Drink? The New Science of Alcohol and Your Health with Dr. David Nutt
In Episode Eight of “Breaking the Bottle Legacy,” Molly introduces Dr. Nutt, a psychiatrist and professor of neuro psychopharmacology at the Imperial College of London, whose recent book “Drink: The Science of Alcohol and Your Health” has played a pivotal role in shaping her new relationship with alcohol. Dr. Nutt discusses his background, motivations for writing the book, and the contradictions surrounding alcohol as both a pleasurable drink and a source of problems. Dr. Nutt emphasizes the importance of using science to understand and change one’s relationship with alcohol, exploring topics such as pleasure, relaxation, sociability, and the impact of habits. The conversation delves into the non-linear relationship between alcohol consumption and harm, challenging cultural perceptions. The episode also addresses the conscious and unconscious aspects of drinking habits, genetics and alcoholism, and the power of conscious awareness in reshaping one’s relationship with alcohol. Molly and Dr. Nutt discuss psychological addiction versus physiological dependence, the role of the prefrontal cortex, and the significance of bringing alcohol into conscious awareness.
You’re listening to breaking the bottle legacy with Molly watts, Episode Eight. Hi, I’m Molly, after a lifetime living under the influence of family alcohol abuse, spending more than 30 years worrying about alcohol and my own drinking, believing I had an unbreakable daily drinking habit, I changed my relationship with alcohol forever. If you want to change your drinking habits than breaking the bottle legacy is for you. My goal is to help you create a peaceful relationship with alcohol, past, present, and future. Each week all focus on real science and using your own brain to change your relationship with alcohol. Nothing has gone wrong, you’re not broken. You’re not sick. It’s not your genes. And creating peace is possible. I’m here to help you do it. Let’s start now. Well, hello, and welcome or welcome back to breaking the bottle legacy. I am your host Molly watts, and I am coming to you from an absolutely gorgeous Oregon if I must say it is January 20. Happy Inauguration Day to everyone in the United States. I definitely hope and inspirational if you watched it today. I gotta say it was pretty amazing. Amanda Gorman, look her up. Wow. So it’s January 20. I should say by the way, I’m 20 days into dry weary, it has been going awesome. And two years ago, I would have never imagined that I could do a full month off of drinking alcohol. I know that sounds crazy. No probably doesn’t to some of you. To many of you, you you are right in there with me. You could not imagine taking this kind of break. And it’s been awesome. I’m loving it. And it’s been easy. And so I’ve been sharing a little bit of that journey in my Facebook group, breaking the bottle legacy. If you have not already joined, I invite you to go to Facebook, search for breaking the bottle legacy, the group and please join. So today on the podcast, I am speaking with one of my experts that I have connected with and this is a preeminent expert in the area of alcohol research. I’m speaking with Dr. David Nutt. Dr. Nutt is a psychiatrist he is also a professor of neuro psychopharmacology at the Imperial College of London. He has researched as the research has been focused on psychopharmacology and the study of the effects of drugs on the brain. And from a perspective of both drug treatments and how inequality works and why people use and become addicted to drugs. He has a career that has spanned nearly 50 years. And so he is literally one of the top point 1% researchers in the world on this subject. So to say that I am thrilled to speak to him is an understatement. He has also recently published a new book called drink, question mark the science of alcohol and your health. And this book has been instrumental for me in understanding and developing my new relationship with alcohol and I highly recommend it, of course will be linked in the show notes. So here is my conversation with Dr. David Nutt. Hello, David, thank you so much for joining me, I just gave a brief introduction into the podcast giving all of your titles and information and but really excited to have you here and to share most importantly, your most recent publication, drink the new science of alcohol and want to share with our with people kind of your background and what led you to write this book I know I’ve said I know that you have an extensive background in both research and addiction expertise. But tell us a little bit about why writing the book now and what your goal is for sharing this information in this way. Oh, thanks, Molly. It’s a real pleasure to be on this podcast with you. And thank you for having read the book. Yeah. A lot of people will do. So I’m a doctor. I qualified in 1975. So I’ve been practicing medicine for over 40 years. And I think it would be fair to say that there’s not a day gone by in my medical practice where I haven’t come across alcohol in some way or other as being either a problem or the cause of a medical illness or the cause of some sort of family dispute. Medicine and alcohol are so intrinsically entwined. That it’s really it’s impossible to be a doctor and not be influenced by alcohol. But of course, I also drink I drink alcohol. In fact, one of the things people find most amusing about me is