This Mind-Blowing Study Fooled Drinkers—What It Means for You w/ Jason Kilmer
Welcome to Journey to the Sunny Side, the podcast where we have thoughtful conversations to explore the science of habits, uncover the secrets to mindful living, and, of course, inspire your own mindful drinking journey. Why do you drink more in certain situations even when you don't plan to? What if I told you it has nothing to do with alcohol itself? Doctor Jason Kilmer has spent over twenty years researching the psychology of drinking behaviors at the University of Washington, where he's helped develop groundbreaking interventions funded by the National Institute on Alcohol Abuse. His work focuses on how our expectations, social environments, and even the way a drink is served can completely alter how much we consume.
mike:In today's episode, we break down his wildly eye opening research, including a shocking experiment where people got drunk without drinking. We dive into the hidden psychological triggers that make us drink more than we realize, the powerful role of perception in shaping drinking habits, and how simple factors like glass size, carbonation, and even the presence of ice can change consumption patterns. Jason shares what really makes alcohol social and why most of the effects people chase aren't coming from the alcohol itself. If you're trying to cut back or better understand your drinking habits, this conversation will completely change the way you think about alcohol. Okay, Jason.
mike:Thanks for coming on today.
jason:Thanks for having me. I look forward to this.
mike:It's gonna be a fun conversation. So let's get into a little bit of your history. So you wear two hats as a professor at University of Washington working both as a researcher and also directly with students. But our conversation today is around alcohol. So what got you interested in studying drinking behaviors?
jason:I was a college undergraduate, in the psych the psych honors program at the University of Washington as a junior. And they have a class where they let you know about who's doing what type of research and who might you wanna work with. And it must have been six weeks in, and I was, you know, we were hearing four different pitches about research a day, and I'm like, I haven't haven't really found something that seems amazing to me yet. Went to a class that literally changed my life and set me in motion for the course of what I do today. And it was because a then graduate student, now doctor Mary Larimer, who's the director of the center that I work in, the center for the study of health and risk behaviors.
jason:She was explaining that Alan Marlatt, who was a professor in psychology at the University of Washington, was looking for alternatives to just say no type of prevention programs. And to go back in time, this was happening in 1989. At the end of president Reagan's second term, we had 12,000 just say no clubs in the country. So that's very firmly where we where we were. And, I had seen in my own fraternity, guys that I really cared about essentially failed by those just say no types of approaches.
jason:So I was sitting there in that classroom going, wait. An alternative to just say no is even a thing? And they said, we're mainly looking at testing in some Greek settings. So if you happen to be in a fraternity or sorority yourself, that's an added bonus. And I was like, done.
jason:I got connected with her, started working with her in November 1989, and literally the rest is history. Because I was I got to see this evolution of how do we develop, then implement, and then evaluate effective prevention programs? And that's what I've done my whole career, and I feel lucky to have a foot in both worlds because it's like we can learn something in the research in the morning, and I can be presenting it to students by the afternoon. And that feels pretty cool. Plus, work with students, they've often told us about things that weren't on our radar.
jason:They'll ask questions about a product that we haven't heard of yet, and it lets us start evaluating those before most people get a chance to.
mike:It seems like early on, even when you were young, you had, like, this sense that whatever whatever the the direction to change things around substances wasn't working, what was that inside of you that were that made you think, you know what? I think that there might be a better way, and I really wanna get involved.
jason:It's, I think seeing, like, as an exhibit a, some of what was out there. So when I joined, I joined a fraternity in in fall of nineteen eighty seven as a first year student. I didn't drink at all. And I was at that time, I think the one guy in my fraternity that didn't drink. And, they said there's a there's a required alcohol program.
jason:And I'm like, finally. Like, maybe maybe there'll be, like, two or three guys that join me in this decision. And the speakers held up pictures of, like, livers that looked bad and started yelling at people and said, this is gonna be you if you keep doing what you're doing. And it was fear based. It was shame based.
jason:It was a lot of yelling. And, there was a yay, we're done being yelled at party. When it was over, I'm like, that must not have been the goal of the facilitators. I think one year later, I saw a speaker that was very similar stuff where there was just it was missing. Mhmm.
jason:But what if you have chosen to drink? Like, when you tell people don't do it, it's like, what if they've already said yes? And so I think that it was fascinating to me that there was a researcher kind of willing to take that step. I now realize, how controversial that was because that I love when I hear people say we've been doing harm reduction forever. That's actually not true.
jason:And, in 1988 when doctor Marlatt first started testing, harm reduction focused approaches, there weren't any published studies showing, look, we can make an impact on college student drinking. So I think it was very exciting to granted. It was as an undergraduate research assistant and then a grad student. But I got to watch this evolution from really darn near near the start, which is pretty cool.
mike:Yeah. Very cool. And you have this really interesting study that you did that we're gonna get to in a second, but you mentioned harm reduction. And I did an interview with doctor Andrew Tatarski.
