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Most of us like to drink.
Often people philosophize about wine, beer,
gin or other high-proof alcohol.
And everyone seems to know roughly how to handle it.
So do I.
However,
when I try to restrict my consumption for several months,
I fail miserably.
Why?
Why is it so hard not to drink?
What do we even know about alcohol?
For 3 decades
we've been drinking a little less in Europe, but worldwide
people are starting to drink more and more alcohol.
The number of people addicted to alcohol is increasing.
There are 140 million worldwide
with around three million deaths every year.
Why is alcohol still so successful?
How can we hide the dangers of alcohol so well
while we are drinking?
ALCOHOL The global intoxication
I love the centuries-old wine culture I grew up with.
There was always a bottle of red wine on the table in the evening at our house
and I like my daily glasses of wine which help me to relax.
Many of my friends produce their own wine, just as the farmers here in Sicily.
Normally I drink one glass for lunch
and one more with dinner in the evening.
Then it can be two glasses with friends around.
But we stay within the limits.
It is supposed to be like an elixir of life.
What a smell, excellent.
I am going to embark on a journey
to find out why we drink,
what alcohol does to us
and why we are exceedingly successful
in blocking its dangers.
Therefore I am going to talk to drinkers, alcohol producers,
psychologists and doctors around the globe.
Alcohol is a wonderfully clever drug. It is quite promiscuous.
It is a small molecule, gets in the brain very fast
and it turns on or turns off a whole range of different brain areas.
It turns off the areas which give us responsibility,
make us worry, make us anxious.
So we relax, we feel cheerful.
We also do crazy things and sometimes we like that.
It has a very broad action in the brain.
It improves mood, reduces stress, reduces anxiety in small amounts.
But of course, the more you take
you get into problems with intoxication and unsteadiness.
It's probably fair to say that every single neuron in the brain,
those 200 billion neurons in the brain,
are all affected by alcohol at some point.
David Nutt talks naturally about alcohol being a drug.
Do winegrowers in this region live in a huge drug cultivation area?
Is that possible?
Some people say, you should never take any drug.
But usually those people are taking drugs, they're drinking, taking coffee or tea.
In fact there is almost no one in the world that doesn’t take a drug.
Taking drugs is a very human thing.
I think it's alongside arts and music.
It's kind of one of the defining features of humanity.
The human brain likes to seek out ways of improving itself.
Drugs do that.
Then cold beer and good wine are also drugs.
But why are they almost never named as such?
The term "drug" is used exclusively for illegal intoxicants.
It is also used to reassure the alcohol community,
"We don't have a drug problem.
We only drink alcohol.
And that is just a culturally established consumer product,
a luxury good, a food product or whatever."
But whatever you call it: psychoactive substance,
intoxicant or drug, it's all correct.
Objectively it applies to alcohol as well as to illegal substances.
No matter which one you choose,
you will immediately face a flood of outrage and denial.
By negatively stigmatizing other substances as drugs,
I unburden myself from the eventual problem of alcohol consumption.
That means with every sip of beer or wine we take drugs.
But we do not openly admit that.
So why do we do that?
Wherever you go every culture on earth seems to have a way
of altering their consciousness.
If they don’t do it with drugs they do it with breathing or exercise.
It may have to do with the realization
that we are only here for a final amount of time and...
what could happen after we die.
And wanting to have some access to another dimension of experience.
You give us wine,
fruit of the grapevine and human labour.
We hold this chalice towards your presence.
For it to become our chalice of salvation.
Alcohol is a substance which,
given that we live in a high performance society,
can damp the effects of a strenuous
and nerve-racking day at work.
It cushions us quite quickly,
psychologically speaking.
It makes us come back down in other words.
Alcohol has the ability to establish drunkenness layer by layer.
That means, with only one glass you can get into a state
of being slightly high if you're used to alcohol.
But you can also drink more and slowly lose inhibitions
until becoming unconscious.
Layer after layer you can build up drunkenness.
This cultural ability is taught and learned at a young age,
that's for sure.
You could also decide to go to a bar somewhere else,
but inhibitions would be a lot stronger there
to act up like this, so to speak.
Or to come out of your shell.
Where you can also...
celebrate excessively in a way.
To be the goof for a while and to have fun,
that's what really counts.
And to be drunk in a big group and to have fun and it's simply OK.
The social setting is even more important in many ways than the drug itself.
If you are drinking alcohol in a romantic... spot,
where you are having quiet, sort of you know, music.
And you're with somebody that you care about,
alcohol can serve a purpose of relaxing and sedating.
But if you are in a war zone and or you are in an...
environment that promotes gangs and violence,
alcohol can stimulate the brain to be disinhibited
and people can do very dangerous things.
So alcohol has a very wide range of activity in the brain.
I wouldn’t want alcohol to not be a part of football
because it does, it brings people together, that social side of things.
And everybody goes to the pub.
They see their friends. It is like you see your tribe of people
and you are talking and you are building up this...
atmosphere and this hype and this feeling before the game.
I think that the two just kind of go well together.
It can be used to really emphasize experiences
and that sort of comradery with this perfect marriage of...
Yeah, it is a ritual, it is people going,
you start at a certain time, first pint of the day on a match day.
I remember being 14 at my friend. She had a house party
and you know, quite a few of us were there,
all having the odd little drink, alcopop or,
you know, light weight stuff really.
But I remember taking my first sip and that feeling,
the feeling of the warmth going through my body,
and feelings of confidence that I hadn’t really felt before as well.
And an energy and I thought, "This is me. You know I like this."
And even on that first time I drank,
I drank way more than everybody else
and kind of got myself into a little bit of... I was drunk.
And...
that kind of stage.
You know, as we grew older me and my friends,
15, 16, 17, you go to these parties.
I noticed that I was the one that was...
really in a mess.
And you know in black-out mode,
so I would do and say all these things
and I would have no recollection.
Go on.
Was that not a foul there?
