Why Do I Feel Buzzed from Nonalcoholic Beers?Reading Time: 7 minutes
Why ‘Beers’ Like Heineken 0.0 and Athletic Might Make You Feel Tipsy, Decades of research suggest we can feel some of the effects of alcohol without the alcohol., Researchers have been studying the effects of pretend alcohol for decades.
Day drinking always makes me tired. So a little more than year ago, I started drinking nonalcoholic beverages during afternoon Jets games in place of boozy craft brews. I figured it would be a compromise—no sleepiness, but also, less fun.
But something strange happened. After drinking a can or two, my reactions to the game would become more intense, and I would be more relaxed. I even would notice a red tinge to my cheeks. Nonalcoholic beer felt a lot like … beer. For a little while, I wondered what in the hell was happening. Then, I dove into the research on the placebo effect and alcohol. I came across an experiment conducted around a decade ago at the University of Pittsburgh.
To start the experiment, a researcher poured a clear liquid out of a Smirnoff vodka bottle into a pitcher and then added a cranberry juice cocktail mix. Participants were told they had about a half hour to consume up to three servings of this ‘cocktail.’ After that, they’d be asked to perform a series of tasks, ostensibly so that the researchers could observe the effect drinking had on their abilities.
The twist: the Smirnoff vodka bottle was filled with tonic water, not vodka. The drinks that participants were served were alcohol-free.
‘We build stories and react to the stories that we build,’ Kathryn T. Hall, the author of Placebos, and a professor at Harvard Medical School, told me. During the University of Pittsburgh experiment, the bottle of Smirnoff and the clear liquid inside of it combined with the cranberry juice, the coldness of the drinks, and participants’ past experiences with alcohol to tell a very specific story. This drink will get you drunk, the story said. Participants believed.
Out of the 237 people who took part in the experiment over separate sessions, all but one of them reported they had consumed some vodka. Many, evidently, felt as warm and fuzzy as if they’d downed three shots.
‘We asked, ‘How many ounces of alcohol do you think you’ve received?’ and the mean amount was 4.6 [ounces], which is about three standard drinks of alcohol,’ said Molly Bowdring, a postdoctoral scholar at Stanford Prevention Research Center and the lead author of one of the studies that used data from the experiment.
This experiment is just one of many conducted since the 1970s on the psychological effects of fake drinks. While study participants tend to recognize when a drink they are told does not have alcohol has in reality been spiked, they are far less skilled at picking up on alcohol’s absence from a drink they are told contains alcohol. Bowdring and her co-author write that ‘a wealth of data across numerous laboratories reveals that individuals receiving a placebo beverage nearly always believe that they have consumed at least some amount of alcohol.’ In a recent study by another team, researchers scanned the brains of participants before and after they were given a placebo-alcohol drink they were falsely told contained alcohol. Placebo drinkers had increased activity in the reward network and these increases directly corresponded to how much participants believed they had drunk.
Denis M. McCarthy, a psychology professor and director of the Missouri Center for Addiction Research and Engagement at the University of Missouri, told me you can see this impact on participants when running the placebo portions of these kinds of experiments. In addition to feeling mildly intoxicated after being given placebo drinks, experiment participants also show changes in their behavior. Placebo drinkers might have difficulty with some complex tasks, such as counting backward by sevens or touching their nose with their eyes closed, McCarthy said. ‘We have people go, ‘Oh this is really strong, I’m feeling this,’ and we have to tell them later that they had the placebo.’
People’s behavior also frequently mirrored their past experiences with alcohol. Maybe drinking reduced your anxiety, or made you more talkative, or more positive. Now when you believe you are drinking, you expect to feel that way, and in some cases that expectation will become a self-fulfilling prophecy. ‘You might end up behaving that way, even though pharmacologically nothing has changed in your body,’ Bowdring said.
But there are limits. No matter how they feel or behave in some instances, placebo drinkers are not actually getting drunk. People tend to believe it when researchers tell them they’ve had one to two or maybe even three drinks—but tell them they had four to five cocktails and they start to see through the ruse. And people who are placebo-buzzed won’t exhibit the same level of wobbliness, and altered behavior, as they would if their blood-alcohol content were actually higher. ‘I don’t think we would get someone to fail the easier parts of a sobriety test from placebo; for example, being unable to walk a straight line,’ McCarthy said. In fact, some research has found that placebo drinkers do better on cognitive tasks, likely because they believe they are intoxicated and so pay more attention to what they are doing in an attempt to compensate. Also, many placebo drinkers don’t exhibit the same levels of increased socialization they would if they were drinking actual alcohol.