that I also run a wine bar, right. And then people say, This doesn’t make any sense at all, you’re dealing all the problems of alcohol, and yet you’re adding to them by having a wine bar. And, and writing the book was really trying to pull together all these contradictions, because alcohol is both the most wonderful, intoxicating, pleasurable drink that many of us enjoy, and particularly in relationships. And it can be one of the most deadly poisons. But it can be both and to understand alcohol, and particularly to understand your own relation to it, you have to think quite carefully about what you’re doing, what you’re getting from it, how it’s affecting you, how it’s affecting your family. And this book really is just a guide to all the modern science we know about this. Yeah, I love that. In the intro to my podcast, I talk about the fact that I will be using science to share this information. I think science is just key to understanding what we do with our bodies. And and and really the relationship we have with alcohol, it’s so important. One of the things that I appreciated and I told I mentioned this to you before we jumped on here is the fact the book is written without question from a scientific perspective, you are very clear on the fact that and have said this over the course of your your career, that alcohol is a drug and is something that you need to consider as a drug when you are deciding how much to drink, when to drink if you’ll drink. And I appreciate it. In the introduction of your book, you actually said that, in the course of writing this, you you do own a wine bar, but you’re not a teetotaler, but you’re also not a heavy drinker, you also used it as an opportunity to examine your own relationship with alcohol. And I think that’s really the driving point of what I believe about, you know, creating a peaceful relationship with alcohol is using science. And then but also weighing that with the results that you have in your life. Absolutely. I mean, there’s a one simple message from the book, it’s think about brink, right. And that’s one of the things that actually came to me as I wrote the book, I wrote the book because I’ve researched alcohol for 40 years, and I wanted to sort of share with the world, my fascination with it and the insights we’ve gotten. And in and the remarkable negative effects it can have and how the drinks industry has kind of helped us be blinkered to the consequences of drinking, but during the writing, and I started to think well, what about why do I drink and and I think they say, Even so someone like me who is kind of a world expert, right? I still have bad habits when it comes to drinking. And, and in the app. The bottom line is, I don’t think you should ever have a mouthful of alcohol that isn’t going to give you something useful. Pleasure relaxation, sociability, drinking out of habit is the reason most people get into trouble. Yeah, you know, I’ve shared a little bit of my life and experience with you but in correspondence but I grew up as a child of an alcoholic became an adult child of an alcoholic my mother continued drinking for really most of my life and she ultimately succumbed to her alcoholism. And it was a very oxymoron much like you you consider yourself you know, you’re an expert, I consider myself somebody that was had such radical negative experiences with alcohol, you would think that it would be therefore that I would simply not drink at all right I mean, in some ways that mental it to me, I developed a habit that I would have considered to be oxymoronic just didn’t make sense to me. And so I’ve spent a lot of time researching that, that whole thing and researching why people develop these habits and, and much to like you said in your book, and the book is so well written, and I will of course, link this folks for you to find it and to pick up your own copy of it. I enjoyed I told David that I enjoyed the audio version just as much. It’s the reason that I felt comfortable connecting with him in the first place. So if you want to hear his brilliant British accent, you can listen to the book as well. But what I loved about it is it it? It does come from a scientific background and there’s clearly your expertise and all of the information that’s available you share that, but you also don’t hit us over the head with it. Don’t shame people with it and you truly tried to make it common sense for people and sensible when they’re reviewing everything that you know goes into the decision to drink or not drink Well, that’s right, because there is a lot to know. And the last thing you want is people just give up because it’s too difficult. So I’ve tried to make it straightforward. I tried to emphasize the key points. And in essence, that there, you know, what you need to do, the first thing you need to do is work out how much you’re drinking. And the second is, why, why each drink is drunk. And as I say, if you get rid of all the drinks that don’t actually serve the purpose for which they’re being drunk, you’re actually going to make some significant impact on your life. Because one of the most remarkable and the most, one of the reasons I go, who is so destructive Is it the relationship between consumption and harm is not linear. It goes up as a curve. And so doubling consumption generally quadruples, four times more harm. And so you can rapidly if you, you know, drink, say over, you know, more than, say, a bottle of wine