Humans have been drinking alcohol for a long time,
demonstrably for 10,000 years.
Only since the industrialization of its production
has consumption increased dramatically.
Suddenly alcohol was permanently and constantly available.
Today annual sales of the global alcohol market
are $ 1,300 billion and rising.
What influence does this industry have on our consumption?
Out of the requested global operating corporations,
only Carlsberg is willing to talk to us.
This is the best time ever to be in the beer industry.
And I don't say that glibly or as a corporate man, I mean that.
You know I am not a brewer, I am a drinker, I enjoy beer.
And there is more beer available than ever to consumers, more choices.
And I think that choice will continue.
You will see people taking their repertoires expanding.
The numbers of different beers that they try will expand
in different occasions.
And you will see that revolution sweeping across the world.
Consumer buying power is growing.
Consumers desire to experiment and try new things
is expanding very fast.
And the whole digital revolution in these markets also
enables us to reach millions of consumers.
You would be insane not to look at the opportunities in India and China.
I as a global person working at Carlsberg,
I spend a lot of my time looking at these markets,
working with the teams there.
We've got really strong management teams in these markets
and it is great growth.
We’ve recently run a small event in Beijing
and we reached over 123 million consumers
through our social media platform, on one event.
Corporations spend billions of dollars annually worldwide
for their alcohol marketing.
It is a gigantic advertising machine,
and Carlsberg is no exception.
So it was this room, we had all the Liverpool hops in.
These four tables,
full of hops from all the way down, all up through past the light.
Cause hops grows really fast,
every day.
So we had put big screens up from here,
one and a half meters, all the way down to the end,
down and up again.
And we’ve played games from the last twenty-five years
of the Liverpool games,
including premier league games, champions league games...
to try to influence the plant, help it growing
and try to build in this Liverpool spirit in our hop cones,
which we will harvest later on.
And we used those for the beer production,
which we then released and gave away to the Liverpool fans.
In the UK we have seen evidence
to show that children and young people
are very heavily exposed to alcohol marketing messages.
So much so that they develop brand loyalty and identity.
For example a recent study showed that UK children in primary school
were more able to identify brands of major alcohol companies,
than they were brands of ice-cream and chocolate biscuits,
which really is a very sad state of affairs.
But it just goes to show how ubiquitous alcohol marketing is.
And how alcohol marketing is present
in every public space that children are in.
We often see alcohol promotions that include
messages with overly sexualized women
or include hyper-masculine messages that can entrench gender stereotypes.
And we also see an awful amount of alcohol promotion online
and on social media sites.
And this is certainly a space where
children and young people are occupying.
And it is also a space that is incredibly unregulated,
where more subversive marketing practices take place.
We don't exclusively drink alcohol because we saw it in a commercial.
On the other hand we can learn quite well from international surveys
what happens when alcohol is sold particularly cheap or expensive.
What happens when alcohol advertising is allowed or not.
What happens when alcohol is constantly available like in Germany,
at every corner or gas station.
And what happens if this is not the case.
So we can make clear assumptions:
With an average consumption of ten litres of pure alcohol
per capita every year,
a considerable amount, ranging from three to four litres,
can surely be traced back
to very favourable circumstances for alcohol consumption.
10 litres of pure alcohol in other words about 200 litres of beer,
85 litres of wine or 25 litres of whiskey.
This quantity per capita presents the Central European average.
Scandinavia is below this average
and it is even considerably lower in countries like Italy.
This gap is due to climatic and cultural reasons.
In Scandinavia due to state regulation.
There is very strong and robust international evidence
to show that restrictions on the affordability,
availability and promotion of alcohol
will make a major significant contribution to reducing harms in the society.
Now these three measures have been listed
by the WHO as best-buy policies that governments should adopt.
Now a major obstacle to progress in this area,
is the activities of the alcohol industry,
who obviously have a very vested interest
in trying to encourage sales and consumption of their products.
Today my friends say, "Wow, you've been dry for over three years now?
How did you do that? I would never manage."
Then I tell them,
"I'm doing well,
because I'm not feeling bad."
Sobriety didn't help me discover the things in life...
that would make my life a lot nicer or more balanced
or more worthy to live
as many others said,
who wrote about alcohol or their alcohol related history.
They say, "Wow.
Only since I'm staying sober I discovered the real beauty of life,
the colours, the smells and so on.
Everything is nicer and totally different..." I don't say that.
As long as I didn't get sick from alcohol,
my life was much nicer with alcohol than it is now without.
No doubt about that.
Eh, cheers.
I am not against alcohol.
After all I have benefitted from it for 30 years.
For the enjoyment, its mood stimulating effects and as doping.
It didn't do me any harm,
I have no liver damage or anything.
The question why parts of the population, 10, 12 or 15 percent,
end up losing control
and become serious addicts,
is a completely different issue.
It is not about alcohol.
As it's not the alcohol which is to be seen as devil or drug.
It's rather our own mental...
and maybe even cultural and social...
dimension that hasn't learned
or that fails at a certain moment to avoid getting sick of alcohol.
But what cocktails? White Russian,
Sex on the Beach,
Espresso Martini.
No... No, stay away from beer until the end of the night.
Stay away from like cider because that's just going to cause trouble.
It used to be Jäger-bomb...
You have one drink and the shots as a side drink.
You have the shots a side. You have a starter which is the cocktail.
I always feel older than I am.
I feel like I was 14 and now it's like I'm 24 now.
And how old are you? - I'm 18.
Have you actually been out in town before?
Yeah, I went out literally like...
I went out on Wednesday and then on Saturday.
Everyone would say, "Oh, Sarah again?
Drunk again?"
And I guess people used to find it kind of funny,
and it was to an extent.
As time went by it wasn’t funny anymore
and I was really struggling with it and I started to think,
"What is wrong with me,
why can’t I just drink like everybody else?"
I would go out with every intention sometimes,
of just having one or two drinks.
