Recipe for Longevity: Social Drinking or Just Going to AA?

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We’re so used to thinking of pleasurable things as “sinful” and “bad for you” that when the popular media, or science for that matter, attempts to validate our guilty pleasures — such as my colleague John Cloud’s excellent piece about recent research showing that heavy drinkers outlive teetotalers — skepticism runs high.

Cloud’s argument is that it’s not drinking per se that leads to longevity, but social drinking. He writes: “Heavy drinkers are less likely to die than people who don’t drink, even if they never had a problem with alcohol. One important reason is that alcohol lubricates so many social interactions, and social interactions are vital for maintaining mental and physical health.”

Today, on the Frontal Cortex blog, Wired writer Jonah Lehrer put forward his thoughts on the matter, expanding on Cloud’s suggestion that greater social connection is what benefits drinkers in the long run. He writes:

Alcohol is a delightful social lubricant, a liquid drug that is particularly good at erasing our interpersonal anxieties. And this might help explain why, according to the new study, moderate drinkers have more friends and higher quality “friend support” than abstainers. They’re also more likely to be married.

What does this have to do with longevity? In recent years, sociologists and epidemiologists have begun studying the long-term effects of loneliness. It turns out to be really dangerous. We are social primates, and when we’re cut off from the social network, we are more likely to die from just about everything (but especially heart disease).

So, that got me to thinking: could the life-extending benefit of drinking be extended to nondrinkers, minus the alcohol? For instance, couldn’t AA’s social network offer similar health advantages to teetotalers?

The reasoning here is that abstainers are on the whole a lonelier and more depressed bunch, compared with their tippling peers (though, again, there are exceptions to every rule: many abstainers don’t drink for religious reasons and still have strong social networks through church). Lehrer notes a spate of recent research connecting loneliness and lack of friends and family to higher risk of illness and death. One major study even found that loneliness may just as bad for your health as smoking. That helps explain why the harm done by staying home alone may be greater than that from binging in bars.

Lehrer continues:

I think that in the rush to decipher the bodily molecules, we are missing the essential lesson, which is that some of the most valuable health benefits don’t come from compounds that can be bottled, or condensed into a gel capsule. Instead, they come from other people, from those lovely conversations we share over a glass or three of wine.

But this has interesting implications for people with alcohol or other drug problems. If social connections — not booze itself — really are the key to longevity, then the most popular and most befriended members of Alcoholics Anonymous should be protected from at least some of the negative health effects they’ve otherwise racked up through years of problem drinking.

If such an AA effect exists, however, it wouldn’t necessarily be found in studies of heavy drinkers versus teetotalers because, contrary to public perception, most nondrinkers — even those who used to be alcoholics — are not AA members.

Research already shows that social support — whether from AA, friends or family — is critical to recovery. So, it would be fascinating to compare health outcomes or mortality rates in isolated heavy drinkers and highly connected AA members. If Lehrer and Cloud are right, the AA members should be the thriving ones.

Incidentally, another possibility that hasn’t been much considered in the debate over whether heavy drinking really is a boon to health is that the recent study [pdf], published in Alcoholism: Clinical and Experimental Research, included only people who were 55 or older. As a result, heavy drinkers who died early — in car accidents, bar fights, falls, alcohol poisonings, from liver disease or other alcohol-related incidents — would not have been captured by the research.

So, the real conclusion might be not that heavy drinking increases longevity — only that if you’re a heavy drinker and you make it to 55 without being killed by it, you’re probably a hardy survivor for other reasons, possibly social ones. Nonetheless, even this may not explain the results because other research finds that the leading killer of alcoholics is cigarette smoking, to which people typically succumb in their 50s or later.

Getting back to the original point, perhaps a study of socially connected AA members and isolated drinkers — controlling for smoking — might eventually help solve the puzzle.

Not to mention eliminating a rationalization for relapse!

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