or half a bottle of spirits a day, you’re getting into levels of harm, which are taking decades of your life. And I think at the very least, people should know that, because a lot of people don’t know, and it’s, yeah, it’s very, you say this in the book as well. I mean, most of the time, there’s a lot of science and a lot of research behind the harmful side effects of alcohol. And in general, the medical community and the scientific community recognize the harms that alcohol, you know, gives in the world, but as a, but culture and society, on the other hand, doesn’t seem to have caught up with this information. And while you know, I think it’s important, and I agree with you, the mission should be to make sure that people really understand the risks and the the, the the risk reward analysis, right. So there has to be a consideration for harm reduction for physical health and harm for your social health. And, you know, even I say, also for your financial health, because it’s not inexpensive. So you know, you need to, these are all things that should go into consideration. But it’s, it is taking it into that conscious brain and making a decision about when you’re drinking, as opposed to the unconscious brain where those habits reside, that you’ve, you know, you’ve told your brain and that’s really, I guess, going to take us into another point I want to talk with you about which is genetics, because I know in the book, you mentioned that one of your interests in alcoholism was spurred by a very old study on the genetics of alcoholism. Of course, this is this is a, you know, dear interest to me just because of my background. But tell me because I have my own view on this. But I would like to hear your what science has showed you and kind of your own interpretation of genetics, and alcoholism. Right. Well, very briefly. Yeah. The study that got me inspired was the one you meant it was a it was called the Danish adoption study. I was training, I worked I was in Duck, I was a medical student, I was in my second year of medicine. 1973. And I was doing psychiatry, and I’ve reading books about psychiatry, and I read about this study, this was a study done in Denmark, in Denmark, they have basically, they collect data on everyone that all the population agree to have all their data collected and be linked. So that they can ask questions like What is the drinking and family life or school performance or whatever. And this adoption study, which was actually done by a couple of Americans, one of them was college, who I got to meet later when I came to America, to be at the alcohol Institute in Washington. And they basically said, the simple question, we can monitor the outcomes of drinking, at least in terms of health harms in anyone in Denmark. So let’s look at men with alcoholism, who had children, and look at the children who were adopted out of the families with the alcoholic pen. And let’s see how they did and compare comparison with children who stayed in the same families as the alcoholic men. And they showed that the boys adopted out had the same likelihood of becoming alcoholic as the ones that stayed in the families. And that was strong evidence that there was some inherited predisposition or alcohol. Because even if you’re in a tea total family, you’ve still had the same risk of being an alcoholic when you grew up. That’s a powerful, powerful proof really, that there is a genetic risk of alcoholism, right. But the thing with genetic risk is that if that person never drink alcohol, right, they’re predisposed, but if they never drink alcohol, they’d never become an alcoholic. It’s not the same as a you know, something that physically manifests itself. The absolutely right. That’s right. And in fact, that’s interesting. What’s interesting about your your story, which I only just heard, but also, it reflects very powerfully. So I have one of my best ever PhD students was from Northern Ireland. And he would want you to work with us for about three months, it was Christmas Christmas party, I left him a drink. And he said, I don’t drink. I said, Oh, you don’t drink. You’re from Ireland. And he said, I took the pledge. I said, What’s the pledge? He said, Well, I was 12. I took the pledge, I would never drink. And I haven’t drunk. And then I researched that. And it was clear that there was such high prevalence of alcoholism in Northern Ireland, that 12 year olds were given a choice to basically say they would never drink in order to protect them. Because then that that avoiding, you know, almost religious way of avoiding alcohol work worked brilliantly for him. And of course, not everyone did take the pledge. The pledge still gave it up. Yeah, well, it’s an interesting to me because I, you know, watched as I said, I watched my mother, and she went through three different rehab, she, she was in a nine month rehabilitation program when she was 77 years old, for the reluctant to recover. So yeah, pretty, pretty strong willed. alcoholic, physically. But you know, what’s interesting, and I know you’ve, you’ve talked about this in the book as well, the difference between psychological addiction versus physiological dependence. Obviously, in a nine month rehab program, my mom came out, and she was no longer physically dependent on alcohol, she drank three weeks later. So there is a psychological part there that she could never overcome. And that’s that psychological part that really drives