jason:Oh, shoot.
mike:And I'd love to know what your definition or how you perceive, what is harm reduction. You know, how can the general public understand the concept?
jason:I think it's a that's a great question. And I do think it's amazing how people often view that term as controversial because they they somehow think that it equals use or equals moderation. And nothing could be farther from the truth. If someone says, I wanna avoid all of alcohol's unwanted effects, abstinence is the best way to do that. And certainly, if someone's 21 and they say, I don't wanna get in legal trouble, abstinence is the best way to do that.
jason:But if someone makes the choice to drink, there is research on ways to do it in a less dangerous or less risky way. And a harm reduction approach acknowledges that any steps towards reduced risks could be steps in the right direction for that person. I come to you drinking 40 drinks a week and experiencing lots of consequences. You do something with me, and I reduce my drinking to 10 drinks a week with way fewer consequences. You know, well done.
jason:However, in many programs in our country, I'm I'm kicked out because I'm still drinking. And it's like, but how can we overlook a reduction that dramatic? I think what's also interesting is how often reducing harm doesn't necessarily mean reducing use. If you're talking to someone, pretty small human being, and they say, I drink five drinks every Friday, five drinks every Saturday. They tell you all five of those drinks are shots of hard alcohol on an empty stomach over two minutes.
jason:Now they go through a harm reduction focused approach, and they decide, I'm done with shots. I'm gonna drink beer. I'm done with drinking on empty stomach. I'm gonna eat prior to and while drinking. I'm done with slamming them all over two minutes.
jason:I'm gonna stretch it out over three hours. I'm gonna alternate with water. Getting you a much lower blood alcohol level, experiencing fewer consequences. And if we ask them, well, how much are you drinking now? Well, I'm drinking five and five.
jason:The quantity hasn't changed, but so much surrounding their drinking has. And it's it's it's sometimes, harm reduction is reducing use, but sometimes it's literally using more protective behavioral strategies. It's reducing harm. If someone says, I drink and about once a month, I drive when I know I shouldn't be. And now they continue drinking, but driving is off the table.
jason:They've downloaded every rideshare app known to humanity, and they no longer drive after drinking. That's that's reducing harm.
mike:Yes. I love that so much. And I I don't think I ever thought about it the way that that analogy that you made or comparison with, doing the shots but in a different way. So that's a really unique take. And I think one of the things that I love about harm reduction, it's kind of encompasses this all are welcome mentality.
jason:Absolutely.
mike:So you have this unique lab in at University of Washington that you started doing some some experiments at. And why don't you tell me a little bit about that lab before we get into the actual experiment and it's itself?
jason:Well, I'm very quick to always point out that lab was doctor Alan Marlatt. And I do what I do today, because of three people. You heard one of the names, doctor Mary Larimer, doctor Alan Marlatt, and also Mike Segal. Those those three really influenced me in a really big way. Doctor Marlatt passed away, fourteen years ago this week, and in some ways, it's feels like it was just last week.
jason:His contributions to this field were gigantic, and he was truly a legend in this field. Alan developed, a lab that looks like a bar. And we call it the bar lab because everything in psychology has to spell a cool acronym. It's one of our three laws. So it's behavioral alcohol research laboratory, bar lab.
jason:And, Alan did research briefly, taking the placebo design that people were familiar with and extending it to what he called the balanced placebo design. For years, there was research telling people, you know, they signed a consent form that acknowledged that they may receive a medication or they may not. And you tell people we're gonna give you a medication. Half of them get it, half of them get a sugar pill. If all of them say, wow, I feel a lot better.
jason:It probably wasn't the medication. It was the belief that the they were taking it that would help them. If only the people that got it feel better, now we have greater faith that the medication does something. Alan said, what if we do the flip side? What if in addition to that traditional placebo approach with we we have people all over 21, they all do drink, they all sign a consent form and say, if you give me alcohol, I give permission for that.
jason:And what if we have these four conditions? People that expect alcohol and get it. People that expect alcohol, but get an alcohol free drink. But then he added two additional equations, conditions to that equation. What if you have people told they're getting an alcohol free drink, then in fact get an alcohol free drink?
jason:And then finally, what if you have people told they're getting alcohol free drink, but they receive alcohol? He would do research to try and find out how much of what people say they get from alcohol really comes from the drink itself versus the belief that they're drinking. And what we probably use the most in our prevention work to this day is the research he did on alcohol social effects. When people think they're drinking, even when they get alcohol free drinks, all that social stuff tends to happen. They get more funny, more talkative, more outgoing, more flirty.
jason:When people don't think they're drinking and actually receive alcohol, they don't activate it. And the group that thinks they're not drinking and in fact aren't drinking. The group that thinks they're not drinking but receive it, the physical effects of alcohol start to kick in, but they attribute it to other things. It's a depressant. It doesn't make us sad.