I’d see my friends do that and they'd go,
"We're just going to have two beers,
two glasses of wine and then we will go home."
But I might go with them for that,
two drinks later, off they go, you know, and I am saying,
"I am not going home, I’ll stay out." Because I wanted more.
What happens when you drink alcohol?
It goes down your mouth, into your stomach, blood and brain.
In the brain it starts to work on a system in the brain
called the GABA system.
This is the brain’s main calming neurotransmitter.
Alcohol calms the brain.
Which is why you feel relaxed,
why you feel sociable,
why anxiety goes down.
As a result of that or through actions on other transmitters it does other things.
It can release dopamine, the get-up-and-go transmitter.
Some people get very animated and excited when they drink,
because the dopamine is released.
It can also release endorphins, which is why alcohol deadens pain.
It possibly also releases serotonin, a sort of feel-good neurotransmitter.
So alcohol has a range of effects when its levels are rising in the brain.
But if you drink more and more,
then it starts to interact with another system, the glutamate system.
Glutamate is what keeps you awake.
But alcohol blocks that and eventually you will go to sleep
when your alcohol level is raised.
Then eventually you go into a state of anaesthesia and eventually you'll die,
because if you block glutamate too much, you stop breathing.
I must say, that I was a mirror drinker for my whole life.
It means that I didn't aim for drunkenness,
but for a constant state of light stimulation
through alcohol.
However,
alcohol can do a whole lot
and it has different phases and stages.
Even on a single day of drinking
and it can be used in a variety of ways.
It can vitalize and push you.
It can calm you down when you're stressed.
It can...
when writing longer texts
or when editing films,
it can round things up and relax things a bit.
Since social recognition
and the realization of my work were so important to me,
it was clear to me that I tried to never take the risk
of my work being diminished
or influenced by alcohol in any way.
But it escalated
until at some point I realized
things were not under control anymore.
The outside world, my colleagues, my fellows
did not notice, because I wasn't alone.
I was surrounded by people who were on the edge of
being an enjoyment drinker to being a risky drinker.
I was a true risky drinker.
It happened that several times a week,
in the evening before going to bed,
to calm me down and to be able to go to sleep,
I would empty a bottle all by myself.
Why do we go to a bar?
You could drink at home alone, but you probably don't want to.
It's above all a social event.
I'd say so, yes.
It should be like a harbour where you can always land, no matter where you are.
And you know that you are
more or less
safe for now.
And the rest of the world
won't get inside.
And then you will need to look after these people.
You need to care of them.
For many it's...
a way to calm down with at first.
And...
then something that beams yourself somewhere else.
Drinking for enjoyment is very rare.
The ability of coping with alcohol...
so that...
so that it...
makes a bit more sense isn't all that easy.
Simply getting hammered is not really a trip
or when you finally black out.
A trip is something else. It's a different state of mind
where you let yourself go if it works.
A slight buzz is achieved best alone
or in a small group.
Because everyone reacts differently to alcohol.
Alcohol...
probably like most other drugs,
was originally used mainly in a spiritual or religious context.
It used to be religious ceremonies
in which you would shoot yourself off together,
but it was regulated who would drink what and how much.
That's not the case anymore.
I think what it was with me was...
When I started drinking alcohol I realized that
all the stresses, all the things that were going on in my head,
anxieties, fears, worries, anything negative in my head...
You have a drink and you forget, you know.
It is party time in your head.
Everything that is bothering you becomes small and irrelevant.
And you just want to keep that feeling of not caring.
Just not caring, not having anything to worry about.
And the more you have that, the more you want to keep it. So you drink more.
That was me, once I had a drop
and I feel like different, I want to chase that feeling.
I want as much of that as I possibly can.
I would stay out with whoever.
I would make friends or acquaintances
to enable me to stay out and continue drinking.
About 10 years ago I decided
to analyse the harms of different drugs using a new scale I developed,
which basically looks in every single harm a drug can do.
It turns out there are 16 different ways in which a drug can do you harm.
There are nine harms to the user.
They range from killing you when you first drink it,
to damaging your body or to making you dependent.
And there are 7 harms drugs do to society.
What popped out was that alcohol was the most harmful drug in the UK.
A lot of people say, that's ridiculous.
We went back and we got a group of European experts,
20 countries, 30 experts. We did the whole thing.
Came up with the same result.
Across the whole of Europe alcohol is the most harmful drug.
And the reason is:
The harms of alcohol to other people, to society are massive,
compared with any other drug.
They cause traffic accidents,
are responsible for a lot of domestic abuse,
child-sexual abuse etc., also huge health care and policing costs.
When I started telling politicians
that drug policy should be focusing on alcohol,
the government got very upset,
because the alcohol industry is hugely powerful.
It influences politicians consistently, repeatedly behind the scenes.
That is why I got sacked as Government Chief Adviser.
I said, "Alcohol is the most harmful, we should be focusing on that."
The production of alcoholic beverages
is deeply rooted in many parts of Europe.
In every European capital as well as in Brussels
powerful lobbying associations
represent the interests of the alcohol producers.
The wine sector is an enormous agricultural market.
In terms of economy
it is the first agri-food export in value of the European Union.
So we sent...
11.3 billion Euros of wine was exported in 2017
outside the European Union
and this provides positive trade balance of almost 9 billion Euros.
So we export a lot. We don’t import a lot.
Three million people are working directly in the production of wine.
We used to say it is an enormous pillar
for the agri-economy of the European Union.
You are in China or you are in Brazil,
or you are in...
Nigeria...
And people buying a wine is not just buying a product,
it is buying the image of the product behind.
It’s a product which is elegant,
which is combined with food,
which is fine.
So all of these elements have been transmitted.
Wine is what makes people "people",
because creative people never drink water.
They only drink wine.
And wine is just... Now it is business for many people.
Wine is about having a good time.
Drinking wine...
And sharing wine...
