Why we drink, despite regrets the next day and the next and the next…

As Dry July came to an end a couple of months ago and many Australians finished up their month of sobriety isn’t it time we look at why Australians find it so difficult to stop or reduce drinking alcohol?

Why, when we wake up with a headache, embarrassed about the things we did the night before and vow we’re “never drinking again” is it so hard to actually give up or reduce consumption?

Most of us know the health risks, know that alcohol kills nearly 6000 Australians every year from disease alone. And maybe you even know of the links between cancer and alcohol, though if you do, you’re in the minority – only 39 per cent of Australians are aware that alcohol is a class 1 carcinogenic, that it causes cancer.

Alcohol causes eight different types of cancer: breast, bowel, stomach, mouth, pharynx, larynx, oesophagus and liver cancer and is responsible for five per cent of the total cancer burden of disease in Australia.

So why, with all that we know about alcohol, do we continue to drink, some of us to excess, many beyond the levels we set for ourselves, for example at the beginning of the night?

Those that have taken part in Dry July, or other similar months of sobriety, know how difficult it is give alcohol away for any length of time. And it’s not surprising that it’s such a challenge, when you look at the psychology behind our use of alcohol.

The early years

For most of us, our association with alcohol starts young, very young. By the age of three or four we’re already socialised in the ways of adult drinking.

Our studies at the Centre for Alcohol Policy Research reveal that children as young as three were able to identify whether or not a drink contains alcohol by smell or sight¹.

Children as young as four know what emotional changes are expected to occur when we drink². Interestingly, girls were more likely to agree that adults became quiet, calm or relaxed when drinking alcohol. We think this is because they are generally more sensitive to emotions than boys.

So, by the age of four, we are beginning to understand that adults drink, and that they often do so at social events³. At that age, many children are aware that adults drink with friends to have fun and to relax. Most kids know alcohol is not for them, that it is a drink purely for adult consumption. And that when they grow up, they will get to drink alcohol.

They learn that whenever there is a party that’s good, people have fun and alcohol is involved. And so, kids grow up associating alcohol consumption with socialising and having a good time.

For the next ten years, children continuously observe their parents, their aunties and uncles, their grandparents but also other adults on television, in bars and restaurants, at public parks on weekend afternoons, at footy games and in movies and advertisements – all occasions and circumstances in which drinking alcohol is commonplace. Over ten years, the convivial nature of alcohol is learned and reinforced – that’s a long time, particularly when growing up.

The teenage years

When we reach our mid-teens, after years and years of observation and exposure, there is eagerness to try alcohol eventually, even if it is only to show that we have reached adulthood for ourselves.

The trouble is that in adolescence our brains become a big building site, where everything is restructured. Neurologically, the differences in the maturation of the prefrontal and limbic systems and the remodelling of dopaminergic pathways – the rebuilding of the brain in preparation for adulthood – makes risk taking appear more rewarding for adolescents than is the case among children and adults⁴. This restructuring is important as it helps prepare teenagers for their next stage in life, but it also means their brains are not fully developed – building is still underway. As a result, teenagers need a larger amount of stimuli for their brains to register any effect and drinking large amounts of alcohol can provide this function. And at the same time, the areas of the brain responsible for impulse control and self-restraint are lagging behind in their development. In other words, while they need a greater amount of stimuli to produce an emotional response, their impulse control and self-restraint is still underdeveloped.

But we know, alcohol provides other functions too. Alcohol can lower inhibitions, increase self-confidence, making socialising easier, effects that teenagers may have observed among adults all those years before.

If they perceive the various psychosocial effects when drinking alcohol as positive they tend to repeat these experiences over and over again for the next ten years or so. As adolescents grow into adults they may also test the boundaries of alcohol, drinking more and more each time to lower their inhibitions and to get greater stimulation.

And so for 20 years, our brains learn again and again to associate drinking with fun and an ‘adult’ thing to do, with parties, camaraderie and convivial times and with alleviating stress and sadness.

