1 in 5 Americans Admit Lying to Their Doctor About Alcohol Consumption

There’s an episode of Seinfeld that opens with a bit Jerry does about medical tests and our all-too-common urge to “do well”: 

“Remember in school, they'd do hearing tests? And you'd really be listening, you know … Trying to do well … I wanted to do unbelievable on that hearing test. I wanted them to come to me after the hearing test and go: ‘We think you may have something close to super hearing. We're sending the results to Washington. We'd like you to meet the president.’"

Unfortunately, this urge to “do well” can come at a hefty price when it comes to lying about our drinking habits. Imagine you’re at the doctor’s office for an annual physical. You know that question is coming … on an average week, how much do you drink? You do a quick tally in your head and respond, “five, maybe six drinks?” But it’s actually 10. Or 15. Or maybe even a lot more.

There are lots of reasons for being less than truthful. Maybe you counted that restaurant “glass” of wine as one drink when it’s actually 2 and a half. Maybe you’re embarrassed to give the actual number. Maybe you’ve simply lost track.

Whatever the case may be, the question is important and leads to the larger topic of alcohol and telling (or not telling) the truth. Does alcohol make you tell the truth when you’re under the influence? Or does it actually do the opposite? And what about lying about drinking — why does it seem to be so common?

Lying While Drinking

Do people tell the truth when drunk? Many people would probably say yes. After all, loosening up and getting chatty (sometimes a bit too chatty) is a classic effect of booze.

Alcohol is often seen as the ultimate “truth serum.” Another Seinfeld episode illustrates this: Elaine and the peach Schnapps, which (apparently without her consent) makes her “tell the truth.” Given how prone most Seinfeld characters are to fibbing (whether under the influence or not), the effect is quite dramatic. Relationships are strained, a destination wedding erupts in a fist fight, and the characters return with physical injuries on top of nasty hangovers. And, of course, it’s all very funny — at least on TV.

In reality, however, things get more serious. Alcohol affects the brain in a number of ways, and our truth-telling abilities get affected in the process. Here’s the gist.

• Our prefrontal cortex (PFC) gets suppressed, lowering inhibitions. The decision-making part of the brain in charge of rational thought normally keeps us from getting into situations that end with wedding disruptions, stitches, or broken friendships. However, with the PFC temporarily “offline,” we tend to let loose, saying and doing things we would otherwise shy away from. And while it might look funny on TV, this loss of inhibitions can be costly in real life. After all, it takes years to develop relationships, but a drunken slip of the tongue can put them in jeopardy within seconds.
• Our cognitive capacities are impaired. The depressant effects of alcohol slow down our thought processes. The result? Thinking under the influence can be a drag. As anyone who has gotten stuck in obsessive thought loops or found themselves unable to follow a movie plot line can attest, our cognitive capacities take a hit. So even if we think we’re being truthful, our “truth” might not line up with reality.
• Our memory gets fuzzy. Alcohol affects the hippocampus — the part of the brain in charge of making new memories and accessing old ones.

So does alcohol make you tell the truth? As we can see, the answer depends on what we mean by “truth.” By temporarily messing with the brain’s self-regulating properties, it prevents us from hitting the brakes when it comes to oversharing. However, it also skews the content of what we’re sharing in the first place, distorting the accuracy of our stories.

Lying About Drinking

But what about lying about drinking itself? Do people do it? Oh, yes. You bet they do. According to an American Addiction Centers survey that asked 3,000 Americans if they tell their doctors the truth about their drinking, around 1 in 5 (21%) admitted to telling an occasional (or not-so-occasional) fib. Men were a bit more likely to lie, making up 60% of the fibbers.

It’s worth noting that doctors can usually tell if we bend the truth. For example, as Ohio physician Amber Tully told The Huffington Post, there are other indicators of drinking: “For instance, triglycerides might be high in someone who drinks a lot, or I could see certain elevated enzymes if I’m testing liver function. High blood pressure in someone with no other risk factors might clue me into excessive drinking.”

The body keeps score, as they say.

The Fallout of Fibbing 

We’re not helping ourselves by lying to the physician who is there to help us. If you’re thinking, “What’s the harm in bending the truth a little,” well, there are quite a few reasons.

• Advice for staying healthy. Okay, now this one’s obvious, but it’s worth emphasizing: drinking too much harms our health. From harming our heart and liver to disrupting sleep and predisposing us to certain cancers, alcohol misuse is no joke. Our doctor can guide us toward resources and recommendations that could be vital to our health (and could even save our life). However, unless we’re stumbling into the doctor’s office or reeking of booze, their hands are tied.
• Signs of health conditions. As physician Todd Sontag explains in The Huffington Post article, “The focus of family medicine is to take a thorough history of a patient, so your doctor can best practice preventative medicine … It is imperative to identify risk factors in a patient that can be harmful to their health. Alcohol use may raise the risks of issues, including cancers and liver disease.” For example, if someone is drinking heavily, certain tests might be warranted: “It may be a reason for high blood pressure, high cholesterol or even migraines, dehydration or poor sleep.”
• Implications for other medical treatment. Many medications don’t play well with alcohol, and if our doctor doesn’t have the full picture of our drinking habits, we could be putting ourselves at risk. The same goes for other forms of treatment, such as surgeries and other procedures.

