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Author Topic: How well do you handle alcohol?
Tresopax
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quote:
Tres, as someone who has often taken an argument with you far too seriously, I have learned that you often seem to craft arguments simply to be contrary (or to argue from a position that is largely theoretical/ideal, rather than rooted in practical reality).

Arguing for argument's sake, or arguing against a theoretical absolutist, isn't something to take too seriously.

Now, it may just *seem* that way and you are always truly honest in your arguments, or you may simply enjoy the role of Devil's Advocate (often in your Xap persona), but either way, it can feel as though one is beating their head against a wall discussing a point with you.

I do not ever spend multiple pages crafting arguments on this forum simply to be contrary. That is a waste of my time/effort and yours. You can take that as a fact.

I do base many arguments in theory, because that is the way I think. And I do often argue against widely accepted common sense assumptions when I think there is a strong argument to be made against them that others are skipping over and which I myself can't see a clear answer to. I don't do this to mess with people. I do it because I believe, in complete seriousness, that even widely accepted assumptions should be questioned and that it is better to try and look at things from a variety of perspectives rather than just whatever one we are used to. The most important question for me to ask, in my view, is the one that is still unanswered, yet nobody else is asking.

If you or others feel that you are banging your head against a wall, I suspect the reason is because I sometimes don't, in the end, accept what you consider to be the common sense truth. But do you really expect me to? Give me some credit - I'm not just making stuff up on the spot; I've thought considerably about these things before. It is not likely that I'm just going to do a 180 on any given topic simply from a single thread, no matter how long it goes. Similarly, I don't expect TomDavidson to accept religion just because someone tells him to in a thread, I don't expect Reshpeckobiggle to reject creationism just because someone points to evidence against it, and so on. People, including myself, have thought out their positions, and the arguments against their positions - it will take more than a few posts to change them.

So, I don't see how any of this justifies taking my posts any less seriously than anyone else who is giving their opinion on a serious topic. But more importantly, (and this is not directed at anyone in particular) if you don't wish to take my view seriously, just skip over it and leave it be. Don't jump in with a one-line insult that adds nothing to the thread (and distracts me from people who are asking real questions). Don't skim over my post and then respond against whatever strawman position you think I probably am taking. Don't go to sakeriver or elsewhere and complain about me, as if it isn't on the internet where everyone can see it. And don't put comments on other threads along the lines of "This is the first time I agree with him!" Don't do this for me or for anyone else. If you don't want to treat some Hatracker seriously, just don't read his or her posts. Thank you.

Now, back to your regularly schedule thread:

quote:
Tres, how are you defining "specific intent to alter one's mental state"?

I generally think that people intend the known consequences of their actions. If someone knows that alcohol changes their mental state, and they knowingly drink alcohol, then they intended to change their mental state.

I'm actually not very sure how to define it. But I do think it is possible to intend one consequence of an action, and simply accept other consequences as known-but-possibly-undesireable side effects. For instance, if I have insomnia and take a medicine to go to sleep, but I know it will give me a headache when I wake up, I am not taking it with the intent to get a headache.

Perhaps motive is the better word, legally speaking.

quote:
What about certain kinds of fasting? It's deliberately avoiding food in order to have a spiritual experience, which is probably partially brought about by not eating. In fact, there are a number of religious experiences where the goal is an altered state of consciousness.
That's a tricky question. I don't really know much about fasting as a method of altering your state of mind. If you know it will impair your judgement in some way, I could see how that would be unethical too.

Fasting seems to skip over my second concern though - which I (for lack of a more descriptive term) labeled disrespecting yourself. When people seek to alter themselves through alcohol, it seems to carry with it the idea that there is some flaw in themselves they want to get rid of for a while. Commonly, I've heard people claim they are more fun while drunk. I think this is disrespctful to one's self because it presumes you are incapable of being fun on your own, that you need an artificial means to fix yourself. In the case of fasting, I would think there is no such implication - you are not saying there is something wrong with you. So fasting, as I understand it, would only carry half of the problem.

But again, as I said, I don't really know much about fasting or what people intend to do through it.