me towards helping people and talking to people, because I really, truly believe that for many people, and for many people who are perhaps drinking more than they should, or is healthy for them, given guidelines, like the CDC, or the UK is, you know, drink recommendations, people that are using more alcohol than what would be considered moderate, etc. A lot of them are doing so out of habit and are not necessarily physically dependent. And really, it’s just a mind, it’s changing your mindset, much like you said, taking a pledge is, is just another form of creating a different mindset around alcohol. And for me, I developed, you know, a 30 year pretty consistent daily drinking habit. And just like you said, it was not mindful at all, it was just, it was what I did. And I trained my own brain to believe that I that alcohol was the answer to daily stress or whatever, and I no longer it, just it, there was no cognitive cognition about it. But at the same time, it was I had all this anxiety about it. So it was very interesting, because I because I grew up in an alcoholic home. So I worried about it all the time. But I didn’t feel I felt completely enabled to unable to break it the habit until I got brought up and really got well trained in terms of my own using the prefrontal cortex and really training myself in a different way to see alcohol in a different way. So it’s interesting, I think, that’s kind of where I, where I land on it is genetics may be there. But I think it’s, I think, ultimately, we have the power to control. Most of us have the power to control our ability, or our relationship with alcohol. Obviously, people that are physically dependent, and I know you mentioned this in your book, you know, you can’t, if you’re if you have developed the physical dependence on it, you’re going to need to do that work first. You are absolutely right, we will have that power. Some of us have less power than others. And of course, the problem with alcohol is that the more you drink, the more that’s why it’s such an easy drug to get addicted to because it not only increases habits, but it does remove that self awareness and also that self control Yeah, do you agree with the the eye or the sentiment that some of the people that you know are really moving towards drinking no alcohol at all are really looking at alcohol and very much saying that they they want to bring the thinking to their conscious thoughts as opposed to all the subconscious that runs in the background fueled by society fueled by the you know, the drug itself, but bringing it into your conscious awareness kind of gives you a power over that being able to see it for what it is and I think that you know, part of your book I really enjoyed is you do not say you know, there’s you can never drink again and I think that some for some people that are that are trying to work on this relation. chippers are really thinking I don’t want to be completely never ever be able to drink again, some of the programs that that focus totally on sobriety and, and abstinence, scare them so much that they don’t want to make a change at all. Well, precisely, if you can’t be perfect, then you know, then you just go to hell for drinking. So that’s one, that’s absolutely one one problem with that kind of approach. But the other is just a lot of people, I think, probably you want an example. They it’s a lot of it is very, very subconscious and habitual at a, at a subconscious level. And until you’ve thought about why you’re drinking, there is no obvious reason to change. And that I think, is the key. So one of the messages in the book is, I think there are some key numbers that everyone needs to have in their life. You know, you need to know your weight. And what you like to be you need to know your waist size, which you do and, and what that would you’d like that to be, and your blood pressure and your cholesterol. And I think how much you drink should be one of those numbers that is central to you. And just as with blood pressure, and cholesterol and weight, you should generally always be trying to reduce it. And even reducing it a little will have a very significant effect not just on your physical health, but on your mental health. Absolutely. Yeah, I agree with that. 100%. And I, like I said, one of the reasons that I really love this book, and one of the reasons I really want to speak with you is because there is there are people that tell us that you know, moderation isn’t possible that it’s not, you know, that it’s it’s either abstinence or you’re, you’re out of luck. And I just don’t agree with that. And I am sure and I know that you would say that there are some people that are that that seriously cannot drink, and they should not drink and but you you in your book, you outline kind of what some of the reasons that that you might fall into that category, things that might types of drinkers things that you that you might want to consider. If you’re really truly having continued problems with alcohol, you may be a candidate for an alcohol free life, and it might be your best choice. But still, for most of us, we have the power to control that relationship and to create the relationship that we want. And I agree with you full heartedly, you should know how much you’re drinking, you should keep a number you should have an idea. It’s not like it doesn’t have to be some huge ly taxing troublesome problem, you know, it just is it is what