Alcohol and Placebo: The Role of Expectations and Social Influence

Abstract

The placebo effect is frequently present in our lives when an expectation, associated with any psychoactive material, leads to subjective and physiological changes. The present work studies the role of expectancies associated with ethanol/alcohol in changes to the subjective state. In experimental situations, we examine how these expectations—with or without social influences—affect participants when consuming alcoholic, pseudo-alcoholic, or non-alcoholic cocktails. Psychological and physical changes can, to a significant extent, arise from an expectation-driven placebo effect. We suggest that expectations of inebriation formed by socialization and experiences can explain most of the behavioural changes following alcohol consumption. These effects seem to be stronger if the alcohol consumption happens in a social context and weaker if it is individually. Regarding the information effect, we suppose that the expectations will positively affect the drunkenness, i.e. toward the placebo “direction”: those who believe they are consuming a non-alcoholic cocktail will be less inebriated than those who know their drink contains alcohol. In this study, we successfully demonstrate the expectation-induced classical placebo effect in the misinformed participants who were, in fact, consuming non-alcoholic drinks. The “social” alcohol consumption further enhances the true or believed effects of the alcohol, and thus the participants reported their subjective feelings in lines with their manipulated expectations. As regards the effect of the alcohol, therefore, many other factors contribute in addition to the alcohol itself, the most important of which seem to be group effect, suggestions and expectations.

The Drunk Utilitarian Revisited: Does Alcohol Really Increase Utilitarianism in Moral Judgment?

“…Alcohol consumption often occurs in social settings (e.g., with friends at a party) and effects of alcohol may differ depending on whether it is consumed individually or in a social setting. Similar contextual influences have been found for placebo effects, which can be different in individual and social settings (Bodnár et al, 2020). Thus, our lab findings may not be representative of the effects of alcohol and alcohol-related beliefs in general if their influence on moral judgments depends on the context.…”

“…Second, only one of the three studies (Francis et al, 2019) included a placebo condition in which participants believed they were consuming alcohol without actually consuming alcohol. Placebo conditions are essential in this line of research to distinguish actual effects of alcohol from effects of people’s naïve beliefs about the influence of alcohol (Bodnár et al, 2020). In the context of moral judgments, it is also possible that people believe that being intoxicated gives them a license to make more pro-sacrificial judgments, even when alcohol itself has no causal effect on moral judgments.…”

Drinking alcohol appears to have no impact on self-perceptions of morality, aggressiveness, or intelligence.

“…Second, not all our participants believed they were in a placebo condition. It is quite hard to convince people that they are drunk because the experience of alcohol intoxication is quite common, and many challenges with using a placebo in alcohol studies have previously been identified (Bodnár et al, 2021). However, it must be noted that the self-assessments in the group that had actually consumed alcohol did not differ significantly from those of the two other groups.…”

The impact of alcohol priming on craving and motivation to drink: a meta‐analysis

“…However, if this is not feasible, studies interested in determining the individual impact of alcohol's expectancy and pharmacological effects on motivation to drink should incorporate a placebo control [5]. If the study is interested in understanding motivation to drink within more 'real world' contexts, where arguably both pharmacological and expectancy effects influence drinking behaviour [89], a soft drink control would be more appropriate. A small number of studies have included an 'alcohol naïve' condition, in which participants are given alcohol, but told soft drink (this is part of the complete 'balanced placebo design') [42,70].…”