The ancients were familiar with problems associated with excessive drinking and sought to protect their societies from alcohol’s ill effects. Excessive drinking was discouraged in ancient Greece, where it was customary to drink diluted wine – three parts water to one part wine. Drinking undiluted wine, or becoming drunk were behaviors attributed to barbarians (Nencini P. 1997, Subst Use Misuse, 32(1): 89-96). In the Laws of Plato, the 5th century BC Greek philosopher outlined appropriate behavior with regard to alcohol. Drinking was forbidden for those under 18, as a “precaution against the excitableness of youth.” Moderate drinking was allowed between ages 18 and 30, with no restrictions on drinking after age 40 (Plato, The Laws, Book II).

During the Middle Ages, physicians began to describe specific pathologies resulting from excessive alcohol consumption. Muhammad Rhazes, a Persian physician of the 9th century AD, noted that regular drunkenness could result in delirium, hemiplegia, sudden death, and numerous other illnesses. In the 11th century AD, Simeon Seth, a physician in Constantinople, wrote that drinking wine to excess caused inflammation of the liver (Sournia J.C. 1990, A History of Alcoholism).