The Telegraph · Editorial reflections
Alcohol tolerance is not a personal safety test
Understand why feeling less affected by alcohol does not establish safety, and how to discuss genetics, drinking patterns, and personal risk with a clinician.
Dr. Simon Feldhaus’s first-person account, as told to interviewer and writer Susanna Galton. The credited syndicated version names THE BALANCE; Ola Fras is the photographer.
People often compare alcohol by how it feels: who becomes flushed, who feels sleepy, or who seems relatively unaffected. Those observations can become a story about being someone who handles alcohol well. The story may feel reassuring while answering only a narrow part of the health question.
In a first-person Telegraph article, Dr. Simon Feldhaus discusses his own choices in an interview written by Susanna Galton. The credited syndicated version identifies his connection with THE BALANCE. A personal account can invite discussion, but it cannot establish that another reader's drinking is safe or beneficial.
The distinction matters. Immediate sensations, inherited differences, the amount consumed, and longer-term risks are related topics, not interchangeable measures. A useful conversation considers them together, without treating apparent tolerance as a medical certificate or another person's routine as a recommendation.
Four questions to prepare
Am I judging alcohol mainly by how quickly I feel its effects?
What does my actual drinking pattern look like across an ordinary week?
Which health conditions, medicines, or family concerns should I discuss?
What support would help me make an informed and sustainable change?
Separate immediate sensation from health risk
The National Institute on Alcohol Abuse and Alcoholism explains that a low response to alcohol can increase vulnerability to heavy drinking and alcohol use disorder. Feeling less affected is therefore not evidence of protection. It can be a reason to examine the pattern more carefully.
Consider what the usual comparison actually measures. Appearing composed at dinner, feeling less sleepy than a friend, or remembering the evening does not answer every question about exposure or harm. Those experiences should not be used to infer a complete health assessment.
The same caution applies to driving. NIAAA notes that driving-related skills and judgment can be impaired before obvious signs of intoxication appear. Do not use how sober you feel as a test of fitness to drive. Arrange an appropriate alternative when alcohol is involved.
A better starting point is to describe the pattern accurately. What do you drink, how often, in which settings, and with what consequences? Those questions provide information a clinician can use. They move the discussion away from whether you seem more capable than another person and toward what is happening in your own life.
Understand what genetics can and cannot explain
Inherited differences can influence alcohol responses and risk, but they do not produce a simple division between people who can drink safely and people who cannot. NIAAA describes multiple biological and environmental influences. A family story or a consumer interpretation should not be treated as a complete assessment of those influences.
If a genetic claim appears in a health article, ask what it actually concerns. Is it about metabolism, a particular response, vulnerability to a disorder, or another outcome? These are different questions. A finding relevant to one does not automatically settle the others.
Bring questions about family history or unusual reactions to a qualified clinician. Describe what you have observed rather than assigning yourself a genetic explanation. If a test is proposed, ask what it can establish, what remains uncertain, and whether the result would change a medical recommendation.
Avoid using ancestry or appearance to make assumptions about an individual. A person's background does not tell you everything about their biology, drinking pattern, or health. The useful purpose of discussing inherited differences is to improve understanding and care, not to create stereotypes or offer reassurance that goes beyond the evidence.
Keep longer-term evidence visible
Personal stories often emphasize the part of drinking that someone enjoys: conversation, ritual, taste, or a familiar social setting. Those experiences can be described honestly without converting them into evidence that alcohol improves health. The social occasion and the substance consumed are different parts of the account.
The National Cancer Institute describes alcohol as a cause of several cancers. Risk is not limited to people who appear intoxicated or choose a particular type of drink. A reassuring personal anecdote does not cancel that evidence.
Ask what a reassuring result can and cannot tell you. An individual clinical assessment may include several kinds of information, each answering a particular question. Invite the clinician to explain the limits of the findings instead of interpreting one result as a general permission to continue any pattern you choose.
When an article discusses longevity, ask whether it presents research or an individual's outlook. A person can make a personal choice while recognizing a risk. That choice should not be translated into a prescription for readers, especially when their medical histories and circumstances differ.
If you do not drink, a profile of someone who does is not a reason to start for health. If you do drink, it can be an opportunity to examine your own pattern and ask informed questions. The point is to make the decision more accurate, rather than to defend a preferred conclusion with a selective story.
Describe the pattern without minimizing or dramatizing it
For a clinical discussion, choose a period that reflects ordinary life and describe it plainly. Include what happens at home as well as at social events. Mention occasions when the amount differs from your intention. Accuracy is more helpful than presenting the version you think will sound most acceptable.
Use the actual beverage, container, and serving size when you can. A glass is not a precise description if its size varies. Ask the clinician how to describe amounts consistently. The aim is a shared understanding, not a contest over whether a particular label applies to you.
If you are unsure how to describe a usual week, bring examples from the settings where drinking occurs. A restaurant serving, a drink poured at home, and a shared bottle can be difficult to compare from memory. Honest uncertainty is more useful than supplying a confident number that you know is incomplete.
Include the role alcohol plays. Is it associated with relaxing after work, managing an uncomfortable social situation, following a familiar routine, or responding to distress? You do not need to decide whether that role proves a diagnosis. It is relevant context for understanding the pattern and considering support.
Mention effects on sleep, relationships, work, finances, or responsibilities if you have noticed them. Also bring your medication list and relevant health history. A conversation that includes the surrounding circumstances is more useful than one focused only on whether you feel visibly intoxicated after a particular number of drinks.
Make change a supported decision
If you want to change your drinking, discuss what kind of support fits the situation. A clinician can help assess the pattern, identify relevant health concerns, and explain options. You do not need to wait until consequences become severe before asking for a conversation.
Take withdrawal risk seriously when there has been prolonged heavy drinking. NIAAA warns that suddenly stopping can cause potentially life-threatening withdrawal. Seek medical help to plan a safe change rather than attempting an unsupported abrupt stop if dependence may be present.
Practical support can include discussing familiar situations in advance. What happens at the end of a demanding day, during a work event, or when someone offers a drink? Identify whom you can contact and what arrangements would make the plan easier to follow. These details belong alongside the clinical decisions.
If a previous attempt did not go as intended, describe what happened without treating it as a final verdict. The circumstances may reveal where additional support is needed. A useful review asks what can be learned and changed, while keeping safety and individualized care central to the next step.
Read personal accounts with context
A media interview can show how one person thinks about a choice. It is less able to show every relevant detail of their health, history, or decision-making. Respecting the account does not require assuming that it contains a complete template for your own life.
Ask which statements describe preference, which identify evidence, and which concern personal circumstances. Keep those categories separate as you read. A confident voice, a professional title, or a striking headline cannot replace an explanation of how a claim applies to a particular outcome.
Look beyond the headline to the format and credits. An interview, an opinion column, and a report on a research study have different purposes. Understanding the format helps you decide what kind of conclusion the material can support, and which questions still require independent evidence or individualized professional advice.
You can appreciate the importance of pleasure and connection while making a different choice about alcohol. You can also ask for help without needing to announce or defend that choice publicly. A thoughtful decision may be private, gradual in its planning, and supported by people who understand your circumstances.
Tolerance is one observation within a much larger conversation. The most useful next step is to describe your pattern honestly, understand the evidence, and seek appropriate guidance where needed. That creates a stronger basis for a decision than comparisons, reassuring anecdotes, or the assumption that feeling fine means nothing harmful can be happening.
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Dr. Simon Feldhaus
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Meet Dr. Simon Feldhaus