Singing songs, writing poetry, having sex. - One of the most important things...
is sharing the wine and the love of affection
and true connection between other people, that’s what it is all about.
We represent roughly one million jobs in Europe
in the field of direct production and sales,
as well as indirectly of course many other economical impulses,
in the fields of gastronomy, hotel industry and tourism.
Last year we exported an equivalent value of 11 billion Euros of liquor.
That means, alongside with wine,
we are at the top of European food exports.
A very valuable sector...
or as the Commissioner of Agriculture here in Brussels says,
"We are one of the crown jewels in the segment of food exports."
To find out more about the specific export machine
of the European alcohol industry
my journey takes me to Nigeria,
one of the growth markets in global alcohol business.
For the beer industry Africa is really
one of the most promising places on earth.
The continent is rising.
In many countries the economy is doing better than...
15 or 20 years ago.
There are middle classes that are rising,
there are more and more people
who consider themselves to be middle class.
And they have some spending money.
According to the latest numbers for every beer sold in Africa,
the profit is almost 50% higher than in the rest of the world.
One of the main reasons Africa is so profitable for Heineken,
is that there is little competition.
You have three big global players.
Those are AB InBev, Heineken and Diageo.
And among them they have almost the complete market.
Obviously Africa is to the interest
of the alcohol industry,
because nobody is checking what they do
and the market is growing.
A country like Nigeria
is probably close to 200 million people right now.
In terms of just commercial interest
this is the place to be.
Many people think that Heineken is only Heineken,
but they really succeeded in creating local brands that are very strong,
like Star here, or you even have a few brands
that are a little bit cheaper.
Even though the abstention rate here
is more than 50%,
in I would say in most countries,
maybe all countries in the continent,
except maybe South Africa.
But if you now take out those who drink
and you take a look at how much they consume,
we see that we are quite competitive
if not even superior
to many countries in other parts of the world.
So that is obviously the problem.
When people drink here, they drink to get drunk.
This one, they usually take it, when rain is falling.
So they take this one and directly disappear,
immediately.
So it’s good for the body.
It’s Gin,
it’s called "Chelsea", this Gin.
In Nigeria, as in many other African countries,
there are no age restrictions or other restrictions on the sale of alcohol.
Since the 1960s, per capita consumption has doubled.
One of my interviews I had, was with a former CEO of Heineken in Nigeria.
He is called Festus Odimegwu.
One of the things he told me was that Heineken launched,
what was called a hot spot scheme.
500 bars were declared hot spots
and you have to know that there is a myth in many African countries,
that Stout beer is good for your sexual performances. Many drinkers believe that.
So Guinness has benefitted from that since a long time.
So what they did, they hired a large group of prostitutes,
about around 2,000 to 2,500,
to promote the beer.
I would be careful using the word prostitutes.
I would say ladies in general were used.
The customers who have come to the bar,
they are also...
encouraged to buy Legend Extra Stout.
After taking three or four bottles they get high.
They can pick on any of the ladies who are on duty,
hire a room for one hour.
They go into the room, enjoy themselves,
the lady comes back to the stage.
The man too may come back to the stage,
have another bottle or two bottles,
pick another girl and the lady too can pick another man.
The girls are paid.
They are paid for the service.
That is what they do anyway.
They sell themselves to men.
So for them too, it would boost their market.
It is a win-win situation.
And for me,
that calls morals into question.
It is not something that...
I would encourage.
This was in the past.
What is still happening is you have promotion women.
If you have to work for Heineken,
you would have to be curvy, but not fat.
Because most times they use premium girls, that would...
Premium girls that are outspoken
and that can convince and that are bold enough.
You can be as pretty as you want,
when you are not bold enough to contact
and confront and talk to your customer about the brand.
The customers treat you like prostitutes.
They can touch you, they can touch your butts.
They can touch your body
or say some things like, "Look how sweet you are."
Probably trying to say some kind of sexual words to you and all that.
And they can actually try to...
abuse you as well.
Thinking about the payment, we really need the money.
You have to take your eyes off and clean your eyes,
go back out there and face your job again.
Promotion women are hired by Heineken in thirteen African countries.
Since I have revealed all the bad behaviour
that they are often victim of,
Heineken says it has now stopped in some of the African countries
where this takes place.
They won’t tell me in which countries.
It's difficult to control if they are keeping their word.
Even after multiple interview requests
Heineken is not willing to comment on the events in Africa.
Heineken's story in Africa is pretty representative
for the way alcohol industry is conducting business in Africa.
From what I've seen and observed and from what I've read,
I really see it as a case study.
Anheuser Busch InBev,
the largest global brewery group based in the US and Belgium,
refuses to allow us to film in their tents at the Oktoberfest in Munich.
They own several hundred brands.
Budweiser, Corona, Stella Artois,
but also Beck's and Löwenbräu in Germany.
Why does the industry so stubbornly reject communication?
Alcohol and health is the big issue.
We are very afraid.
We really think that...
some organizations or...
There’s a push from some part of the society that wants to...
demonize alcoholic beverages.
If we are not able to defend
the right place of a moderate consumption of wine
within a healthy lifestyle in our society...
Puhh...
In five or ten years,
we will see a completely different environment for wine production.
In Germany our state policy set itself the task
to outline health goals.
And one of those health goals is to reduce alcohol consumption.
This process was going on for several years
and was unofficially massively influenced by the alcohol industry.
The corresponding documents were put on display.
It was the alcohol industry that tried
to influence certain measures
and primarily to obstruct those.
They even tried to influence the definition of this goal.
Reducing alcohol consumption wasn't supposed to be the goal anymore.
An industry that has publicly explained several times,
including the "German Brewer Association",
"We are open to any kind of alcohol prevention.
We participate in that and also do it on our own,
as long as it doesn't reduce the revenue."
The result was that
the health goal to reduce alcohol consumption in Germany
wasn't thoroughly discussed and was far from being passed.
The work on it was discontinued.
The drinks industry has learned from the tobacco industry's mistakes.
