Under the influence

Young drinkers are succumbing ever earlier to the attraction of an age-old ingredient of social life - alcohol. David Newnham takes a measured look at the nation's drug of choice

Switch on the radio or open a newspaper any morning of the week and somebody will be talking about drugs. On Monday, it's gun-toting crack dealers turning the city centre into a battleground, and on Tuesday, it's men selling heroin at the school gates. Wednesday's news centres on yet another ecstasy death, and on Thursday, a celebrity is sacked for taking cocaine. A fresh row about the legal status of cannabis has us all talking on Friday, and the weekend is given over to the misuse of temazepam, the abuse of amphetamines and the recreational use by children in rural areas of vast quantities of veterinary drugs.

With all this talk of illegal substances and their widespread consumption by the young, you might be forgiven for thinking that alcohol was fast going the way of church attendance and the traditional roast dinner as a part of our familiar way of life. But a recent survey of secondary school children carried out for the Joseph Rowntree Foundation produced figures so sobering that, for one whole day, they actually pushed illegal drugs out of the news.

According to the report, a third of the 15 and 16-year-olds who took part classed themselves as regular drinkers, a quarter of the 13 and 14-year-olds claimed to have drunk at least five alcoholic drinks in a single session, and binge drinking was becoming a perfectly normal way for some teenagers to spend a Friday or Saturday night.

Seek out some more detailed information about alcohol abuse by the young and you'll soon be reaching for a stiff drink yourself. Between 1990 and 2000, when manufacturers were actively developing colourful new fruit-flavoured tipples that would appeal to kids, the average number of units of alcohol consumed weekly by 11 to 15-year-olds almost doubled. One in four deaths among men aged 15-29 in Europe is now attributable to alcohol, says the World Health Organisation. And according to the charity Alcohol Concern, more than a third of underage drinkers in the UK say they know where to buy bootleg booze.

The fact that these unhealthy trends only occasionally make it into the headlines is a measure of how closely we in the West have woven the use of alcohol into the fabric of our society. Readily and legally available, it is our real drug of choice and, as such, its presence in our lives, not to mention our bloodstreams, is taken pretty much for granted. Why, a sip of this mind-altering substance takes pride of place in the Eucharist, that most sacred rite of our official state sponsored religion.

So what is this magical potion that the WHO reckons one in 13 human beings now cannot function without? There are several organic compounds in the series known as alcohols, including amyl, butyl, propyl and methyl alcohol. But whether our favourite beverage is beer, rum or sake, the main active ingredient, and the one that causes the desired intoxication, is ethyl alcohol, also known as ethanol, or just plain alcohol. In beer of average strength, the proportion of alcohol by volume is around 4 per cent, rising to 11 per cent in wine and 50 per cent in spirits. The remainder comprises mostly water, in which are dissolved a cocktail of chemicals that give each beverage its individual colour, taste and smell.

Alcohol is the thin, colourless liquid that is produced when the type of microscopic fungus known as yeast feeds on the various sugars that occur in plants. Yeast spores are present in the air and so, in the right conditions, any fruit or vegetables left hanging around will sooner or later start to be digested. The process is called fermentation because another of its by-products, along with alcohol, is carbon dioxide and, in a sweet liquid, the gas bubbles give rise to a foam, foment or ferment. In the same way as wild animals invariably return for further helpings of the overblown, fizzy fruit that makes them feel nice, so humans must have always had a weakness for this naturally occurring substance that dulled their physical and mental aches and pains, made them fearless in battle and ensured that their religious and other ceremonies went with a bang.

In time, we learned how to manage the fermentation process, putting yeast to work on all manner of sweet substances, including fruits and berries, cereals, root vegetables, tree sap, honey and even milk. In Egypt, they worked out that if they allowed bread dough to ferment in the same way the carbon dioxide gave their loaves a light, spongy texture (the alcohol in the dough is boiled off when the bread is baked).

