Food Policy

Uncle Sam's Drinking Game

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

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

In January 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. In fact, the CDC says this guy is drinking too much even if he is the host and not going anywhere except bed.

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: Friday A/V Club: A Nightmare Vision of a World Without Congress

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  1. Last time I had a physical, they asked if I smoked, how much I drank daily, and if I had a carbon monoxide detector. I was surprised I didn’t get get the gun ownership question. It annoyed the hell out of me and they didn’t appreciate my snarky answers.

    Do you smoke?

    No. Why, do you think I should start?

    1. I always wondered about the smoking question: what’s the definition of “smoking”? I don’t think occasionally indulging in the habit makes one a “smoker”.

      1. “You smoke one cigarette…”

        1. Addicted for life! Gateway drug! Death sentence!

      2. Not only are you a smoker but you are an evil person who must be shunned.

        1. I read somewhere a description of the late Spanish Hapsburg monarchs as “stupid and pious”. It made me immediately think of our current culture. The word “pious” can actually be quite pejorative. You are not pious because you are moral or good. You are pious because you strictly follow the rules. Your morality or intelligence is a product of the rules you follow not your piety in following them.

          When you look at how dogmatic and judgmental our society is about really stupid things like jokes or smoking, stupid and pious really describes it well.

          1. Human nature remains the same. Only the costumes have changed.

      3. I actually do smoke on occasion – like when I’m drinking at the bar. But I don’t consider one or two packs a year a habit.

        I’m sure the nannys would disagree.

        btw, the word is they are going to start testing for tobacco use at my job. Hurrah.

        1. There is a big company around here that flat won’t hire people who have nicotine in their system. That includes executives and other top-level people. Stupid policy that will yield stupid results.

          1. Hell, I work for one. Idjit policy, IMO.

          2. How the fuck do they expect their evil executives to light up thousand dollar cigars with hundred dollar bills while polishing their monocles under such a policy?

        2. when I’m drinking at the bar

          Fond memories. Enjoy that while it lasts in your state.

          testing for tobacco use

          When this crap came up at my last benefits meeting (not testing, but just “different” pricing) I wanted to raise my hand and ask about charging more for automobile drivers. Hell, why stop there. Every risk should be punished, right?

          1. You want to put a spanner in the gears, ask them about e-cigs and vaping, and whether they are intending to penalize people who are (a) quitting cigarettes that way and/or (b) indulging in a pretty damn harmless activity.

            1. Good point. E-cigs were not a thing at the time. I suspect the answer will be a stoopid one.

          2. I wanted to raise my hand and ask about charging more for automobile drivers.

            Except the costs associated with the risks of driving are generally borne by automobile insurance.

            1. Not if you crash into a tree and only have liability coverage.

          3. Every risk should be punished, right?

            Add to the list people who ride motorcycles, ski, rock climb, eat raw or undercooked seafood, play any team sport that might involve physical contact and people who have ever had sex without two condoms.

    2. Doctor: Do you smoke?

      Lord: No, my cigarette does. I just inhale it.

      Doctor: Do you drink?

      Lord: yes, it prevents dehydration.

      Doctor: Next!

  2. Maybe they wouldn’t drink so much if other drugs were more available.

    1. You kid. But I wonder the same thing. Drinking makes you fat and if you have too good of a time you feel like shit in the morning. Pot, assuming you have some self control about munching, doesn’t make you fat and doesn’t give you anything like the hangover drinking does.

      If pot ever became legal and more socially acceptable, I would imagine people would drink less. Maybe I am cynical but I bet the big alcohol manufacturers have long since figured this out and are to some degree behind the efforts to keep marijuana illegal.

      1. oh no, no joking around here. I believe that opiates, for example, should be much more free-flowing, like they were in the 19th and early 20th centuries, because I think they’re a much healthier substitute for drinking.

        1. I believe that. The thing about drinking is that it just intensifies whatever mood you are in. That is a very good thing if you are in a good mood having a good time. That is a very bad thing if you are depressed or angry.

          I am not familiar with the history, but there were a lot of opium dens in the 19th century. I don’t think I have ever heard of there being many stoned out brawls in them. Taverns in contrast have been hosting drunken brawls since civilization first opened them.

          1. Curly bill shot Sheriff White after a night in the opium den. Check and mate.

            1. He was only funnin’, is all…

          2. Science says opiates have the least side affects of all mind altering drugs. One problem, if you do too much at one time your heart stops. Sounds like a warning label to me.

        2. I definitely agree with that. Opiate addiction is not a great thing, but (particularly if there was a safe, cheap, legal source) is enormously better than serious alcoholism.
          If you don’t have to be scheming all the time to get your next fix, being an opiate addict is pretty manageable. Being the sort of alcoholic who needs to drink all the time to stave of DT is just awful. I’ve know people addicted to heroin, coke, speed. None of that was pretty, but severe alcoholism seems by far the worst, both for health and for having any kind of life or career.

