WEBVTT - What's the deal with alcohol? 0:00:01.480 --> 0:00:03.400 Emily. I don't know if I've ever told you this, 0:00:03.600 --> 0:00:08.280 but this is not the first podcast idea I've ever had. Well, 0:00:08.360 --> 0:00:13.319 this actually is the second on the list, and the first, okay, 0:00:13.360 --> 0:00:16.239 ready was going to be it's me and my wife 0:00:16.280 --> 0:00:19.440 were both doctors, as you know, and we were going 0:00:19.640 --> 0:00:27.160 to sit and drink alcohol and talk through medical studies together. 0:00:27.920 --> 0:00:30.560 And do you know what I was going to call it? 0:00:31.640 --> 0:00:33.239 No, But first of all, I love it, and I 0:00:33.280 --> 0:00:35.080 hope you should also. I think you should also make 0:00:35.080 --> 0:00:37.040 this if one podcast is not enough, I would listen 0:00:37.080 --> 0:00:38.360 to that. But what is the title? 0:00:38.760 --> 0:00:39.800 Docs on the Rocks? 0:00:40.240 --> 0:00:43.479 That is so plascular? I love everything about it. Is 0:00:43.520 --> 0:00:45.760 the problem that your wife is too smart to get 0:00:45.800 --> 0:00:46.720 involved with this with you? 0:00:47.240 --> 0:00:50.440 Yes, that is one hundred percent of problem. I was enthusiastic. 0:00:50.479 --> 0:00:53.040 I brought as I bought two microphones. I was like, 0:00:53.240 --> 0:00:55.720 and it'll be like date night. It's like, but we're 0:00:55.720 --> 0:00:58.280 going to record it and we're gonna have drinks and 0:00:58.320 --> 0:01:00.480 then there would be a segment at the end, maybe 0:01:00.520 --> 0:01:01.880 at the beginning of the end. I didn't really think 0:01:01.920 --> 0:01:03.960 it through, but like, what are we drinking tonight? Like 0:01:04.040 --> 0:01:07.000 maybe one night it's some wine, maybe something maybe it's 0:01:07.000 --> 0:01:11.399 a fancy cocktail of some kind, and you know, I 0:01:11.480 --> 0:01:14.160 would be me and she would be like a normal person, 0:01:14.280 --> 0:01:17.520 a more normal person. I think it works, and I 0:01:17.600 --> 0:01:18.039 think it's so. 0:01:18.160 --> 0:01:23.200 Great, and I'm also feel like she said no, and 0:01:23.200 --> 0:01:26.440 then you were like, who's next. I'll go to Emily. 0:01:26.480 --> 0:01:31.640 She'll probably come. You'll probably be Emily's game. 0:01:32.840 --> 0:01:35.319 But I'm excited that to at least like have a 0:01:35.319 --> 0:01:37.160 little bit of the vibe of docks on the rocks 0:01:37.200 --> 0:01:39.880 right now because we're talking about alcohol though it's early. 0:01:39.920 --> 0:01:41.399 When we're Perry, what are you drinking? 0:01:41.760 --> 0:01:45.800 Drink any It's just a vodka enema, so technically nothing. 0:01:46.040 --> 0:01:50.720 I'm drinking a Fair Life Nutrition Plan protein shake, which 0:01:50.800 --> 0:01:53.160 is a touch of gin. 0:01:54.680 --> 0:01:56.840 Okay, alcohol coming right up. 0:01:59.480 --> 0:02:02.560 I'm Emily. I'm an economist and a data expert. 0:02:02.640 --> 0:02:04.720 And I'm Perry Wilson. I'm a medical doctor. 0:02:05.200 --> 0:02:08.480 It's Thursday, July twenty third, twenty twenty six. And this 0:02:08.600 --> 0:02:10.200 is wellness. 0:02:09.520 --> 0:02:13.520 Actually, because you're getting a staggering amount of health and 0:02:13.560 --> 0:02:17.560 wellness information nowadays from every source imaginable, and some of 0:02:17.560 --> 0:02:19.079 it is awesome and. 0:02:19.120 --> 0:02:24.280 Some of it is well actually bull Fortunately, we are 0:02:24.320 --> 0:02:26.880 both people who know how to read studies, how to 0:02:26.919 --> 0:02:29.480 parse the data, and can tell you what's worth thinking 0:02:29.480 --> 0:02:31.760 about and what you can safely ignore. 0:02:32.040 --> 0:02:34.320 But before we dig in, a note that this podcast 0:02:34.440 --> 0:02:37.000 is for educational purposes and should not be construed as 0:02:37.000 --> 0:02:40.240 medical advice. We don't know your unique situation, so talk 0:02:40.240 --> 0:02:42.120 to your doctor for personal health decisions. 