Alexander DeLuca, M.D.
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Spreading a Culture of Moderation

Editorial; New Zealand Herald; 12/15/2003
Originally posted 2/24/2005:
[www.doctordeluca.com/Library/AbstinenceHR/SpreadModCulture03.htm]

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If 'tis the season to be jolly, 'tis also the season for reminders of the dangers alcohol presents. This week the Herald features a series on the trends and effects of drinking in our society. In some ways we have been improving but we are still a long way from entrenching a culture of moderation. That message is heard constantly, but how many ever take it to heart and alter their habits?

Drinking in moderation means learning to stop when the party is in full swing. For those driving, of course, it means drinking no more than a glass or two, but even those not intending to drive must learn how much is enough if we are to generate a healthier attitude throughout society to a drug that features in so much crime and misfortune.

As our series reports this morning, 35 per cent of injured patients who came into the Auckland Hospital emergency department during December 2000 had been drinking. The criminal courts hear alcohol blamed for a continual parade of violence and stupidity. Much of it results from "binge drinking", which the Weekend Herald traced to the earliest roots of our colonial history.

But 35 years after the extension of licensing hours it is becoming harder to blame the heritage of the "6 o'clock swill" for the way too many men, particularly young men, drink today. And not only men. Young women these days have caught the habit.

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Everyone, young and old, needs powerful messages to counter the notion that unlimited drinking is somehow stylish. They probably need to see themselves in a drunken state. Most people who drink too much are surprised when somebody tells them so. Under the influence they imagine they are urbane, witty, splendid company and, of course, that they can hold their liquor.

The truth, they should be told later, is that they were none of those things; the truth is they turned themselves into shambling, slack-jawed oafs. Drunkenness, they need to realise, deserves the worst term of approbation in the language of youth: drunkenness is boring.

It is several years now since the legal drinking age was lowered to 18, and since spirit mixtures aimed at teenagers came on the market. Opponents of the age reduction say it has not improved drinking behaviour among the young and has merely made alcohol available to an even younger group just under the legal purchasing age. But any reversal of law would be pointless. Teenagers were binge drinking in parks and on beaches before the law permitted them into licensed premises.

Alcohol is part of human life and has been produced in some form in most cultures since time immemorial. It is best controlled by unwritten codes of acceptable behaviour rather than laws that limit the rights of the sensible as well as the abuser.

These days the codes of behaviour can be underwritten with health warnings. Alcohol, we report today, is the first suspect in disorders of the liver and heavy drinkers are also at greater than average risk of heart disease, breast cancer, anxiety and depression. Last year the effects of alcohol were estimated to cost the public health system $655 million a year.

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The Alcohol Advisory Council estimates that deaths from liquor consumption cost the country $5.5 billion annually in lost production and taxes, while alcohol-related injuries cost $6.6 billion. But the liquor trade, of course, pays more than the usual taxes. Like tobacco and petrol, alcohol carries a special excise to reflect the social and environmental costs of its use. Much as the trade resents the special treatment, its total taxation contributes $600 million a year, not enough to cover the estimated public health bill alone.

The best way to start spreading a culture of moderation may be simply to decide here and now that drunkenness will no longer be treated as a joke. When someone regales you with his or her exploits while under the weather this festive season, don't force a laugh. Let's be honest; it's not funny.

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Dr. DeLuca's Addiction, Pain, and Public Health website

Alexander DeLuca, M.D., FASAM

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Originally posted:  2/24/2005

All Email to: adeluca@doctordeluca.com 

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