Inhibition can be reduced by stress and ingesting alcohol, making it more difficult to employ working memory, such as recall of instructions on how to avoid trouble. Alcohol tends to induce alcohol myopia; that is, a focus on the present and away from potentially future troubles. Some lust killers display ambivalence about offending, suggesting that excitation and inhibition are competing in strength. As with excitation, inhibition is organized in layers involving the Old Brain and New Brain. A distinction is drawn between cognitive empathy (the ability to simulate the mind and moves of another) and emotional empathy (feeling the pain of another). Lust killers are not deficient in the former but show serious deficiencies in the latter. Lust killers fit the role of dehumanization and employ neutralizing techniques of the kind ‘she should not have been out at night’. They have commonly experienced brain damage, which might explain the compromised empathy.

Alcohol can increase pleasurable feelings and facilitate social interactions. It may decrease anxiety, although unreliably. With alcohol-produced “myopia,” immediate events and surroundings become more salient than remote or distant concerns. Disinhibition of behavior is often part of the rewarding effect of low to moderate amounts of alcohol. However, larger amounts and greater degrees of disinhibition can lead to dangerous behavior, even in individuals who do not have a diagnosable alcohol use disorder. High levels of intoxication impair sound judgment, sometimes promoting risky sexual activity or sexual assault. Alcohol impairs coordination, concentration, and vigilance, causing many traffic accidents. Large doses of alcohol can suppress respiration and cause death. A life-threatening withdrawal syndrome can occur when prolonged heavy drinking stops. Alcohol can produce depressive states, and suicide risk increases, especially for individuals suffering from pre-existing clinical depression. Because about two-thirds of the adult population in the United States consume alcohol, the small percentage with an alcohol use disorder includes an estimated 14.5 million individuals.3