0:02:42.960 --> 0:02:46.120 This week we're asking what's the deal with alcohol? Harry 0:02:46.120 --> 0:02:48.240 and I will give the official smasher pass, and then 0:02:48.280 --> 0:02:50.600 we'll get to your question of the week. But first 0:02:50.680 --> 0:02:53.040 let's do the health news roundup. After the break. 0:03:05.160 --> 0:03:08.359 And we're back with the health news of the week. Emily, 0:03:08.680 --> 0:03:12.000 there is one thing that keeps coming across my health 0:03:12.000 --> 0:03:16.120 news feed over and over and over again as frequently 0:03:16.520 --> 0:03:20.119 as many people across the country are running to the bathroom, 0:03:20.200 --> 0:03:24.520 and that is, of course, cyclospora. What is the latest 0:03:24.520 --> 0:03:26.440 status of the cyclospora outbreak? 0:03:26.919 --> 0:03:29.080 So I should say we're recording this at ten thirty 0:03:29.120 --> 0:03:33.000 six am on Tuesday, so it is very possible that 0:03:33.240 --> 0:03:36.520 something else will have happened. I cannot explain to you 0:03:36.680 --> 0:03:40.600 how insane the public health messaging has been around this. 0:03:41.040 --> 0:03:45.040 So at the end of last week they had identified 0:03:45.120 --> 0:03:48.120 Iceberg Lettuce as a core cause. And the way they 0:03:48.160 --> 0:03:50.480 did that is like in Michigan, they talked to a 0:03:50.520 --> 0:03:53.480 subset of the people who had the explosive diarrhea, like 0:03:53.880 --> 0:03:56.360 a huge share of them had eaten a Taco Bell 0:03:56.440 --> 0:03:59.360 and of those, like ninety percent had eaten iceberg lettuce 0:03:59.360 --> 0:04:01.080 at Taco Bell. So it was like, okay, it's probably 0:04:01.080 --> 0:04:03.640 the iceberg letus from Taco Bell. And then they traced 0:04:03.640 --> 0:04:05.360 that back to Taylor Farms, who traced it back to 0:04:05.400 --> 0:04:07.560 a single plant in Mexico, who then said, okay, let's 0:04:07.600 --> 0:04:09.800 just recall all of the iceberg lettuce from that plant 0:04:09.840 --> 0:04:13.000 because it seems plausible it has cyclospora. That felt like, okay, 0:04:13.040 --> 0:04:15.480 we're kind of getting there. That seems like the answer. 0:04:15.720 --> 0:04:17.440 This is how epidemiology works. 0:04:17.520 --> 0:04:20.120 Then over the weekend, the FDA said that they had 0:04:20.200 --> 0:04:23.880 tested some iceberg lettuce, not from Taco Bell, but some 0:04:23.920 --> 0:04:26.240 other iceberg lettuce from Tailor Farms, and they had found 0:04:26.320 --> 0:04:29.080 cyclospora parasites on it. And it was like, okay, that's 0:04:29.120 --> 0:04:31.440 like check. Now we're even more sure. 0:04:31.800 --> 0:04:32.440 Yeah. 0:04:32.560 --> 0:04:34.720 Then they walked that back and they said, actually, that 0:04:34.760 --> 0:04:39.320 particular test maybe was a false positive. Okay, everything else 0:04:39.400 --> 0:04:42.320 is still true. All the taco bell stuff, all the epidemiology, 0:04:42.360 --> 0:04:47.080 all of this is still true. But then Taylor Farms said, oh, 0:04:47.120 --> 0:04:49.240 now the FDA has said it's not us, which is 0:04:49.240 --> 0:04:51.839 not what the FDA said. And then the FDA was like, no, 0:04:51.920 --> 0:04:55.840 we didn't, we didn't apologize, and then people started talking 0:04:55.880 --> 0:04:57.960 about how Taylor Farms had given Donald Trump a million 0:04:58.000 --> 0:05:02.960 dollars like over the weekend. And I think fundamentally the 0:05:03.000 --> 0:05:07.719 messages donate Iceberg. Let us right now. But it could 0:05:07.800 --> 0:05:08.720 not be more stupid. 0:05:08.720 --> 0:05:12.280 I confusing, It is so confusing. I did dig in 0:05:12.360 --> 0:05:15.200 a little bit to like the various tests that are 0:05:15.279 --> 0:05:20.359 used to essay for cyclospora and the false positive rates. 