COMING SOON!

A week and a half after the debut of the new edition of the Dietary Guidelines for Americans (DGA), the dust is settling and press coverage is winding down. Most stories continued in the same vein seen in the immediate aftermath. Outlets with the widest reach kept mentions of alcohol short and mostly sweet, often citing Dr Oz's comments on sociability. Sources that went deeper or that generally lean toward stances more critical of the Trump Administration were more likely to hold up alcohol as one of the confusing or concerning elements of the new guidelines. Still other sources cheered the DGA's broader revamp as well as the more generalized guidance to drink "less." Comments from the health community varied depending on their particular interest. An overarching response published by the Journal of the American Medical Assn (JAMA) last week didn't mention alcohol at all. Folks focused on alcohol, however, worried that the lack of both specific guidance and any reference to chronic health issues "creates uncertainty at a time when the science is clearer than ever," president of the American Association for the Study of Liver Diseases, Dr Saul Karpen, commented.NY Times Picks Up Where Reuters Left Off, Plays Up Acute Harms Other sources followed Reuters' lead to blame industry influence, with the NY Times only getting around to the news service's story about a "draft proposal" recommending 1 drink per day for both women and men late last week. Though not stated specifically, the Times' reporting suggests that the internal document from the Dept of Health and Human Services (HHS) based that proposal on the Alcohol Intake & Health (AIH) study from the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD). The Times cites both Dr J&uuml;rgen Rehm and Dr Tim Naimi, two of the study's six authors, recall.Defending the case for lowering drinking guidance for men to 1 drink per day, the paper referred to arguments in the AIH study about harm from acute injuries. "Even at lower levels of drinking, men are more likely to engage in impaired driving, commit violence or experience drownings and falls," the paper asserted. "Men drink more, binge-drink more and generally do dumber things when impaired," Dr Naimi told the Times. Men also account for around three-quarters of alcohol-attributable deaths and "a majority of 'secondhand harms,'" he continued.If it feels confusing that these researcher-advocates claim men experience acute harm of intoxication "even at one drink a day," it's because the usual difficulty with studying alcohol's impact on health remains hidden. The group includes men who reported an average of 7 drinks per week, so could include the kind of binge drinking most closely associated with these types of harms. To assume such a consumption pattern fell within the prior DGA's guidance that men consume no more than 2 drinks per day is a gross misreading, at best. Furthermore, these are not the kinds of harm documents like the DGA are designed to prevent, in the first place.Note too the emphasis on "secondhand harm," i.e. caused by drinkers on non-drinkers. In so doing, Dr Naimi applies to alcohol an argument that successfully expanded the class of people harmed by smoking, increasing totals of both individuals impacted and dollars collected. But again, the acute harms of intoxication are well understood in ways that are not exactly parallel to knowledge about chronic health harms linked to smoking and secondhand smoke.Industry Lobbies, Advocates Call Foul Amid Chaotic Day at SAMHSA Then there was this headline from NOTUS: "Inside the Alcohol Lobby's Quest to Water Down Federal Booze Guidelines." A pair of anonymous industry lobbyists acknowledged that "they made the case to Trump administration officials that more generalized alcohol regulations would align with 'make American healthy again' principles of individual choice and health empowerment," the outlet reported. But much like Reuters, the outlet did little more than remind that the industry does in fact lobby the federal government on its own behalf and that different corners of the industry aren't always aligned in those efforts.Still, NOTUS offered the US Alcohol Policy Alliance a handy citation to claim "a well-resourced aggressive lobbying operation" on the part of the industry "in the face of declining consumption," according to a note to members from CEO Mike Marshall last week. Marshall wrote to emphasize the potential harm of a chaotic 24 hours when federal officials first cut and then reinstated an estimated $1.9 billion in grants to local and state mental health and substance use service providers.Late on Tuesday, January 13, federal officials issued notices immediately canceling funding for about 2,000 recipients of what are called block grants from the Substance Abuse and Mental Health Services Administration (SAMHSA), as reported by NPR and other sources. These are charities that help people in recovery and provide training to medical, educational and law enforcement professionals, for instance. By Wednesday night, grants were being reinstated, leaving folks wondering why it happened and if it would again. (Is it, for instance, linked to the plan to fold SAMHSA and other agencies into what HHS Secretary RFK Jr proposed to call the Administration for a Healthy America, NPR wondered.)Back to the USAPA, which used the chaos to rally the troops, pairing the threat of lost funding with the decision to remove any mention of underage Americans in the new DGA's drinking guidance. "Taken together, these actions suggest that the federal government is retreating from a meaningful commitment to preventing underage drinking," USAPA's Marshall wrote to members. He then took the finger-pointing further, adding that "we believe this retreat is a direct response to alcohol industry pressure." The clever turn of phrase merely implies that the industry wants the government to back off efforts to prevent underage drinking, which has no basis, by assuming reductions at SAMHSA (which oversees ICCPUD) can in part be tied to the industry's successful advocacy against the use of ICCPUD's AIH to inform the DGA.The Ironies of ICCPUD Advocacy Lost in the org's unfounded claims about industry influence is a glaring irony apparent from the outset of the DGA drama a couple years back. Industry advocacy was crucial to the passage of the STOP Act, which established funding for ICCPUD over two decades ago. Without industry support, ICCPUD may never have existed. Instead of industry lobbying, USAPA-connected advocates leveraged their connections and muddied the water by intermingling ICCPUD's youth-focused mission with an effort to change adult drinking guidelines. If ICCPUD loses funding, it can be traced back to that muddying, not an industry uninterested in stopping underage drinking.To be clear: ICCPUD is still funded, at least technically and for now. Last September, a House appropriations subcommittee issued a draft funding bill for HHS and other departments that included "defunding" ICCPUD entirely. But that wasn't one of the three funding bills passed late last year to reopen the government and final HHS appropriations for fiscal year 2026 has yet to be voted on. That said, ICCPUD's coordinator was among the many SAMHSA and HHS officials who lost their job during sweeping cuts at the department last year. Many remaining employees focused on alcohol were reassigned, according to the NY Times and Reuters. So current activity may be curbed, even if funding is still on the books.But there's another familiar irony hidden in USAPA's messaging last week. The org followed numerous press outlets in presenting the industry as desperate to combat the ICCPUD report's thesis and the overarching argument that there is "no safe level" of alcohol consumption. To do so, these anti-industry advocates highlighted "declining consumption" in conjunction with stepped-up lobbying efforts. Of course, they fail to acknowledge that such declines have been achieved without any major population-level policy intervention and in the face of what they term an "organized, strategic, and persistent" industry.Cheers,

Commentary Plays Up Acute Harm, Misses Key Ironies in DGA Aftermath

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