Think from KERA Why do only some drinkers become drunks?
Jan 20, 2026
Dr. Charles Knowles, a colorectal surgeon and chief academic officer at Cleveland Clinic London, dives deep into our complex relationship with alcohol. He shares his own struggles with drinking and how societal and biological factors influence alcohol use. The discussion covers the science of addiction, how early drinking can lead to dependence, and the importance of understanding our habits. Charles emphasizes the need for sustainable change, the risks of relapse, and the significance of personal reflection in recovery.
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Early Discovery Shaped A Lifetime
- Charles Knowles discovered alcohol at 13 and quickly found it relieved unwanted thoughts and feelings.
- That early relief made him enthusiastic about drinking and set a path toward heavy use.
Drinking Is Learned Through Reinforcement
- Alcohol problems are driven by learning and memory through reinforcement mechanisms.
- Positive and negative reinforcement together produce especially strong drinking habits.
Tolerance Blunts Pleasure, Not Relief
- Tolerance reduces alcohol's pleasurable effects but not its relief of negative feelings.
- This difference helps explain continued drinking even when it stops being fun.