0:05:20.720 --> 0:05:25.720 I mean they're not zero, but they're very low. You know, 0:05:25.960 --> 0:05:28.599 they have specificity of ninety eight to one hundred percent, 0:05:28.680 --> 0:05:31.520 so false positive rates of sub two percent. So there's 0:05:31.760 --> 0:05:32.880 I mean, it's always possible. 0:05:32.920 --> 0:05:35.279 Of course, now you're the tin hat. You're joining the 0:05:35.320 --> 0:05:38.640 tin Hath conspiracy theory of like the FDA is being 0:05:38.640 --> 0:05:40.760 bought off by something. 0:05:40.920 --> 0:05:42.360 I'm just asking questions, Emily. 0:05:42.680 --> 0:05:45.080 It's a little suss, a little sus. If the kids 0:05:45.120 --> 0:05:48.000 would say, there's something going on, I don't know what 0:05:48.000 --> 0:05:48.280 it is. 0:05:48.360 --> 0:05:51.159 Can I tell you the most genius thing that happened 0:05:51.160 --> 0:05:53.560 this weekend is we were out celebrating a friend's birthday 0:05:53.880 --> 0:05:56.000 and it was like a fun night, and we go 0:05:56.080 --> 0:05:57.760 back to their house at the end of the night 0:05:57.800 --> 0:06:01.280 and someone's like, let's door dash bunch of taco bell 0:06:02.040 --> 0:06:05.920 and the theory here was there is no better time 0:06:06.520 --> 0:06:08.560 to door dash a bunch of talk. This is going 0:06:08.600 --> 0:06:10.400 to be the healthiest talk of my husband ever. 0:06:10.520 --> 0:06:12.440 Is as the economist firm of that which he's like, 0:06:12.480 --> 0:06:14.520 tacobo must be so cheap. Right now, we should go 0:06:14.560 --> 0:06:16.039 you know how much food you can get for almost 0:06:16.080 --> 0:06:19.600 nothing and there won't be any lines. Mean, we're thinking, 0:06:19.720 --> 0:06:24.880 we're thinking the same the time. But guys still avoid 0:06:24.920 --> 0:06:28.200 iceberg lettus for the moment unless you know where it 0:06:28.240 --> 0:06:31.599 was grown and it was like your backyard, all right. 0:06:31.760 --> 0:06:35.680 Next up, aging research is setting upper bounds on our 0:06:35.760 --> 0:06:39.960 human life span. Disappointing news for Brian Johnson and for 0:06:40.000 --> 0:06:43.039 the rest of us. But what does this say? How 0:06:43.080 --> 0:06:44.599 old could I live to be? 0:06:45.800 --> 0:06:48.760 These studies are entirely theoretical and always so interesting to me. 0:06:49.880 --> 0:06:52.040 Like people have asked the question, this isn't what this 0:06:52.080 --> 0:06:53.880 study is about. But people have asked the question, like 0:06:53.880 --> 0:06:55.920 what if you what if the only thing that could 0:06:55.960 --> 0:06:59.839 kill you was accidents? Right, like like you're basically a mortal, 0:07:00.080 --> 0:07:01.840 you're an l or something, but like you can get 0:07:01.920 --> 0:07:03.919 killed if you fall out of a tree or something 0:07:03.960 --> 0:07:06.119 like that, but you'll never get sick, you'll never get old. 0:07:06.680 --> 0:07:09.479 And you can model this mathematically because you know what 0:07:09.560 --> 0:07:12.240 like the rate of accidents, fatal accidents are And it 0:07:12.280 --> 0:07:14.160 turns out I'm not going to get exactly right, but 0:07:14.240 --> 0:07:16.240 it turns out like unaverage, people would live to be 0:07:16.280 --> 0:07:18.960 seven hundred or eight hundred years old if the only 0:07:19.000 --> 0:07:21.920 thing that could kill you was getting in an accident. Okay, cool. 0:07:22.440 --> 0:07:26.680 This study looked at DNA mutations, so as you age 0:07:26.680 --> 0:07:29.560 your DNA, you know, little gamma rays come from outer 0:07:29.640 --> 0:07:33.640 space and they mutate DNA, and they asked the question, 0:07:33.880 --> 0:07:36.840 if this is the only thing that can kill you, 0:07:37.080 --> 0:07:40.120 are these like random gamma rays? Like we fix everything else, right, 0:07:40.120 --> 0:07:42.720 there's no heart disease, there's no cancer, but we can't 0:07:42.720 --> 0:07:45.480 fix the random gamma rays mutating your DNA. What's the 0:07:45.520 --> 0:07:48.640 maximum you can live? And the overall answer it