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TheOtherDave comments on Why do people ____? - Less Wrong Discussion
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Agreed about the recovering alcoholism excuse; I've occasionally implied that to good effect.
Medical reasons is complicated; I've had this both succeed and fail depending on particulars.
That said, I generally find "No thanks, I'm good" works pretty well.
I've heard this excuse suggested before on LW, and it still sits wrong with me. I'd expect it to be fairly disadvantageous to be thought a recovering alcoholic in many situations.
(nods) In many situations it is. Context is everything. Also, indirection matters here. Saying "No, I really don't drink anymore" while staring at my feet gets the implication across, for example, without saying anything false.
Cool. I suppose it'd make sense in relatively "disposable" social interactions.