[ December 17, 2007, 11:26 PM: Message edited by: Tresopax ]

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erosomniac
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quote:
I think this is disrespctful to one's self because it presumes you are incapable of being fun on your own, that you need an artificial means to fix yourself.
Y'know, if you also find the use of any/all mood enhancers/modifiers (e.g. the vast majority of drugs prescribed through psychotherapy) unethical and disrespectful of oneself, then your viewpoint is at least consistent.
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The Rabbit
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quote:
Look, one doesn't have to believe that all alcohol use is all bad for everyone, or even that it is a lesser choice for everyone, in order to make the choice oneself not to imbibe it, or to make the claim that or some people, it is likely a very bad choice indeed.
And I myself and am example. I have chosen not to drink alcohol for a variety of reasons and yet I recognize that for many people moderate alcohol use isn't a bad thing and in some situations for some people moderate alcohol use can be beneficial. But I have also known people who have seriously skewed up their lives by excessive drinking and for me any potential benefits are out weighed by the risks.
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The Rabbit
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quote:
Originally posted by steven:
I thought it was "absurd", with an "a" at the beginning.

And you are correct. Obsurd means to cause hearing damage which was not my intended meaning.

D**N the freaking non-phonetics of the English language.

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ClaudiaTherese
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quote:
Originally posted by The Rabbit:
This I agree with completely and not just regarding this particular discussion. It is hard to find any absolutest stance that can't be pushed to an extreme that illustrates its obsurdity.

Oh, for sure.

I also am not under the impression (illusion [Smile] ) that everyone who drinks is doing it to get positive longterm effects. This would be even harder to swallow in the case of binge drinking, which represents by far the most significant social & physical morbidity and mortality from alcohol use. Binge drinkers are usually not dependent (in the medical sense) on alcohol, and thus are not generally in the group thought of as "alcoholics," but they are most seriously affected by problem drinking.

I'd argue that alcohol abuse (particularly binge drinking, particularly in certain circumstances) is the single greatest cause of life problems in the US, other than other medical or mental health disorders. I'm not pro-gettting-boozed-up across the board at all, in case that wasn't clear.

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ClaudiaTherese
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quote:
Originally posted by The Rabbit:
But I have also known people who have seriously skewed up their lives by excessive drinking and for me any potential benefits are out weighed by the risks.

Which I think (for all that's worth [Wink] ) is a very reasonable and justifiable decision to make, and I admire you both for thinking it through carefully and for following through on your decisions. [Hat]
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Tresopax
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quote:
I think the evaluation of acts which impair judgment is multi-dimensional. Some of the factors that matter:

1) The benefits derived from the act.

2) The amount of impairment.

3) The type of impairment.

4) The possible consequences of impairment.

5) The probability of the consequences occurring.

6) The ability and willingness to cure any negative consequences that do occur.

These factors inter-relate in unexpected ways. Moreover, a person performing a mind-impairing act can take steps to alter each of these factors - arranging for a designated driver, limiting one's intake of mind-altering substance, etc.

This is probably all correct... But I am not very confident in the average person's ability to weigh all these factors very well, especially once they've started drinking. I say this not based on any scientific study, but just based on things I've observed friends and other people choosing to do.

quote:
Look, one doesn't have to believe that all alcohol use is all bad for everyone, or even that it is a lesser choice for everyone, in order to make the choice oneself not to imbibe it, or to make the claim that or some people, it is likely a very bad choice indeed.
I am not arguing that all alcohol use is bad. My claim, now modified from what it was intiailly, is that it is fine as long as you (1)don't use too much, (2)have the correct sort of intentions/motives for using it, and (3)don't feel a moral obligation to avoid something that causes the sort of damage that alcohol does to the world.
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ClaudiaTherese
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If one is fasting to achieve enlightenment or spiritual insight, then one might be viewed as thinking of oneself as incapable of doing it on one's own.
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ClaudiaTherese
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quote:
Originally posted by Tresopax:
My claim, now modified from what it was intiailly, is that it is fine as long as you (1)don't use too much, (2)have the correct sort of intentions/motives for using it, and (3)don't feel a moral obligation to avoid something that causes the sort of damage that alcohol does to the world.