jason:It depresses or slows down the central nervous system. So people get tired, but they blame it on a long day at work or a long day of school or a bad night's sleep the night before. Some people get flushed. Their face gets red hot and they blame it on the temperature of the room and ask if we could quit being cheap and turn on the air conditioning. It also wouldn't be that rare for people to get a little clumsy, maybe spill their drink.
jason:But instead of questioning what was in their drink, they just be they just say, sorry. Clumsy. They clean up and try not to cause any more trouble. So Alan's work was groundbreaking in allowing people to see if someone says, I drink because I like the taste. Okay.
jason:If someone says, I drink because it makes me more funny, outgoing, and confident, it's literally not coming from the alcohol. And if someone says, I drink drinks one and two because they taste good, but I drink drink three, four, and five for those social effects, it's not coming from the alcohol. And if a barrier to considering making a change is, what if I cut down and I miss out on all that good social stuff? It's not coming from the alcohol to start with.
mike:So walk me through this a little bit. So to recap, there were four groups. The first group got alcohol. What happened? They were more social?
jason:Sorry that I I gave the cliff notes version. Cliff was my favorite author when I was younger.
mike:No. That's alright.
jason:Yeah. That's how I understood the grape.
mike:Paint some visuals of some college kids drinking in the first group. They're getting a little chatted and getting into it.
jason:Upper so I I always describe it as a square. So in my head, I'm like, upper left hand corner. It's a two by two grid. Expect alcohol or none. Get alcohol or none.
jason:And so in some of the demonstration things, we would work with college students. So the group that's told they're all over 21, they all do drink, they all sign a consent form and say, if you give me alcohol, I give permission for this. Ethically, this is the gold standard in how to do alcohol administration. Because we even tell people we're gonna need you to be here x number of hours because we have to wait to get people back to a zero before they can leave the lab. So one group's told we're gonna give you alcohol.
jason:They could drink beer. They could drink vodka and tonic. It depended on what condition or what study or focus was actually being looked at. And what do we give them? Beer, vodka, and tonic.
jason:What do you see? Nothing magical happens here. The volume of the group increases. People interact a lot more, but you need this group for comparison's sake. You clear all them out.
jason:You bring in a different group. We tell them, we're gonna give you, no alcohol. And in fact, they get none. They're told they can drink alcohol free beer or they can get tonic water with or without a lime wedge depending if we had money or not. State school.
jason:Wow. What do you see here is also not that different than what you'd expect to see. Much quieter group, much less interaction. At best, it looks like a bunch of people who don't know each other who are asked to hang out and drink water together for an hour. Where you see the really cool stuff happen is where we tell people, we're gonna give you alcohol, but we give them alcohol free drinks.
jason:The vodka and tonic in quotes that they get is tonic water with a lot of lime in it, and all you do is put vodka right around the rim of a glass. To keep it sanitary, we put it on a sponge, and then we can just sponge the rim of the glass. People bring the glass to their mouth, they smell the hard alcohol. That first sip, they might taste it, and that's the clincher. Because a lot of people take that first sip, and they're like, oh, that's a strong drink.
jason:Well done researchers. And they don't even think twice about the rest of the time. Beer, you know, the nonalcoholic or alcohol free beers are have advanced dramatically from when this research first started being done. In their early years, the nonalcoholic or in quotes near beers, something tasted off. They didn't taste quite right.
jason:And knowing that was a knock on them, Alan did an independent study where he took four different types of non alcoholic beer and made this near beer blend where he did a little bit of dumping and made this concoction that in taste test, people couldn't tell the difference between this near beer blend and the real thing. We had people at the end of this condition say, you should bottle this and sell it. And we looked into that and that's really illegal as it turns. Yeah. You bet.
jason:They're told they're getting alcohol. They're getting alcohol free drinks. I mean, we do lots of things to prepare people to believe they're drinking. As they enter the bar lab, they're carded to make sure they're 21. They have to blow a breathalyzer to make sure they hadn't been drinking before they got there.
jason:People have to sign forms saying there's no medical contraindications for drinking. And if they think they are, are dropped from the study. And so with this group, the million dollar question becomes, how does this group act? What does this group feel? What do we see?
jason:By the twenty minute mark, coders watching videos of the group that thinks they're drinking actually are versus this group, the think the group that thinks they're drinking art can't tell the difference between those two groups. The volume of the group has increased. People are shoving tables together and playing drinking games with water. By the forty minute mark, that's when you start seeing the really cool stuff happen. Now the original experimenters never predicted the people report feeling physical effects.
jason:Some people even report feeling physical effects. People talk about what a great buzz they think they have, or we would hear people say, wow. I'm really glad this experiment's on campus because I know me shouldn't be driving right now. You know, sometimes we'd even see people almost get defensive of it. We'd say, we noticed you're looking tired.
jason:How common is that for you when you drink? And they're like, well, hello. It's a depressant. We're like, hello. It's water.