A habit

The first time we try alcohol is more or less a conscious decision to do so, that is we may accept an offer from a friend, driven by curiosity, circumstances, the wish to demonstrate becoming an adult, the need to relax and so on. However, as the behaviour is reinforced hundreds and hundreds of times the effects we perceive as positive in the short term by ignoring the long-term adverse effects of drinking becomes a conditioned response.

This means that like Pavlov’s dog an even distant stimulus is sufficient to trigger our desire to drink and the according action without being aware of it. In this way, people have already ordered their drink before even entering the bar after work with their colleagues simply because of the bar setting; the social company and the desire to calm down after a hard day all trigger the decision without us even being aware of it. It’s the same when you go to a sports stadium. Most likely, you will buy and drink the same beverage as the person next to you and the same drink the adult had when you went to see the game as a little kid.

Alcohol sponsorship is playing the same game. We don’t need an explanation to know what the VB on the cricket player’s shirt stands for or what the red man with the cylinder hat and the walking stick is about. It is all about the conditioned response that pushes us to grab the bottle or glass.

It’s such a strong response, that even though we may drink too much and embarrass ourselves horrendously, even though we may spend the next day feeling physically sick, the next time we think of alcohol, or even just see the same green as a Dutch beer brand, or the shape of a champagne glass, we’ll remember the fun times we had. We’ll immediately think of the social events, the laughing, the feeling of increased confidence we experienced ourselves or saw in the advertisements so often.

Our conditioned response is that immediate response, the fun, the relaxation; the negative effects, the hangover and even the potentially embarrassing behaviour come too late to form part of our conditioned response.

We’ll have forgotten all about the ill side effects that might come later in the night or the following day.

After a while, our decisions around alcohol become a natural part of our response system, just like walking which we learned when we were very young, the process becomes automated⁵.

So how do we fight 20 or more years of conditioning?

Since alcohol consumption appears omnipresent – in bars, stadiums, parties, barbecues, celebrations at work, when friends are over– we excuse ourselves and others for drinking too much on a single occasion.

However, if we are honest with ourselves – when do we really stick to the National Health and Medical Research Council guidelines of drinking no more than two standard drinks on any day, knowing that most alcoholic beverages we buy or serve contain more than a standard drink?

Often ‘social’ drinkers think they can stop or reduce their alcohol consumption if they wanted to, but never try.

Shouldn’t we be more mindful about our drinking? Wouldn’t it be a good idea to assess how and why you use alcohol now?

We teach kids to think before they act, but when it comes to alcohol, it’s probably a good mantra for adults as well.

At the end of the day alcohol consumption is often a habit. For most, it may not be as addictive as nicotine, but the conditioned psychological effects are also very resistant to change. In this sense, a lot more people are ‘addicted’ to alcohol than we would think. People will say “I could give it up tomorrow”, and believe they are choosing not to.

But few people actually reduce their drinking permanently to stick to recommended guidelines or give it up completely even only for a month or so, despite the harm it is shown to cause.

Also, know what you are seeking from alcohol, why you are drinking. Is it to overcome something? Is there an underlying issue that could be better addressed by seeing a counsellor?

Like any habit, the secret is to be aware and not doing it simply out of habit.

[1] Voogt, C., Beusink, M. Kleinjan, M., Otten, R., Engels, R., & Kuntsche, E. (2017). Alcohol-related Cognitions in Children (aged 2-10) and How They are Shaped by Parental Alcohol Use: A Systematic Review. Drug and Alcohol Dependence, 177, 277-290.

[2] Kuntsche, E. (2017). “Do grown-ups become happy when they drink?” Alcohol expectancies among preschoolers. Experimental and Clinical Psychopharmacology, 25(1), 24-30.

[3] Kuntsche, E., Le Mével, L. & Zucker, R. A. (2016). What do preschoolers know about alcohol? Evidence from the electronic Appropriate Beverage Task. Addictive Behaviors, 61, 47-52.

[4] Steinberg, L. (2008). A social neuroscience perspective on adolescent risk-taking. Developmental Review, 28(1), 78-106.

[5] Wiers, R. W., & Stacy, A. W. (Eds.). (2006). Handbook of implicit cognition and addiction. Sage.