Although the first alcoholic preparations would probably have been in the nature of a mash or gruel (barley was found to be ideal for brewing, while wheat made better bread), we later learned to filter out the solids, thereby producing the first true alcoholic drinks. Eventually we discovered that by heating the drink and allowing the steam to condense, separating out the droplets that formed at a slightly lower temperature, we could reduce the water content, increasing the concentration of the psychoactive drug contained in the brew and producing the fiery drinks which we know as spirits.

Alcohol doesn't need to be digested in order to be absorbed into the bloodstream. About 20 per cent of it passes directly through the stomach wall as soon as it is swallowed, while the remainder passes through a junction called the pylorus into the small intestine, where it is quickly absorbed. The overall rate of absorption varies depending on the nature of the drink. Paradoxically, strong drinks can, on reaching an empty stomach, cause the pyloric sphincter to contract, thereby slowing down the rate at which alcohol enters the blood. On the other hand, the presence of gas bubbles, either as a by-product of the fermentation process (beer, champagne) or added when the drink is blended with a carbonated "mixer" (scotch and soda, gin and tonic) speeds up the process. And as soon as the alcohol reaches the brain, we begin to feel its effects. In low concentrations, it seems to act as a stimulant, possibly because it damps down parts of the brain that normally have inhibiting functions. At this mood-altering stage, a drinker may feel exhilaration, becoming talkative and more than usually emotional. But as the concentration increases, alcohol begins to act as a depressant, working on the central nervous system in a similar way to barbiturates, tranquillisers and general anaesthetics, to produce sedation, stupor and, ultimately, coma.

The first obvious signs of intoxication are usually slurred speech and an unsteady gait. Laboratory tests reveal that alertness, visual acuity and the capacity to distinguish between external signals, are all impaired, and reflex responses and neuromuscular functions are slowed. One of the first things to be affected is the brain's ability to process two or more types of information simultaneously (a prerequisite for anybody intending to drive a car). Interestingly, though, tests have shown that, after the equivalent of only two drinks, some people are better at learning and solving problems. Facts memorised under the influence, it seems, are more easily recalled under the same influence, while a person who is sober will be better able to recall what they learned when sober than what they learned when drunk.

By the time their blood contains 0.4 per cent alcohol, most people will be so thoroughly anaesthetised that they could easily undergo surgery (a man of average build needs to drink at least three quarters of a litre of spirits in order to achieve this). At higher concentrations, deep coma sets in, and death may be caused by accidental obstruction of the breathing passages. Between 0.5 and 1 per cent, the heart or the part of the brain responsible for breathing may themselves be put to sleep.

Its numbing properties mean that alcohol has always been useful as an anaesthetic, while its power to relax us and dissolve our inhibitions has given it important functions as a social lubricant. Nevertheless, the consequences of overindulgence by groups and individuals, together with the inevitable association of alcohol with moral laxity, mean that there have always been those who opposed its use. And, from time to time, anti-alcohol lobbies have held sway.

While governments frequently attempt to regulate consumption (while invariably raising revenues by taxing sales), various peoples, including the Aztecs, have tried at one time or another to ban intoxicating drinks altogether. It happened in ancient China and feudal Japan, in Canada, India, Russia and Polynesia. Iceland, Finland, Norway and Sweden have all tried forms of prohibition (the Swedish government even introduced a system of ration books for spirits), and in some Muslim countries a total ban is still in place. In the US, the wave of idealism that gave rise to the abolition of slavery also inspired the earliest temperance movement. By the beginning of the 20th century, various other factions had nailed their colours to the mast, including the evangelical Protestant middle classes and those opposed to the growth of cities and anything associated with them. In 1919, after a temporary act of prohibition introduced to save grain during the First World War, it was all to culminate in the Eighteenth Amendment.

Known as the Volstead Act, after its promoter, Congressman Andrew J Volstead, the new law got most of its backing in rural areas and small towns. Not surprisingly, therefore, it was here that enforcement was strictest. But in big cities, where the population was least sympathetic to prohibition, illegally manufactured alcohol continued to be sold on a large scale, by way of such illicit outlets as the "speak-easy".

