There’s too much judgement in the standards. If you admit to very moderate social alcohol consumption, you’ll get tagged as an abuser. Risky move these days.
While I disagree and think your assessment is a bit hyperbolic, I do see that there may be some stigma in whether patients admit to their doctor that they drink. My dad apparently lied to his doctor quite a bit about his junk food consumption prior to his double bypass. Patients feel guilty about things they know or think to be unhealthy and for some reason think that lying will help them in any way. It's weird. Like, why are people more afraid of what some random person thinks than they are of seriously fucking up their doctor's ability to treat them?