was 0:07:48.680 --> 0:07:50.800 one hundred and forty six to one hundred and ninety 0:07:50.800 --> 0:07:56.000 four years. This was limited mostly by problems in your heart, 0:07:57.240 --> 0:08:01.880 which the DNA mutation accumulation would cause fatal heart ysfunction 0:08:01.960 --> 0:08:05.120 at about one hundred and fifty years. Similar levels in 0:08:05.160 --> 0:08:08.080 the brain. Interestingly, the liver, which is always just like 0:08:08.600 --> 0:08:11.720 down to party, could go for thousands of years before 0:08:11.840 --> 0:08:14.600 it would kill you from just DNA mutations alone. And 0:08:14.680 --> 0:08:17.960 so the researchers are saying, like, Okay, this is like 0:08:19.200 --> 0:08:23.280 longevity people. You know, this is the upper limit here, 0:08:23.320 --> 0:08:25.680 like you fix all the other stuff, you know, this 0:08:25.760 --> 0:08:27.040 is what's going to get you. But of course, like 0:08:27.080 --> 0:08:28.440 if you fix all the other stuff, I don't know, 0:08:28.520 --> 0:08:29.440 can't wait fix totally. 0:08:29.480 --> 0:08:31.040 I mean, this seems ridiculous. I don't know if these 0:08:31.040 --> 0:08:33.440 people have not watched Futurama where you just put your 0:08:33.480 --> 0:08:36.520 heads in the in the continue to watch Futurama. That 0:08:36.559 --> 0:08:38.240 was so great. People just live forever and their heads 0:08:38.240 --> 0:08:39.840 were like and these like it was just their head 0:08:39.920 --> 0:08:42.720 in like a little tube or whatever. I don't know 0:08:42.720 --> 0:08:45.560 how it worked, but it's yeah, yeah, like all the less, 0:08:45.600 --> 0:08:49.480 so get with it, aging researchers. But but I think 0:08:49.480 --> 0:08:53.360 it's like, mathematically, this is a super interesting approach. I 0:08:53.440 --> 0:08:54.480 like it I like it a. 0:08:54.400 --> 0:08:57.959 Lot of Yeah, that's kind of fun. Let's move on 0:08:58.360 --> 0:09:06.719 to talk about Secretary of str I mean, I think 0:09:06.800 --> 0:09:11.679 legally it's still the Secretary of Defense, but whoever he 0:09:11.800 --> 0:09:16.319 is has a plan to test all I guess nope, male. 0:09:16.400 --> 0:09:21.120 Sorry, it's to test all people in the military for testosterone, 0:09:21.280 --> 0:09:24.880 including ladies. Spoiler, they don't have very much. 0:09:25.280 --> 0:09:28.719 Oh geez, Okay. I love when stories are even stupider 0:09:29.000 --> 0:09:30.920 than I assume more. 0:09:30.760 --> 0:09:33.079 Logic than than he was going with this. 0:09:33.920 --> 0:09:36.800 So I think the overall, at least the overall idea 0:09:36.880 --> 0:09:42.720 here is that they want to identify people with low 0:09:42.800 --> 0:09:47.880 testosterone and presumably to supplement it in order to increase 0:09:47.920 --> 0:09:51.599 the efficacy of the armed forces. If you want to 0:09:51.640 --> 0:09:55.040 go back in time to our testosterone replacement therapy episode, 0:09:55.120 --> 0:09:57.480 you can get all the science about why this is 0:09:57.480 --> 0:10:02.000 a bad idea, including the fact testosterone supplementation doesn't end 0:10:02.080 --> 0:10:05.720 up doing much for men except increasing libido, and testing 0:10:05.760 --> 0:10:09.960 testosterone levels is not really recommended unless you're having libido 0:10:10.160 --> 0:10:13.040 or rectile dysfunction problems. And I don't think that's what 0:10:13.400 --> 0:10:17.000 the Secretary of War is worried about. God, I hope 0:10:17.000 --> 0:10:17.439 it's not that. 0:10:18.760 --> 0:10:20.520 Yeah, I mean I think his you know, I think 0:10:20.559 --> 0:10:24.520 he's sort of pitching an idea here that's like, I mean, 0:10:24.559 --> 0:10:28.640 we've seen this, this is Captain America. But I think 0:10:28.920 --> 0:10:32.720 you know, FDA approved level of testosterone supplementation will not 0:10:32.760 --> 0:10:36.160 produce Captain America. No, So I'm not really sure where 0:10:36.160 --> 0:10:37.760 we're going with this issue. 