jason:It's the social realm. This is my favorite thing to see in psychology. Someone usually surfaces kind of the stand up comedian of the group. Someone usually surfaces kind of the loud ringleader of the group. Top interpersonal thing thing we see more than anything else is flirting.
jason:Again, we have people play drinking games. We've even had times where people would push tables to the side and dance. End of the hour, lights go on bright, stereo goes off, and in my favorite ten seconds in psychology, we say none of the beverages you've consumed contained any alcohol. In all the years this research has been done, no one's ever been angry or upset at that announcement. But depending on what they said or did during that hour, they do different their reaction to that announcement.
jason:I've seen people who never in a scary way, but who will scream. It's funny to watch the occasional person that kinda looks around and goes, yeah, I knew there was no alcohol in there the whole time. Can they try to blow it off like they're in on it? But what's crazy is that time and time and time again, the belief for drinking, all this great social stuff happens. So it would be easy to say so alcohol does a lot of stuff.
jason:The buzz is real. Reaction time impairment, real. Judgment effects, motor coordination effects are all legitimate pharmacological effects of alcohol. But the social or interpersonal things we get are million times more due to our beliefs, our expectations, where we are and who we're with than the contents of our cup. But we can't conclude that a % yet until we run that final condition.
jason:The question becomes ethically, how do you do that? How do you go, here you go. Here's water. And actually, you have a b alcohol. Remember, they're all over 21.
jason:They all do drink. They all sign a consent form that says, if you give me alcohol, I'm good with that. The question became one of dosing though. Because if someone's like, yes, tonic water. It just starts pounding.
jason:Mhmm. That'd be problematic. So an independent study was done to find out how many parts of vodka you have to add to how many parts tonic water, Put a lot of lime in there and have people not be able to tell there's alcohol to drink. Once you get that concoction, we know everyone's sex assigned at birth. We know everyone's weight.
jason:We know everyone's gonna be drinking for an hour. We work backwards from a blood alcohol chart and give each person a drink. Then based on their sex and weight, we'll get them to a point 06% blood alcohol level. That's a big dose in one drink. That's three quarters of the way to the legal limit of point o eight.
jason:That's enough to keep someone in a positive blood alcohol level almost four hours once they've hit that peak. When they finish that drink and they go, can I have more? Drink number two is just tonic water. So that way you can get the whole room to the exact same blood alcohol level. Mark doctor Marlowe was brilliant in this.
jason:People are told, please drink as you normally would for about the course of an hour. Ready? Go. This is in some ways a more impressive group, but it's way less entertaining. Why is it more impressive?
jason:Because the conviction with which people tell us, if I drink, I am more confident. When I drink, I am more talkative. When I drink, I'm the life of the party. None of that happened. Twenty minute mark, everyone's sitting around going, when is this dumb study gonna get done?
jason:Looking super bored. By the forty minute mark, as I mentioned, the physical effects kick in, but they have attributed to other things. End of the hour, light goes on bright, stereo goes off. We say, surprise, you all did get alcohol, and everyone blows blows a breathalyzer to verify that. The research shows that if you lecture about this, people learn information, but it doesn't necessarily change their behavior.
jason:But if you can incorporate this content into other evidence based strategies, approaches that use Miller and Rollnick's motivational interviewing to prompt consideration of change or prompt contemplation of change, then it can be a very effective component of those types of approaches. So sorry if that was too lengthy, description.
mike:Absolutely not. It it's What completely fascinating, and it it has me thinking so many different questions. First of all, I just wanna ask, have you ever run that experiment at a party at your house with people thinking that they're drinking and see what happens?
jason:We always joke that no one trusts us if we work in this field. It's like, would you like a drink? It's like, I got it. I'll make my own friend. But, you know, obviously, the the the lines between research and how you do all that ethically are very different than what you might do in the real world.
jason:So I can I can happily say I've never never done any kind of, placebo effect on people or placebo?
mike:Key takeaway, I guess. You you recapped it a little bit, but what's the key takeaway? I'm really interested to know, like, how we could take some of what you learned and and were able to discover, basically, and apply that into our own lives, especially for people that do attach themselves to things like, hey. This makes me more social or this makes me, you know, funnier and more outgoing and all these other things. Like, what what can we take away from that as us as people that are trying to be mindful drinkers?
jason:Yeah. I mean, I I and I apply this myself. I told you when I entered college, did not drink. I do drink now. I'm constantly aware of standard drink size of all of these I mean, you can't unlearn the research when you're if you're making the choice to drink.
jason:And I think that in motivational interviewing, I made a reference to Miller and Rollnick's motivational interviewing. It's an approach that guides. It's nonjudgmental. It's nonconfrontational. It meets people where they are and tries to elicit personally relevant reasons to make a change.
