This is in a different measurement from a casual understanding of 6 drinks. It’s 6 daily alcohol units. UK’s NHS alcohol calculator says 2 pints of 5.2% beer is 6 units.

> UK’s NHS alcohol calculator says 2 pints of 5.2% beer is 6 units.

It's actually quite easy to calculate fwiw, a 'unit' is 10ml ethanol:

    2pints * 0.052 / 10
    = 2(568ml) * 0.052 / 10
    = 5.9072 units

... I'm not sure if that made my 'easy' point well enough, obviously pints mess it up a bit (and you have to know a pint is 568ml - I've remembered ever since I went to study at Imperial, where the student bars include the well-named 'Metric' & '568') but 10ml is nice and round so it's fairly easy to get a rough idea or with rounder numbers - e.g. a whole 75cl bottle of wine at 12% is 3/4 * 12 = 9 units.

In my experience of knowing alcoholics, I'd say 6 a day really isn't that bad; it's the bottle of liquor a day types that I find impressive. Also, if they were the kind of people who could get access to professional help, they probably wouldn't drink so much to begin with.

6 cans/bottles/pints a day isn't terrible in the grand scheme of things, but its not good either, and it almost always escalates over time.

You can sustain a pretty serious drinking problem that will cause long term harm to your health while also remaining a functional member of society, even getting up to the bottle of scotch a day or more tier.

A fair amount of my professional peers are basically highly functional alcoholics, who have not yet reached a point where it causes sufficient impact on them to recognise the problem.

Most of those people may well have access to professional help, they just don't use it because they don't see a problem. Yet.

There is a such thing as a high-functioning alcoholic.

High-functioning might contradict calling it a problem? From the stories I read about Christopher Hitchens, he seemed like the definition of an unrepentant alcoholic and seemed to function quite well, but of course he died a bit young. I don't think many people are Christopher Hitchens though.

A friend of mine is a very talented and successful salesman. If he doesn't get some alcohol by 7 PM, his skin starts to crawl and he can barely keep it together. What do you call that?

The disease isn't defined by any outcome other than alcohol consumption and dependence.

I don't know. Many of us live with disease of one sort or another; I was just saying that in my personal experience, while a 6-pack a day might seem like a lot to some, it's really not the depraved, want-to-die-alcoholic consumption level.

I knew a functioning alcoholic too, until he died. At 35.

From what?

He killed himself.

To be exact: his was high functionning until he wasn't. From my understanding, he had a bad week (health troubles), which spiraled into a worse one at work. He took a month off, but was so nervous and on the edge that he beat his kid, and his ex-wife told him to put himself together or she would ask for full custody (basically you only see your child two weekend a week instead of half/half).

Don't know what happened then (i had taken my distance since the divorce). The day before he had to go back to work (or the day after, not sure), he killed himself.

[edit] This is my flawed understanding of the events. It probably did not happen like this exactly, most of it was discussions at the church and after the incineration (we usually have dinner with friends and family during those times where i live).

I'm sorry to hear that. It seems to be a theme in this thread that it's hard to make a causal association with alcohol, and your friend would seem to illustrate this. I would think death via alcohol would mean alcohol poisoning or cirrhosis (apparently this took a friend of a friend of mine last month who worked as a bartender at a popular venue in town) or other health condition more easily related to alcohol abuse.

Mostly I think unbinding basic health care in the US from employment would help with many issues. I don't know how people are supposed to be able to heal from illness while also putting in their efforts to a full time job.

You can be alcohol dependant without it causing you a great deal of professional/personal issues. Your healths fucked though.

Same goes for other drugs - I know a few people who are dependant on opiates or cocaine, but function just fine in society.

I didn't see https://www.nature.com/articles/s41467-022-28735-5/tables/2. It looks like going from 0 to 3 drinks would be a 2% decrease in brain matter.

I'm trying to understand. The impact reported by the study seems to compound with higher amounts (I would imagine as liver and kidney throughput is exceeded and the poison hits you more directly).

      Standard Control:

         GMV     WMV

0–1 AU −0.030 −0.020

1–2 AU −0.127 −0.074

2–3 AU −0.223 −0.129

So cumulatively, 0-3 drinks is is GMV: -0.380, WMV: -0.223

What I don't know and can't seem to find with a quick search is the conversion method for IDP standard deviations in brain matter relate to absolute percentages of brain matter (which I assume is not linear?). If your comment is correct, then these numbers correlate to an absolute reduction of 2% of brain matter?

I also see that the third drink seems to do about 50% more standard deviation movement than the former 2 put together.

EDIT: Never mind it's been a while since I took statistics, I remembered that standard deviations _are_ a linear amount. I'd been thinking of percentile placement on a normal distribution.

I tried to go a little further since the depression study seemed to be focused on total brain matter. I might make a mistake here, but...

Grey matter is about 40% of the brain, white matter is 60%, so if we're talking about absolute matter, we should factor that in.

For 0 to 3 drinks:

GMV: -0.380 x 0.4 = -0.152 SD WMV: -0.223 x 0.6 = -0.1338 SD

Should be sum of 0.2858 standard deviations of total brain matter, or about 2.5% reduction.

For 0 to 2 drinks:

GMV: -0.157 x 0.4 = -0.0628 SD WMV: -0.094 x 0.6 = -0.0564 SD

0.1192 SD or about 1.05% reduction

> 6 drinks a day, every day,

One glass of wine, 125 ml, at 8%, is one UK unit. Half a .75l bottle of wine at 14% would be 5.25 units.

It's not unusual in the UK for people to drink half a bottle of wine each evening, and then more on the weekends.

We drink a lot. It causes a lot of harm.