The previous discussions about alcohol on this blog have prompted me to wonder how we are supposed to keep reasonable about the issue. It seems everyone’s invested in it for various reasons, which makes it a lot more difficult to discuss openly. My mom has noted recently that I’m becoming more and more set against alcohol in general, and though she’s right to curb my judgmental tendencies, I think by now I have some reason for my view.
I’m looking at an entire lifetime of observing the freshman pattern. All freshmen get worn out and fade over the course of the fall semester. I’m quite happy by December to send them home to their parents for rest and good food. But those who really get into alcohol drop like a brick, appearing only erratically and full of distraction and often duplicity. I think we all take a deep breath and hope for guidance when rush season starts for fraternities in the spring, because it’s never pleasant.
When I then attend parties with fellow grad students and faculty, there’s a lot of conversation about alcohol, and a fair amount of imbibing. The discussion is all about how the young ones effectively don’t know how to control themselves. I can’t help but think, “Pot calling the kettle . . .” in a lot of those situations. For our students, alcohol’s something they lack the skill to use, and for adults it’s a sign of maturity and culture. After working department parties as an undergrad and observing that culture, I decided I’m most definitely out of it, and happy to be so. Furthermore, I don’t know why we wouldn’t set the “culture” next to the “youthful stupidity” and think that, perhaps, the culture’s simply not worth it. To me this issue is different from driving privileges or voting rights: with those we hope there’s some gain, but is there enough here to warrant the trouble that comes along with it? Ideas?
Erin
Alan Schmierer
Once again, I have to say that living in England for a year showed me that not only can adults and students drink and not get drunk, they can also drink *together* and not get drunk. Faculty and “Visiting Students” came together once a trimester to celebrate with champagne and wine, and no one abused it. It was an enjoyable time for all of us.
I drink and I’ll be honest, sometimes I’m irresponsible about it. I’m not perfect. However, I never drank as a freshman, I was never involved in the greek system, and my drinking never effected my school work or grades. I also never drove drunk or put myself in a situation where alcohol could hurt people around me. If I wasn’t being irresponsible about drinking, I probably would have been irresponsible about eating way too much pizza instead, which may have had just as many health side-effects as drinking (at least for the amount I drank, anyway!).
I went to a state school with the largest greek enrollment of any school in the country and I’ve seen the effects of what you’re talking about. I whole heartedly agree that there is a very serious problem with what goes on there. However, at the same time, I’m not a product of that “culture” (or youthful stupidity) or of any of the other “cultures” you mentioned.
And yet, I enjoy picking wine that will taste really great with my meal when I go out for a nice dinner. And there are times when I enjoy having a really great margarita with my mom. So when you say, “is there enough here to warrant the trouble that comes along with it,” I really find myself thinking, don’t lump everyone who enjoys a drink with the people you’ve mentioned above. There are some drastic differences.
That doesn’t mean we shouldn’t talk about these issues and that there aren’t problems we often fail to acknowledge. But that also doesn’t mean that everyone fits neatly into that category.
I was hoping to garner discussion precisely because I don’t think there is a single category. What I’m worried about, though, is that many who drink carefully want to simply say, “I’m not abusing alcohol, so I’m doing my part, and that’s enough.” But I’m worried that, in drawing such a definitive line, we’d be leaving those who do have problems handling it to their own mistakes and that’s that. I think we need to take the benefits and costs of all “groups” into account and make decisions on a larger scale about how and if alcohol should be made available to the public as a whole, because that will include those who can handle it AND those who can’t, no matter how much the former try to separate themselves from the latter.
Erin
Then I guess my question is whether banning alcohol would really solve the problem? It didn’t work very well in the 20s. Are there greater problems that are causing that result in people abusing alcohol that we should be tackling instead? Are they some of the same problems that cause people to gamble their houses away? How many problems should we ban?
Sometime in my life I want to spend a good deal of time in a Muslim country and see how they manage to do it. The fear of God and tradition and peer pressure do wonderful things 🙂
I’m not calling for prohibition. I actually want something much more difficult: a change in culture. I don’t know if I’ll get that, but I think it’s something we should consider an option, rather than rest easy.
Erin
Good questions and thoughts. I don’t drink, my sister does and I don’t really care. Obviously, drinking is not wrong just the abuse of it. What should be done? Hmmm…probably nothing that our government could do would really help. I mean, people need Jesus. How else can any problem be solved?
