Ladies and Liquor

Question: if Mary, an otherwise successful woman, sometimes polishes off a whole bottle of white wine by herself, should Winifred, Emma and Agnes be kept from drinking? Unlike Mary, they are light drinkers, but like Mary, they are women, and who is to say what they might do if they were to get their hands on a bottle of Stiletto or Little Black Dress or Cupcake?

For epidemiologists, the question is one of risk. Since women are on average smaller than men, they are less able to absorb alcohol. If they are pregnant or nursing, the risk becomes still greater. This sounds reasonable—we can all accept that there are objective differences between men and women—but the practical result is to provide a new and seemingly scientific rationale for telling women they should drink little or no alcohol. Drinking is harmful not because it is unladylike but because it carries too many risks.

If epidemiologists were only interested in Mary, nobody could accuse them of trying to make life a little less fun for women in general. The problem is that epidemiologists think in terms of populations, not individuals. They can propose interventions for women, but not for the woman named Mary. To cut off Mary they must also cut off Winifred, Emma and Agnes.

Ann Dowsett Johnston once had Mary’s problem. For several years, she was in the habit of drinking alone at night, sometimes a couple of glasses of wine, sometimes more. Occasionally she would also drink scotch or vodka. Strictly speaking, she was not a true alcoholic, an alcoholic being defined by Alcoholics Anonymous as someone who cannot stop drinking once he or she starts. If you can walk into a bar, order two drinks and then call it a night, you are not an alcoholic.

Johnston wrote Drink: The Intimate Relationship Between Women and Alcohol in the hope of sparking an “adult conversation” about drinking and women’s drinking in particular. To join in that conversation you must accept its premise, that women’s drinking is a real and growing public health crisis, after which there is really only one possible conclusion: something must be done and it must be done now.

For Johnston, that something stops short of prohibition, but not by much. It includes raising taxes on alcohol, reducing availability and banning advertising because it might put thoughts of alcohol into the minds of people too addled or naive to think for themselves. Put her plan into action and the “alcohol industry would stand to lose close to half its market”—an unsubstantiated claim but no less interesting for that.

The women who most worry Johnston are those who drink much as she did: too much for their own good but not enough to destroy their careers, and certainly not enough to qualify as alcoholics. They are, in the words of one of the experts Johnston interviewed, “high-functioning professional women” whose problems are no less serious for being unseen.

This is not to say that Johnston is unsympathetic to alcoholics—on the contrary, just about all of the women drinkers she interviewed clearly were alcoholics—but the actual percentage of alcoholics in the population is in fact very small. Heavy drinkers, by contrast, constitute a much larger group. There is correspondingly more variation among them, ranging from the frat rat who drinks 14 bottles of beer on a Saturday night to the older woman who drinks the equivalent amount of alcohol over the course of an entire week.

Heavy drinkers also happen to be the demographic that most interests epidemiologists who study alcohol problems. This paradigm shift can be traced back to the mid 1970s, when the old Addiction Research Foundation, the Finnish Foundation for Alcohol Studies and the World Health Organization collaborated to produce Alcohol Control Policies in Public Health Perspective. This was followed by the publication of Alcohol and the Public Good in 1994 and Alcohol: No Ordinary Commodity in 2003. The new paradigm shifted the focus away from alcoholism. Now everyone who drank was potentially at risk, and from this it followed that what mattered were levels of drinking in the whole population. The goal also changed, from getting alcoholics to stop drinking to reducing overall ­consumption.

From the perspective of epidemiologists, heavy drinkers have the obvious advantage of being numerous enough to study—a desideratum in a discipline that deals in large numbers—but one may be forgiven for suspecting an ulterior motive as well: job security for people who have made it their life’s work to study them.

Johnston quotes epidemiologists whenever she is particularly keen to make a point. She interviewed a dozen or so of them, but does not say how they were chosen. This leaves her open to the charge of confirmation bias, especially since a) she always agrees with the epidemiologists she quotes and b) they never disagree with each other. This is not credible research: it is circular reasoning.

The selection criteria matter less in the case of the women drinkers Johnston interviewed. But since the stated purpose of the book is to sensitize the public to the problems caused by heavy drinking, one is left to wonder why almost all of the women interviewed were out-and-out alcoholics. Absent a more representative sample, it is hard to escape the impression that the consequences of women’s drinking are being presented in needlessly dire terms.

If we assume that women’s drinking habits have changed for the worse, the most obvious question is why. Here Drink offers no satisfactory answers. We are told that the beverage industry is aggressively targeting women. True enough. But the implication that women are inherently susceptible to advertising effectively places them in the same category as children. Groups deserving of special protection—children, the mentally feeble and now, we are told, women—are groups whose rights are circumscribed by their protectors.