The tobacco industry lied about the addictiveness of tobacco,
was exposed and then essentially had its science
completely undermined.
The drinks industry by contrast says,
"Alcohol is dangerous, but you've got to drink responsibly."
And I am thinking, "Isn’t the point of drinking to lose responsibility?"
How many people think, "Oh my goodness, I am losing responsibility.
I must stop drinking."
But at that time you are already drunk.
So they are very clever and they don’t make...
They don’t deny the harms. They just say,
it is something you have to put up with,
drinking irresponsibly is your fault.
We are conscious of the risk of abuse of wine,
of any alcoholic beverage.
We know that the molecule of alcohol is...
is addictive.
We know people who have been with alcoholism,
we know it is a reality we cannot close our eyes.
But we think that integrated...
integrated into a normal life style,
in the wine culture,
this risk of getting addicted is minimized to irrelevant.
At the moment we have around 100 projects running
that deal with different aspects
of responsible consumption.
This is possible through either
awareness campaigns about "drink-driving"
or training for bartenders or training for supermarket employees
not to sell to minors
or not to sell more products to customers who already had enough to drink.
In the UK analysis has shown
that 68%, so two-thirds of alcohol industry profits,
are due to consumers drinking above the recommended
low risk alcohol guide lines.
Therefore if all UK drinkers
were to heed the government’s advice
on drinking to lower their risk of health consequences,
UK alcohol industry would lose
approximately 13 billion pounds each year.
Alcohol prevention through the alcohol industry is important
to prevention experts mainly for one reason:
It shows us which prevention methods don't work.
Alcohol prevention through the industry is designed not to work
but to look good while making an effort.
That is why its results usually aren't evaluated.
I was part of a research team which analysed
more than 3.000 alcohol industry corporate social responsibility initiatives.
And we found that the overwhelming majority of initiatives
were not based on any evidence of effectiveness.
They did not employ good robust evaluation techniques
to measure their success and impact.
And really, all of this material is branded.
I think, the majority of these initiatives
are simply extensions of marketing
and could be seen as stakeholder marketing practices.
Whereby major multinational alcohol companies
are able to win favour and demonstrate to politicians
they are doing good and spending money doing good,
when really they are protecting their profits
and making sure that no proper evidence based
public health measures are introduced.
Vulnerable, young woman, you know, on my own.
I've been fortunate but a lot worse things could have happened
because not everybody is a good person
and sometimes people will prey on the fact that
it is a young person,
it is a young lady who had too much to drink, or men or whatever it is.
I started to notice that I was getting myself into more and more
of these unsavoury unfavourable positions.
And for so many years my family, I have two sisters, a good mum,
a good dad and they used to break their heart
every time I would go out.
As they wouldn’t know if I would come home.
That was the nature of my drinking particularly towards the end.
I would got out and I wouldn’t come home for four days.
My own friends wouldn’t know where I was.
My phone would be off.
My own little sister one day, and this will always,
always, stick with me,
had said that she had gone
to the field by my house with my dad. They were looking for my body.
I’m leaving my shoes because...
We will have to walk.
We have to keep on feet, otherwise we are going to fall.
We are off on an adventure.
We love you darl'.
Stop, stop, stop.
Look how good I’m walking.
In my head I still thought, I am not an alcoholic,
I know I’ve got a problem,
but I was just trying to figure out what it was,
because there is this stigma and there is this stereotype
of somebody who is an alcoholic or is a problem drinker.
And I had that stereotype in my mind that
because I was 24 and because I had a roof over my head
and I had a job and clinging onto my job.
I was looking for differences.
I thought, "I can’t be an alcoholic, I am not."
I worked in a little shop at that time.
And there was a lady who always came into the shop
and we would have a little chat.
She was called Anna Lisa and she was lovely and glamorous
and well-spoken and a very calming person.
I just always felt a connection with her.
And...
I wasn’t well enough to be in work, but I forced myself to go in,
because I needed to go into work, but I was in a mess.
I had the shakes, I mentally was really scatty
and frightened and anxious and depressed.
I was not in a good mental space at all.
And this lady...
who came in, she came into the shop and I remember thinking,
"I am so glad to see this lady."
I feel very, you know, she is calming.
She came up to the desk with things at the end of the tilt to pay
and said, "How are you?"
And I said,
"I am not very well. I am really scared.
I don’t know what to do. I think I have a problem, I need to get to AA."
And I was like, wow...
what made me say that,
because I have never ever felt like that before.
And then this lady, who is so glamorous and well-spoken
and the good clothes and the handbag and everything, says to me,
"I have been in recovery for 6 years,
if you want to take my number and we can chat
and maybe get to a meeting together, then..."
You know, so I did, I took her number, because I saw her and I thought,
"You know what, you don’t look like a bad person
and you are telling me that you don’t drink and you’ve turned around."
So that was enough for me to go,
okay, let’s see what this is about.
Given that I was,
from early youth on a tendentially depressive person,
there are ways to cover that with many activities
such as working and drinking alcohol.
But in the long run
it intensifies, amplifies this depression,
because alcohol is of course a...
substance that promotes depression.
"Depressants" is what they're called.
And from there
I went from a risky drinker to someone suffering from alcohol abuse.
It was a linkage and a chain of 3 or 4 years
in which you are permanently under intense psychological stress
and face difficult challenges.
Several misfortunes, illnesses, fatalities.
It is like a tilted path.
This descent within a depression which leads
to a loss of inclination to do anything
until the question arises, "What am I actually alive for?"
Separation from your wife, it all comes together.
Welcome, Mr. Gallmetzer.
Please come with me. You know the way.
Yes.
Sadly we can't tell
the exact moment as of which you are an alcoholic.
I would give a lot to be able to tell somebody,
"You can drink until the 16th of January
then you have to be cautious and rather leave it,
because from the 17th or 18th on you will be an alcoholic."
That's not possible.