jason:And so two of the principles that we keep in mind are if you can develop discrepancies between values and goals that are of importance to people in ways in which the status quo could be in conflict with that. That could prompt consideration of change. You also wanna support self efficacy, someone's confidence and optimism that they can change if they want to. We have said, does the bar lab research develop discrepancies or support self efficacy? And what we have concluded is, yes.
jason:Both. If if I say I drink those three extra drinks because they make me more funny, that's my value or goal. What's the status quo? It's not coming from the alcohol. Even if by drinking those three additional drinks, I don't feel so good the next day, I say or do things I regret, it's costing me more.
jason:We often hear that a barrier to considering cutting down is what if I cut down and I miss out on all this good social stuff I get from alcohol. It's literally not coming from the alcohol to start with. So that means, if someone decides tonight, I only wanna drink two. Set yourself up for success. Do what you can to still have fun.
jason:And so if someone genuinely understands those social things weren't coming from the alcohol to start with, you can still have fun. I've talked to college students that say, I tried to to I know I always drink six. I tried to drink three. I'll ask them, how did it go? Brutal.
jason:Wasn't fun at all. What happened? I pounded a three and then I sat there the whole night going, hey. Not drinking. It's like, why would you do that?
jason:We encourage people, if you say I normally drink six, now I'm trying to drink three, keep six cups in your hand. Alternate with water. When we ran out of things to use the bar lab for, we had a post doc do a drink matching study. If you think about it, you know, watch people at a party or watch people at a bar. Not in a creepy way.
jason:Just to be clear. Having a cup in her hand, it's this weird buffer. Everyone's sitting around talking. There's that inevitable awkward sounds. Everyone at the same time takes a sip.
jason:Someone says something funny and people are like, clink clink. Everyone takes a sip. Someone says something questionable and people are like, yeah, that's not cool. Everyone takes a sip. So if you have a cup in your hand, it's this buffer.
jason:This post doc did a study where they brought in 14 people into the bar lab. Seven of them worked for the researcher. Half the time, he told those seven, when you get in there, pound. Drink as fast as you can. The other half of the time, they were told, make it awkward, never sip.
jason:Hold your cup, never sip. When the seven people working for the researchers started pounding, it increased the frequency of drinking of the other actual participants in the room. When those seven set the stage by literally never touching their drink, it slowed down the drinking of other people. So if you feel more comfortable having a cup in your hand, keep a cup in your hand. But things like alternating with alcohol free drinks can make a world of difference.
jason:So we do think there's elements of developing discrepancies as well as supporting self efficacy for people considering change.
mike:Yeah. That's fascinating. And I think as far as the especially the influence part, we all have friends that we know that we drink more with just because of their own habits, and we're mirroring those habits even whether it's consciously or unconsciously. So that makes total sense.
jason:And that's really tough when you have a friend group where there's people of different sex and different size. The littler you are, the less blood you have going through your bloodstream, higher someone's blood alcohol level will be. Alcohol affects males and females differently. So we always have to be mindful of know what you bring to the table best based on your sex and your wage. Because if you are with a friend group or a friend that tends to drink more frequently, it will likely impact your frequency as well unless you kind of have that sense ahead of, I am gonna keep x number of drinks in my hand, only this number will actually contain alcohol.
jason:Things like that.
mike:Which of the two groups that that came out as surprising surprised you the most? Was it the one that got the alcohol but didn't think that they were drunk? Or was it the other one?
jason:It was the I think, in all honesty I mean, it's funny with with hindsight, of course. I will never get tired of watching the demonstration studies. When we can tell people, we're gonna give you alcohol, they get alcohol free drinks. You're always like, is this the one time it won't work? Nope.
jason:It always works. And so I guess Incredible. That has to be yeah. I mean, it has to be the one that's most incredible. That said, I always say that while it's less entertaining, that condition that didn't think they were drinking but actually were, in some ways, is more impressive in a way.
jason:Because the conviction with which people do tell you, no. No. No. When I drink, all this great social stuff happens. They got the alcohol, none of that happens.
jason:I mean, what's always amazing to me is that, you know, do you need research to prove this? Always. Do you need research to have the hunch? I mean, not really. We all know that one person who two sips in is more giggly, and it's like, come on.
jason:There's no way that's affecting you already. We can ask people, have you ever had a bad party? Of course. What were you drinking? Same stuff I have when I have a good time.
jason:Really? What was going on? I was in a bad mood, or my friends were in a bad mood, or we went to check out this band and they were terrible, or everybody I hit on had nothing to do with me. Like, they describe things about the environment or their mindset, not about the contents of their drink. And we even hear, you know, alcohol specific expectancies.
jason:You You know, the number of times I hear people say, like, tequila, oh, I can't drink that. That makes me crazy. There's no in quotes crazy ingredient in tequila. That's an expectancy. And, I mean, it's amazing when you really even hear people say, this type of alcohol does this.