Understood. Thanks for the clarification.
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Tresopax
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quote:
Y'know, if you also find the use of any/all mood enhancers/modifiers (e.g. the vast majority of drugs prescribed through psychotherapy) unethical and disrespectful of oneself, then your viewpoint is at least consistent.
I'd distinguish between trying to fight psychological diseases versus trying to alter other personal traits. I think there is a difference.

But I don't, for instance, like the consistent usage of coffee in the morning to make you more alert - for precisely that reason.

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Morbo
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quote:
Originally posted by The Rabbit:
quote:
Originally posted by The Rabbit:
quote:
The thing is, if one takes an absolutist stance with regards to a choice which is intended to impair judgment, then one has taken an absolutist stance. Relativity regarding more worse effects is beyond the point.
This I agree with completely and not just regarding this particular discussion. It is hard to find any absolutest stance that can't be pushed to an extreme that illustrates its obsurdity.
I just realized that this itself could be seen as an absolute condemnation of absolutism.

Anyone want to try to push it it its logically absurd extemes![?]

Death to all extremists!
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The Rabbit
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quote:
Originally posted by Morbo:
Death to all extremists!

We will have you shot first, at dawn!
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The Rabbit
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I have a hypothetical question,

If we could eliminate all alcohol from our society (and I know that such a thing is likely impossible but if it weren't impossible) and in doing so we could prevent all the deaths by drunk drivers, all the crimes committed by binge drinkers, all the premature deaths from alcohol abuse, all the divorces caused by alcoholism, all the children born with fetal alcohol syndrom, all the fights between drunks all the child and spouse abuse done by drunks and all the societal problems caused by excessive alcohol use would you want to do it even though it would mean also giving up all the pleasure experienced by moderate drinkers and any health benefits incurred by moderate drinkers?

Would the trade off be worth it to you?

And once again I recognize that this is a fully hypothetical question since we can't eliminate alcohol for our society. But if some magical power existed in which we could make it so that alcohol didn't exist, would that be overall a good or a bad thing?

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erosomniac
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quote:
I'd distinguish between trying to fight psychological diseases versus trying to alter other personal traits. I think there is a difference.
I think there is a difference, too, but the two (among other things) are often so entangled that they become indistinguishable from each other. I don't think one is any more or less deserving of a treatment than the other.
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erosomniac
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quote:
Originally posted by The Rabbit:
I have a hypothetical question,

If we could eliminate all alcohol from our society (and I know that such a thing is likely impossible but if it weren't impossible) and in doing so we could prevent all the deaths by drunk drivers, all the crimes committed by binge drinkers, all the premature deaths from alcohol abuse, all the divorces caused by alcoholism, all the children born with fetal alcohol syndrom, all the fights between drunks all the child and spouse abuse done by drunks and all the societal problems caused by excessive alcohol use would you want to do it even though it would mean also giving up all the pleasure experienced by moderate drinkers and any health benefits incurred by moderate drinkers?

I think the damage caused by alcohol outweighs the benefits others may obtain from it. I think if the universe had never contained alcohol, it might be a better place.

But if someone discovers a way to eliminate it tomorrow, I won't support it.

Edit to clarify: I'm referring to alcohol for consumption, since Rabbit's post seems to want to differentiate between that and other forms of alcohol, e.g. isopropyl.

[ December 17, 2007, 11:30 PM: Message edited by: erosomniac ]

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Morbo
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quote:
Originally posted by erosomniac:
I think if the universe had never contained alcohol, it might be a better place.

I'm undecided about Rabbit's hypothetical in the present. But in the past, wine, beer and spirits had an important role in providing cleaner beverages than often disease-ridden water. Millions could have died in an alcohol-free universe.
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The Rabbit
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quote:
But in the past, wine, beer and spirits had an important role in providing cleaner beverages than often disease-ridden water. Millions could have died in an alcohol-free universe.
Quite true!
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Jhai
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I agree with erosomniac, on every point.

To add a bit:
I think it depends on societal context. In some times and places, drinking the local brew was a better choice, health-wise, than drinking the likely-contaminated water. I don't think that it's required that alcohol be a bad societal force, either by human nature or anything else.