0:10:37.920 --> 0:10:40.720 I mean, yeah, you could like juice up all the 0:10:40.920 --> 0:10:44.559 army people. You've give them real steroids, like anabolic steroids, 0:10:44.559 --> 0:10:47.040 and you know, have them go into roid rage in 0:10:47.080 --> 0:10:49.160 the battlefield. I'm not really sure that's what we want. 0:10:49.200 --> 0:10:51.679 I don't know. This feels I don't exactly know how 0:10:51.720 --> 0:10:57.360 to put this, but this obsession with testosterone and sperm 0:10:57.440 --> 0:11:02.600 count and stuff feels like this is what my kids 0:11:02.720 --> 0:11:06.800 would say. It's like small dick energy. Okay, that's what 0:11:06.840 --> 0:11:07.120 this is. 0:11:07.679 --> 0:11:08.440 That's what it is like. 0:11:08.880 --> 0:11:13.959 Just you don't have to prove your manliness constantly by 0:11:14.040 --> 0:11:17.000 like announcing it to the world and performing it just 0:11:17.120 --> 0:11:20.040 like be a good dude, Jesus, be a good dude. 0:11:20.080 --> 0:11:22.880 But consider getting your sperm count and disosterone levels and 0:11:22.920 --> 0:11:26.040 a small tattoo in a place that you know, just 0:11:26.120 --> 0:11:28.600 people might see, like on your cheek. 0:11:29.480 --> 0:11:32.920 Consider the lower back. That's what I want all our army, 0:11:34.920 --> 0:11:37.960 you know, like that's it, That's what I'm talking about. 0:11:37.960 --> 0:11:39.240 It's amazing, that's what I want. 0:11:39.800 --> 0:11:43.760 Let's make that manly, all right. I think with those 0:11:43.800 --> 0:11:48.240 news items under our belt, let's take a dive into alcohol. 0:11:49.000 --> 0:11:51.880 And you know, I think we can actually skip this 0:11:52.080 --> 0:11:56.160 entire episode because someone has summed it up more perfectly 0:11:56.880 --> 0:12:00.400 than you and I ever could. Emily. Let me play 0:12:00.480 --> 0:12:01.120 the clip to. 0:12:01.240 --> 0:12:07.319 Welcome because of and solution to all of life's problems. 0:12:09.120 --> 0:12:11.800 Homer is very wise. He's wise. 0:12:12.280 --> 0:12:14.920 This is the best episode if you're a Simpsons fan. 0:12:15.160 --> 0:12:17.920 The prohibition episode is so great when he becomes the 0:12:17.920 --> 0:12:21.640 beer baron and Marge is actually proud of him for 0:12:21.720 --> 0:12:25.440 doing something clever as he's filling bowling balls with hooch, 0:12:25.679 --> 0:12:29.160 and like there's a whole system of pipes that takes 0:12:29.160 --> 0:12:31.240 sit from the bowling alley to mose bar. Such a 0:12:31.240 --> 0:12:36.480 classic alcohol Emily has been around for quite some time. 0:12:36.960 --> 0:12:42.120 Yeah, people have been fermenting things for a very long time. 0:12:42.880 --> 0:12:47.800 I think the first confirm fermentation is seven thousand BCE, 0:12:48.160 --> 0:12:50.280 so that's what nine thousand years ago. 0:12:50.559 --> 0:12:51.200 That's a long time. 0:12:51.920 --> 0:12:54.480 I mean, fermentation is not hard, you leave stuff. You 0:12:54.480 --> 0:12:57.360 could imagine how this happens, right, You make some stuff 0:12:57.400 --> 0:12:59.200 with rice, you leave it out for a little while, 0:13:00.040 --> 0:13:02.640 you're thirsty, you taste it, you realize it doesn't taste 0:13:02.640 --> 0:13:05.360 that great. But boy, is this fun? And then we're 0:13:05.400 --> 0:13:06.959 kinda off to the races. 0:13:07.240 --> 0:13:11.040 Yeah. Absolutely, And it's not just humans who do this amazingly. 