Knowingly drinking nonalcoholic beverages, as I do while watching afternoon Jets games, is not the same as consuming a placebo which you have been led to believe does contain alcohol. The effect I experience on my couch with NA beer is not as strong as it is with real beer, and probably not as strong as it would be if I were in one of those studies. But I was clearly feeling something, and it wasn’t from the trace amounts of alcohol present in some NA beers. In the U.S., NA beers can only legally have an alcohol by volume value up to 0.5, which is comparable to the amount of alcohol you’d consume with a few glasses of orange juice or by eating a ripe banana, and I’ve never felt even the slightest bit tipsy after having bananas. Nor was it just the sting of yet another disappointing Jets season. I’ve since had similar experiences while drinking NA beers at bars, and if anything, watching the Jets fumble things would ‘sober’ me up. On the other hand, ‘beers’ like Heineken 0.0 or Athletic Brewing Co. IPA still share a lot of similarities with their boozy counterparts, coming in bottles or cans of the same size, and with labeling that looks right at home in a cooler of beverages at a party. Maybe even though I knew I wasn’t drinking beer with alcohol, my past associations with the beverage were powerful enough to override that knowledge and make me feel like I was drinking.
‘One of the things that we found to be critical in boosting or enhancing placebo effects is the symbols around them,’ Hall said. ‘So for instance, a beer can, which you associate with having a beer, the cold feeling, all the writing on the beer can, and even just the ritual—having a beer with TV—is going to stimulate all those pathways that have been conditioned previously from your drinking habits.’
Drinkers pick up on cues associated with alcohol that can create a learned association with intoxication. ‘That learning and conditioning is really powerful,’ said Dylan Kirsch, a clinical neuroscientist and postdoctoral fellow at UCLA who did the work on brain imaging and the effects of placebo drinks. She and Bowdring both note that more research would be necessary to really suss out the effects of knowingly consuming a drink with no alcohol that is designed to mimic some aspects of the appearance and taste of alcohol. ‘I think the comparison that we really need is, what is the impact of drinking a nonalcoholic beer, for example, compared to a soft drink like a soda,’ Bowdring said.
The impact of NA drinks on alcohol cravings also needs to be studied, specifically for those with a tendency toward addiction, Bowdring said. ‘Does it reduce alcohol craving and kind of satisfy that need because you get a taste and you feel like that’s enough? Or does it cue craving?’ Hall takes things one step further and offers a piece of advice for NA drinkers that would have seemed absurd to me when I started down this road, but makes perfect sense now: ‘Drink your placebos responsibly.’
In the meantime, it is already clear that our expectations can, in the right circumstances, have an impact on our response to substances of all sorts. A recent study suggested caffeine is not responsible for all of coffee’s impact on our feelings of alertness. Researchers found increased connectivity in regions of the brain associated with cognitive control, working memory, and goal-directed behavior in people after they drank coffee, but not after they drank another beverage with the same amount of caffeine as coffee. Whether this is caused by something like the placebo effect or some other property wasn’t assessed, said the study’s lead author, Maria Picó-Pérez, via email. ‘The only thing we can be sure about is that when we drink coffee, there is more going on in our brain than just the effect of caffeine,’ Picó-Pérez wrote to me.
In a 2020 review in BMJ, Harvard professor and placebo expert Ted Kaptchuk found that placebo responses can account for 50 to 75 percent of the drug treatments for pain. Kaptchuk’s research also suggests that ‘open-placebo’ treatments—when patients know they are receiving a placebo—are comparable in efficacy to deceptive placebo designs, when patients don’t know they are receiving a non-active pill or treatment.
Hall said that while people are constantly surprised by the impact of placebos, maybe we shouldn’t be. All day every day, what we think is changing the way we feel and how our bodies function in significant ways. For example, if someone knocked on your door and shouted to you that there was a fire in your building and you needed to get out, your heart rate would go up; your hair might stand on end.
‘Your whole physiology changed in response to a piece of information that may or may not be true,’ she said. ‘So in a way, every day we’re responding to information physiologically.’
Given all of this, I’m now confident that something like the alcohol placebo effect observed in the laboratory is occurring for me when I ‘day drink.’ I love this realization for what it reveals not just about NA beverages but about our world. There is something mysterious and beautiful about embracing the idea that our expectations influence us in such profound ways and that we don’t need mind-altering substances to alter our minds. Or at least, this is the story I’ve started telling myself.
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