Controversy Grows Over ‘Moderate’ Drinking

Roger Vogler has opined, in interviews and talk shows, about holiday drinking so often that he has a sheaf of papers specially prepared for such occasions, summarizing what hosts and guests can do to get through this time of year as safely as possible.

As such, with appearances on television and radio and in newspaper and magazine interviews, the Pomona College psychologist has emerged as a key spokesman in what seems to be a new national emphasis on “moderate” drinking.

Just as quickly as this is happening, though, a controversy of sorts has opened up. Critics contend that trying to define such amorphous terms as moderate or socially responsible drinking is pointless and that the new attention to the concept is little more than finding ways to rationalize alcohol abuse.

Industry Promotion

The main alcoholic beverage industry group, the Distilled Spirits Council of the United States, has joined in the fray, distributing a holiday season press kit noting that the council has, for years, “promoted safe, responsible, moderate consumption of alcoholic beverages for those who choose to drink.” The industry campaign also draws on a small number of research studies that have tentatively linked moderate drinking with modest health benefits.

In response, a quartet of alcohol abuse experts published a letter in the Journal of the American Medical Assn. criticizing the new emphasis on moderation and health as a canard, warning that “the scientific community and the media should rebuff attempts . . . to exploit these research findings.”

Among those signing the letter was Dr. Jokichi Takamine, a Los Angeles alcohol abuse expert, who discussed his views in an interview.

“Just the other day,” Takamine said, “I heard one guy on some television show pooh-poohing alcoholism and saying crack (cheap street cocaine) is the big thing (in terms of abuse potential).

“But other drugs come and go and alcohol keeps running like the Mississippi River.”

Vogler doesn’t argue the point about alcohol’s pervasive role in society. But in his media appearances and in “The Better Way to Drink,” a book he first published in 1982, Vogler has become a champion of the contention that drinking in moderation can be learned behavior and that most alcohol abuse isn’t a sickness at all, just bad behavior that can be corrected. The book was written in concert with Sacramento psychologist Wayne Bartz.

Vogler argues that, except for a small number of extreme alcohol abusers, the notion that there is a disease called alcoholism is inaccurate, a point on which he comes into direct conflict with much of mainstream alcoholism therapy--most notably Alcoholics Anonymous, a spokesman for which declined to discuss Vogler and his work.

Sitting in his office at Pomona College’s Claremont campus, Vogler rifled through his special holiday drinking file, expanding on tidbits uncovered as he went.

Vogler’s ideas about moderate drinking are predicated on the objective of drinking so as not to exceed a level of alcohol in the blood of .055%--a little more than half the .10% alcohol content necessary to be presumed guilty of drunk driving. A .20 blood alcohol level would connote extreme drunkenness and a level of .50 could mean coma or death.

Drinking and party-going behavior, then, Vogler said, should be predicated on means to stay within the .055 limit--a level of alcohol influence that stops short of the feeling most people would equate with being tipsy or drunk but recognizes that perhaps the main reason humans use alcohol is to feel a little high.

Staying within the limit may be a little trickier than it would seem at first flush, though, Vogler said. In studies that he and his research associates still have not published, Vogler said he has confirmed that one’s awareness of an alcohol high is subject to what is called an “adaptation” response similar to the body’s reactions to odors, taste and strong illumination.

In that sense, Vogler said, just as a light seems brightest to the eye when a lamp is first turned on or a kitchen filled with the odor of garlic is at its most pungent when it is first entered, the alcohol high is freshest and most enticing when it is first achieved. If a drinker continues to drink and pushes his or her blood alcohol level above .055%, Vogler said, the higher high won’t feel materially better and the descent past .055% again will seem a far different, definitely worse sensation than the same level when it was first reached.

“You are definitely going to feel more euphoric (when you first reach .055%) than when the same blood alcohol level is reached on the way (back) down,” he said. “Pay attention to it.”

Drinking Strategy

So if this is all true, Vogler said, a person’s drinking strategy now--or at any other time of the year--should be formulated with the adaptation phenomenon and the blood-alcohol objective constantly in mind. By paying attention to the time that has passed since drinking began and a precise count of the number of drink equivalents that one has consumed, Vogler said, a party-goer can precisely control his or her level of intoxication, making allowances for how much to drink, how fast, based on his or her body weight.

A “drink” means one 12-ounce beer, a four-ounce glass of table wine (if you don’t know how much your wine glasses hold, Vogler advises filling them with water and pouring the water into a measuring cup to find out), 2 1/2 ounces of fortified wine (sherry or port, for instance), or a 1-ounce serving of hard liquor, straight or with mixers.

Tables developed for the book show that, for a 110-pound woman, for instance, just two drinks in the first hour of a party would bring the individual close to the .055% limit. But a 170-pound man could have three drinks and be at the same blood-alcohol level. For someone who weighs 240, the drink limit could increase to as much as five in the first hour.

