Uncle Sam's Drinking Game

The federal government's definition of excessive alcohol consumption mixes medicine with moralism.


Does your doctor nag you about your drinking? The federal government wishes he would.

Last week the U.S. Centers for Disease Control and Prevention (CDC) noted with alarm that most Americans say they have never discussed alcohol consumption with a health professional. Physicians' reluctance to broach the subject is especially troubling, the CDC said, because "at least 38 million adults in the U.S. drink too much."

Most news outlets reported the latter claim as a fact, failing to notice the value judgments embedded in it. Contrary to what the CDC wants you to believe, the question of what it means to drink too much is a matter of moral and medical dispute.

According to the CDC, "problem drinkers" consist mainly of "binge drinkers," which does not mean what you might think: people who spend days in a drunken stupor, devoting themselves to intoxication in a way that seriously disrupts their lives. No, according to the CDC, a man is a binge drinker if at any point in the last month he has consumed five or more drinks "on an occasion"; for a woman, the cutoff is four drinks.

This definition is based on the amounts typically needed to reach a blood alcohol concentration of 0.08 percent, which corresponds to the legal per se standard for driving while intoxicated (DWI). What if you do not plan to drive? It does not matter. The CDC has decreed that no one should ever drink this much, no matter the circumstances.

Note that the CDC's definition of a binge is determined legally rather than scientifically. When the DWI standard was 0.10 percent, many of today's binge drinkers would not have qualified as such. If Congress lowers the cutoff to 0.05 percent, will the number of binge drinkers skyrocket overnight?

The government's notion of a binge encompasses patterns of consumption that do not cause measurable harm to anything except the CDC's sensibilities. If a man at a dinner party drinks a cocktail before the meal, a few glasses of wine during it, and a little bourbon afterward, he is drinking too much, according to the CDC, even if he takes a cab home.

Even if you never binge in this manner, that does not necessarily mean your drinking meets with the government's approval. The CDC also worries about men who have more than 14 drinks per week and women who have more than seven.

If you are a woman, don't think you can get a pass by sticking to one drink every day but Saturday, when you have two. That puts you over the government's limit and makes you part of the problem.

Unless you live in Canada, where 10 drinks a week is deemed OK for women; or the U.K., where women are safe if they do not "regularly" consume more than three "units" (1.5 glasses of wine) a day; or Italy, where they are allotted up to 40 grams of ethanol (nearly three shots of vodka) each day. Evidently the CDC's rules are not as obviously correct as it pretends.

The relationship between alcohol consumption and mortality (like the relationship between weight and mortality) follows a J-shaped curve, meaning that drinking more is associated with better health—up to a point. Where is that point? Around two drinks a day for women and four for men, according to a 2006 analysis of 34 prospective studies published in the Archives of Internal Medicine. That's a lot more generous than the CDC's quotas.

The CDC also goes beyond the scientific evidence in declaring that pregnant women and adults younger than 21 are drinking too much if they drink at all. There is no evidence that light to moderate alcohol consumption during pregnancy harms fetuses, and the legal drinking age is an arbitrary limit questioned by many.

In short, the CDC's pronouncements about drinking mix medicine with moralism in a way that may not be healthy. They should be consumed with caution.

NEXT: I'm Not Dead Yet

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    1. You smell of juniper berries.

      1. Well … Well … Your mother was a hamster!

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  1. Sometimes man you jsut have to roll with the punches.

  2. I’ll read this in full after my second Bloody Mary this morning….Then I’ll be ready to pay attention…

    1. If you are only up to 2 this morning, you just ain’t trying.

  3. “Drinking Alcohol Doesn’t Actually Kill Brain Cells”…..1498785941

    1. I know quite a few people who if they were missing a brain cell or even fifty, they wouldn’t be to marginalized beyond their present state.

    2. How about voting progressive? Because anecdotally…

  4. drinking age is an arbitrary limit questioned by many.

    This something I have been thinking about lately. I think most people who visit this forum think adults should be allowed to do what they want as long as they don’t harm anyone else and are willing to take responsibility for the consequences. I tried finding out why 18 is an adult but it seems the age of majority varies country to country with the lowest at 14. The question is when should a human be deemed an adult?