Elsewhere there is the suggestion that alcohol is the modern woman’s steroid, “enabling her to do the heavy lifting necessary in an endlessly complex world.” I am not convinced by the comparison—steroids enhance performance, while alcohol has exactly the opposite effect—but either way this, too, is patronizing. Are women not up to the challenges they face? Should they find more ladylike outlets—yoga, Pilates, needlepoint perhaps? Nor, I suspect, are most women likely to agree with the assertion that their real problem is “perfectionism” and that this perfectionism of theirs is driving them to drink.

Myself, I would have thought that most women drink because they like to drink.

It is possible to be against women’s drinking and still be a feminist in good standing. The Woman’s Christian Temperance Union, for example, is still accepting new members, pledging them, like their great grandmothers, to abstain from all alcoholic beverages and “employ all proper means to discourage the use of and traffic in the same.”

But it is not quite the organization it used to be, possibly because very few women consider alcohol to be “their” issue—or even an issue at all.

At its core, however, Drink is one of those unarguable books, if only because its wellspring is Johnston’s own story. Memoirs may elicit strong emotional responses, but their fundamental solipsism means that there is no arguing with them in any meaningful way. They can inspire action, as Johnston’s is so clearly meant to, but only by appealing to the heart and not the head.

It helps that addiction memoirs are big. A few years ago it was Brenda Wilhelmson’s Diary of an Alcoholic Housewife and Marc Lewis’s Memoirs of an Addicted Brain: A Neuroscientist Examines His Former Life on Drugs. Before that, it was Susan Juby’s Nice Recovery and Bill Clegg’s Portrait of an Addict as a Young Man, and on and on until we at last reach the disgraced bestseller that started it all: James Frey’s A Million Little Pieces. The phenomenon is so big that even people without real addictions are cashing in on it: I am thinking specifically of the physician who wanted people to believe that his mania for buying classical CDs is every bit as serious as being hooked on heroin.

For all their seeming seediness, addiction memoirs, like all other memoirs, are a fundamentally middle-class genre. Middle-class people have the time and tools to write their stories; poor people do not. This is a problem. If, as creative writing instructors are always urging, you should write what you know, what happens when what you know is not all that interesting? Virginia Woolf was already saying as much back in 1928 (the context was the contemporary English novel and the essay was “The Niece of an Earl”). Or as Diane Johnson put it in “They’ll Make You a Writer!,” a recent essay in the New York Review of Books, first-person narratives are “good when you have an exciting story to tell, of something that happened to you, but of course, in our privileged comfort, we mostly don’t, hence the rise of the abuse narrative and the prevalence, practically amounting to a convention, of molester fathers and violent drunken moms.”

In the case of the addiction memoir, that convention has an especially narcissistic subtext: the hero has great gifts that an addiction is keeping him or her from realizing. Then comes recovery and with it a fresh start that allows the hero to be the exceptional person he or she was always meant to be.

And so it is with Drink, which can at times read like an entry out of the Canadian Who’s Who. The author “took on a project that became one of the most successful in Canadian publishing,” namely the launching of Maclean’s hugely popular university rankings system. She is invited to Paris to give a keynote address at “a major conference.” After a “successful career in journalism,” she takes “the big job of vice principal of McGill.” The big job comes with a big staff of “more than 180.” This is clearly no ordinary woman.

Except for being written by a woman and dealing in part with alcohol, Virginia Berridge’s Demons: Our Changing Attitudes to Alcohol, Tobacco and Drugs has absolutely nothing in common with Drink. Alcohol, as the subtitle makes clear, is just one of three categories it discusses, the key point being that their positions vis-à-vis each other have undergone considerable ups and downs over the past two centuries—and are likely to continue to do so. During that time they have gone from a sort of positive parity, in which all three were tolerated in the early 19th century, to the negative parity we have now, in which all three find themselves under attack in public health circles. For examples one need look no further than Drink, where Big Drink is constantly compared to Big Tobacco, and where the anti-smoking campaigns of the last several decades are held up as an example of the great things the public health model could accomplish if only it were unleashed against drinking.

Demons is a corrective to Drink because it shows that beliefs, even the supposedly scientific assumptions behind the public health model, depend very much on their time and place. In the case of public health, what began as an effort to clean up the cities has today morphed into something altogether different: a preoccupation with the long-term risk factors associated with chronic disease. That is the home alcohol, tobacco and drugs have been assigned—for now.

As with the public health model, so with alcohol: its chemical properties remain constant, but place it in another historical context and what we believe about it will shift, sometimes dramatically so. This by itself should be a warning against believing that anyone, even someone who has earned her bona fides the hard way, has the answer to a problem like women’s drinking.

If it even is a “women’s” problem.