          1. True story, I will try to make it short:
            I was working for roofing company, everybody quit, i was only one left but didn’t know shit about roofing as I was young buck. Boss brings guy around, says “here’s your new help, you are foreman, now”. Smelled alcohol on guy, said “can’t have you on roof after drinking, come back tomorrow sober.” Guy showed up next morning sober, I didn’t realize he was hard-core alcoholic. We was working, suddenly he said some weird nonsense like a sleep walker would, then started going into seizure. Guy was biting through his tongue, three stories up, on a roof with a steep pitch. Had nothing to stick in his mouth but bags, which were full of nails, so no good there. Tried to take off belt, but it was stuck and I had to do it one-handed. Couldn’t let go, he would fall off roof. This was back when cell phones were rare, and i didn’t have one. Yelled for help, but other crews below (electricians, etc.) had radios blasting, compressors, etc.; couldn’t hear me. Just had to hold on to guy while he bit almost all the way through his tongue. Finally the boss showed up and called 911.
            Will give the guy props, though: he DID show up sober that first morning.

      2. Also, amphentamines are good to stunt ones’ desire to drink as well.

        1. Several of my friends are work a day criminal defense attorneys. Each one of them has the occasional DUI client who is literally drinking himself to death. Often their families are glad to see the person go to jail because they know that will at least keep them away from drinking and a live a bit longer.

          Really, would these sorts of people, and there are a lot of them, be worse off if we got them on pot or speed or even opiates? I don’t think so. Yes, such a solution is not ideal. But I don’t live in these people’s heads. Maybe living a clean sober life is just not an option and given that, speed or pot the best option available.

          1. Yes, I agree. you have to deal with reality and not pine for utopia. If someone is going to be addicted to substances anyway, we need to find less harmful substances than alcohol to substitute. Opiates, marijuana, amphetamines and benzos are all less harmful than alcohol, IMO. Also, if we opened these avenues up to the mainstream, it’s likely that the market would develop even safer alternatives to them and make the risks even lower. No one wants to be the company that kills its customers.

            1. Maybe if it was easier for people to get counseling there would be a decrease in substance abuse. The only idea I have is removing licensing for mental health and decrease education cost by getting rid of government student loans. Then meeting with a substance abuse expert might cost 50 bucks a session or so.

              1. That wouldn’t hurt. But I think there are just some people who for whatever reason are beyond counseling. They just can’t get through life sober. I wish we would just acknowledge that and work on finding safer ways for these people to cope.

                1. I agree. Some people are going to be self destructive no matter what. Other people just need the tools to get better. A problem I see is substance treatment cost 30 grand and who can afford that on top of trying to get their life together?

                  1. I don’t see how regularly taking some sort of mood altering substance is “self destructive” in and of itself.

                    1. I don’t see how regularly taking some sort of mood altering substance is “self destructive” in and of itself.

                      It is only self destructive if it you are neglecting your health or not able to maintain gainful employment. If you are taking mood altering drugs and that helps you get out of bed and into life I think that is great. If you are taking drugs and laying in bed not eating for days on end I think that is destructive.

                    2. I don’t see how regularly taking some sort of mood altering substance is “self destructive” in and of itself.

                      + 1 Prozac

    2. I would greatly reduce my drinking habits if cannabis were made legal and socially acceptable. In fact, I would go out of my way to avoid alcohol (even in a social setting) if cannabis were more available.

  3. They also ask “Are you sexually active?”

    I wonder how many women respond with “Not really. I just lay there.”

    1. “You mean, with other people?”

    2. The intake nurse the last time I went in (I was there for a torn tendon in one of my fingers) asked if I practiced safe sex. I told her I was flattered by her offer, but I was already married.

      She was flustered by that. It only got worse when she went into the “do you smoke”, “do you drink” etc questions and I just said none of your business.

      I also refused to get weighed, get my height measured and have my blood pressure taken. I just told them that I was there to get my finger looked at and none of those mattered.

      The medical profession is not used to customers telling them what to do.

      1. I had a similar experience when I went to see a specialist about something relatively minor. They wanted to do a full physical with all these tests, and I was like, no I just need this done. I’m not paying for all that extra bullshit, and my time is better spent doing anything else. They weren’t very happy, but they went with it.

        1. And I imagine with people getting pushed into insurance where they pay fifteen grand a year for the insurance, and are still responsible for the first eight grand of care, more people will be doing the same thing.

          1. I hope so. That is one thing that the profession needs to learn. Patients are their customers, not their wards.

            I had some fun at the ER last night for reasons I won’t get into. But suffice it to say that I have lots of fresh disgust for the way the medical profession is run.

