The Stanton Peele Addiction Website, September 7, 2010.

Are there cultural differences in drinking?

From: Stanton Peele
Sent: Sep 7, 2010 12:29 AM
Subject: Are there cultural differences in drinking?

It is the burden of those who seek to impose global alcohol policies to minimize cultural differences in drinking.

There are five sorts of evidence to indicate these differences are real, deep, and must be taken into account.

  1. Cultural studies. For many decades, cross-cultural differences were the realm of anthropologists (cf. Heath, Marshall). Although these explorations of cultural differences are powerful and persuasive, they could always be disregarded as non-quantitative, and thus perhaps nonsubstantive.
  2. Question responses. The basis for assessing cultural differences progressed monumentally with the advent of systematic cross-cultural research instruments -- e.g., ECAS, EPSAD, HBSC - which INVARIABLY present large - sometimes massive - differences in drinking patterns. Room here questions the meaning of such responses.
  3. Export informants. Ironically, in their Cross-Cultural Applicability work, Room and colleagues - examining the objective basis for international addiction assessment tools (DSM-IV, ICD10) - found export informants defied these fundamental tools - even those supposedly banked in biological measurements. Room here seemingly found such evidence persuasive.
    Schmidt, L., Room, R., and collaborators. (1999). Cross-cultural applicability in international classifications and research in alcohol dependence. Journal of Studies on Alcohol, 60, 448-462.
  4. Health outcomes. ECAS systematically attempted to assess alcohol-related causes of mortality, and the ratios for these favoring Southern over Northern Europe exceeded any self-reported differences (in a ratio of 6:1). Always wary of such measures, epidemiologists scrutinized and built on earlier work in compiling the global burden of alcohol - with similar results. Of course, these are meant to be the most concrete measurements - and an answer to the oft-offered canard - "Southern Europeans only drink themselves to death more politely."
  5. My senses. Ironically, after all sorts of attempts at objective assessments, people return to their core beliefs in deciding whether to accept any sort of data.

When I first visited Oslo as a graduate student circa 1970, I repeatedly encountered drunks in the streets, which I never saw in continental Europe. Even though I was a relatively sophisticated social scientific graduate student, I questioned my senses - and came up with this explanation to explain what I observed - all alcoholics in Norway were brought to Oslo for treatment, and what I saw before me were simply the outpouring of patients released from such clinics.

When I revisited Oslo (and proceeded to Bergen) for a KBS meeting decades later with my wife, the first person we encountered leaving the cab was a street inebriate.

During our stay, we regularly encountered drunks in public places, were often told by Norwegians we encountered (like waitresses) in such situations about "the disgusting Viking style of drinking," were stunned to find on Oslo parks on a Sunday morning well-dressed people who had fallen dead drunk and lay there all night, encountered a sculptured form of a man laying drunk in the street in Bergen, were kept up all night by drunken wassailers in Bergen. . . .why pile on more examples?

Since then, I have spent time in Sweden and Finland, where I have come to speak of addiction. I have found, inevitably, people in these countries believe their fellow nationals drink problematically.

In more recent years, I have had more of an opportunity to spend time in Spain, Portugal, France, and Italy. Like any American, I am struck by people drinking beer at a cafe on a summer morning - "Shouldn't that be illegal?", I ask myself. I have now consumed MANY glasses of wine with many Southern Europeans, been served many glasses of wine in many restaurants alongside many people, often with my teenage daughter. I believe I have some feel for the meaning of these experiences.

Last night, I went to a festival in Turin, where two of my host's 20-something sons were playing in a band, a fascinating hybrid Cajun-sounding music. A bar serving cheap (5 Euro) cocktails was directly next to the performance area. I don't spend the kind of time I used to with dancing youngsters in musical venues (who knew they danced facing the stage, rather than with one another?). I was stunned by the absence of intoxication.

But, now, with the assistance of those who can interpret my experience better than can I, can explain away the data, increasingly refined as it is, alongside reports from those who experience these cultures themselves - I learn that all such differences are illusion - a meaning of words - a phrase tossed to the winds! - like the sounds of music wafting, disappearing, into the midnight air. My senses - these are so wrong!