.

From a narrow public health perspective, these benefits of alcohol are almost invisible. Whether someone is shy, has a good night's sleep, or is miserable, are matters of supreme indifference to the government, except insofar as a population of shy, insomniac miseries is easier to control.

Unfortunately, alcohol is not a very good antidepressant. To achieve the effect of dulling the mind to pain, alcohol must be taken in large enough doses to produce a significant degree of intoxication. Substantial impairment of mental function is inevitable, and physical damage and addiction are probable in the long term. This is how alcohol is traditionally used, or abused, in high-latitude northern European societies such as Finland, Scotland and Newcastle-upon-Tyne - people drink to forget, and to escape.

In contrast to the berserker intoxication of a macho Viking or Geordie, Spanish men would regard slurring their words or uncontrolled behaviour as shameful, unmasculine behaviour leading to loss of reputation. So, in Spain most people drink, most of the time, yet very few get drunk.

Small frequent doses of alcohol are an effective treatment for some types of shyness. And - because humans evolved in small, stable, tribal societies - debilitating shyness and social phobia are common in our mass industrial society populated by a mass of strangers. Hence the use of alcohol as a social lubricant is, by and large, life enhancing.

The most straightforward alternative to alcohol as a social lubricant are drugs such as diazepam, or Valium. These share many of the disadvantages of alcohol in terms of being potentially addictive and prone to abuse, but they have the advantages of being longer-acting and safer than alcohol, both in acute intoxicating doses, and in the long term.

But a more promising alternative to alcohol as a social lubricant would be the newer drugs marketed under the "antidepressant" label, drugs such as Prozac. In general, a person who is shy and wants to try taking something like Prozac should be able to do so. Personal freedom, not public health policy, should decide on the risks we wish to take.