Given the drinking is so disapproved an activity nowadays, what can be said about drunkenness? Harkening back to the Talmud (the Jewish holy book) admonition to Jews (a group known for moderate drinking since antiquity) that, on Purim, "You should drink until you don't know the difference between 'Cursed is Haman (an archetypal enemy of the Jews), Blessed is Mordechai'," Stanton here shows that there has always been a role for drunkenness, and there remains one. Recognizing some human urge for drunkenness gives public health a leg up in dampening its worst excesses. But, in any case, intoxication will always remain a regular part of human experience.
International Center for Alcohol Policies, Website: Invited Opinion, May, 2001 <http://www.icap.org/invited/opinion_peele.html> (reprinted with permission).
The End of Drunkenness?
Throughout history, in the United States and other societies, drunkenness has been accepted as ineradicable, even necessary and beneficial in some circumstances. Various cultures establish niches, sometimes referred to as "time-outs," that permit alcohol intoxication but at the same time limit and control it. This tolerance and quasi-approval are being withdrawn in the current atmosphere towards alcohol in the U.S. Something may be lost in this movement, however. Even in regards to preventing and remedying alcohol problems, an extreme intolerance for intoxication can be counterproductive because it ignores a reality, rather than softening its impact.
Once drunkenness was tolerated, even recognized as a social custom. Americans often regarded drunkenness in a bemused light. Recall that the Roman god of wine and revelry, Bacchus, was depicted as a merry drunk in the Disney feature cartoon Fantasia when it was originally released in 1940. This attitude has shifted radically in the last several decades.
The Persistence of Drunkenness
Although acceptance of or tolerance for drunkenness has largely evaporated, drunkenness has not disappeared. Indeed, it has actually increased among some populations including American college students. Henry Wechsler, of the Harvard School of Public Health, has been studying binge drinking on U.S. campuses since 1993. Such drinking is commonplace 44 percent had binged (5 or more drinks at a time for men, 4 or more for women) at least once in the prior two weeks in 1999. By 1999, furthermore, the percentage of students who frequently binged had increased significantly (to 23%). Among those who drink, a majority in 1997 (52%) said a major reason to do so was "to get drunk" up from 39 percent in 1993.
There are other groups, times, and places where drunkenness is expected for example, at pre-wedding bachelor parties. These all-male (and sometimes all-female) assemblages seem to feel it is obligatory to have one last binge before tying the marital bond. Other settings in which intensive or binge drinking may be required are marriage, birth, or death celebrations (such as the bouts that accompany the jazz processions following interments in New Orleans, or at Irish wakes).
The New Temperance Public Health Versus Drunkenness
The U.S. is in one of its periodic cycles of disapproval of alcohol and drinking. That is, beginning in 1980, American alcohol consumption declined precipitously (a decline that has leveled off, but has not reversed itself, since the mid-1990s). Opprobrium is attached to heavy drinking across the board including massive efforts to discover and resolve the sources of alcoholism, as well as to reverse heavy drinking among young people from adolescence through their twenties.
In this process, sometimes moderate social drinking is held out as a possible alternative sometimes it is not. But the idea that sometimes drunkenness will occur and may even serve a function has disappeared. Today, to get drunk ever is to invite a negative diagnosis, and certainly disapproval. To put it another way, modern public health and public opinion generally recognize no positive role for drunkenness.
We can extend this point even further American public health now focuses on drunkenness, whether occasional or otherwise, even more than on alcoholism. For instance, public health specialists point out, a large proportion of accidents and other negative drinking outcomes occur due to the occasional drunkenness of nonalcoholic individuals.
But these specialists have become so intolerant of drunkenness that they seemingly cannot accept that it will ever occur, or deal with it when it does. That is, in the field of drug abuse, public health has largely embraced an approach called "harm reduction." This model recognizes that illicit drug use and abuse will never disappear entirely, and that fallback positions are required to protect the health of those who continue to use these drugs, including those who are addicted.
