Professor David Nutt - Drink?

IT WAS MY first day at Cambridge, and somehow all of us first-year medical students in the same college found one another. Nine of us went to the pub around the corner.

We settled in for the evening. It was a typical 1960s city pub: small sticky tables, even stickier carpet, with a smoky atmosphere that had given a yellow veneer to the walls and ceiling. I wasnt a big drinker, but I had, I think, three pints of the local beer. Most of the others drank maybe four or five, which seemed a heck of a lot to me. At 10:30 p.m., the pub closed. Someone said they had a few bottles of wine back in their room, so we went back to the common room and hung around drinking them.

The mood was pretty loud and raucous, a bunch of green 18-year-olds having a laugh. But then, one of the guys started to cry. Not quietly but very loudly, wailing and weeping. It was an enormous outpouring of negative emotion so intense that I thought he was going to kill himself. I asked a friend whod been at school with him, should we call an ambulance? But he said, No, dont worry, he always does this. He wont even remember it in the morning.

He didnt remember it. But I couldnt help wondering: How could alcohol turn someone whos a high-achieving school success, on the surface confident and likeable, into a gibbering mess? I began to think, what does this tell us about alcohol? Looking back, that was the beginning of my fascination with drugs, including alcohol, and how they affect the brain, the person, and society at large.

As a doctor, Ive seen firsthand all the types of havoc that alcohol causes, from liver disease and cancer to drunk-driving accidents and violence. What is clear is that you dont have to be a homeless alcoholic on the street to be harming your body and/or brain with booze. You can be a high achiever, like my university friend.

In fact, he wasnt the only one of that small group who had problems with alcohol. The school friend who reassured me he would be OK was also a heavy drinker. Very sadly, he had problems with alcohol his whole life and died of liver failure in his forties, his promising career and indeed life ruined by alcohol. True, theirs are extreme stories. But theyre not particularly unusual ones.

Now, 50 years later, I want to share what Ive learned about alcohol. Im not here to preach, and I do not judge you, whether youre drinking too much or youre worried that you are; Ive written this book to help you make informed and smart drinking choices. Even while Ive been writing, its made me rethink, again, how and what I drink myself. Im not a big drinker and I know all the risks, but even so I can see how easy it is to slip into the habit of overindulging.

My position has always been: Alcohol is a drug and one that shouldnt be taken lightly. This may sound odd in our culture, where having a drink and indeed getting drunk is broadly acceptable. But its a position most doctors, scientists, and