Dost thou think, because thou art virtuous, there shall be no more cakes and ale

Animals regulate their body temperatures a bunch of different ways. Warm-blooded animals like mammals and birds have more mitochondria per cell, which make more heat but also mean we have to eat more. We also shiver and sweat and, when we’re babies, have brown fat around our backs and kidneys that stop us from freezing. So that’s all physiological self-regulation (homeostasis). Cold-blooded animals do a lot of behavioral homeostasis, which is why I find garter snakes sunning themselves on the gravel next to my back door in the spring time and box turtles hanging out in the middle of the road. Warm-blooded animals do a lot of behavioral thermoregulation too, which is why we tend to come in out of the rain. Some animals do very interesting social behavior to regulate their body temperature- termite mounds are partially designed to balance getting enough ventilation with not getting too hot, and the tent caterpillars you can see throughout the Northeast US swarm inside their tents as a group to stay warm on cool days and nights in the spring and then spread out on warmer days to cool off as well as to feed on leaves. And of course, humans do a lot of social thermoregulatory homeostasis as well, what with building houses and making clothes.


So when you think about something like why the alcohol-related death rate is so rapidly rising over the last few years… alcohol

…you could see it as a breakdown of each of these types of homeostasis or self-regulation: physiological, behavioral, and social. While it’s true that alcohol is in many ways a toxin, and as Alice says, if you drink very much from a bottle marked poison it’s bound to disagree with you sooner or later, this isn’t exactly fentanyl, a novel if apparently attractive way of killing ourselves, newly introduced into our social environment.  Take this description, from Wolfgang Schivelbusch’s Tastes of Paradise, of 17th century beer drinking habits:


Sure, sure, the beer was of varying and often low alcohol content,  But three liters a day, “children included,” is still a lot. More recently, as Mad Men and various cinematic versions of Winston Churchill remind us, mid-20th century men and occasionally women were drinking a lot throughout the day, not just at night, and stronger stuff. So increasing deaths from alcohol in populations and cultures with hundreds or thousands of years of exposure to alcohol is at least suggestive of a breakdown of certain forms of regulation and self-stabilization or homeostasis.

To take the hierarchy above, I wonder if physiologically, Americans are, due to interactions with other drugs compromising their livers and obesity, greater inactivity and general ill-health, less able to metabolize alcohol. To go back to Winston Churchill, perhaps whiskey and cigars were a more sustainable combination than the whiskey and prozac, whiskey and oxycodone, and whiskey and adderall combinations we subsidize now.

Increasing chronic pain might also increase the temptation to self-medicate.

pain (1)Behaviorally,  increasing free time as well as the easy availability of alcohol in great quantities for very little money relative to incomes can make it easy to drink too much, too quickly. And socially, we are both more isolated, allowing us to drink more alone, and liable to view alcohol and sexuality as the sole remaining redoubts of adult life distinct from childhood, encouraging us to drink more- and more competitively and excessively– together.


Failures in physiological, behavioral, and social homeostasis can all accompany and reinforce one another to produce a single worrying trend.


11 thoughts on “Dost thou think, because thou art virtuous, there shall be no more cakes and ale

  1. It is indeed remarkable how much people in past drank, even taking into account a less standardized product. Perhaps many of our ancestors were simply buzzed *all* the time, or perhaps something really has changed.

    A possibility that occurs to me is microbiological. In addition to chemical interference with the liver, an infection could also interfere with ethanol metabolism, perhaps even long after the organism in question had been fought off. This is speculation, but not a priori impossible.

    Liked by 2 people

    1. This is a great hypothesis, and deserves to be put in a separate category from physiology- also, what if it’s about symbiotes/microbiota that we’ve eliminated or swapped out for others through antibiotics or changed physiological/nutrient environment. That link you shared on Twitter ( ) in particular makes me wonder if you’d had to have some pretty tough enteric bugs as well as an adaptive liver back then.


  2. Good story, but the graphs are too small, even when opened in another tab. I like to be able to read the legends without squinting.
    Watching a show about the Borgias I was thinking that everyone was insane, but then I realized they were just drunk. Everybody drank wine all the time because drinking water was a good way to die.


    1. There might be some circle of causality- alcohol makes you crazier, makes you drink more, etc. The assumption is always that these days Mediterranean populations like Italians are more resistant to alcoholism, though perhaps that was less true then.


  3. Deaths 25-54? There has got to be a difference is the types of alcohol related deaths in that wide age range. Even the hardest drinker at 25 is physically better off than at 54, when cirrhosis and other problems of a life of drinking just start to show up.

    Liked by 1 person

  4. I wrote a long comment and then decided to spare you, so here are the final points.

    1. The spike may be related to breakdown in norms since banning teen drinking.

    2. The timing is particularly suspicious if you take the “effective start time” for this slippery slope to be not the initial MADD campaign in the 1970s/’80s but rather post-2001, when fake IDs disappeared.

    3. The breakdown in social norms about drinking and a change in medical norms about psych drugs / painkillers give quite different predictions for death incidence, don’t they? If banning teen drinking gradually destroys all the norms around drinking, the collapse in norms effects the younger part of each cohort the most, so they have the most deaths. If psychiatrists start prescribing more drugs to all age cohorts at once and it doesn’t play nice with the ethanol, then the older parts of the cohort will get just as fucked up as the younger.

    4. I assume the spike in deaths is mostly toxicity? If it were mostly drunk driving, then I would instead look at (drinking X cellphones). Driving + texting is dangerous, drinking + driving is dangerous, but conceivably the biggest danger might be drinking + (temptation to text).

    Liked by 1 person

    1. I know that traffic and pedestrian deaths have been increasing, but I don’t think those are included here. I think it’s plausible teen drinking decreasing is partially at fault here- Freddie Deboer had a very good line about how American life including for young women now involves going from atotal infantilized supervision to slamming seven shots of Cuervo without any intermediate step.

      Liked by 1 person

      1. Do you think there are people working on this? Even the indicators I mentioned (I’m sure you’ve thought of many more yourself) seem simple enough that there should already be working papers covering them


  5. The first thing to establish is whether the definition and identification of alcohol-related deaths have been stable.


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