Also, in studying economics, I've found that people generally underestimate the small, marginal benefits of a thing spread across a large population when confronted with a few large, in-your-face costs. (Free trade & manufacturing layoffs is probably the classic example.)

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HollowEarth
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The awesomeness of this thread went downhill fast once we got to page two. To do my part to correct this slide, on Friday I'll try to get really drunk, make some terrible choices while drunk and then (hopefully) report back on Saturday. All this theoretical hand waving isn't getting anywhere, we need some actual experimental data.
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The Rabbit
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quote:
Originally posted by HollowEarth:
The awesomeness of this thread went downhill fast once we got to page two. To do my part to correct this slide, on Friday I'll try to get really drunk, make some terrible choices while drunk and then (hopefully) report back on Saturday. All this theoretical hand waving isn't getting anywhere, we need some actual experimental data.

As with any experiment, you should be careful to review all the available literature before hand so that you don't waste your time repeating work that someone else has already published.
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ClaudiaTherese
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quote:
Originally posted by The Rabbit:
Would the trade off be worth it to you?

And once again I recognize that this is a fully hypothetical question since we can't eliminate alcohol for our society. But if some magical power existed in which we could make it so that alcohol didn't exist, would that be overall a good or a bad thing?

I honestly don't know. As was mentioned, having it as a beverage was critical at some times in the past. And although I'm not a big believer in making lives harder in order to build character, I'm not sure that making a bad choice unavailable (given that I think in some contexts, it may be a good or at least tenable choice) is better than helping people make better choices in general.***

Maybe, maybe not -- not sure, and definitely not certain I could understand the full ramifications enough to make a good choice here myself. Interesting question, though.

---

Edited for clarification:

*** I think the negative sequelae from problem drinking are very real and very serious. I don't think this is inherent to alcohol, however -- that is, I don't think that "demon alcohol" (to use an old phrase) is the corrupter of man.

I do think there are a lot of people who have a tendency to make choices that get them into trouble (all of us do, to some extent, but some more than others), and that if it weren't alcohol, it would be something else. The problem is in the bad decision-making, not in this substance, which can (I think) itself be used in ill or okay ways.

And to go further out on a limb, I suspect many patterns of making bad choices are driven by an attraction to chaos and problems or a lack of comfort with stability and health. Again, that's just a problem looking for a tool, and there are many tools to drive chaos other than alcohol. I suspect if we *poof*ed out alcohol, those bad decisions would still be made (just different context), and that chaos and trauma would be just as attractive for some.

---

And again added:

I also am not sure that a drive to chaos and drama is always a bad thing. I think it has been behind some of our greatest and inspiring works of art, for example. Just to be clear on that.

[ December 18, 2007, 12:12 AM: Message edited by: ClaudiaTherese ]

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Jhai
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I'll report in tomorrow night with some experimental data. Does anyone want to draw up a research methods section, or are we just winging this thing?
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Icarus
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Tres, I appreciate the answers you've provided. I perceived your original post as making an absolute statement, and as implying a criticism of people who didn't share your absolute position (since you framed it in the guise of advice). Your position seems not to be as cut and dried as it originally appeared, after all. I don't agree with you on many of the particulars, but you have been thoughtful and responsive and I appreciate that.
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ClaudiaTherese
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Seconded. Very much so.

---


Note: editing my last post re: Rabbit's question

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erosomniac
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quote:
Originally posted by The Rabbit:
As with any experiment, you should be careful to review all the available literature before hand so that you don't waste your time repeating work that someone else has already published.

It's frequently beneficial to replicate a previous experiment in order to learn proper methodology.

In this particular instance, I recommend running the experiment multiple times to ensure accuracy.

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HollowEarth
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quote:
Originally posted by Jhai:
I'll report in tomorrow night with some experimental data. Does anyone want to draw up a research methods section, or are we just winging this thing?