I know that sounds like I’m just brushing all your points and questions aside and trying to give some simplistic answer to a complex question. But, I guess I’m not sure what else to say. I mean people will make their own decisions……….(unfinished thoughts)…..
With reference to having tried prohibition, the logician in me is somewhat uncomfortable with induction on a sample size of one. I know this is a standard line of thought, but isn’t it a little too facile?
– Sydney
Prohibition has been tried in other countries as well. Prof. Insler in the Yale Linguistics department would go onto random tangents in class with stories starting with, “I once lived in Madras during prohibition…” Highly entertaining.
I’ll agree with other previous commenters that it is the abuse of alcohol that is far more problematic than responsible use. Most things are bad in excess. Gambling, overeating, etc. Should food be banned because some people abuse it? No. Is alcohol as essential as food? No, but I’m trying to make a point.
I suppose the other side of the question is: whose problem is it if people want to abuse alcohol? Should we care if they want to mess up their lives? Clearly, if they’re driving under the influence and so on, it becomes a public hazard. As they’d say in my ethics class, the conflicting values here are “benificence” vs. “autonomy” – is it more important to impose what “we know is best” on others, or let them make their own decisions?
Honestly, a good psychopharmacology course would scare most people out of doing drugs (or make them sound so painfully boring that it would take the fun out of it anyway). I’ve never tried illegal drugs, but I feel I know too much about them now to be able to ever rationalize experimenting. I think a good dose of education might be what this country needs. Not just “don’t do drugs”, but “and this is how it messes up your neurochemistry longterm and makes you worse off than before”, etc.
That response was all over the place. Sorry. Maybe I should refrain from replying to your blog in the middle of the night…
-L
Yes, prohibition has been and is being tried in other countries. My point was that people generally just talk about the American experiment. Once other countries are taken into account, the data becomes much less clear. After all, some countries with prohibition do not seem to have the rampant bootlegging and so forth that the U.S. experienced. So the lesson might be that under the right conditions, whatever those might be, prohibition can succeed.
That said, all of this is not really to the point, since nobody here, as far as I know, has been calling for prohibition. Erin certainly wasn’t. Rather, the question she raised was whether it is really defensible for the ‘moderate’ drinkers to pass all responsibility for the problems associated with alcohol off to those who abuse alcohol. And that strikes me as a very good question and one that would be worth serious discussion. We live in an incredibly individualistic society where most people’s knee-jerk reaction is to say ‘I’m not responsibly for your problems and your failings’. But it’s not clear to me that such individualism is ultimately defensible. My choices do affect the choices that you can and will make, so how can it be obvious that I am not to some degree responsible for these indirect effects of my actions? And I take it that in some cases significant numbers of people are starting to doubt this hyper-individualism, e.g., with smoking bans and with some of the recent activism regarding junk foods. Of course, the examples I just cited involved state intervention or requests for state intervention. I’m actually not sure how well state intervention works for these sorts of things (e.g., I have some qualms about NYC’s trans-fatty acids ban, though I think there is some admirable motivation behind it). But I am quite convinced that at personal and local institutional levels we should pay more attention to the effects that our choices have on people around us, rather than just assuming that they bear all the responsibility for taking care of themselves. How does all of this play out with respect to alcohol? Well, that’s the question.
As for education, I’m really sceptical about how much that will accomplish. Just look at the dismal results of the decades of all sorts of programs to educate people about the dangers of smoking. Those of us in academia seem to be especially prone to thinking that real people actually reason sort of the way that economists model practical rationality. But that’s just simply false. People both do a terrible job of figuring out what is in their best interests and they do a terrible job of actually doing what they already know to be in their best interests. Perhaps my experiences are anomalous, but most smokers I’ve talked to know better than I do what the consequences of smoking are. But for a lot of teens in high school, there are things that seem more important than avoiding getting cancer a few decades down the road. For a lot of undergraduates, smoking marijuana still seems worth it even if you know that it will make it more likely for you to get schizophrenia. Does this mean that education plays no role? Of course not. I think it is important that people know what the effects of their actions are. But I think education is only preparatory work.
Maybe I should quit rambling and shut up for a while.
Sydney
Just for the record, there have been no conclusive studies tying illegal drugs to schizophrenia as far as I know. If anything, I think it’s more often the other way around, that people use cigarettes/marijuana/etc. to self-medicate their mental illness.