            1. yes!!! My old lady is sick, and I have spent way too much time in ERs, Hospitals, Dialysis clinics, etc., ad naseum. They remind me of nothing so much as government workers. They are the ONLY non-government people in the world who don’t understand that we are the customers. I believe the attitude of both stems from the lack of competition. I mean, you’re in the hospital, where else are you going to go? Are you going to check yourself out and drive to another Hospital? Actually, my ball and chain almost did about 6 months ago. She was actually telling me that she was going to check out and go somewhere else! Long story, won’t go into it. But I tell you, as soon as she started getting dressed, the attitude of the nurses, doctors, etc., sure changed fast.
              Now, if we could only get some competition for the DMV…

  4. 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.

    Polling about faith and church-going habits is taking a nose dive, but honestly, it’s like they never left. One way or the other, we’re going to get the morality and unpalatable decisions of others forced on us.

    1. Check this out

      http://www.the-american-intere…..-religion/

      It is a very interesting review of a new book written by some priest entitled “An Anxious Age: The Post-Protestant Ethic and the Spirit of America”.

      In it, the author argues that the secular progs are just the inheritors of the old Puritan Protestant establishment. They have traded sin for “racism and sexism” and God for “government”. It is a point many on here have been making for years. The book review makes it quite well.

      1. Yes – My liberal relatives are avowed atheists but believe in all kinds of crazy shit like global warming, socialism, and big government – with absolute faith. Even though the stuff they believe is disproved so much easier than Christianity.

        1. I am always amazed at the number of people I meet who claim to be rational atheists yet believe in even crazier shit than you mention like crystals or Feng Shui or UFOs or something.

          They deny the need for a metaphysics and a spiritual life but really never stop needing such. The repressed desire for the spiritual and higher meaning then comes out in all sorts of strange ways.

    2. I’m an atheist. Lately I’ve been thinking organized religion is important, not to keep people moral, but to give the control freaks something to do.

      1. People need a sense of belonging and higher purpose. We have basically eliminated organized religion from most people’s lives. But that hasn’t made them any less moralizing and in fact has made them in many cases even more meddlesome.

        1. People need a sense of belonging and higher purpose.

          Some people do. But not everyone.

      2. How do we get them off government, though?

        1. Out of curiosity, what do you want to do that is prevented only because of religious people in government?

          1. “Let me be clear.”

            I meant, how do we get control-freaks to quit the government.

      3. Theoretically, if a person were to do Christianity the way Christ told us to, there would be choice little “control-freakism” in it at all.

        Of course, most people do it quite wrong.

        1. Thank you ace. “Control freak” is a human trait not a spiritual one.

    3. I’m in the clear if a four-ounce shot of tequila counts as one drink.

  5. 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 Independents Thread

  6. I got asked how much I drink on a form at the optometrist. I checked “yes” but declined to put how much, because, well, it was the damn optometrist.

    1. Were you blind drunk?

      1. Blind, yes. Drunk, no (well, not at the time).

      2. Maybe you should work on getting that methanol out of your white lightening?

        1. Lightning. Maybe *I* should work on not drinking so much on a school night.

  7. A doctor would probably tell me I drink too much, but I don’t go to the doctor.

  8. Do I drink?
    Only to excess.

  9. Funny how liberals dedication to privacy rights never seems to extend much beyond your choice of partners for bed-sport.

    And it is past time We The People told the CDC, in no uncertain terms, to stick to communicable diseases.

    1. If someone pours you drink, how is that not transmitting alcoholism?

      1. 2nd hand booze?

    2. And lets not forget that antibiotics get a little less effective every year, bedbugs have made a comeback. childhood diseases once thought extinct are now happening and a few dozen other no shit public health problems that our “public health experts” seem incapable or unwilling to address.

      Meanwhile they waste time on lifestyle issues like drinking and eating and bullshit political crusades about guns.

      1. It is insane that public health has had mission creep to the extent is has. Dealing with dangerous contagious diseases that could cause major outbreaks is probably an appropriate role for government. But that should be it. But that seems to be what most of “public health” stuff has become.

        1. The problem is that if they don’t find something to do that The Powers That Be find pleasing, their budget will get cut. Then, when there IS an epidemic, they won’t have the money to do anything useful.

          The childhood diseases that are “making a comeback, are doing so for various reasons that are massively politically incorrect to mention, so they won’t get addressed until the children of the Beautiful People are at risk.

    3. Those people are progressives not liberals.

      1. The difference between a Progressive and a Liberal is not visible to the naked eye. Sort of like the difference between a Communist and any other kind of dictator.

  10. If you didn’t get at least half drunk then you have abused alcohol.

    1. or at least wasted what you have already drank

  11. When I woke up this morning, I realized that no one was telling me what to do, so I felt lonely. I’m so glad the government is going to step up and start nagging me about everything I do.

    YAY!

    1. hmmm… I think the ole battle-ax I live with has a few sisters…

  12. These drinking rules prove that the federal government should not be in charge of anything because they’re too stupid to make decent decisions.

  13. consist mainly of “binge drinkers,” which does not mean what

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