Well, there always JIR
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Noemon
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Thirded.
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ClaudiaTherese
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For what it's worth, my partner has just last week been asked by the Canadian federal government to head the research team selected to provide plan and implementation strategies for dealing with problem drinking in that country. I've been doing lit review and editing on draft proposals for the last few months, so the topic is fresh on my mind. As are the problems. [Frown]

But for all the problems, an abstinence model of treatment is not as effective as a harm reduction model: i.e., helping people learn about and enact better decisions about when and how they drink *** rather than telling them or necessarily encouraging them not to drink at all. The research is pretty clear on this, and it holds across cultural and national boundaries when methodologically assessed as a matter of general policy.

(Of course, the Rabbit Hypothetical is not what is being measured against! It is being assessed against the abstinence model of treatment in this world, where alcohol still exists around us. A different beast, for sure.)

---

Edited to add:

*** And these decision-making skills seem to be transferrable to other types of choices. Without those skills, after alcohol abstinence, the tendency is to find another way to "abuse" (i.e., engage in problem behavior with negative sequelae).

---

Edited agin to add: Alcoholics Anonymous, which is based on the abstinence model, works extremely well for some problem drinkers. However, it doesn't seem to work (for whatever reason) for most people who try it, even though it works very well for some. The numbers for Brief Intervention (the standardized harm reduction approach) are much better overall.

[ December 18, 2007, 12:38 AM: Message edited by: ClaudiaTherese ]

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Tresopax
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quote:
I perceived your original post as making an absolute statement, and as implying a criticism of people who didn't share your absolute position (since you framed it in the guise of advice).
In fairness, my original one-sentence post was an absolute statement, and not really an accurate statement of what I think. I intended it to be largely tongue-in-cheek; I wasn't quite expecting to get in an actual discussion of what distinguishes when drinking is or is not a good idea, although I probably should have.
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Shigosei
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I brought up fasting because I've made a choice not to use it as a spiritual practice precisely because I'm well aware of how much not eating interferes with my ability to think clearly. I would not look down on other people for doing it, and I think some people handle it much better than I do.

Also, what's wrong with acknowledging that I do need artificial means to fix myself? I don't drink coffee, but I do take stimulants to stay awake during the day. I'd be unable to have a normal life without artificial help, but I really don't think that makes me less of a person.

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Icarus
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I do.

.

.

.

.

.

.

[Razz]

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Morbo
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quote:
Originally posted by ClaudiaTherese:
For what it's worth, my partner has just last week been asked by the Canadian federal government to head the research team selected to provide plan and implementation strategies for dealing with problem drinking in that country. I've been doing lit review and editing on draft proposals for the last few months, so the topic is fresh on my mind. As are the problems. [Frown]

Congratulations to your partner, it sounds like an honor, and a lot of work. To further your research, shouldn't you two get on-board with HollowEarth's research proposal to get totally smashed and make awful decisions? Be sure to post a shot-by-shot account here. [Taunt]
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Shigosei
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Good thing I wasn't asking your opinion, Icky [Razz]
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tt&t
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I handle alcohol very well. [Smile]

I like the taste (of some but not all), but I can choose whether or not to drink and how much to drink, and I know my limits really well. I would usually drink 1 to 2 glasses and unless I've eaten just before that I would get a bit of the "buzz" (and I do like that feeling). But my actual limit would be about 5 drinks - although I'm not falling down drunk, I would start to feel a bit strange. More than 7 and I'd be feeling sick, and I do not like throwing up from drinking at all, and haven't done that for many years, since I learnt the limits! I can't even remember the last time I even got close to having 5 drinks, but I do have 1 or 2 quite regularly, and I do enjoy it, especially with some cheese and crackers and good company.

In saying that, I have no doubt that I would immediately choose to rid the world of (drinking) alcohol as of tomorrow if this would stop the damage and deaths that it currently causes. But there are many other things I would like to rid the world of, and it's unlikely that any of it will happen...

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Lyrhawn
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I was going to comment on the original thread question, but I feel like I just walked into a gathering only to find the people within arguing, and prudence cautions me to slowly back out of the room before someone hears the floorboards creak.

But! I'll answer it anyway, prudence be damned!