But we know that certain people
have a higher likelihood
of making that step into addiction.
Those are not personality based factors,
as we had assumed for a long time.
Today we know that there is no such thing
as a "type" of predisposition for an addiction
explaining why somebody suffers from an addiction.
But there are other factors that matter,
especially a very high alcohol consumption,
a frequent alcohol consumption
and especially the alcohol consumption because of its effects.
So not drinking out of enjoyment,
complementing a meal for example,
but drinking to achieve a certain psychological effect.
There's a second mechanism which amplifies this fatality:
the so-called "tolerance development".
Meaning that I need more and more alcohol
to achieve the same effect.
That is more or less your ticket to suffering from alcohol abuse.
The difference to the first time,
when I told myself, "I'll get a treatment now and then we'll see",
was, that this time I knew
that if I went in there, I would have the will and intention to succeed
in living a life without alcohol.
The most difficult thing is the thought:
"No alcohol ever again. Never."
Given that
it had been through your whole life such a pivotal
doping companion, enjoyment furnisher and so on...
And on top there was the social aspect.
Drinking is the pinnacle of doing something good for yourself.
When partying or enjoying yourself and so on.
Alcohol is a substance that damages pretty much all body systems.
First of all inside the alimentary canal, it damages the liver,
the pancreas, the gastro-intestinal system...
But also the cardiovascular system,
the skin, and of course the nervous system,
the central one in the brain as well as the peripheral.
Nerves get damaged and finally even the bones,
with a toxic bone oedema.
So there is practically no body part that won't be damaged
by a highly dosed intake of alcohol.
The WHO has pointed out
that 200 illnesses are caused or worsened by alcohol.
Cancer is
an important secondary disease caused by too much alcohol.
The cancers are located in the oral cavity,
the throat, the larynx, the gullet.
There are two other types of cancer that are very frequent.
You might know that the colon carcinoma
is one of the most common types of cancer in Germany and Europe,
alcohol boosts the numbers of colonic and rectum cancer.
The second one is breast cancer.
Breast cancer is the most common type of cancer for women
and alcohol enhances that.
Young women
who start drinking at the age of 13, 14, 15, 16, which they do,
have a much higher risk of suffering from breast cancer 20 or 30 years later in life.
If you're healthy
and not the child of an alcohol addict,
or suffering from a disease worsened by alcohol,
then as a male you can handle a daily quantity of alcohol
corresponding to 1/4 litre of wine.
And half of that as a women.
Women react much more sensitive to alcohol
for various reasons.
Those reasons aren't fully discovered but they are debated.
Those are the limits and if we stick to them
we are in the low risk area.
Not in a risk-free area, but in a low risk area.
In the EU a total of 23 million people are alcohol-dependent.
Illegal drugs are only a fraction of this amount.
These numbers have remained quite stable for several years.
For men, they are declining.
For women, however, there are permanent growth rates.
Alcohol is more easily available for women today
and it has become part of emancipation.
All in all we have to say,
"In Germany we have a global alcohol problem."
Almost everyone has that.
The average alcohol consumption in Germany is way too high.
Those given 10 litres of pure alcohol per capita and year.
Per capita and year means: Every baby is included
and every 105 year old.
Those 10 litres of alcohol consumption per capita and year
cannot be consumed in a healthy way. It is impossible.
The amount is so big
that alcohol problems affect the entire population.
Why is the government's attitude towards alcohol so supportive, if a low revenue
opposes high expenses.
To be precise, the expenses caused by alcohol
are about ten times higher than the alcohol tax revenues.
The tax revenues are down to a low single-digit billion
but the expenses reach a double-digit-billion sum,
with 20-30 billion at least.
Usually 40 billion are stated.
The essential reason for this apparent contradiction
is however that the revenues go into public hands,
all revenues from taxes go into public hands.
The expenses however are initially paid by the affected persons,
their relatives, family and so on,
by the health insurances and the pension fund.
Every health insured person pays for the alcohol problems
even if it's not him who has the problem, but others.
The government doesn't.
The losses are in the long-term.
The tax benefits are immediate.
If you change the availability of alcohol,
then you lose tax revenue within days.
So politicians prefer to sacrifice long-term health
for short-time financial gains.
I spent 20 years of my life
dealing...
a drug that wrecks lives.
Everyone goes to a bar to start their party off.
When you work behind the bar you start people’s parties.
What other way to start parties than going,
"Here's a round of shots, let’s all have one together." Yeah, I mean...
Sometimes it has ruined my life, by...
You know, hell, by going out...
There is a good three or four years of my life
that I don’t remember very well.
From working hard, partying hard,
working hard, partying hard. Just doing that seven days a week.
I know that I have done that to other people’s lives.
And, yeah, I mean...
We are legalized drug dealers.
What can you say about that?
The government licenses us to sell alcohol,
to sell the most addictive drug in the world to people.
And takes profit from it.
It is a hard thing to say that...
eventually...
being deep and philosophical about it,
I've probably ruined a lot of people’s lives.
But I've probably given them a great time while ruining their lives.
One of my researchers was actually in Parliament
looking around because one of his colleagues was working there
and he took him to a party,
a party in Parliament on one of the big terraces overlooking the Thames.
And it was a free party.
Diageo was giving free drinks to anyone who was there.
He said it was amazing.
I stood there, I watched MPs and their assistants drinking.
There were several editors of national newspapers
and they were all drunk.
My student he said to his friend,
"What is this, is this the Christmas party?"
Thinking is was once a year.
He said, "No, they do that every two weeks."
Diageo have a free party every two weeks in Parliament.
You can drink as much as you like for free.
And who is going to oppose the drinks industry,
when you got your noses in the trough every fortnight?
Diageo is a London-based multinational alcohol company
and one of the largest producers of spirits in the world.
Diageo is also very strong in Africa for example,
with Guinness beer.
There is a system in our society concerning the blind spot
which blanks out the harmful side of alcohol.
