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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.

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.