Other than the occasional drinks at family holiday parties I never really had a drink before I was 19 (19 being the age around here that people start drinking since Canada is only a few minutes away), and after that I rarely did because even with Canada being so close it wasn't worth the hassle. When I turned 21 I tried to like beer, I really did, but after a couple years and trying different beers I sort of gave up. I found one beer, Franziskaner, that I really liked, but otherwise a sip of beer makes me gag, and though my brother calls it an acquired taste, I don't imagine it's worth the effort. Wine too I've never developed a taste fore.

Fruity girly drinks aren't bad, but I don't drink them (usually) for two reasons: 1. I'm always afraid of having my man card instantly revoked. And 2. Much more importantly, those things are wicked expensive and not worth it at all.

When I'm drinking to get drunk (which happens exactly once a year when I go camping in July), I drink Jaeger, which I find delicious.

Other than that I make a very yummy drink called rum slush (rum mixed with orange juice, iced tea, lots of sugar, lemonade, frozen over a couple days and then mixed with Sprite or 7-UP) that I've had a least a taste of since I was a kid, so I'll always like it.

For the most part, pertaining somewhat to the argument at hand, I don't drink that often (socially once in a great while) mostly because alcoholic drinks are just too expensive and I'm rather frugal about things like that. Still if there's a gathering of sorts amongst my friends and we're in a party mood I've been known to toss back a beer, sometimes even two! But the fact that I don't drink that often and I'm rather on the skinny side leaves me with a pretty weak tolerence. One shot of Jager or two beers and I'm probably not safe to drive for awhile until it wears off. I'm a lightweight, but hey, it also makes me a cheap date.

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ClaudiaTherese
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quote:
Originally posted by Morbo:
Congratulations to your partner, it sounds like an honor, and a lot of work. To further your research, shouldn't you two get on-board with HollowEarth's research proposal to get totally smashed and make awful decisions? Be sure to post a shot-by-shot account here. [Taunt]

*grin

It wouldn't go over well.

----

I have imbibed alcohol to the point of getting silly (in a disinhibited state, I am terribly cheerful, and that takes for me like one margarita), but I've never made a bad decision with consequences in such a state.

I did drink specifically to get drunk once, and that was to the point of throwing up, and that was alcohol poisoning. My mother had just told my brother and me that her breast cancer had reoccurred with metastesis, and he wanted to know what that meant. In her and our situation, it meant many bad things, and I had a keen sense of not wanting to be able to think that night for a period of time. We were with very close friends we had had for over fifteen years, one of whom as the designated driver was not drinking anything that night (actually, so was another), and they had offered to take care of us that night.

It was awful, horrible, and I'd never do it again.

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El JT de Spang
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quote:
Originally posted by Tresopax:
My claim, now modified from what it was intiailly, is that it is fine as long as you (1)don't use too much, (2)have the correct sort of intentions/motives for using it, and (3)don't feel a moral obligation to avoid something that causes the sort of damage that alcohol does to the world.

This is much better than your initial statement. I still disagree with it, however, because I'm not going to let you dictate which motives are the acceptable ones.
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Farmgirl
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quote:
Originally posted by ClaudiaTherese:

Edited agin to add: Alcoholics Anonymous, which is based on the abstinence model, works extremely well for some problem drinkers. However, it doesn't seem to work (for whatever reason) for most people who try it, even though it works very well for some. The numbers for Brief Intervention (the standardized harm reduction approach) are much better overall.

CT - As a member of Alcoholic Anonymous myself, I would love to see this data that you speak of. Because I can't wrap my mind around how a true alcoholic can ever consider "just learning about how to make better decisions when they drink" as opposed to not drinking at all. I can tell you that I can't drink without becoming drunk. My decision has to be made prior to the first drink, or else no good decision will be made at all.
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Tresopax
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quote:
I still disagree with it, however, because I'm not going to let you dictate which motives are the acceptable ones.
*I* don't dictate what motives are acceptable. Reality dictates it - and I can just offer my opinion on what reality is saying.
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El JT de Spang
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That doesn't even make sense. But, regardless, you're making a judgment about other's motives that's not yours to make.
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Dagonee
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quote:
I can't wrap my mind around how a true alcoholic can ever consider "just learning about how to make better decisions when they drink" as opposed to not drinking at all. I can tell you that I can't drink without becoming drunk. My decision has to be made prior to the first drink, or else no good decision will be made at all.
It's clear to me that AA was designed* by and for people who are in a similar situation to you. The distinction seems quite clear to me in the parts of the Big Book I've read.

