Why we drink too much The impact of alcohol on our bodies and culture

Knowles, a professor of surgery at the Queen Mary University of London, combines in this accessible debut primer an account of his own struggle with alcoholism and a comprehensive analysis of alcohol's biological and psychological effects. He touches on the motivations for alcohol use, both external--toasts at weddings, after-work camaraderie with colleagues--and internal, like providing a pick-me-up when feeling down, or a jolt of "Dutch courage" (a term dating to the 17th century when soldiers heading to the front lines were given a shot of gin). Knowles unpacks how alcohol hijacks the brain's internal reward systems while damaging individual and collective well-being--aside from being a risk factor for a long list of diseases and mental health issues, alcohol misuse is estimated to cost the public $250 billion a year in healthcare, crime, and lost economic productivity. The most resonant sections delve into how Knowles's alcoholism strained his marriage, rendered him incapable of caring for his kids, and caused suicidal ideation before he committed to recovery nearly 10 years ago. These passages provide an effective frame through which he unpacks the genetic, environmental, and psychological factors that contribute to addiction and counters myths that alcoholism results from moral weakness or lack of willpower. Readers who are considering reevaluating their relationship with alcohol should take a look. (Jan.)

Thinking about drinking. Problem drinkers who seek to get sober are told they will always remember their first drink and how it felt. The mind-altering experience is indelible and life-changing. For Knowles, a British surgeon and professor, that moment came on a school trip in Germany at age 13 with a liter of lager. Nearly 30 years later, his love affair with our favorite drug ended with a half-empty bottle of Bacardi, a gun, and thoughts of suicide. In seeking to understand his own troubled relationship with alcohol, Knowles has produced a work that turns the magnifying glass on human society and history and how we developed a global relationship with a drug that has caused us great harm to our health and our relationships. These are questions many are asking in this moment, after alcohol consumption rates, which soared during the Covid-19 pandemic, are crashing. The number of Americans who drink has fallen to a 90-year low, according to a 2025 Gallup survey. Though not every person who drinks is addicted to alcohol or exhibits problematic behavior, many of us are reexamining our relationship with a drug that is legal, socially condoned, and often more dangerous than we like to acknowledge. The paradox, of course, is that drinking feels good to so many. We speak less openly of its wreckage. This investigation, the author is careful to note, is not a lecture: "I have no wish to ban alcohol or stop anyone who enjoys it from continuing to do so." Nor is it a manual on how to get sober in 30 days. Rather, the book digs deep into the relationship with our favorite mind-altering chemical and offers a robust, thorough examination of how alcohol seeped into our lives and the many ways it endangers them. A comprehensive look at the human relationship with alcohol, at a time when many are beginning to question it. Copyright (c) Kirkus Reviews, used with permission.