jason:All of that is expectancy. To the body, it's ethyl alcohol. And to the body, it has you know, the ethyl alcohol that's in tequila is the same that's in vodka is the same that's in wine is the same that's in beer.
mike:Yeah. I I've always personally thought that that was just kind of exactly what you explained it and a little bit dumb, but not at the same time. I don't wanna correct somebody and say, no. You don't get crazy on tequila and well, maybe you get crazy on tequila after you've had, like, six or eight beers, and then you decide to have it, you know, a couple shots after it. Of course, you put anything in front of you at that point.
jason:And that's the issue. I mean, we can even even if they don't have those six beers to start with, you know, how do people typically drink tequila? I mean, if it's really, really expensive stuff, they're sipping slowly is the idea. But if people are doing shots, they're getting ticks intoxicated quickly. And so the what happens that night could have just as much been due to drinking a lot in a short amount of time unless to do with the type of alcohol.
mike:Totally. So I wanna get into another thing that you have some opinions on, and these are things that change our drinking behaviors. So things like you've mentioned it, but I'm gonna let you go off on the full list. Things like glass size or ice or type of drink or serving method. Can you how does that, like, affect how we consume?
jason:I mean, from a research standpoint, we really do try and take a look at what are some of the things people might do that could be associated with increased risk or harm, and what are things that people might do that could reduce their risk or harm. There's a a friend and colleague in this field, doctor Matt Martins at the University of Missouri, who actually did research on developing a protective behavioral strategy scale and even did a factor analysis to find out were there things that kinda hung together, and there totally were. There are things people could do before they even go out. There are things that people could do while they're out. And there are things people can do to reduce serious harm.
jason:And so I'll go back to what you asked me earlier about how do you define harm reduction. And it's the idea that any steps towards reduced risk are steps in the right direction. You know, you bring up glass size. If I say I'm only gonna drink two tonight, two what? Because two mixed drinks with three shots in them, that's six standard drinks.
jason:And so it's really having people think critically about what counts as a drink. We look at things like the rate of drinking. The more quickly we drink, the more quickly gets absorbed. If you make the choice to drink, wanna be more control of your night, slow down. And if it helps to slow down by altering with water, alternate with water.
jason:There's research that doctor Martin's did that showed that when people put extra ice in their drink, if it's a drink that ice would fit. Right? Don't put ice in your beer. But if people are, put extra ice in a drink, it's a physic. They experience fewer harms and for a couple reasons.
jason:One, it's a physics issue. The more ice there is in the cup, the less room it is for the drink to go. Plus, as the ice melts, it keeps the cup full longer. So even something as subtle as ice can make a difference. There's only one state I'm aware of that has actually incorporated the effervescence research.
jason:I feel like I know, like, six classy words and effervescence is one of them, but it's how bubbly a drink is. When people drink champagne and they go, oh, that hit me fast. That's the thing. The more bubbly a drink is, the more quickly it gets absorbed. When we drink, alcohol goes into the stomach and starts to go into the bloodstream.
jason:From the stomach, it moves to the small intestine, and at that point, it's pouring into the bloodstream. Leading from the stomach to the small intestine is a little flap called the pyloric sphincter, and really bubbly beverages cause spasms in that, and it moves the contents of the stomach into the small intestine more quickly. A screwdriver, vodka and orange juice, gets absorbed slower than a vodka and soda or vodka and tonic. If other states have done this, my apologies for not knowing, but the state of Virginia, their alcoholic beverage commission, I just see in their guidelines for being, hosting a party. Even recommend, if you're making mixed drinks, consider a flat mixer like a juice instead of a carbonated mixer.
jason:Because with carbonated mixers, you will have a more quickly, a more rapidly, a group of people who are going to more rapidly get intoxicated.
mike:Yeah. It's
jason:interesting because I mean, I feel like this is why you ask if I ever do placebo things at parties. I think this is why I don't get invited to parties. You're like, rapid takes the fun out of this a bit and then like, hey. Wanna hear about the pyloric sphincter? No.
jason:I really don't. Who invited? But, it's all these little things we can do that can really set us up for the night we're looking for.
mike:Yeah. I mean, I think it's definitely being more informed, more aware, more mindful when you make those choices. I know for me, like, of course, in college, you know, I I drink everything fast. But that was, like, how I drink I drink everything fast even when I'm not drinking alcohol. I drink my coffee fast.
mike:I drink my I chug my water and everything. So for me, like, I I was never a hard alcohol drinker, but occasionally, of course, I'd be somewhere and there'd be drinks. I always would just get it in a tall glass no matter if it was a single, you know, or whatever because I knew that if I got those little glasses with, like, a double shot in it, that would be gone in, like, a minute. And then I want something else in my hand again. And in my twenties, early thirties, I wasn't being mindful.
mike:I was just refill it up. I wasn't gonna, like, you know, have a glass of water in between or think about a lot of these things. And it's really important though. It probably would have changed a lot.
