Couldn't resist this article; it's been hanging around my desk for a few months and it still makes me smile. In a world where there is a lot to be grateful for, know that you can ethically study what happens when people make, let's say, not ideal choices regarding their health.
Copied from The Economist, Sept 6 2025 issue in their Science & Technology section:
How to study people who are very drunk - Naturalistic experiments are all the rage
Sep 3rd 2025|5 min read
Visitors to Minnesota’s state fair in 2024 could hear live music, enjoy white-knuckle rides and compete to make the best tinned goods. They could also get drunk. And if they did, a team of neuroscientists from the local university was waiting to gently torture them.
The researchers were on site to test how well alcohol can numb pain. Although booze’s analgesic effect has been understood for centuries, experts did not know if it continued or tailed off with greater consumption. Testing either hypothesis in a controlled trial, where guidelines limit how much a subject can be asked to consume, is difficult. “Ethically, we can’t ask people to drink alcohol to levels they do in their day-to-day lives,” says Jeff Boissoneault of the Minnesota Alcohol and Pain lab.
That is why he and his colleagues went to the fair. The experiment they conducted, the results of which were published earlier this year in Addictive Behaviours, a journal, is an example of a naturalistic study: one freed from the constraints of clinical trials to better simulate day-to-day experiences and behaviours. Such studies are often quicker and cheaper than laboratory trials, and can yield important insights into how people act outside of clinical settings. They have been around for decades, but are currently enjoying a boom in the fields of neuroscience and psychology. The benefits could be felt widely.
Covid-19 is in part responsible for the boom, says Nehal Vadhan, a clinical psychologist at the Feinstein Institutes for Medical Research in New York. “Many labs had to learn how to collect data in a remote fashion, which then naturally leads to a more naturalistic approach,” he says.
Researchers are also increasingly making use of real-world data gathered for other purposes. These data-sets, usually collected under naturalistic conditions, are on a scale beyond most controlled trials. In 2024 Dr Vadhan and his colleagues published the results of a naturalistic study that checked how well an online programme reduced problem drinking in more than 46,000 people. After three months, average weekly consumption dropped by a third. Few smartphone and online self-help apps have their claims checked in this way, he notes, and certainly not at such scale.
Fair game
Convenience and size are not the only benefits of naturalistic studies. Scientists are keen to study the effects of all sorts of common behaviour that is unethical or illegal, as well as harmful to health. Dr Vadhan has started a study to collect the experiences of people who take recreational drugs including ecstasy and LSD, which can be done without the permissions and paperwork of a more formal trial.
The Minnesota state-fair study also took advantage of this freedom. Whereas review boards in America typically limit alcohol consumption to the drink-driving threshold of 0.08 grams of alcohol per decilitre of blood, Dr Boissoneault and his colleagues tested 149 people with levels up to 0.15—the point beyond which they felt proper consent was hard to establish. The results revealed pain tolerance rose with alcohol levels, which will help public-health researchers model how people with chronic pain use alcohol as a self-administered anaesthetic, says Dr Boissoneault.
The study of hangovers is another area ripe for naturalistic studies. One test carried out in the Netherlands, the results of which were published in 2023, studied people after evenings when their blood-alcohol levels were estimated to have risen above 0.2. That is a level associated with severe impairment of hearing, motor skills, speech and vision, and one likely beyond the ethical approval of a review board anywhere in the world. (The study’s chief finding was that a fortunate few seem not to experience the negative effects of hangovers no matter how much they drink.)
Yet it is not only intoxicants that are of interest. The neurological effects of more everyday triggers are also being studied. Some researchers are scanning the brains of people as they watch films including “Back to the Future” and “Pulp Fiction”, because they are thought to trigger emotional responses that better reflect people’s encounters in the real world.
Such studies, which may help paint a better picture of people’s emotional and cognitive responses to real-world events, had been considered too uncontrolled to test specific hypotheses, says Chris Buckland, a PhD student in psychology at the University of Queensland. Films build suspense, for example, with a combination of lighting, music, dialogue and facial expressions. In a controlled test of how people respond to suspense, these stimuli would need to be whittled down to just one that could be varied in an experiment.
But, says Mr Buckland, the field is starting to acknowledge that chaos is a part of life. In January he published his own contribution in Journal of Pain: a collection of images of people’s faces showing pleasure and agony, for use in cognitive research on recognising states of arousal. Unlike many previous efforts that used expressions posed by actors, this database uses pictures captured from YouTube videos and shows real people celebrating, as well as moments they suffer genuine—and therefore impossible to ethically replicate—injuries and emotional distress.
He hopes the new database could be used to train artificial-intelligence models to better recognise pain-related facial expressions in hospitals. If nothing else, it will allow algorithms to grapple with factors such as differing image quality, lighting, colour and viewing angles—wrinkles that would be ironed out of most data-sets. Increasing the experimental realism of a study in this way also introduces noise, says Mr Buckland, which means that more trials and examples are needed than usual to test and prove an idea. The eventual insights, however, might be worth it.
https://www.economist.com/
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