So this place now...
this holds some memories for me,
but not necessarily the nicest of memories.
These cobbled streets here I remember on my 18th birthday.
I came to Liverpool with a few of my friends.
And...
absolutely on your 18th birthday, people always get drunk when they're 18.
That is your rite of passage and everything.
And the night had such high expectations.
I was really looking forward to coming out here
and of course it all went very downhill.
The amount of times I must have ended up face down on the cobbles here,
walking in some heels that I couldn't walk in,
cut knees, crying, tears and arguments with friends you know.
So I’m coming back here now, it feels...
I'm just... I’m a different person.
It is like that girl is dead. And, you know...
I wouldn't say she's dead, I'd say she is asleep
and we have to try very hard not to wake her up,
but that is what comes back to me when I am here.
And I look at that girl with a great deal of sympathy and sadness.
I am just so grateful that that's not my life anymore.
People say to me still now:
"Oh so you’ve not have drunk for 2,5 years, 3 years,
so you could probably have one or two." And I say, "No!"
Because if I gave myself a drink,
little Sarah would wake up and be back big and as bad as ever before.
So it is about learning to live a life,
where I don’t have alcohol anymore,
because I know where that would take me.
It would take me back to the ground. So I'm not doing it anymore.
So that is the 64.000-dollar-question:
What is better than dope?
If you can find something that really feeds your need for excitement,
or fantasy, or relaxation, but in a socially redeeming or acceptable way,
then you have something better than dope.
What I discovered in research at the Bellevue Psychiatric Hospital,
the drug of choice is harmonious
with your characteristic way of reducing stress.
That is why people chose drugs. If it fits in how you cope,
it is like a hand in a glove.
So that got us into the idea
that people are not getting so much addicted to drugs,
but addicted to styles of coping
and self-induced changes in brain chemistry.
You can do it with drugs, you can do it with gambling,
with sex, with crime, with cults.
There are lots of ways to change the chemistry of your brain.
We have the three beacons of human compulsion:
arousal, relaxation and fantasy, you can use it with...
have it with drugs or you can have it with activities.
Once you have realised that, you start thinking about
why not orchestrate a social movement where people can have
natural ways of changing their brain chemistry
and come to positive feelings that are beneficial
to the individual and the society.
And I became really involved in promoting that idea.
I'd like to get to know the influence of Harvey Milkman's ideas
as a solution approach in two projects.
The first journey leads me to Colorado in the USA.
What we do in "Natural Highs", it’s a leadership program.
It’s an education program.
We want to teach young people and adults
that you can understand yourself.
And you can help your friends understand themselves.
There are tools that you can do to support yourself in a healthier way.
If you want to know how a drug like alcohol works,
you have to understand how our emotional system works.
Because it is happening in the same system.
When you feel a sense of love and connection,
it is probably serotonin.
OK, so then there’s serotonin that is released and then,
what happens next?
Where does it go next?
It gets reabsorbed. - Yes.
On the other side there are serotonin receptors
and when the serotonin clicks into the receptor,
it creates a new electrical impulse.
And that is what we feel as a feeling like love.
What?
Isn't that crazy? - Yes.
Did you ever know that before? - No.
OK. Wouldn’t that be important to learn?
Yes. - Yes, I agree with you.
Take a moment, close your eyes
and do a body checking.
Do a body checking.
And especially see if you feel any stress,
or any anxiety
or any kind of challenging feelings.
Just check it.
You can study each drug and figure out
which neurotransmitter is actually getting manipulated by this drug.
So, in "Natural Highs" we say,
"Well, if you are drawn towards a particular drug,
you have what we call a favourite neurotransmitter."
So if you are drawn to cocaine,
your favourite neurotransmitter is probably dopamine.
If you are drawn towards alcohol,
your favourite neurotransmitter system is probably GABA.
You wanna step here, OK.
Once you know that,
you can study the particular aspects of how to move this neurotransmitter,
even down specifically to,
"What food would I have to eat
to produce more of that neurotransmitter."
A lot of these neurotransmitters are also moved by certain activities.
Go, go...
We try to create experiences where kids have the experience
that I can actually move this neurotransmitter on my own.
I already have everything inside of me that I need.
Drugs are just copying these precious chemicals
that make us feel good.
Crazy, totally crazy!
Everything looks sharper. - Yes, yes.
It is like you are mobilizing your own DMT.
Don’t stop when you feel tired.
OK, keep going until I say stop.
And...
Go!
What we know now, what happens in terms of brain development
between the age of 12 and 25,
it’s very clear that any use of substances
will set up patterns that will affect somebody for the rest of their lives.
The longer somebody delays any use of alcohol or any other drug,
the better it will be in terms of their mental health.
And then, if you are up for it, we can do a little GABA experiment.
So, GABA gets released naturally,
when we feel comfortable in our own skin
and it gets released through touch and feeling safe.
So, what you can do if you'd like,
you can actually find a way in this web that we have right now.
We can create a big kind of like spider web.
And if you feel like it,
you can actually find a way of touching another person,
if that feels comfortable to you.
If you don’t want to do it, you stay in your own space.
You'd be lying to people if you said,
that "natural highs" are the same as drug highs.
And of course the reason that people take drugs,
is because it is so powerful and...
so long lasting.
But the brain is not really wired for that.
The brain is wired
for moments of ecstasy and extended pleasure.
Extended ecstasy is neurologically impossible.
So people will have cause all kinds of problems,
because the brain resists this
like intense dose of dopamine in the middle part of the brain,
called the nucleus accumbens. That’s the pleasure centre.
All these activities that we are talking about: art, music, dance, sports...
They also deliver dopamine to the nucleus accumbens of the brain.
So people do experience pleasure.
More than 20 years ago a prevention model was started in Iceland
where the main aim is nothing less
than changing the drinking habits of a whole nation permanently
by directly approaching juveniles.
We had quite a problem specifically with alcohol use,
binge drinking.