    1. When they can pass a rigorous Rite of Adulthood and not before.

      1. Like building their own fully functional lightsaber?

        1. And then going out in the bush and killing a lion with it.

        2. Some sort of technical component to the test, sure. Like building your own weapons before you’re abandoned naked in Nunavut.

          1. I like the naked part. Maybe I’m weird but I enjoy being naked. First thing I do when I get home.

            1. The rest of us don’t enjoy your being naked.

              1. Then don’t go to his house. Or mine when my roommate is away.

            2. I suspect someone who goes by that handle will not like being naked in Nunavut.

    2. when should a human be deemed an adult

      When they’re 27 and no longer on their parents’ health insurance – duh!



      1. Agreed. The minute I saw 20-year-olds demanding the “right” to remain on their parents health insurance is the minute I stopped objecting to the 21 year-old drinking age. If you are too young to buy your own health insurance, you’re too young to drink!

        1. “Is that all?”

          “Yup, just a sixer today.”

          “Proof of insurance please.”

        2. I like that conceptually, tying drinking age to purchasing your own insurance, but we both know that would be the first step in a long chain ending with the government spooning alcohol into the mouths of elderly frat boys.

    3. Certainly not before they can live on their own dime.

      1. Maybe that is the answer. Not an age, but the ability to be independent. Maybe a certificate showing you are employed and have your own residence. An individual could be an adult at 16 or not ever if they are irresponsible.

        1. “Drunk child actress ravages quiet township”

          1. At least a child actor has the ability to pay damages.

    4. Not that I support unnecessary wars…because I don’t—but I think that these 18 year old kids who go over to Afghanistan on some ‘wild-goose-chase’ and end up with shrapnel in their faces or see their buddy blown to bits should at least be able to have a whiskey when they get back.
      I mean, if you’re old enough to die for your country, then why shouldn’t you be old to enough to drink?
      Maybe I’m wrong. I don’t know. It’s early and I haven’t had my 2nd cup of coffee.

      1. There’ve been a few movements to try and lower the drinking age for enlisted people between the ages of 18 and 21. Which is solving one ridiculously arbitrary rule with another.

        1. Serve the State in a way we like, and we’ll give you privileges that will keep you from getting arrested!

          What a disgusting idea. And it’s no better when it’s in service of the military.

        2. I can see the recruitment commercials now:
          (Tough guy ‘Merica-voice a la Trey Parker/Matt Stone) “Do you want to be a red, white and blue hero? Do you want to fight for what’s right? Do you want to get drunk? If you answered yes to at least ONE of those questions…then the Marines are calling brother! Let’s shine up our guns and get wasted while we waste bad guys!”

          1. Well, for a while there was that rule f you’re stationed within 50 miles of an international border (say, Mexico) where the drinking age was 18, they’d sell you alcohol on base just to keep you from getting into trouble somewhere else.

        3. I think the enlistment age should be raised. Something seems wrong about recruiting (legally speaking) children for an army.

          *I’m talking about going into high school to get commitments before 18

          1. Or we could just make a Youth Corps…

            Jus’ sayin’

            1. What would their duties be? Maybe keeping an ear out for dissenters.

            2. As long as I get a cool knife I’d be down for that…

              1. And booze, don’t forget the booze.

      2. I mean, if you’re old enough to die for your country, then why shouldn’t you be old to enough to drink?

        I drink for myself, not for my country.

        1. “when I drink alone, I prefer to be by myself”

      3. When I was in 20 years ago, Marine bases on federally owned land allowed 18-20 year-olds to drink at least beer and wine at the E-Club. Twentynine Palms on CA state land enforced the state law.

        1. I remember that at Goodfellow, too. Still, I was an eighteen year old girl, never had to buy my own anyway.

      4. Hayes Carll ‘KMAG YOYO’ , give it a listen on YouTube. There’s a great live version available. SiriusXM Outlaw. Check it out.

      5. This argument carried more weight back when you could be drafted. Now, when every 18-year-old who risks getting shrapnel in his face or seeing his buddy blown to bits voluntarily assumed that risk, not so much. (And there are some 17-year-old soldiers. I don’t see anyone arguing that their risk of mutilation, death, or psychological trauma is a reason for waiving the drinking age laws in their cases.)