I think a lot of people, though, have lost that sense of distinction - that is, they don't believe that it's possible to have a serious problem with alcohol and not be an alcoholic as defined in the Big Book.

*I'm using "design" for convenience to refer to how AA came to be.

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ClaudiaTherese
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quote:
Originally posted by Farmgirl:
quote:
Originally posted by ClaudiaTherese:

Edited agin to add: Alcoholics Anonymous, which is based on the abstinence model, works extremely well for some problem drinkers. However, it doesn't seem to work (for whatever reason) for most people who try it, even though it works very well for some. The numbers for Brief Intervention (the standardized harm reduction approach) are much better overall.

CT - As a member of Alcoholic Anonymous myself, I would love to see this data that you speak of. Because I can't wrap my mind around how a true alcoholic can ever consider "just learning about how to make better decisions when they drink" as opposed to not drinking at all. I can tell you that I can't drink without becoming drunk. My decision has to be made prior to the first drink, or else no good decision will be made at all.
Sure.

Note that you may be conflating "problem drinking" with just "alcoholism" (usually medically tied to "alcohol dependence," although used in a highly variable way colloquially). Most problem drinking is from binge drinking, not alcohol dependence, and that is where the primary burden of morbidity and mortality from alcohol lies.

Most people referred to Alcoholics Anonymous are not dependent on alcohol in the medical sense, and yet they may be problem drinkers. Brief Intervention is established as an effective tool for problem drinking without dependence (again, most cases of problem drinking), and it is being studied for use in dependent populations (e.g., those admitted for hospital treatment of alcohol dependence).

Cochrane [meta-]Review of Brief Intervention for problem drinking of alchol:
Effectiveness of brief alcohol interventions in primary care populations.

Cochrane [meta-]Review of Alcoholics Anonymous and other 12-step programs:
Alcoholics Anonymous and other 12-step programmes for alcohol dependence

AA and the abstinence approach is very useful for some people (as I noted as clearly as possible above), and you may well be one of those people. Brief Intervention appears by the research to be more helpful for more people longer term. That doesn't mean AA isn't right for you, just that the most effective standard referral for most patients with problem drinking is probably somewhere else.

---

Wikipedia article on BI for reference

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ClaudiaTherese
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Dagnabbit. And now Dagonee is dancing with me. [Wink]
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Dagonee
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[Big Grin]
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Jhai
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JT, I think that Tres believes in objective moral truth - that is, that there are actions which are wrong and actions which are right, and that these things just are by the nature of the universe. There a number of philosophical accounts as to the grounding of this moral reality. God often plays a large part. Personally I think that moral facts are similar to logical or mathematical truths, and tied up into the fabric of any logically possible universe.

Of course, there's lots of argument regarding how to know/learn moral facts - which is Tres is referring to when he says that he "can just offer [his] opinion on what reality is saying."

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Dagonee
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CT, can you clarify what you mean by "morbidity" in "that is where the primary burden of morbidity and mortality from alcohol lies"?

I know it means incidence of disease, but it's not clear to me which incidents are included in your statement.

I assume things like cirrhosis would be included. Would STDs acquired during careless drunken behavior? How about trauma from alcohol-caused accidents?

And does it include social harms (job loss, marital problems, etc.)?

I'm probably asking a question with a very obvious answer.

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ClaudiaTherese
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quote:
Originally posted by Dagonee:
CT, can you clarify what you mean by "morbidity" in "that is where the primary burden of morbidity and mortality from alcohol lies"?

I know it means incidence of disease, but it's not clear to me which incidents are included in your statement.

I assume things like cirrhosis would be included. Would STDs acquired during careless drunken behavior? How about trauma from alcohol-caused accidents?

And does it include social harms (job loss, marital problems, etc.)?

I'm probably asking a question with a very obvious answer.

Sure. Brief answer: includes all of those negative sequelae of illness, which is often (now) taken to include associated ills, such as the burden of side effects of treatment. Often used within public health to include financial costs, etc.