0:13:11.920 --> 0:13:15.600 So a brief list of animals who have been documented 0:13:15.640 --> 0:13:18.480 to actively seek out fermented fruits. So these are animals 0:13:18.480 --> 0:13:21.360 basically that like, there'll be a you know, fruit rotting 0:13:21.480 --> 0:13:25.600 essentially becomes alcoholic over time. Here's some animals that like 0:13:25.920 --> 0:13:30.079 to play around with these chimpanzees, black handed spider monkeys, 0:13:30.360 --> 0:13:35.360 African elephants, tree shrews, and even fruit flies. Although apparently 0:13:35.400 --> 0:13:38.800 fruitflies aren't getting drunk. They're laying their eggs in fermented 0:13:38.800 --> 0:13:42.960 fruit because the antiseptic properties of alcohol prevent some egg 0:13:43.000 --> 0:13:46.640 diseases on fruitfly eggs. That's nice. 0:13:48.040 --> 0:13:51.480 So people have been consuming alcohol, either for fun or 0:13:51.640 --> 0:13:56.000 you know, in some periods, beer was a sort of 0:13:56.080 --> 0:14:00.080 much safer way to consume liquid than water because it 0:14:00.120 --> 0:14:03.280 was much less likely to be full of cholera and 0:14:03.320 --> 0:14:06.400 so on. So we really, alcohol is you know, it's 0:14:06.400 --> 0:14:09.959 one of our oldest customs. The Romans loved wine. Every 0:14:10.600 --> 0:14:11.760 everybody loves alcohol. 0:14:12.080 --> 0:14:14.840 Everybody loves alcohol. Why are they telling us it's so 0:14:14.880 --> 0:14:15.480 bad for us? 0:14:15.520 --> 0:14:16.959 Then? I don't know. I guess we're ready to get 0:14:16.960 --> 0:14:18.960 into that. But it is. It has been popular for 0:14:19.000 --> 0:14:20.480 many millennia, let's put it that way. 0:14:21.360 --> 0:14:24.760 On the medical side, a bit of fun history of prohibition. 0:14:24.840 --> 0:14:27.320 Not that prohibition was that fun. So US Prohibition was 0:14:27.320 --> 0:14:30.360 from nineteen twenty to nineteen thirty three. The Eighteenth Amendment 0:14:30.400 --> 0:14:32.160 ban the sale of alcohol at that time, but it 0:14:32.200 --> 0:14:35.400 did carve out an exception for medicine, and so you 0:14:35.400 --> 0:14:39.760 could get a prescription for medicinal whiskey. And apparently in 0:14:39.800 --> 0:14:45.000 that period doctors wrote an estimated eleven million prescriptions for 0:14:45.160 --> 0:14:51.360 medicinal whiskey, treating ailments ranging from indigestion to depression, usually 0:14:51.480 --> 0:14:54.359 charging a hefty fee for those prescriptions. 0:14:54.520 --> 0:14:57.520 What else is new that sounds right? I mean, Prohibition 0:14:57.600 --> 0:15:02.520 is a very interesting historical episode, obviously, because there were 0:15:02.560 --> 0:15:04.040 a lot of social problems. There are a lot of 0:15:04.040 --> 0:15:07.440 social problems caused by alcohol. You can see the instinct, 0:15:07.920 --> 0:15:11.280 and yet you seem to really backfire in a lot 0:15:11.320 --> 0:15:14.280 of ways. It was certainly unpopular in addition to generating 0:15:14.280 --> 0:15:18.280 a lot of mob related crime and apparently fake prescriptions. 0:15:18.680 --> 0:15:20.680 You banned stuff that is really easy to make in 0:15:20.720 --> 0:15:22.200 your own home, and people are going to make it 0:15:22.280 --> 0:15:23.680 in their own home totally. 0:15:23.720 --> 0:15:25.000 Have you ever made your own alcohol? 0:15:25.320 --> 0:15:28.720 I have. I brew I've brewed my own beer. That's 0:15:28.760 --> 0:15:31.360 all I've done. I've never distilled anything, but I had 0:15:31.360 --> 0:15:34.800 fun brewing my own beer. I made this very delicious 0:15:34.840 --> 0:15:37.960 tasting IPA that was not very high in alcohol content, 0:15:38.320 --> 0:15:40.160 which is now like a popular thing. 0:15:40.840 --> 0:15:42.920 One time in college, one of my roommates brought back 0:15:44.040 --> 0:15:50.280 raisin based homemade liquor from Christmas break. It was bad. Actually, 0:15:50.560 --> 0:15:54.080 I wouldn't recommend making hard Linger out of raisins. 0:15:54.800 --> 0:15:58.480 One thing I used to see in Pennsylvania are people 0:15:58.760 --> 0:16:03.240 who would come in with chronic lead toxicity, which can 0:16:03.280 --> 0:16:09.440 present doctors as the triad of kidney disease, gout, and hypertension. 