jason:Well, you bring up the that that that that hindsight component. And I think that people do. You know yourselves best. And so if someone says, well, that night did not go the night I I wanted it to. What happened?
jason:Well, I did drink more hard alcohol than normal. Or the number of times I hear a student say, I hadn't had any food that night, and it hit me faster. That's true too. I mean, if we drink on an empty stomach, you get to absorb more quickly. So if you wanna be more control of your night, eat prior to or while drinking.
jason:And that even something like that can make a difference.
mike:Yeah. That's great. So let's let's, finish off with something that I think is really important to discuss, which is something called normative misperception.
jason:Can you
mike:explain what this concept is?
jason:It was in the eighties that, there was, like, the big five of norms researchers. Alan Berkowitz, Wes Perkins, Jeff Linkenbach, Michael Hans, and Kareem Johansen. There are all these people that said and started a document that there were very significant misperceptions, about how many people drink. People think that more people drink than they actually do. They think that those that drink drink more than they actually do.
jason:And they think that people approve of some of the more excessive behaviors more than they actually do. So what does all that mean? You can ask someone, what percentage of students do you think drink at this school? And if they estimate, like, everybody or 95%, they're probably gonna be more likely to drink themselves. Because I wanna fit in, and if everyone does this, I'm I'm more likely to drink myself.
jason:The most recent data we have from the monitoring the future study out of the University of Michigan using college students as an example shows that seventy five percent of students drink at least once in the past year. The past year is a big time frame. If we look at in the past thirty days, fifty five percent drink at least once in the past thirty days. It's almost a fifty fifty split of those that don't drink and those that do. So if someone says, I really wanna fit in, they're more likely to drink.
jason:Consider the person that's like, tonight, I really don't wanna drink. But the problem is if I don't drink tonight, like, I'll be like the one person not drinking. Not true. At least based on past month's data, forty five percent of students or more on any given night are choosing to not drink as well. We know that, what, twenty two percent, if I'm remembering that statistic right, report that they have five or more drinks at least once in the past two weeks.
jason:What do people see in every movie about college? Five or more. Every TV show, five or more. Every social media post, five or more. What do most students do?
jason:Not that. Seventy eight percent either don't drink at all or if they make the choice to drink have one, two, three, or at the most four. So that's the big setup that not only do we look at how many people do you think drink, but then we ask people, of those that drink, what do you think they have? And what's amazing is the students that drink two are like, I think the typical student drinks three. The ones who drink four are like, yeah, but most people drink five or six.
jason:The ones who drink eight are like, well, at least I'm not bad as everybody. They drink nine or 10. And there's research that shows that not for everyone, but for many people, if you can correct a misperceived norm, that can actually lead to them making changes in their drinking. Again, it could develop discrepancies. I just wanna fit in and do what everyone else is doing.
jason:What's the status quo? I'm actually the one set in the bar. I'm drinking much more heavily than other people. No. It's not like two other people drinking that lunch.
jason:Exactly. The other hundred weren't. And if you can correct a misperceived norm, that discrepancy bet of where they wanna be and where they're at could be, introduced. But you can also support self efficacy. If someone's like, tonight, I only wanna drink two.
jason:I worry I'll be, like, the only one drinking two. If we have data that show that's what most people are doing, people are more likely to comfortably and confidently go and do that.
mike:So interesting. So a little bit of my own personal experience here is that I think this hit me in the face without even realizing it. But when I was late twenties, I was in this entrepreneurial program, and they had us do this hustle where we had to go on the streets in Chicago. And we had a tablet, and we had to get people to fill out this form. And so what we did was we thought we could get them to fill out the form by giving them a free beer to a local bar.
mike:So we went and hustled the bar. We got the, hey. Can we get drink coupons? We'll bring Pringle back to your bar. They said, sure.
mike:We went. So we started going person to person on the street to fill out these surveys with the offer of the free beer. And to my surprise, so many people were like, I don't drink or I I don't want that. And I and I thought for sure, you know, being in my twenties and being how I was, all you know, most people are gonna be like, oh, heck yeah. I'll take a free drink.
jason:But
mike:Yeah. You know, this is so so fitting and, like, I I realized that firsthand. And then now with that knowledge here, now that I'm here in Spain, people have drinks all the time. And so if you didn't really have this perception, you would think everybody drinks and everybody probably drinks to excess. But they probably have, like, just one.
mike:It I always just see the drink sitting on the table, but they're seldom, like, drinking. They're always full. And I also think you never realized a lot of them are probably having nonalcohol drinks because they serve nonalcohol beer in abundance here. And so I think it's more of a cultural thing, but one would think by looking around, oh, everybody drinks and everybody drinks a lot.
jason:It's so fascinating what contributes to this. I worked at the Evergreen State College. I'm pointing. It's 10 miles that way. And, today is a perfectly very rainy day in Olympia, Washington.
