Notes
This book gives general information. It isn't medical or psychological advice, and it's no substitute for a doctor, pharmacist or alcohol service who knows your situation.
I've kept sources out of the chapters where I could so they read easily. Here they are by chapter, with the limits I'm aware of. I read the published summaries of these papers and not the full texts, with one exception noted under chapter 4. Where a chapter isn't listed, it rests on my own reasoning. That includes the list in chapter 2, the account of where pleasure sits in chapter 11 and the closing chapter. The NHS pages were read in September 2026. They're written for England, and services differ elsewhere.
Before you start. The withdrawal symptoms, their timing and the advice to get medical help before stopping are from the NHS pages "Alcohol-use disorder" and "Alcohol support". The advice on pregnancy is from the first of those pages.
Chapter 1. Mitchell, Teigen and Ramchandani, "Absorption and peak blood alcohol concentration after drinking beer, wine, or spirits", Alcoholism: Clinical and Experimental Research 38, 2014, pages 1200 to 1204. Fifteen healthy men, drinking after an overnight fast. It's a small study and it measured blood alcohol and not mood. The step from its timings to the claim that the first sigh can't be the drug is my inference. The account of the pour as a ceremony is mine too.
Chapter 3. Bresin, "A meta-analytic review of laboratory studies testing the alcohol stress response dampening hypothesis", Psychology of Addictive Behaviors 33, 2019, pages 581 to 594. The pooled effect on distress after a stressor was d = -0.38. The author says the review doesn't give a definitive answer. Steele and Josephs, "Alcohol myopia: its prized and dangerous effects", American Psychologist 45, 1990, pages 921 to 933. This is a theory paper built on the authors' own experiments. My three reasons for a twitchy evening without a drink are not from a study.
Chapter 4. Abrams, Kushner, Medina and Voight, "The pharmacologic and expectancy effects of alcohol on social anxiety in individuals with social phobia", Drug and Alcohol Dependence 64, 2001, pages 219 to 231. The authors describe the gap between the alcohol and placebo groups as a strong trend, which means it fell short of the usual statistical threshold. Bègue, Bushman, Zerhouni, Subra and Ourabah, "Beauty is in the eye of the beer holder: people who think they are drunk also think they are attractive", British Journal of Psychology 104, 2013, pages 225 to 234. Sayette and eight colleagues, "Alcohol and group formation: a multimodal investigation of the effects of alcohol on emotion and social bonding", Psychological Science 23, 2012, pages 869 to 878. I read this one in full, and the three bonding scores are from the full text. Participants were aged 21 to 28 and were strangers to one another, so the results may not carry over to a forty-year-old among friends. The authors' own conclusion is that the drug mattered more than the belief in their study. My guess about why the placebo group scored lowest isn't theirs. Fairbairn and Sayette, "A social-attributional analysis of alcohol response", Psychological Bulletin 140, 2014, pages 1361 to 1382. The idea that confidence is a drop in self-monitoring is my reading of these papers. So is the point about the first twenty minutes of a party.
Chapter 5. Elvig, McGinn, Smith, Arends, Koob and Vendruscolo, "Tolerance to alcohol: a critical yet understudied factor in alcohol addiction", Pharmacology Biochemistry and Behavior 204, 2021, 173155. Most of the work it reviews was done in rodents. The list of signs is from the NHS page "Alcohol-use disorder". The argument that setting and belief fill the gap tolerance leaves is mine.
Chapter 6. Ebrahim, Shapiro, Williams and Fenwick, "Alcohol and sleep I: effects on normal sleep", Alcoholism: Clinical and Experimental Research 37, 2013, pages 539 to 549. The review covers healthy volunteers in sleep laboratories. The NHS wording is from "Tips on cutting down on alcohol". I found no study of how long sleep takes to settle in regular drinkers who aren't dependent, so the chapter gives no figure.
Chapter 7. Kushner, Abrams and Borchardt, "The relationship between anxiety disorders and alcohol use disorders: a review of major perspectives and findings", Clinical Psychology Review 20, 2000, pages 149 to 171. The authors call their proposed cycle tentative, and it concerns disorders. Applying a milder version to ordinary regular drinking is my interpretation, as the chapter says. Opponent processes are mentioned in the Elvig review above. The NHS line on hangovers and mood is from "Tips on cutting down on alcohol". The estimate of two or three weeks is mine.
Chapter 8. Crum and ten colleagues, "A prospective assessment of reports of drinking to self-medicate mood symptoms with the incidence and persistence of alcohol dependence", JAMA Psychiatry 70, 2013, pages 718 to 726. The adjusted odds ratios were 3.10 for new dependence and 3.45 for persisting dependence. Robinson, Sareen, Cox and Bolton, "Role of self-medication in the development of comorbid anxiety and substance use disorders", Archives of General Psychiatry 68, 2011, pages 800 to 807. Both used the same American survey and both are observational. Self-referral is described on the NHS page "Talking therapies".
Chapter 9. De Visser, Robinson and Bond, "Voluntary temporary abstinence from alcohol during Dry January and subsequent alcohol use", Health Psychology 35, 2016, pages 281 to 289. One author worked for the charity that runs Dry January. The advice on what to say, on rounds and on partners is mine. So is the remark about people who push drinks.
Chapter 10. Steele and Josephs 1990, as above. The NHS line on memory is from "Tips on cutting down on alcohol". The rest is my argument.
Chapter 12. Mehta and sixteen colleagues, "Short-term abstinence from alcohol and changes in cardiovascular risk factors, liver function tests and cancer-related growth factors: a prospective observational study", BMJ Open 8, 2018, e020673. Average intake in the abstinence group was 258 grams a week, which I've converted at 8 grams to the UK unit. De Visser and Nicholls, "Temporary abstinence during Dry January: predictors of success, impact on well-being and self-efficacy", Psychology and Health 35, 2020, pages 1293 to 1305. One author worked for the charity that runs Dry January. Yao and six colleagues, "Change in moderate alcohol consumption and quality of life: evidence from 2 population-based cohorts", CMAJ 191, 2019, pages E753 to E760.
Chapter 13. Units, drink sizes and the low-risk guidance are from the NHS pages "Alcohol units" and "Tips on cutting down on alcohol". Kaner and eight colleagues, "Effectiveness of brief alcohol interventions in primary care populations", Cochrane Database of Systematic Reviews 2018, issue 2, CD004148. The reduction was 20 grams a week, with a range of 12 to 28, and the reviewers rated the evidence as moderate quality. The people in those trials were drinking about 30 units a week on average. Plans in "when, then" form are from Gollwitzer and Sheeran, "Implementation intentions and goal achievement: a meta-analysis of effects and processes", Advances in Experimental Social Psychology 38, 2006, pages 69 to 119. The Drinkline number and the app are from the NHS page "Alcohol support". The claim that urges rise and fall if left alone is a common one in advice on habits, and I haven't cited a study for it.
Chapter 14. The signs, treatments and emergency advice are from the NHS pages "Alcohol-use disorder" and "Alcohol support". The advice against counting streaks is mine.