Different people may use the word with a more or less restrained definition, and it's usually apparent from context. For example, "morbidity rate" usually just refers to the occurrence of the disease itself.

Good question, certainly. In this case, I'd be happy to substitute "negative sequelae" for "morbidity and mortality." [and have that include trauma, STDs, unwanted pregnancy, and the rest of what you indicated]

---

On a side note, Brief Intervention is not primarily about learning how to make better choices after you start drinking. It is primarily about the choices made and understanding of yourself and the consequences of your decisions before you start drinking. For some, the best choice is not to start at all -- but for most problem drinkers, the path to get to the most effective not-drinking-state is not the 12-step one, but a different sort of process. At least, according to the research, which does show (IIRC) that AA is very effective for some subgroups of people, and that is great, too. [Although identifying in advance who would fall into that group isn't easy. It's hard to find a definition of "alcoholism" that fits just that group without being tautological: i.e., "you are the sort of drinker who would be benefitted by AA, because that is the sort of drinker you are."]

[ December 18, 2007, 11:34 AM: Message edited by: ClaudiaTherese ]

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The Rabbit
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CT, I understand that some people have a genetic defect in the enzymes that process alcohol. Some are even missing the enzyme completely. This defect causes alcohol to remain in their blood stream for a much longer period of time so that they get drunk with very little alcohol and stay drunk for a longer time. I have read that people with this defect have a very strong predisposition to becoming alcoholics and that people who have this genetic defect (particularly those who are completely missing the enzyme) can never really drink responsibly.

Are you aware of any studies that look at various alcohol treatment programs specifically for this subset of alcoholics?

I ask this in part because this defect is particularly common in many native american tribes include Inuit or Eskimo groups in the Northern Canada. Since alcoholism is a serious problem in this problem, it may be worthwhile for your partner to look specifically at programs that work for this subset of alcoholics.

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Dagonee
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Thanks for the info, CT.

I've heard of what Rabbit just wrote about, including the greater chance of alcoholism in such people.

But, I've also heard that an unnaturally high tolerance to alcohol (before one would normally develop a high tolerance through heavy drinking over time) can indicate a greater likelihood of alcoholism. Anecdotally I've found this to be true, although I obviously don't know a statistically relevant sample.

Any thoughts on why both extremely low and extremely high tolerances seem to indicate such a greater likelihood? The dichotomy never struck me until today.

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FlyingCow
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quote:
And don't put comments on other threads along the lines of "This is the first time I agree with him!"
But it's so rare! [Big Grin]

I do this with Lisa, too, btw. It happens rarely enough that it is shockingly noticeable to me. I will refrain from now on, though.


quote:
So, I don't see how any of this justifies taking my posts any less seriously than anyone else who is giving their opinion on a serious topic.
I try not to take anyone's posts seriously in the sense that I get upset about them and dwell on them outside of hatrack. I used to - and our arguments in years past have driven me to - but I try not to any longer.

I do take them seriously in the sense that I weigh the argument at hand before responding. I think that's just a semantic difference though, and I should find another word to use for the former.

quote:
But more importantly, (and this is not directed at anyone in particular) if you don't wish to take my view seriously, just skip over it and leave it be. Don't jump in with a one-line insult that adds nothing to the thread (and distracts me from people who are asking real questions). Don't skim over my post and then respond against whatever strawman position you think I probably am taking.[quote]

I try not to do this, either, though I admit that I may be guilty of it in the past.

[quote]Don't go to sakeriver or elsewhere and complain about me, as if it isn't on the internet where everyone can see it.

Since I don't post anywhere else, I'm going to assume this isn't directed at me.

quote:
If you or others feel that you are banging your head against a wall, I suspect the reason is because I sometimes don't, in the end, accept what you consider to be the common sense truth.
The "banging my head agianst the wall" bit is not because we disagree, really. It's mostly because of arguments based purely in theory without concern for actual practice - but also because of tangential questions picking at a small aspect of a larger argument without addressing the larger argument itself.

Though the endless questioning of premises does get old, too.


I do apologize if at some point over the last 6 years that I have offended. I will, in the future, do my best not to.

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