it is just like you would just like you keep track of your blood pressure, just like you keep track of your your weight loss waistline. This is another area where you can just simply manage that relationship in a very calm and peaceful way. Yes, and the other the other kind of insight I came to when I started thinking through, what messages I would give to people was about who you drink with. And it occurred to me and I’d be interested in your thoughts on this. If you never drink alone, you’re probably gonna do yourself a lot of good for two reasons, because alcohol is the social drink. And it’s great for drinking with friends. So if that’s what you did it, you get the maximum benefits from alcohol. And as when I know in my clinical work, people who drink alone, there’s no constraints. And sitting in front of the TV, you can knock back two bottles of wine over a quarter of an afternoon evening without even getting drunk. And that is really damaging to your body. So ever drank socially. That would be if it was a rule for everyone that would reduce the harms of alcohol, normalcy. Yeah, no, I agree with you that I 100% agree with that. I also agree with and one of the things that’s in the book, and I think this is just I don’t know if this is in the UK is recommendations specifically, but it might be is to alcohol free days a week. And I think that’s something that everyone should be striving towards is you know, I didn’t used to think that way at all. I didn’t see much problem with drinking three to four, you know, 234 drinks a night I never got altered. So I sort of thought, oh, therefore I do not have a problem. But I didn’t I hadn’t done a cost, you know, a risk reward analysis. I really hadn’t gotten I knew that I lived in a constant state of anxiety. And I kind of just accepted that as a default that was acceptable and did not realize and right now actually I’m in the midst of dry you wearing my first my first ever one going through a full month. Yeah, taking a full month off of of alcohol. So I’m really kind of excited to see how this translates moving forward because there’s been a lot of research that doing this, actually, again, and probably like you said with writing your book you it caused you to reevaluate Wait, this has been causing me to evaluate my own relationship. So you’re two thirds of the way through? Well, I know. I know. I know. And it you know, strangely enough, if you had asked me two years ago, about the prospect of doing this, I would have told you, you’re absolutely crazy. There’s no way I’m going to give up beer for two for a month. And it’s been absolutely no problem whatsoever. Again, just changing my mindset around alcohol over the last two years, and the work I’ve been doing, and it’s been no struggle at all. And actually, like I said, I’m really noticing. And this is again, a part of everything. You talk about really noticing what is happening without it, you know, so that’s a really positive side as well. Well, there’s two things. Two things to say though. The first is it. This is staggering statistic from the Britain sort of leading liver alcohol expert in his liver, liver clinic in Southampton University. A third of the people coming in with alcoholic liver damage, had never ever even considered themselves being drunk every day, and they wouldn’t alcohol change. You know, they were tolerant, who never got drunk. There we go. And they just slowly peddling their liver, which is kind of that’s kind of chilling, isn’t it? The way it hides? I’ll go home. And is this a sort of a highway or? Yeah, it blinkers you too. It’s what it’s doing? Yeah. No, I actually have that’s I understand that completely, because I had a gallstone had to have a scan. And I remember the scan showing that I had. I don’t know if it was mild or moderate, one of the two words, fatty liver, and I was like, what, like, I was literally shocked, even though I mean, that was a couple of years ago now. But really good news on that, folks, is that if you are participating in dry, where you’re doing anything like this, even those, just like I mentioned, taking two days off a week, anything where and just like David has said to any time where you are reducing, you’re actually giving your liver a break, taking time off and it helps your liver, your liver is a great, very restorative Oregon, so you can really improve your liver health, just by, you know, to making these small changes. Exactly. Well, David, I know I could talk to you for hours, I’m sure about all of this. I don’t know that you’d enjoy that. But I would love it but I won’t keep you because I know that your time is precious. And I really do appreciate you taking the time to discuss this with me. I cannot wait to have people find more copies of drink the new science of alcohol it’s drink question mark really is, is you know exactly so and I just hate it again, appreciate you taking the time. Well, it’s been a pleasure and do keep up your good work yourself. All right, I will. Thank you so much. Thank you. Thank you for listening to breaking the bottle legacy. This podcast is dedicated to helping you change your drinking habits and to create a peaceful relationship with alcohol. Take something that you learned in today’s episode and apply it to your life this week. Transformation is possible. You have the power to change your relationship with alcohol. Now, for more information, please visit me at www dot Molly watts.com