    5. I always go with, if you are old enough to enter a contract, you are old enough for all of the other adult things too.

      1. Sure, but what age should you be able to sign a contract? Puberty starts around 12. Studies have show that the human brain is not fully developed until 25. Should it be an arbitrary number or a set of requirements, like financial independence?

        1. If you are old enough to reproduce you are old enough for all the other adult things too.

        2. Whatever age the state tries people as adults.

          If a 13 year old can be tried as an adult, then their classmates should be able to meet up at the bar across from the courthouse to talk about what happened.

        3. The problem is (and will be) that children’s maturity levels are highly dependant on societal expectations. Back when the question was about survival and getting enough food for your family to eat, children matured very quickly. They needed to be able to tend to the house and the garden within a few years of being able to walk. The older children (pubescent ones) were expected to take over much of the caretaking responsibilities of the younger children, and the children that are in the age we now call “adolescence” were expected to be out of the house with their own family before the current age of majority.

          This comes back to the “soft tyranny of low expectations.”

        4. You should be deemed a child until you are no longer a child. Probably the best criteria is whether or not you still live with your parents.

    6. “The question is when should a human be deemed an adult?”

      When they can make a lucid argument as to why getting “free” stuff from the government might be a bad idea.

  5. Carrie Nation is smiling in her grave.

  6. You know what – I think this is part of Natural Selection and evolution, and human beings exercise free will to determine what Society? considers to be “adult” or “appropriate age to drink alcohol”.

    I wonder what John thinks?

    *sprints away*

    1. Some people say there is no true evil in this world. To those people I say: Almanian! has just been given your address.

      1. Is Almanian! an Albanian-Armenian? I’ve always wondered.

        1. He does own a lot of shiny purple suits, which does support your hypothesis.

      2. Isn’t that how the Brits say “Aluminum”?

  7. “. If Congress lowers the cutoff to 0.05 percent, will the number of binge drinkers skyrocket overnight?”

    Of course! The same way underage drinking became a skyrocketing National epidemic overnight when the drinking age was raised from 18 to 21.

    Classic case of mission creep and government expansion. We pass a law or adopt a program to deal with one alleged crisis, and then the violation of the new law becomes a new “crisis” that must be addressed with more laws and programs.

    1. The same way underage drinking became a skyrocketing National epidemic overnight when the drinking age was raised from 18 to 21.

      Like when they came up with that stupid term “food insecure,” and suddenly the country was swept with a hunger epidemic.

    2. If Congress does such a thing, I think statues should be commissioned and placed in public gardens of Teddy Kennedy’s and Tip O’Neill’s noses.

  8. The nagging fear that someone, somewhere, is having a good time.

    1. Make them stop!! Make them stop!!

  9. An artifact of the human diaspora is that different humans have different abilities to handle alcohol consumption. Scandanavians are rock stars. New Guinea highlanders are lightweights.
    Looking at lactose intolerance, we see patterns as well, but different ones, but related to genetic adaption to the raising of dairy cows.
    Right now, I am binge drinking in Oslo. I have just polished off a Dugges Christmas Idjit!, a Dugges Idjit!, and a Revelation Cat Double Dealer, all very well made beers in the 8 to 10 % range. I am feeling good and I’m not done.
    The vinmonopolet store had a nice selection of brews that are not available back home. Next up are the locals by Nogne O.

    1. The vinmonopolet store had a nice selection of brews that are not available back home.

      Try getting a beer that’s not available at the Vinmonopolet. And try paying a reasonable price.

      1. That’s not a problem really. The regular, below 4.5 % beers are available at the supermarket. Like everything else in Norway, they are relatively expensive.
        But if you’re someone excited about ales, in reality, Norwegian micro beers are well made and compare well price wise with similar well made beers in the USA like AleSmith, Lost Abbey, or Ballast Point, to name a few breweries in short distance of my folk’s place in San Diego County.

    2. I supported raising the legal age to buy dairy products to 21.

      1. But not raw milk? Say it isn’t so!

        1. The black market is always open.

    3. Smart, I don’t think they count drinking in a foreign country against your total. Anytime you get over your arbitrary allotment, run the border!!