-L
Here are the studies that I was thinking about when I mentioned schizophrenia and cannabis use (there are some more comments at the bottom, for those who don’t derive pleasure from reading citations):
1. D’Souza, D. et al. 2005. ‘Delta-9-tetrahydrocannabinol effects in schizophrenia: Implications for cognition, psychosis, and addiction’. Biological Psychiatry 57.6: 594-608.
2. Andreasson, S. et al. 1987. ‘Cannabis and schizophrenia: a longitudinal study of Swedish conscripts’. Lancet (Dec. 26) 8574: 1483-6.
3. Caspari, D. 1999. ‘Cannabis and schizophrenia: results of a follow-up study’. European Archives of Psychiatry and Clinical Neuroscience 249.1: 45-49.
4. Arseneaul, Louise, et al. 2002. ‘Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study’. British Medical Journal 325: 1212-1213.
Are these studies conclusive? Well, I won’t claim that they are, for three reasons: (a) I’m in no position to judge the merits of these studies, (b) obviously, I’ve not even come close to doing a complete literature review, and (c) I’m not sure that we all have the same standards in mind when we talk about research being conclusive, since conclusiveness clearly comes in many degrees (unless we are talking about the highest degree of conclusiveness possible, in which case nothing empirical can meet the standard anyway). If a great deal of current research on a hypothesis indicates a lack of conclusiveness, then we have not reached conclusiveness on the hypothesized link between cannabis use and schizophrenia. But should people have waited until we had reached conclusiveness about the link between tobacco use and lung cancer before they stopped smoking? Hardly.
By the way, for those of you, presumably the majority, who don’t care to read papers from medical journals, here are some more or less accessible discussions of some of the research: here, here, and here.
Sydney
Just skimming the abstracts:
D’Souza finds: People with schizophrenia who use cannabis experience worse schiz. symptoms. Does not suggest causality.
Andreasson: Group who used cannabis was more likely to develop schizophrenia. But direction of causality still unknown as no random group assignment (still don’t know if people are using pot to calm their schizophrenia or whatever).
Caspari: Similar to D’Souza – don’t smoke pot if you’re schizophrenic.
Arseneault: More convincing, although their results are based mostly on the smallest part of their sample (3 out of 22 who’d used pot by age 15). Further, once they controlled for psychotic symptoms at age 11 (far before the onset of schizophrenia for most people), the results were not significant.
Of course, I’m just doing this for argument’s sake – I miss our random down-the-hall chats, hehe. I agree, pot is bad. It causes cancer. It makes people do stupid things. It makes people apathetic and lazy. But I’m not convinced it causes schizophrenia. I think for me to be convinced, I’d have to see a controlled study (probably in rats since it’d be difficult to get IRB approval to do it with humans) where some rats get THC, and control rats do not. If the THC rats develop schizophrenic-like behaviors, then I’d be convinced of a connection between the two.
I’ll report back when we get to the schizophrenia part of my psychopharmacology course, but there was no mention in the part about THC. And now, back to writing a paper about opiates (how a propos!).
-L
Oops — wrong paper by D’Souza. I guess that’s what happens when I hurry too much. Here’s the paper that I actually meant: D’Souza, D. et al. 2004. ‘The psychotomimetic effects of intravenous delta-9-tetrahydrocannabinol in healthy individuals: implications for psychosis’. Neuropsychopharmacology 29(8):1558-72. The study setup is similar to the one that I cited earlier, except that it involves healthy subjects instead of ones that already have schizophrenia. And intravenous THC produced schizophrenia-like symptoms.
I think Lisa is exactly right in the weaknesses that she identifies above of the studies I cited. No disagreement there. I do think, though, that we differ on exactly what the significance of those weaknesses is. As those of my friends know to whom I’ve harped about the importance of controlled study and about the dangers of jumping to conclusions, I appreciate the value of controlled studies. Nevertheless, they can’t be the only way we come to know things. After all, there are many areas of human knowledge where we simply can’t perform controlled experiments about causal directions (e.g., in astrophysics). So I’m inclined to think that the cited studies may provide a bit more evidence for the claim that cannabis use causes schizophrenia than Lisa thinks that they do. But arguing for that would take us too far afield into theories about probabilistic confirmation (I’m tempted — I’ve been reading a bit about Bayesianism recently and am finding it more and more interesting — but since I hope to avoid permanently turning everyone off of this blog, I think I should refrain).