0:16:09.960 --> 0:16:12.720 And what we would occasionally trace it back to are 0:16:12.760 --> 0:16:19.120 people making moonshine, because in Appalachia, people will often distill 0:16:19.200 --> 0:16:22.360 the liquor. The moonshine liquor in old car radiators, which 0:16:22.560 --> 0:16:26.480 used to be lead lined and so the lead would 0:16:26.520 --> 0:16:28.680 leach out into the moonshine. Then they drink moonshine. They'd 0:16:28.720 --> 0:16:32.200 come and see us with gout and kidney disease. 0:16:32.600 --> 0:16:36.640 Yikes. Okay, all right, so don't make your moonshine and 0:16:36.680 --> 0:16:40.840 your car radiator more. You know, how does alcohol work, 0:16:41.040 --> 0:16:44.240 doctor Perry, Let's do it. What are the reasons the 0:16:44.320 --> 0:16:48.440 alcohol is fun? Basically, that's the first question. 0:16:48.680 --> 0:16:51.160 Yeah, it works in your brain. It actually works like 0:16:51.240 --> 0:16:52.960 a lot. We have drugs that kind of work in 0:16:53.080 --> 0:16:56.720 similar ways, and alcohol sort of touches on all of these. 0:16:56.760 --> 0:16:59.640 So the primary one that you'll read about is that 0:16:59.800 --> 0:17:04.000 if it stimulates the GABBA receptor in the brain. This 0:17:04.359 --> 0:17:08.960 is the same receptor that benzodiazepines like adavan, valuum, those 0:17:09.000 --> 0:17:12.439 types of drugs bind too, So it gives that sort 0:17:12.480 --> 0:17:17.439 of tired, sleepy, funky feeling that comes with stimulation of 0:17:17.480 --> 0:17:22.160 that receptor. But it also blocks the NMDA receptor. That 0:17:22.359 --> 0:17:24.880 is what ketamine does, so it has a little bit 0:17:24.920 --> 0:17:28.200 of the depressiant effect or the dissociative effect that you 0:17:28.280 --> 0:17:31.840 see with ketamine. It causes dopamine release in the brain, 0:17:31.960 --> 0:17:35.359 which is why it feels pleasant and happy and good 0:17:35.640 --> 0:17:40.359 at least for most people, and it releases endogenous opioids, 0:17:40.400 --> 0:17:44.160 so it has even an opioid effect in the brain. 0:17:44.320 --> 0:17:47.360 So it kind of it's like it's like an amazing 0:17:47.400 --> 0:17:51.879 cocktail note pun intended of drugs that people like to 0:17:51.920 --> 0:17:55.080 abuse because it makes their brain feel nice and it 0:17:55.119 --> 0:17:56.160 also makes you peel lot. 0:17:56.359 --> 0:18:02.000 Okay, So we talked about prohibition and and post prohibition, 0:18:02.080 --> 0:18:04.680 Americans have been drinking a lot. But actually in the US, 0:18:04.720 --> 0:18:06.679 the amount that people drink has been going down very 0:18:06.680 --> 0:18:10.320 precipitously over time. There was a sort of bump up 0:18:10.520 --> 0:18:12.960 over the last short period. There was a bump up 0:18:13.320 --> 0:18:17.720 during COVID wheneveryone was at home drinking, but it has 0:18:17.960 --> 0:18:20.800 continued a downward slide and we are now seeing both 0:18:20.840 --> 0:18:23.240 the sort of the lowest levels of drinking, the most 0:18:23.320 --> 0:18:27.320 number of people who are totally sober, and also a 0:18:27.359 --> 0:18:31.520 lot of discussion in I would say, the wellness and 0:18:31.640 --> 0:18:37.040 health space about how much alcohol is okay and more 0:18:37.119 --> 0:18:40.360 and more a message that none is okay. I would say, 0:18:40.359 --> 0:18:43.159 the kind of there's a piece of health messaging that 0:18:43.240 --> 0:18:45.000 comes some of it from the government, some of it 0:18:45.080 --> 0:18:48.600 from official sources, some of it from online that's in 0:18:48.680 --> 0:18:52.199 the space of you know, the appropriate amount is really none, 0:18:52.440 --> 0:18:56.200 and that even a small amount is bad for your health, 0:18:56.680 --> 0:18:59.760 and how bad is not so clear, and that's the 0:18:59.760 --> 0:19:02.040 piece of the messaging. I'm most interested in looking at 0:19:02.040 --> 0:19:03.840 the data on today because I think it's the piece 0:19:03.840 --> 0:19:06.520 that's most relevant for a lot of people. But before that, 0:19:06.560 --> 0:19:09.320 I actually do want to touch just briefly on the 0:19:09.400 --> 0:19:14.880 question of problematic drinking, because these are fundamentally somewhat different questions, 0:19:14.920 --> 0:19:17.400 And the question of you know, is it okay three 0:19:17.440 --> 0:19:19.040 times a week to have a glass of wine with 0:19:19.080 --> 0:19:22.600 dinner is pretty different from you know, how do we 0:19:22.640 --> 0:19:24.720 think about someone who from whom alcohol is getting in 0:19:24.720 --> 0:19:27.960 the way of their life or their family's life or 0:19:28.000 --> 0:19:31.280 other things. But that is an issue for many people. 