The best-known of these approaches involves distributing clean needles to heroin addicts in order to prevent them from becoming infected with HIV. Alternately, addicts are switched to substitute drugs that they do not inject methadone therapy is one example. These steps are taken not only for the benefit of the addict public health improves when the spread of AIDS is curtailed.
But we seem not to be able to develop a similar approach for alcohol. Such an approach reckons that, although some people continue to drink excessively, they deserve to live and to be protected. Harm reduction techniques would include making sure that drunkards have sufficiently nutritious diets, or are protected from the elements, or can enter protected environments when they drink. A protected environment for drinking would also mean that drunks would not endanger others most especially by driving drunk.
Today, these ideas seem impossibly radical "Why encourage drunkenness?" the objection would be. Yet, in 1981, the prestigious National Academy of Sciences published a symposium on alcohol problems that called for making the world safer for, and from, drunkards as one approach to preventing alcohol problems. But, today, nothing that is seen to tolerate drunkenness has a chance even to be discussed, let alone to be adopted as public policy.*
(*Some might say that MADD Mothers Against Drunk Driving recognizes drunkenness will occur and suggests providing for alternate transportation home for those who have been drinking. Although this is in fact a harm reduction approach, MADD has become increasingly oriented towards preventing drunkenness itself, rather than protecting people from their own and others' drunkenness.)
Harm reduction is implemented in the case of drugs not simply for reasons of humanity; rather, the approach is justified as offering cost-effective ways to prevent morbidity and mortality. Likewise, the case for accepting and working with drunkards or individuals who occasionally get drunk might be that to do so is to recognize and deal more effectively with an ineradicable reality. In contrast, the predominantly zero-tolerance approach taken to fight binge drinking on college campuses has been a bust "Efforts to curb excessive drinking on college campuses fall short," newspaper headlines announced when the latest collegiate binge-drinking study was published. Researcher Wechsler's reaction: "My disappointment is, given all the action on college campuses to deal with this problem. . ., the fact that it has stayed so remarkably stable shows what a difficult problem it is."
The Social Custom of Drunkenness
Students of human culture have noted that drunkenness is often built into social custom. That is, even in societies or groups where alcohol is typically consumed moderately or rarely room is allowed for feasts or revels in which general drunkenness occurs. The classic description of this phenomenon is the book "Drunken Comportment: A Social Interpretation," by MacAndrew and Edgerton. These researchers examined drunken episodes cross-culturally and determined that these typically occurred within tightly regulated social boundaries. How people acted when drunk was consistent within a given society, but varied tremendously from culture to culture suggesting that drunken behavior was socially constructed.
In this model, drunkenness often serves as a social release as an agreed-upon "time out" from ordinary social constraints. Nonetheless, when drunk, people were not forgiven all social obligations. Certain behaviors were still forbidden for example, incest taboos were observed in native tribes during drunken orgies, even when relationships were defined in such complicated ways that Westerners were not able to comprehend them. Anthropologist Dwight Heath described drinking among the Bolivian Camba, who once a month or so gathered as a village to drink themselves into a stupor while never acting out against one another.
Indeed, drunkenness seems to have been a well-accepted part of drinking in American society, especially before the industrial revolution. In the Colonial period, Americans drank about three times as much per capita as they drink today. This drinking generally took place in tightly regulated social environments, and antisocial acting out was not tolerated rather, it was strongly disapproved. According to historian Harry Gene Levine, "The 'liquor problem' was not a public issue or fact of consciousness in colonial America. In the 17th and 18th centuries. . . , . . . [a]ll liquor was regarded as good and healthy.... It was drunk at all hours of the day and night, by men and women of all social classes, and it was routinely given to children." Drunkenness often resulted but it nonetheless did not fall outside the social constraints on drinking behavior.
More recently, in America and other societies, ritualized drunkenness occurs during certain celebrations, or get-togethers, or commemorations of shared experiences. School alumni, or work colleagues, or people who have collaborated to reach a goal or achieve an award drink together, sometimes or often to excess, in order to forge a common identity. The need to transcend individual boundaries, to feel part of a larger group or experience, is one often associated with drinking and heavy drinking. People often speak of these episodes as key experiences in their lives, even years and decades after they took place.