One question, though, for Lisa or anyone else who knows something about methodology in the sciences that involve controlled studies. I often hear people say that a study that reports correlations between A’s and B’s does not say anything about causation between A’s and B’s unless you have random group assignment, etc. But isn’t this actually just shorthand for some more complicated principle? For example, it seems to me that this principle would apply in a case where there are two hypotheses under consideration: H1, which says that A’s cause B’s, and H2, which says that B’s cause A’s. It would also apply if we added a third hypotheses: H3, which says that there is no causal link between A’s and B’s. But it seems to me that background knowledge could often already make some hypotheses improbable. So suppose that the highest prior probabilities go to H1 and H3, i.e., the prior probabilities of H1 and H3 are higher than that of H2. Now if we observe a correlation between A’s and B’s, isn’t that correlation already good evidence for H1? Or am I missing something here?
Sydney
The “correlation does not equal causation” argument applies in a couple cases such as:
1) bidirectionality of causation (A–>B vs B–>A)
2) “lurking” variables (C –> A & B)
3) spurious correlations (statistical “noise”)
So, for example, in the current argument, we would be cautious of a “schizophrenia is correlated with THC use” argument because:
1) we don’t know if THC causes schizophrenia, or people with schizophrenia use THC to self-medicate or whatever
and
2) maybe a third variable causes both THC use and schizophrenia (e.g., another psychiatric disorder, or an environmental factor like poverty)
3) correlations could be by chance
I’m not sure I entirely know what you mean by “prior probabilities”? Are you talking about some sort of logical likelihood, or something statistical?
In any case, generally correlational research comes first – observing things in the environment, then it is followed by controlled experimental studies. So for example, we see your correlations about THC use and schizophrenia-like symptoms, and then do my controlled study in a rodent population. That combo seems to be the most respected in the psychological lit as the controlled lab study shows causation, and the observational correlations show that it’s applicable in the “real world”.
Hope that helps. 🙂
-L
Thanks, Lisa, for the explanation. And sorry about the use of the term ‘prior probabilities’ — it’s a technical term from the Bayesian literature. It just means the probability of something being the case prior to some new evidence. So, for example, if we know that there is a causal link between A and B but we have no idea in what direction it goes, then the hypothesis that it goes from A to B would have a probability of being true of .5, as would the hypothesis that it goes from B to A. Obviously, new evidence would change these probabilities. But the idea is that in order to know what new probabilities we will be left with, we need to know what probabilities we had before we got the new evidence, i.e., the prior probabilities.
Applying it to the case at hand, suppose we had evidence that low enough numbers of schizophrenics use cannabis so that that direction of causality would not explain a correlation between cannabis use and schizophrenia. In such a case it seems to me that evidence of a correlation would in fact be evidence for the hypothesis that cannabis use causes schizophrenia. The evidence would be defeasible, of course, since, for example, other confounding variables have not been ruled out. But defeasible evidence is still evidence.
In general, your explanation above sounded very sensible to me. But the nitpicky me wants to apply a little bit of pressure using this point about defeasible evidence. Note that I didn’t actually object to the principle that ‘correlation does not equal causation’; in fact, I take this principle to be obviously true. But I think sometimes people make the stronger claim that correlation does not provide evidence of causation. And that claim, it seems to me, is much more dubious, especially once we notice that evidence can be defeasible.
Did that make any sense? Or did it sound terribly confused?
Sydney
Just to follow up: I’m not sure we have any “prior probabilities” in this case. Nor do I think we can assume that there is definitely a causation/link of any sort.
Also, I asked my psychopharmacology prof today about the THC-schizophrenia connection and she had heard of no such thing. She agreed that there is a high comorbidity between schizophrenia and substance abuse, but didn’t think that the latter caused the former – more likely the other way ’round.
-L
Hey, Lisa,
I’d be interested in what profs say who have actually read the studies, since they seem to have garnered some interest that would not be warranted if they simply showed that schizophrenics seek out narcotic relief–not that you have to go trolling the halls for psych professors. You could get an interesting reputation if you’re known as “the girl who asks a lot of questions about marijuana.” 🙂
Erin
Erin,
The prof I asked was the one most likely to know about any sort of drug study. She injects rats w/cocaine (and other things) for a living. 🙂 (In retrospect, that sounds horrible written out…) I think if this THC-Schiz. connection were at all popular in the field of psychopharmacology, she’d know about it. Of course, it is possible that she’s missed this part of the lit, but I doubt anyone else in the dept would know about it if she didn’t.
-L