It was quite usual that you started drinking when 13 years old.
You know, alcohol use, tobacco use, hashish use
was going up and had been going up for some years.
It was really important that we had this sense of emergency,
that we had to do something.
I just realized that we are all the sons of alcoholics.
And I'm like, yeah, OK.
We have strong leaders and all political parties stepped behind it
and said, "This is what we're going to do."
That thing that used to be so Icelandic,
to drink until you just die, you know.
But you don’t see that anymore.
Thank God.
The project was academically accompanied
by the University of Reykjavik.
From there all possible participants were included.
Researchers, policy makers and practitioners
working with children and adolescents
came together and decided to try out a new approach.
First and foremost it was evidence-based.
The questionnaires measure the risk and protective factors
in the lives of young people.
So this is the one that we will be...
carrying out next week,
in all of the schools for 16 to 20 year-olds.
We learned these sort of key risk and protective factors
and we started...
trying to change them.
Since the project began Iceland's cities have been investing
up to 10% of their household budgets in recreational activities for young people,
not only in sports,
but also in music, dance and creativity.
The idea was:
"Can we try creating healthy communities,
like communities that give a lot of opportunities for meaningful days,
for fun in life,
and through that affect the behaviour of the group?"
So, it was not focused on changing each individual mindset,
but on changing the community and through that,
affecting the behaviour of adolescents.
The Icelanders said,
"Why don’t we give them natural highs
before they start having problems with drugs?
Why don’t we institute a social model where
people don’t even have to get so far into this from the beginning?"
In my opinion,
the most important thing for coaching children in Iceland
is to make good, strong individuals,
who will later on
participate in sports or just be a good member of society.
So we...
put emphasis on getting everybody involved.
We want everybody to be able to play,
no matter how good they are when they are young.
We give everybody the same chance
and we don’t only train them
in the sport technique.
We also want to train their mental side.
Over 90 percent of every child in Iceland
at some point is playing sports for an official club.
We have the opportunity
to influence these children in so many good ways.
Which foods are good for us?
Apples, bananas, fish...
broccoli.
Most teenagers eventually
try alcohol.
But...
in sports, we try to delay it as long as possible.
And I think it is somehow
just involved in the team's culture.
We saw that the family is a protective factor,
and there are three elements within the family,
that seem to be most important.
Emotional support:
Believing that you can get support from your parents, if needed.
Positive monitoring:
Do you know, where your adolescents are on a Saturday night?
Do you know with whom they are?
And the third key protective factor
was the quantity of time spent together.
Which was kind of not very popular in Iceland at the time,
because we liked to believe,
that we didn't have to spend too much time with them.
We liked to believe in this idea of quality time,
where you only have to spend one hour per weekend with your kid.
But it's not that simple.
The more time we spend with our kids, the better.
Night out rules
The best thing about this is,
that it's for everyone.
So it’s this idea of:
"You need a village to bring up a child."
Making it easier for parents to be parents,
because if this is the rule in all of the houses,
you don’t have to argue for,
why she needs to come home at eight o'clock.
Because it says so on the refrigerator, right?
Yeah.
The idea behind the "parental walks", you know,
groups of parents walking around the neighbourhood,
is to strengthen the community.
Seeing to it, that nobody is outside drunk, late in the night.
But of course one of the key ingredients
of this very good occasion is for the parents, to get to know each other.
It is a popular place here for people to come and people to shop for a long time.
And here’s an ice cream store and maybe centre for the neighbourhood,
like shopping and things like that.
So we walk around here and we look if there's someone too young inside.
And we help them to remember to go home.
In Iceland advertising and marketing for alcohol is completely banned
and the sale of alcohol is only possible in their own, state-run stores.
This multi-layered prevention model is extremely successful.
Regular consumption of alcohol among 15-year-olds
dropped from 42% in 1998
to only 5% today.
The Iceland model shows that it lies in the hands of governments
to reduce the population's alcohol consumption.
Yes, they even have the obligation to do so.
As with any drug,
much of our dealings with alcohol is socially conditioned.
I have been working for the last 20 years
in the whole area of drug policy.
And I started working for the British government back in 2000.
And to my horror I discovered
that there was no definition of what a drug is.
Then I started looking at the UN conventions
and the WHO regulations on controlled drugs
and I realized that there is no definition of what a drug is.
And that of course is a huge problem.
And that is one of the reasons why alcohol is considered not a drug
and drugs like heroin and cocaine are considered drugs.
Because the decision is not made by pharmacologists like me,
it is made by politicians.
It only becomes clear to me during my journey what it means
that alcohol is not a pure stimulant but a drug.
Since then, I am stunned by the frivolity with which most of us,
myself included, just drink.
There are hundreds of rules, I've tried them all.
They say,
"Don't drink for one day of the week, don't drink for one week in a month,
and don't drink for a whole month."
Adding it all up you wouldn't be drinking for half a year per year.
If I had managed, I wouldn't ever had any problems.
Somebody who's capable
of telling himself not to drink a single drop once a week,
then, not do drink a single drop for one week a month,
and finally adding one entire month.
Well, he is not addicted.
I actually blamed my drinking on various different things.
I blamed it on first on the fact that I was gay
and afraid to tell people.
Then I told people and it didn’t stop me drinking.
I thought it was, you know,
from traumatic things in my childhood and things like that.
But actually I had a very
privileged upbringing compared to a lot of people.
I find that it’s a common threat with alcoholics
that we are all very sensitive, very vulnerable people.
So alcohol was our way of coping in the big bad world.
When we take away the alcohol we have to learn how to...
manage our emotions and manage our vulnerabilities
without reaching for a bottle of beer or alcohol.
So that is what I am learning to do on a daily basis now.
Bettering myself, getting myself stronger
so that I’ve got a defence built up against alcohol if you like.
Every year, 3 billion people die from consuming alcohol,
1 person every 10 seconds.
That's more victims than through crime, traffic accidents and illegal drugs combined.