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Do You Drink Too Much? Don't Ask the CDC.


Does your doctor nag you about your drinking? The federal government wishes he would. Yesterday the U.S. Centers for Disease Control and Prevention noted with alarm that "only one in six adults [says] a health professional has ever discussed alcohol use with them." Physicians' reluctance to broach the subject is especially worrisome, the CDC says, because "at least 38 million adults in the United States drink too much."

How does the CDC know at least 38 million Americans drink too much? Because survey data indicate that "approximately one in six (38 million) U.S. adults binge drink." And what counts as binge drinking, as far as the CDC is concerned? Five or more drinks "on an occasion" for men and four or more drinks for women. Why were those cutoffs chosen? According to the National Insitute on Alcohol Abuse and Alcoholism, because those are the amounts that typically raise a person's blood alcohol concentration to 0.08 percent, which corresponds to the per se legal standard for driving while intoxicated.

What if you don't plan to drive? It doesn't matter. The federal government says you should never drink that amount, period. If you do, you are drinking too much by definition (the government's definition, that is). As I have noted several times, the government's notion of a binge encompasses common patterns of social drinking that cause no measurable harm to anyone or anything, except for the CDC's sensibilities—e.g., an after-work cocktail, followed by wine during dinner with friends and an after-dinner drink. I confess I have been known to binge in this manner from time to time. Once a month is all it takes to be counted among the 38 million, the vast majority of whom would not qualify for a diagnosis of alcohol dependence or even alcohol abuse but who nevertheless need to change their ways, according to the CDC.

Why does the CDC say "at least 38 million" Americans drink too much? Because it maintains that "drinking too much" includes not just so-called binge drinking but several other categories as well. If you are a man who consumes 15 or more drinks in a week or a woman who consumes eight or more, you drink too much. Ditto if you are pregnant or younger than 21 and drink any amount at all. If you are a woman, the CDC does not want to hear about how you limit yourself to one drink every day except Saturday, when you have two, thereby exceeding the government's arbitrary limit. Nor does the CDC care that you think 18-to-20-year-olds, who are legally adults in every other respect, should be allowed to drink beer. And don't even try to point out the lack of evidence that light to moderate drinking during pregancy harms fetuses. The CDC has decreed that all these patterns of drinking are excessive, and its only challenge now is convincing the rest of us.

That may be a tough sell. All together, the CDC says, "29% of U.S. adults drink too much." Based on data from the National Health Interview Survey, that means nearly half of all Americans who drink at all, and most (about 60 percent) of those who drink at least once a month, drink too much. Among past-month drinkers, according to the CDC, excessive consumption is the norm.

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