0:19:31.320 --> 0:19:33.840 Alcohol is something a lot of people have a problem 0:19:33.840 --> 0:19:37.000 with and abuse. And it's also very clear in the 0:19:37.080 --> 0:19:39.520 data that heavy drinking is associated with quite a lot 0:19:39.520 --> 0:19:43.200 of bad outcomes. There are large estimates of amount of 0:19:43.240 --> 0:19:46.760 access death from heavy drinking. So I'm not even sure 0:19:46.800 --> 0:19:49.879 how to separate these, and I think it gets complicated 0:19:49.920 --> 0:19:52.720 because there's a continuum, it's not just two groups of people. 0:19:52.800 --> 0:19:55.240 But I do want to try hard in the discussion 0:19:55.280 --> 0:19:57.680 to sort of separate those two things. 0:19:58.320 --> 0:20:00.560 Yeah, I couldn't agree more. I think I think most 0:20:00.840 --> 0:20:03.159 people you know, if you have alcohol use disorder, if 0:20:03.160 --> 0:20:05.359 your alcohol use is affecting your daily life, if you 0:20:05.359 --> 0:20:09.359 feel guilty about drinking, if a loved one has brought 0:20:09.359 --> 0:20:11.600 it up to you that perhaps you're drinking too much, 0:20:11.640 --> 0:20:13.679 if you need to drink after you wake up in 0:20:13.720 --> 0:20:18.159 the morning, Like, there are plenty of signals of problematic drinking, 0:20:18.240 --> 0:20:21.560 and that is a group of people who need to 0:20:21.560 --> 0:20:25.000 seek some help because it definitely is associated with many 0:20:25.040 --> 0:20:28.040 bad health outcomes and of course life outcomes. And that's 0:20:28.080 --> 0:20:30.639 not really what we're talking about today. We're talking to 0:20:31.119 --> 0:20:34.879 the majority of people who may drink a bit, they 0:20:34.960 --> 0:20:38.920 drink moderately, who are hearing all these statements that every 0:20:38.920 --> 0:20:41.240 single glass of wine you have, every single drink is 0:20:41.359 --> 0:20:43.600 poison and want to know if that's true or not. 0:20:43.720 --> 0:20:45.879 And that's where we have to break down the data. 0:20:46.119 --> 0:20:49.439 Yeah, before we leave the question of problematic drinking, this 0:20:49.560 --> 0:20:51.919 is actually a space where we could do another episode 0:20:51.960 --> 0:20:53.600 on it. But there's a space where there is an 0:20:53.640 --> 0:20:57.800 increasingly interesting discussion about different possible treatments. There's been some 0:20:57.840 --> 0:21:01.800 evidence of gilp ones have improved alcohol use disorder. There's 0:21:01.840 --> 0:21:05.960 a drug called nltroc zone which people have used, and 0:21:06.200 --> 0:21:10.080 actually a variety of interesting ways to try to limit 0:21:10.119 --> 0:21:12.240 alcohol use. So that's for another day, but let me 0:21:12.280 --> 0:21:14.600 just leave here by saying, if you are struggling with 0:21:14.640 --> 0:21:16.840 alcohol use disorder, if you feel like alcohol is getting 0:21:16.840 --> 0:21:19.040 in the way of your life, that really is something 0:21:19.080 --> 0:21:22.679 to seek treatment for, and it is there are an 0:21:22.720 --> 0:21:26.800 increasing number of possible solutions that might be helpful. 0:21:27.800 --> 0:21:31.919 Sounds good for the rest of you. We are going 0:21:31.960 --> 0:21:35.040 to dig into the data about light to moderate drinking 0:21:35.280 --> 0:21:36.639 and its health effects if any. 0:21:37.040 --> 0:21:45.600 After the break, Okay, Perry, we are back and we're 0:21:45.600 --> 0:21:48.440