jason:We had data on the percentage of students that smoke cigarettes, use tobacco, use cannabis, drink alcohol, and it would never fail. There were times where people would visit campus and say, everyone smokes on this campus. And I'm like, they really don't. I mean, we have the very, very clear data to a human. The only times they said, everyone smokes on this campus were really, really rainy days.
jason:How come? Because people that don't smoke don't stand outside in the rain. And just people that smoke cigarettes were the ones huddled under a smoke shack or under a tree or trying to find shade. They were smoking outside on a very rainy day. And, yeah, if you looked around, most of the people you saw may have a cigarette in the hand because the people weren't smoking while indoors and staying out of the blustery weather.
jason:And so you can take it out of substance use. If you're driving on an interstate for thirty minutes and traffic's actually moving, we can ask people how many cars do you see in those thirty minutes that, that are, what are the pardon me? Let me rephrase that. In thirty minutes, how many cars what what are the cars that really stand out to you and that you really notice? People tend to say the ones weaving in and out of traffic, the ones blowing by me.
jason:How many of those do we see in those thirty minutes? Five, six, let's say 10. What's the first thing we say when you get out of the car? Everyone drives crazy around here. No one knows how to drive.
jason:What's wrong with people? We don't notice the hundreds doing exactly what we're doing. With the exception of the people going super slow in the left lane, we don't notice the ones going slower than us because they're all behind us. And the same thing happens with alcohol. If you're at a party or if you walk into a bar, you tend to hear the people going, whoo, clinking glasses being really loud and you're like, this place is crazy.
jason:If a hundred typical people based on college student data at a party, 45 of them aren't drinking at all. Another 20 are drinking one drink, another 15 are drinking two drinks. It's probably only six people drinking the six, seven, eight, nine, 10 or more. But who does everyone talk about on Monday? That's what you hear about.
jason:And that could even be what you noticed. Even if we go to a party and all hundred people are drinking, we don't notice the thousands not at that party. So it's not unique to the age group I work with. It's not even unique to substance use. It's how we work as people.
jason:It's what we notice.
mike:So it has nothing to do with just alcohol alone. It's not isolated to that. And but let me ask you this. So that false perception is just basically what we're seeing in front of our eyes.
jason:How much
mike:do you think that on top of what we're exposed to is attributed possibly to the marketing machines that are going through the alcohol companies? Because those are always in our face at every ballgame, turn on to TV, the Super Bowl. You know? I mean, I can't even list that, the amount of places that that placement is. Do you think that that plays part?
jason:There's research that shows that advertising plays a part. It's advertising, it's media, it's movies, it's TV shows, it's songs. You know? Years ago, it's been a while, but I I was a co author on an article where we looked at the role of media. And there's research that shows with the with kids, for example, adolescents, that the more they see alcohol portrayed in TV shows, movies, commercials.
jason:If they don't drink, the more likely they are to start. And those that do drink are more likely to increase their use compared to when there's less exposure to that. And so, you know, I, had to present to a group of eighth graders once. Here's a fun tip. Never present to eighth graders.
jason:Because they're really they're really scary. But, I was like, I bet I can do an eighth grade version of the bar lab. I bet I can make this appropriate for middle school students. I walked into the room. I set the stage.
jason:The kids were great. They were they were listening. And I said, I didn't wanna at all, if a kid had already drank, I didn't want at all them to disclose that in front of a teacher, in front of me. So I worded it as wisely as I thought I could. I said, what are some of the ways you've heard alcohol attacks people positively?
jason:Every kid in that class raised their hand. And I mean, I don't see that with college students. I don't see that when I present to adults. I got very nervous. I called on who I thought was the most innocent looking kid.
jason:And I said, go ahead. And he goes, helps you get the ladies. And I was like, you're an eighth grader. Go play a video game. And I'm like, why why would you see that?
jason:And he cited as evidence of commercial. It was on TV at the time. And the list just went on and on and on and on. And it made me realize, like, obviously, that bar lab research, you have to wait till people are 21 before you do it. But well before the age of 21, ask someone who doesn't drink.
jason:If you do drink, well, how will it affect someone? They know how to answer that because they've seen it portrayed, they've heard it, and they've seen things like the advertisements that you reference as well. But beyond ads and media, I mean, it's older siblings, it's parents, caregivers, and guardians. It's right? These these stories people tell, it all contributes to what people expect might happen.
mike:Well, this has been an incredible episode. I actually wanna keep going because it is really fun and entertaining and and just, like, so informative. So but, unfortunately, we're out of time. But thank you, Jason, for taking the time to share these experiments, your background, your knowledge with everybody listening.
jason:Well, you're far too generous and far too kind. You made this fun. Thanks for doing the work that you do, and it was a pleasure to join you.
mike:This podcast is brought to you by SunnySide, the number one alcohol moderation platform. And if you could benefit from drinking a bit less, head on over to sunnyside.co to get a free fifteen day trial.
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