In party situations, both hosts and guests should have a “game plan” for drinking, Vogler said, that takes these factors into account:

Have Food Available

- Hosts should make certain that food is available at any social function from the moment guests arrive. Not only does having something in the stomach impede intoxication, eating can be a distraction that prevents people from drinking as quickly--or as much--as they otherwise might. Interesting nonalcoholic beverages, from exotic fruit juices to fashionable designer water drinks, should be easily accessible. Hosts should also try to plan for diversions, like singing and dancing, to take people’s minds off drinking.

- If a meal is to be served, a non-alcoholic beverage--water is an excellent choice--should be included. Guests should be made to understand that it is not necessary to have a drink constantly in their hands. They should be encouraged to put their glasses down if they don’t want anything more to drink, and it should be socially acceptable to decline another round if it is offered. “You don’t have to hold that glass all night,” said Vogler. “It becomes like a security blanket. With a glass in your hand, you know your chemicals are right there.”

- If a group of people is going to the same party together, one person should refrain from drinking to eliminate any uncertainty over the safety of the drive home. A host should go over his or her guest list, identifying anyone on it who may be inclined to drink too much. If necessary, the host should call possible problem guests in advance and make sure that they understand they can stay the night if they should not drive after the party or that they have made alternative transportation plans.

Host Intervention

- A host should not hesitate to politely intervene with a guest who is drinking too much, too fast. To avoid an unpleasant confrontation, the host may want to have another guest join him to make it clear to an inebriated person that his or her safety and well-being is of significant concern.

- Guests and party givers should set personal alcohol consumption limits before the party and know enough about drink equivalents to be able to stay within them. If necessary, a person can even carry a piece of paper on which to keep track of the number of drinks and the time period in which they have been consumed.

“I think people need to be aware of their propensity for overdrinking during the holidays in general and at specific occasions, like office parties, family gatherings and New Year’s Eve,” said Vogler.

“Americans make the mistake of regarding alcohol as something that it is OK on occasion to use to excess. And they use that as an excuse for unpleasant, overbearing kinds of social behaviors.

“I think that is a big mistake. There is an attitude that, if you’re drinking, you can be excused for your misbehavior. Europeans are not like that. Americans really do cut loose and go for the gusto and, when that happens, they’re not fun to be around.”

Ideas Controversial

But Vogler’s ideas about drinking in moderation are not without controversy among his colleagues in the field of alcohol research.

Dick Bast, research manager at the federal government’s National Clearinghouse for Alcohol Information, noted that what moderation is and how it may be achieved is an amorphous question.

“We really can’t define moderate drinking,” said Bast. “Even the liquor industry can’t say for sure (what it is) because we don’t know.”

That is at least in part what bothers Takamine, who called the semantics of drinking little more than “word games” in which social scientists have tried to employ terms like “moderate,” “socially responsible” and “disciplined” drinking, all to no avail because, on reflection, the terms themselves are meaningless.

“It (the idea of identifying ‘moderate’ drinking) can be used by a lot of people who will say, ‘This (concern about overindulgence in alcohol) doesn’t apply to me, I drink moderately.’ ”

But Takamine isn’t a teetotaler, either--which may only serve to emphasize the quandary of trying to advise people on how much they can drink without doing any harm. “I’m not anti-drinking,” he said, “except for three individuals: the pregnant woman, the alcoholic and the person behind the wheel.”

These charts show combinations of time elapsed since drinking began and number of drinks consumed and blood alcohol levels for people of different sizes. Blood alcohol values are the numbers in the central columns of the chart and can be extrapolated to more familiar percentages. For instance, the blood alcohol level of a 170-pound person who had six drinks in the first hour is 110, or .11%, which is just over the legal minimum to be convicted of drunk driving. 110-pound person

Hours since Number of Drinks start of drinking 1 2 3 4 5 6 7 8 9 10 1 15 50 85 115 150 180 215 245 280 315 2 0 35 70 100 135 165 200 230 265 300 3 0 20 55 85 120 150 185 215 250 285 4 0 5 40 70 105 135 170 200 235 270 5 0 0 25 55 90 120 155 185 220 255

170-pound person

Hours since Number of Drinks start of drinking 1 2 3 4 5 6 7 8 9 10 1 5 25 50 70 90 110 135 155 175 195 2 0 10 35 55 75 95 120 140 160 180 3 0 0 20 40 60 80 105 125 145 165 4 0 0 5 25 45 65 90 110 130 150 5 0 0 0 10 30 50 75 95 115 135

Source: “The Better Way to Drink,” Roger Vogler and Wayne Bartz. Simon & Schuster, 1982, and New Harbinger Publications, 1985.