  10. Right around New Year’s Eve, PBS dredged up an old article about how British Columbia, at the behest of grieving parents, reduced their legal limit to .05 and alcohol deaths plummeted. Obviously, this new magic spell should be adopted here.

    1. If roundthing the children up and putting them in concentration camps where only responsible government-approved adults look after them could save the life of even one child, don’t we have an obligation to try?

    2. I hate it when alcohol dies.

  11. Half of american males would be considered severe alcoholics by the Govt’s measurement….who gets away with creating this sort of conclusion and who signs off on it with a straight face?

    1. People who get their rocks off on controlling others.

      1. People who get their rocks off on controlling others.

        People who get paid for getting their rocks off controlling others.


    2. who gets away with creating this sort of conclusion and who signs off on it with a straight face?

      People who believe that any amount of alcohol consumption is a public health hazard…and thus should be eliminated?

    3. Half of American males, the entire British Isles, and all of south and central America…

    4. “who gets away with creating this sort of conclusion and who signs off on it with a straight face?”

      I’m guessing it’s the same people who claim that CO2 is a pollutant?

  12. Serve the State in a way we like, and we’ll give you privileges that will keep you from getting arrested!

    What are you, a fuckin’ commie? I don’t want no commies in my car. No Christians, neither.

  13. Fun Fact: The original CDC employed mostly civil engineers and entomologists.
    My how they’ve grown.

  14. If a man at a dinner party drinks a cocktail before the meal, a few glasses of wine during it, and a little bourbon afterward, he is drinking too much, according to the CDC, even if he takes a cab home.

    …walks home, has his wife drive, hangs around for another four hours or God forfend, is in his own fucking house. Make sure you see the long game here, this is simply shaping tomorrow. As with all choice naught one Keep your laws off my body is not the progressive rallying cry.

  15. Drink!

    1. These blog posts about drinking were much better when Postrel was in charge…

  16. A moral judgment in America? Surely you jest…

    I’ve never understood setting the drinking age at 21. At 18 you are legally an adult, you can vote, join the military and be tried as an adult in court.

    It seems that the drinking and smoking ages etc should all be set to legal adulthood. If they’re mature and competent enough to vote or carry a weapon in combat then what’s the problem. Perhaps we should move the adulthood goal post all together, make it all 21 or hell since we’re picking arbitrary numbers why not 25 or 30.

    1. It’s got to be increments of 3. Next is 24. The move to 27 is 40 years out.

      I remember reading a Senate transcript from some of the debates in the mid 80s about the push to 21 and they mentioned that the 21 things comes medieval knighthood stages – 7,14, and 21 were milestones of some kind.

      1. Awesome. So, it’s based on British fiction…that makes sense.

  17. I’m not really much of a drinker. I enjoy a drink from time to time, but it’s usually not that big of a deal for me.

    However, if Uncle Busybody is going to tell me how much I should drink, I’m going to make it a point to break every one of their idiotic limits just on principle.

    Thanks Obama!

    1. I’m a teetotaler, but I’ll buy ’em and give ’em away before I’ll blindly submit.

      1. I’m afraid to find out what “tee”totaler is.

        1. It’s spelled correctly, but I looked it up after the case. A teetotaler doesn’t drink alcohol.

  18. When I read the headline, I thought the drinking game was to take a shot every time a politician lies, but I don’t think my liver could handle that!

    1. We’d all die from alcohol poisoning within hours.

      1. Obama lied and Reason died!

    2. “I never read anyone’s emails without their permission”
      “I never lied to a congressional inquiry.”
      Keep on going like that and the spooks with be too snookered to tap your phone.

  19. I started off on Burgundy, but soon hit the hardest stuff…
    Was that Bob Dylan?
    No! He could never write shit like that! The children…………!

  20. Apparently the alcohol prohibitionists never really went away, they just all went to work for the CDC.

  21. The CDC is always ripe for mischief, since they have nothing to do unless there’s a major infectious outbreak.

    1. You would think the dire “obesity” outbreak would keep them occupied.

  22. I love when the CDC derps out like this. It only serves justify keeping the prohibition on the CDC lobbying for gun control.