There emerged a new kind of criminal known as the bootlegger because in earlier times smugglers would hide flasks of liquor in the upper parts of their long boots.

The most notorious bootlegger, Al Capone, was reckoned to be earning $60 million a year at the height of prohibition, and it was the explosion of criminal activity (Capone had seven of his rivals killed in the St Valentine's Day Massacre), together with the consequent erosion of civil liberties, that led to the main supporters of the Eighteenth Amendment becoming disenchanted with their handiwork.

In 1932, the Democratic Party called for repeal, and the following year the Twenty-First Amendment, reversing the Eighteenth, was ratified. However, it wasn't until 1966 that the last state finally legalised the sale of alcohol, and one town in Ohio continued to ban the sale of alcohol until July this year. The Prohibition Party, founded in 1869 to campaign for the outlawing of alcohol, remains exists to this day.

It was two years after Congress repealed the Eighteenth Amendment that a stockbroker known only as Bill W met with a surgeon known only as Dr Bob S. Bill had been a heavy drinker and Bob still was, and both had learned the hard way about one of the less attractive properties of their favourite drug, namely, its potential addictiveness. When an organism is under constant attack, as the body of a regular, heavy drinker is under attack, it adapts itself in such a way that, if the attacks are discontinued, it cannot simply switch back to its previous mode of functioning without first going through a lengthy period of readaptation. Surprisingly, it was the stockbroker who pointed out to the medical man that, in this very real sense, alcoholism amounted to a disease, not only of the mind, but of the body also. With Bill's help, Bob was at last able to kick the habit. Together the pair devised a strategy for addicts who wished to cure themselves, a strategy based on group support and strict adherence to a dozen guiding principles, the most important being total abstemiousness.

By 1939, three such groups had been set up in the US, and 100 alcoholics had been cured. Bill wrote a book called Alcoholics Anonymous (only by guaranteeing anonymity to those who needed it was such a group strategy possible) in which he spelled out the now-famous Twelve-Step recovery programme, and by the end of the year, membership of the groups had soared to 2,000. By 1950, there were 100,000 recovered alcoholics worldwide, and today, the "fellowship", as it calls itself, is a global institution.

Nevertheless, each addict who manages to pull back from the brink of self-destruction is instantly replaced by another, as successive generations fall into the drinking habit. It is predicted that annual alcohol sales in the UK will reach pound;22.3 billion by 2006, and a total of pound;94.8 billion across Europe. Western-style beer has become the most widely consumed alcoholic drink in the world, with the Chinese brewing more than the Germans for the first time in the mid-1990s. In 2000, the World Bank estimated that global consumption of alcoholic beverages stood at about five litres of pure alcohol per person per year.

Despite recent World Bank reports that moderate alcohol consumption had the potential to reduce the risk of heart disease in older men, in terms of total years of life lost from premature mortality, alcohol's net effect on health was negative in all regions: "Alcohol abuse is an important contributor to the global burden of disease and injury and ranks fourth among the top 10 risk factors for disease and disability globally."

While the World Bank reckoned that overall alcohol consumption had remained static for around 20 years, it acknowledged that levels were rising in many developing countries, and it is this swing, together with an increase in young drinkers, that concerns many critics.

A recent industry document outlining useful sales strategies talks about the success of "ethnic marketing of beer in the US", a multi-million-dollar campaign "to create a female mega brand", and the importance of "maintaining brand loyalty among younger consumer groups". The document even talks enthusiastically about how new launches of pre-mixed drinks in Europe "are showing higher than average percentage rates of alcohol by volume", and this at a time when Alcohol Concern is observing that "more young people are choosing stronger brands".

It might not make it into the headlines as often as its illegal cousins, but one thing is clear about alcohol: far from slipping out of fashion, our drug of choice is going from strength to strength.

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