Reasons for Lying About Drinking

So why do people do it, especially in an ultra-private (HIPAA-protected) context? Especially one where the stakes — our health — are some of the highest?

The distortion of reality we just talked about is only part of the reason. There are other issues at play. Let's explore!

Honest Mistake

Let’s start by giving ourselves the benefit of the doubt. Maybe we made an honest mistake! After all, it can be difficult to count those drinks (or count anything, for that matter) once we get going. 

Moreover, we might be confused about what “counts” as a drink in the first place. Picture a “glass of wine,” for instance. In the U.S., a “standard drink” (or one “unit”) is defined as 14 grams of pure alcohol. 

For wine, this adds up to a 5 oz. serving, or one “glass.” However, anything from a thimble to a pitcher could technically be called a “glass.” And, of course, the amount of alcohol units inside doesn’t automatically adjust to the name of the drinkware we use to put it in: just because it fits in one glass doesn’t mean it’s “one drink.” You know those jumbo-sized ones at restaurants? They can easily hold two or more. (To learn more, check out “Alcohol Units.”)

Denial

Further down the “innocence scale,” there’s denial.

The truth is, alcohol is addictive. By releasing a cocktail (pardon the pun) of pleasure-inducing neurotransmitters such as dopamine, alcohol hijacks the brain’s reward system, making us come back for more. Over time, our drinking can slide into misuse and, eventually dependence — we feel as if we “need” alcohol to feel normal and might experience withdrawal symptoms if we attempt to stop.

This gradual slip into alcohol misuse might go unnoticed for a time, but it’s likely that, at a certain point, we’ll start questioning our habits and worrying about the health consequences. At the same time, the addictive pull of booze makes it difficult to let go or cut back.

The result is cognitive dissonance: we want something more and more, all the while wishing we didn’t want it. Since cognitive dissonance is a stressful state to be in, the brain “mutes” one of the competing voices to stop the mental struggle. In other words, we start to side with our own “preferred” version of reality (or, to put it bluntly, we believe our own lies).

Shame

Eventually, we come to the point where denial doesn’t quite hold up anymore. As much as we’d like to keep believing our own version of reality, we simply can’t anymore. At this point, we’re likely to feel ashamed.

The silver lining? Shame can also be the way out. Let’s see how it can help us get out of the trap set by alcohol as we explore the way back to the truth. (For more information, check out “Regret and Shame: Harnessing Their Power in Your Journey.”)

Finding the Truth

Before you start feeling hopeless with all this talk of lies, shame, and regret — relax. We’ve got great news for you! Just as we can lose touch with our authentic selves when alcohol is in the picture, we can find our way back.

• Lean into the mental discomfort. Yes, shame is no picnic, but it has a purpose. It can serve as a crucial warning signal that’s telling us something about the way we’re living is amiss. By approaching shame as your mind sending you a persistent message that your actions don’t align with your true intentions, you can see it from a nonjudgmental perspective. Instead of getting mad at yourself, stop and thank your mind for sending you this reminder — it’s worth listening to!
• Take note of the physical signs. At the same time, it can be helpful to pay more attention to the physical signs your body is telling you about booze. How do you feel after having the first drink? What about the second? Now, think about the morning after. Are you waking up feeling groggy? Do you find that a night out leaves you nauseous, dehydrated, and nursing a hangover more often than not? Your body might be sending you persistent signals that it’s tired of dealing with all the booze. Why not give it a much-needed break?
• Speak up. No, you don’t have to shout your weekly number of drinks from the rooftops. But make sure to tell your doctor. And, most importantly, tell yourself the truth. 
• Write it down. On this journey of exploration, it’s helpful to have a clear picture of what’s going on. Journaling can be a great asset in this process. Set aside some time in the morning to write about your experiences from the day before. Write down how many drinks you had, and exactly how you felt then (as well as the morning after). Nobody has to see it but you, so be as honest as you can!
• Find a community. Everything is easier with a support system, and the alcohol journey is certainly no exception. Reach out to friends or family members who have been where you are and check out the vibrant Reframe community —  we’re eager to back you up every step of the way!

If you commit to being honest with yourself about your drinking habits, the rest of the pieces will fall into place. It’s never too late, and in time you can rediscover a version of yourself that’s happier and healthier than the one looking back at you in the mirror today. 

“Better Than Before”

The most exciting part? There are no limits here. Many find that once they start their journey of self-discovery, the result is a level of well-being they’ve never experienced before, with, or without alcohol. Challenges help us grow into versions of ourselves that surpass our own expectations. 

And those healthy habits truly do add up. As Gretchen Rubin writes in Better Than Before: Mastering the Habits of Our Everyday Lives, “Habits are the invisible architecture of daily life. We repeat about 40 percent of our behavior almost daily, so our habits shape our existence, and our future. If we change our habits, we change our lives.”