The frontier psychiatrist is a daily health-themed newsletter. The plural is currently an anachronism. It’s written by Owen Scott Muir, M.D., a child and adult Psychiatrist and Healthcare muckety-muck. Please subscribe to support this absurd endeavor. Today, I'm writing about a question people ask all the time, but probably shouldn't.
I don't drink alcohol. I have never had a drink of alcohol. I have had three sips of alcohol in my life. There were: one sip of wine when I was seven. One sip of Korean potato vodka when I was in college by accident. One sip of a mixed drink with my wife. I may have had a tiny sip of a tequila drink on a date 1 million years ago? It wasn’t consensual. I have never imbibed an entire alcoholic drink. I am 44 years old.
This does mean that I went through high school at an “elite New England boarding school,” college at Amherst college, my 20s and 30s in New York City, all of medical school, all of residency, and every night of my life without ever drinking. I don't drink.
People feel entitled to ask about “why I don't.”
This ends up being a very personal question. It is a peculiar entitlement. I've always found it strange.
I'm going to answer the question, about my personal reasons for not drinking in the first place. And the reasons I kept not drinking. And reasons I still don't drink.1
The initial reason, for me, was simple. It was easier to rebel against my peers in high school than to rebel against my parents.
I was a nerdy outsider. This, if you're reading a newsletter written by me, is unlikely to be surprising to you. I am not cool. I have never been cool. I may be entertaining or fun, but cool, or popular? No. None of these words have ever been used to describe me.
As a grumpy iconoclast, being oppositional is also a long-standing character trait. There's a great rage against the machine song… “F- you, I won’t do what you tell me!” I always loved that song.
I didn't want to drink, because I didn't really like my classmates drinking. It turns out that what I didn't like, many years later, was probably that my classmates were struggling. I’d later understand the struggles to be related to likely psychiatric illnesses. It was not like effective treatments were just available in the campus snack bar—we called it the “Oscarson Jigger Shop.”
There is a lot of unwellness that gets misunderstood, especially in young people. There is a lot of struggling that goes on, and alcohol was available, if not legally, to help alleviate the stress and reduce social anxiety. This cause severe problems for some students. As someone who didn’t want to do that— I was a social pariah.
I wasn't happy about that. And so I chose to be a rebel. And that meant not drinking. The band Minor Threat had a song called straight edge, and this gave me an identity to hang my hat on. You could be coolish in the way that was sanctioned by DC area rockstars by not drinking, and that was good enough for me.
My dad also had an alcohol use disorder that was pretty serious. I dodged a bullet by never starting drinking. In college, I kept not drinking. This kept being difficult in social situations. By the time you're in your 20s and can legally drink, and you don't, people ask you a question.
“Why don't you drink?”
This question has a number a good answers, but a lot of them reveal personal health information. In my case, the complete list of answers would be something like:
I'd like to avoid exacerbating bipolar disorder for which I required medical management as early as 16 years old, and don't want make that worse.
My father had an alcohol use disorder.
My paternal grandfather died by suicide, likely as a result of an alcohol use disorder and other factors
My older sister has a substance use disorder that would lead to her eventual death
I don’t like bars
A researcher from the NIMH told me that not drinking was the best decision I ever made, and probably is the reason I'm alive, as a research subject in my early 30s.
I'm socially awkward enough already
I built my entire identity around not drinking in high school, and I don't really feel like dismantling that now. I might as well stop liking Fugazi and DC hard-core!
Drinking is expensive, and I don't have a lot of money to burn on alcohol.
I plan on writing a newsletter— I'm a nerd— later in life, and if I keep not drinking, I get to say things when I'm in my 40s like I never had a drink. And people will be surprised. And that's good for my brand as a nerd.
I like having awkward conversations that disclose tremendous amount of deeply personal information with strangers, and one of the ways I do that is by not drinking, and then anticipating that they're gonna ask me why. It has been a real game changer when it comes to dating, let me tell you.
I value curiosity, and that means the more I don't drink, 20 or more years later, when I'm a physician, and I'm narrating Educational content about how to talk to kids about substance use disorders, I can say, with the utmost sincerity, “I have no idea what your experience is like, and I'd appreciate it if you could educate me.”
The most invasive question that you never knew was invasive.
Thanks for asking!
As a brief addendum, I've never smoked a cigarette. I've never used a recreational drug.
"I'll answer that question when you tell me why you really drink"
Beautifully written and lots to think about.