Even groups historically noted for their moderate drinking such as the Jews apparently have a place for drunkenness. Wine has been a part of sacrament and prayer in Judaism since biblical times. According to the "Virtual Jerusalem" website, in Judaism, "alcohol is a sober pleasure. We appreciate the fact that it gladdens the heart, and include it in all our festive occasions. What would Pesach (Passover) be without the four cups? Or Shabbat (sabbath celebration) without kiddush (a glass of wine)? Every holiday, and personal occasions like weddings and Britot (circumcisions) include a kiddush (as, of course, do many other religions)."
The site notes, however, that "to get drunk is 'not Jewish' at all, and is condemned strongly by the sages." Yet, although Jewish temperance (meaning moderation) has been noted since biblical times, this too has exceptions. The site describes Purim as the holiday in which "Everyone gets drunk, eats a bunch of food and walks around in crazy costumes while making a lot of noise and beating an effigy." According to virtual Jerusalem, "The Talmud (the guiding Jewish holy work) which normally presents a particularly severe view of intemperance features a strange statement about Purim (another Jewish holiday) 'You should drink until you don't know the difference between "Cursed is Haman (an archetypal enemy of the Jews), Blessed is Mordechai".' "
There seems to be a drive toward drunkenness (as identified in Ronald Siegel's book, "Intoxication") as a way of transcending ordinary experience, of fusing one's identity with a larger social unit, or as just plain fun. Whether the urge for intoxication is inherent or irresistible or not, drunkenness nonetheless seems to be a commonplace human experience. There is a long history of such behavior, it is almost universal across societies, and it persists despite efforts in our society to extirpate it (especially among the young). As Andrew Weil points out in "The Natural Mind," even quite young children twirl around until they achieve an altered state of dizziness. Yet, in contemporary America, we are having trouble accepting and managing this experience. For individuals whose drunkenness is habitual and obviously harmful, some have recognized a need to quarantine and protect the drunkard. That this is not likely to be made a part of public policy (certainly in the United States) expresses a particular attitude towards drinking at this time and place. Whether it is a realistic, or optimal, attitude can be questioned.
Heath, D.B. (1991). Continuity and change in drinking patterns of the Bolivian Camba. In Pittman, D.J., and White, H.R. (eds.), Society, Culture, and Drinking Patterns Reexamined. New Brunswick, NJ: Rutgers Center of Alcohol Studies, pp. 78-86.
Levine, H.G. (1984). The alcohol problem in America: From temperance to alcoholism. British Journal of Addiction, 79: 109-119.
MacAndrew, C. and Edgerton, R.B. (1969). Drunken Comportment: A Social Explanation. Chicago: Aldine Publishing Company.
Room, R. (1981). Reducing environmental risks. In Moore, H., and Gerstein, D.R. (eds.), Alcohol and Public Policy: Beyond the Shadow of Prohibition. Washington, DC: National Academy Press, pp. 100-111.
Siegel, R.K. (1989). Intoxication: Life in Pursuit of Artificial Paradise. New York: Dutton.
Virtual Jerusalem. Drinking on Purim. Located at http://www.virtualjerusalem.com/holidays/purim/drinking.htm.
Wechsler, H., Davenport, A., Dowdall, G., Moeykens, B, and Castillo, S. (1994). Health and behavioral consequences of binge drinking in college: A national study of students at 140 campuses. JAMA, 272(21): 1672-1677.
Wechsler, H., Molnar, B., Davenport, A., and Baer, J. (1999) College alcohol use: A full or empty glass? Journal of American College Health, 47(6): 247-252.
Wechsler, H., Lee, J.E., Kuo, M., and Lee, H. (2000). College binge drinking in the 1990s: A continuing problem. Journal of American College Health, 48(10): 199-210.
Weil, A. (1986). The Natural Mind: An Investigation of Drugs and the Higher Consciousness. Boston: Houghton Mifflin.