    I really wish we could go all the way and forbid them doing any research on firearm issues the way gun control groups claim is already being done.

  23. I went for a check up twice in the last six years. Two different doctors. Both their prognosis? Drink more. The exchange with the first doctor:

    “Son you should drink more”

    “You mean wine?”

    “Sure, but you just need the ethanol”


    “It’s that or the treadmill”

    “I’ll drink”

    Turns out alcohol induces the liver to make good cholesterol.

    1. This is what you get for choosing sane and sensible physicians.

  24. The correct legal drinking age is the government has no fucking business telling me at what age I am legal.

    I’d like to speak the truth to my doctor, but I know he is required by law, at times, to share information about me with the government. With that in mind, it is appropriate that any inquiry my doctor (anyone really) makes respsecting my consumption patterns be met with a lie, not a refusal to divulge, a lie. I am a model citizen.

    1. Just so I understand. Your position is that you should lie to you doctor?

      I’m a an/minarchist as much as the next guy, but this makes me want to invent a word like ‘disarchy’; where one’s misarchy extends to the point of causing harm to themselves. Not to say you should be cured of it, but you should be aware that advising others to do it is not the best idea for you or them.

      Chaotic neutral means never having to say you’re sorry, I guess.

  25. my neighbor’s aunt makes 68 dollars/hour on the laptop. She has been out of a job for nine months but last month her pay check was 15377 dollars just working on the laptop for a few hours. read the full info here


  26. This country’s attitude about drinking in general is utterly bizarre.

  27. So is fetal alcohol syndrome a farce? I’m confused by that in this article. I thought there was a period where alcohol consumption can be very bad for the fetus, but after that point it really doesn’t matter.

    1. It’s not a farce. But in America even having a sip of wine equals potentially killing the fetus so complete abstinence is recommended.

      Having in excess will lead to fetal problems and “excess” means much less than it does when you’re not pregnant, but not zero.

      1. The British study basically said that one drink (12 oz beer, etc) a day was HEALTHIER for mother and fetus than abstaining. But heavy drinking was worse than abstaining. And Fetal Alcohol Syndrome is caused by very heavy drinking indeed.

        I believe the CDC thinking is that the mom to be, if told that ANY drinking is okay, will go ahead and have a six pack a night. That the typical pregnant woman has no logic or judgment and needs to be somehow sheltered from her choices.

  28. Hey CDC…your left is showing! How many hypocrites were involved in coming up with this nonsense…all of them!

  29. if you are old enough to enter a contract, you are old enough for all of the other adult things too.

  30. CDC Temperance Nazis? I’ll drink to that!

  31. I saw the title and immediately thought: “Have all your emails read, take a shot.”.

  32. Sorry Jacob, I usually love your work but here you’re mistaken. I now work in Primary Care, and before that as a Gastroenterology PA. I am one of those conscientious providers who will nag. A lot. Because unless you know the enzyme phenotype of your liver, you are playing Russian roulette. One drink a day for some may already cause Fatty Liver Disease, alcoholism or cirrhosis, whereas others can safely drink up to 3 or 4 a day.

    Most people lie about the amount they drink, even social or binge drinkers. Women and alcohol is a huge problem too (“it’s just one or two glasses with dinner”), but huge wine glasses easily hold two servings instead of one 5 oz serving. I live in New Mexico and yes, I gently nag my patients. The patient will often divulge that in reality they drink too much. Other issues (it’s a two way street of course): financial stress, MVAs, domestic violence, depression, increased risk of esophageal and stomach cancer and Alzheimers.

    However, in the next 30 years the main reason for liver transplants is going to be Fatty Liver Disease and obesity, not cirrhosis due to alcoholism. Alcohol is pure sugar though and may contribute to Fatty Liver Disease and obesity. I am not a fan of Big Government, but agree with one drink a day for females and two drinks a day for males max. If patients have problems with these guidelines, it usually is because their intake is well above those recommendations.

    1. Alcohol is not pure sugar.

  33. This “binge drinking” crap has been pushed by CDC for years.

    Kevin R

  34. I am pretty like the naked part. Maybe I’m weird but I enjoy being naked.

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