Here's the drinking conversation we need to have

Mail & Guardian

2 days ago

Telling most South Africans they can't drink is a nonstarter. But what we all do need to know is just how dangerous it is — and what we can do to curb it. (Canva)
It sounds macho, but there's science behind the idea that bigger men are better at holding their drink.
Size matters. A larger person absorbs more alcohol into their body tissue so that means that less goes to their brain, which is when you start to feel its effects.
Sex matters, too. It generally takes less alcohol for a female to get drunk than a male. This is
But those aren't the only reasons it's hard to predict exactly how much alcohol you can safely drink.
It also depends on how long it will take for your body to process it and the amount of pure drinking alcohol (ethanol) that is in your drink. That is measured by
In
A useful guide to safer drinking is a
For example, I weigh 85kg. An hour after drinking two glasses of wine, my BAC is about 0.03%, low enough for me to legally drive home. But if my wife, who weighs 61kg, drinks two glasses of wine over the same time, her BAC would be 0.056%, which is above the
While you might only feel really drunk at a BAC of
No safe amount
In fact, the
The Canadian Centre on Substance Use and Addiction has produced an excellent
A 2025 report on alcohol and cancer risk from the
Heavy drinking
In a 2024 global report on alcohol and health, the WHO estimated that
A study published in the
South African Medical Journal
in 2018 found that
Young people are at especially high risk. Using figures from the
But it's the immediate effects of heavy drinking that are most devastating for both the individual and society.
In a global analysis of alcohol and risk of injuries, researchers found that after having four or five drinks, you're at
The risk curve for alcohol is exponential, meaning that the rate of harm increases with every drink.
But every legal drink also contributes to jobs, tourism and taxes.
In fact,
Moderation
The findings present a dilemma for public health advocates in South Africa. On the one hand, we must inform the public that even one drink a day can have serious health consequences for an individual. On the other, drinking patterns here are so extreme that a call for such drastic reduction in drinking would be scoffed at.
While there is no doubt that heavy drinking is both bad for society and bad for the economy, we don't need to smash the liquor industry to combat heavy drinking. But we must intervene to optimise its social and economic benefits.
Based on the
Limit the advertising and promotion of alcohol, which
Close on-consumption liquor outlets (taverns and bars) at midnight, as required by the
Introducing minimum unit pricing so that liquor cannot be sold extra cheaply in poorer communities, which
Inequality in South Africa is so severe that it's hard to make a dent in the armour-proofed vehicles of violence — crime, toxic masculinity and the devaluation of human life. But we can starve them of their fuel, if our political leaders are informed and brave enough to act, to change our culture of heavy drinking in South Africa to one of moderation.
David Harrison is a medical doctor and the chief executive officer at the
, a public innovator based in Cape Town.
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