Drinking by Numbers

http://www.nytimes.com/2016/06/19/opinion/sunday/drinking-by-numbers.html

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Berkeley, Calif. — AT a recent physical, I was surprised by the way the usual questionnaire jolted me with one query in particular: How many drinks do you have a week, on average? There was a time about 10 years ago when I’d have said two a week as a baseline; now it’s more like two a day.

When did two drinks a week become 14? A few things happened between then and now. These days I’m a parent of two young children, whose acute dependency upon me makes socializing around a glass of wine or beer at a friend’s toy-filled house often the best choice. I live in California, where wine is available on tap, and sold in nearly every neighborhood grocery store. I can afford a few bottles in the house, whereas before I’d run out to buy one only before a party or dinner. Heck, I’m a writer.

I live at the place where these circles meet: I am the Venn diagram of drinking as habitual and easy entertainment.

You might say, “Why worry?” Much of the epidemiological research out there is pretty decisive on the benefits of moderate drinking, though the Centers for Disease Control and Prevention, which recommends a daily limit of one drink for women and two for men, says that recent research on health benefits is inconclusive.

Here’s the thing: At this middle stage of my life, I can easily make out the slippery slope where two a day becomes three; when you split a bottle of wine and open another; when you go out for a special event and three drinks doesn’t do much because you’ve built up a tolerance and it takes four or even five drinks to achieve a celebratory state of inebriation. Perhaps I think more about these borderlands because though my husband is also a moderate drinker, he has a strong family history of alcoholism. For him, the slippery slope is more like a cliff.

But my inquiry is not about the descent into addiction. It’s an attempt to investigate more deeply the middle ground between the poles of addiction and abstinence, at a time when our culture is sending out dueling messages. The first is coated in optimism: “Have some! Alcohol is pleasurable and it’s proven to be good for you.” The second is our puritanical side chiming in: “Watch out! Alcohol is poison and it’s proven that it can kill you.”

We tell people to go ahead and have just a little bit of an addictive substance. Let’s acknowledge that that’s complicated.

Most of us occupy the space between teetotaler and drunkard, but that’s a big span to move along. We measure everything in our modern world, and yet the data we’ve gathered doesn’t tell us what moderation really means. And if we’re somehow in that approved zone, how do we stay there? Is there a useful way to think about it that isn’t as precise as prescribed numbers or as vague as guilt?

I asked people in the wine industry how they manage the territory when they are exposed to it every day. “When I get to the ‘number of drinks’ question at the doctor’s office, I skip to the next line,” Yoav Gilat, a founder and owner of Cannonball Wine Company, in Napa, told me. He referred to the numbers with a laugh, but his point was serious: There’s a lot we don’t admit about drinking because we’re fearful of being judged. (For what it’s worth, many doctors assume you’re fudging and automatically double the number you give them.)

“Even if you decide to have just one drink, it’s easy to get into the next one,” Mr. Gilat told me. “The third one is calling an Uber and giving the kids to your wife or your husband or your friend. It’s the one that everybody is intimidated by, or afraid to admit that they’re having.”

In “Three Glasses Later,” the photographer Marcos Alberti documents the effects of three glasses of wine on subjects in his studio; the portraits reveal people moving from the stress and sobriety of the after-work hour to, well, a great many moods. “The third glass,” Mr. Alberti notes, “is about mayhem.” It leads you to a place where everything is unreliable, including the decisions you’re capable of making.

So it’s not just about counting the drinks — it’s about the number where each of us becomes untrustworthy. What am I no longer capable of in the shift between one number and the next? We are conditioned to think about that third drink as it pertains to driving, but it goes beyond how we get home. Most of us don’t like to recognize problem drinking as a possibility within our own orbit, or the toll it can take on our emotional, family and work lives. The truth is you don’t have to be a binge-drinking alcoholic for drinking to be problematic.

Numbers have always been key to our understanding of alcohol: The Aztecs called their gods of drinking “centzontotochtin,” or the “four hundred rabbits,” representing the myriad ways intoxication could make a person feel and act. It is entertainment, social lubricant, creative stimulant, sensory experience, delicious beverage. At the end of a long day, it feels like a reward. But at some point — maybe it’s falling asleep at 7 while getting the kids to bed after a couple of beers, or going to work for the third day in a row feeling vaguely muffled — signs start pointing toward too much.

And when it comes to knowing your limits, the baseline is always shifting. Mr. Gilat and others say that the regular reset is how they stay on speaking terms with the limits they started with. “It can mean a couple of days, weeks or months off from drinking to come back to that baseline,” he told me. The pause isn’t a punishment, but a check — a way to remind yourself that you can get by without drinking, that you can still fathom the responsibilities of life as a parent, partner, worker, friend. And that the pleasures of those roles are still palpable.

WE can expect that when it comes to recommended allowances for alcohol, the numbers will continue to change. The public-health pendulum swings frequently in this country, and guidelines vary greatly among countries. France appears to have no government-sanctioned limits. Britain, which has some of the highest rates of heavy drinking in the world, recently revised its limits downward; the government cites an increased risk of certain cancers. And yet, as the American addiction specialist Stanton Peele has observed, “despite being heavily outdrunk by the English, we have almost exactly twice their levels of diabetes, cancer and heart disease.”

Dr. Peele has studied cultural drinking patterns, alcoholism and recovery for decades; his work suggests that we Americans are too concerned with the extremes — binge or purge, all or none. The benefits of alcohol are strongest when you drink moderately, but even if you drink more than is “perfectly” recommended, he argues that it’s “generally better for you than drinking nothing.”

But what we shouldn’t miss, I think, is that nothing is as important as something. Nothing is the reference point from which we can judge all else. The numerical middle is different for everyone, but perhaps that’s the point. Because my number is two and yours may be one and his might be five, the most relevant number to us all is zero.

Maybe the only way to think about drinking by numbers is not to obsess over how much is too much, but to be acquainted with what zero feels like — that is, to come back to zero often enough to understand the relative value of our numbers. The reset helps us see those numbers for what they are. It’s what keeps two from becoming three, three from four, and so on.

I recall my great-grandmother, who lived to a sharp, convivial 99. Most evenings she’d sit down with her shot glass of Johnnie Walker and beckon me for a chat. Did she have one or two? I doubt she worried about it. Lately I’ve been reacquainting myself with zero so I won’t have to, either.