The Silent Epidemic: Dr. Susan Rich on Fetal Alcohol Spectrum Disorder and Men’s Health

In this eye-opening episode of the Ultimate Men’s Movement, host Dr. Jack Rocco welcomes psychiatrist, physician, and author Dr. Susan Rich, to explore a topic too often overlooked: Fetal Alcohol Spectrum Disorder (FASD).Dr. Rich, author of The Silent Epidemic, explains how alcohol use before or during pregnancy—even in the earliest weeks before pregnancy is recognized—can have lifelong impacts on brain and body development. Unlike the more widely known Fetal Alcohol Syndrome (FAS), FASD often hides beneath the surface, misdiagnosed as ADHD, autism, or other behavioral and learning disorders.Together, Dr. Rocco and Dr. Rich draw parallels between FASD and adoption trauma, discuss how society underestimates the risks of alcohol, and unpack why this is not just a women’s issue—men’s drinking habits and sperm health also play a role. They also shed light on how lobbying by Big Alcohol has shaped public health messaging, leaving generations vulnerable.The difference between Fetal Alcohol Syndrome (visible traits) and Fetal Alcohol Spectrum Disorder (often invisible but widespread).Why many patients are misdiagnosed with ADHD, autism spectrum disorders, or mood disorders.How alcohol affects every organ system and even alters DNA.Alcohol use by men can affect sperm and pass epigenetic changes to future generations.Men with undiagnosed FASD may struggle with focus, impulse control, substance use, or incarceration.Both partners’ choices before conception matter.CDC estimates suggest 1 in 20 children are affected, though some studies put it closer to 1 in 10.High prevalence of undiagnosed FASD in foster care, adoption, and incarceration populations.Stories of misdiagnosis and overlooked cases—including individuals on death row.Alcohol as our “social drug of choice”—accepted yet deeply harmful.The political and financial influence of Big Alcohol, shaping warning labels and public awareness.Why current warning labels don’t go far enough—women often drink heavily before realizing they’re pregnant.The need for better education and prevention before pregnancy.The role of nurturing and supportive environments in mitigating damage.Advocates and resources like Jeff Noble and Patty Kasper supporting families living with FASD.“Alcohol is not an innocuous substance—it’s a mutagen, a carcinogen, and it alters DNA.” – Dr. Susan Rich“Men need to understand: their drinking matters too. Alcohol affects sperm for up to three months before conception.” – Dr. Susan Rich“The iceberg of FASD lies hidden beneath the waterline—misdiagnosed, misunderstood, and too often ignored.” – Dr. Jack RoccoBook: The Silent Epidemic – PrenatalAlcoholExposure.comLinkedIn: Dr. Susan D. Rich, MD, MPHFASD United: fasdunited.orgFASD, Fetal Alcohol Spectrum Disorder, Men’s Health, Adoption Trauma, Neurodevelopment, Big Alcohol, Epigenetics, Public Health, Substance Use, PreventionKey Topics Covered:1. Understanding FASD2. Why It’s a Men’s Issue Too3. The Scope of the Problem4. Alcohol, Society, and Policy5. A Path ForwardMemorable Quotes:Resources & Links:Tags: