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Binge Drinking

DEFINITION

Binge drinking is the rapid consumption of a large amount of alcohol, leading to intoxication. In the past, binge drinking was usually considered to be heavy, out-of-control drinking, usually alone, for periods of up to several days. Binge drinking is now defined by the quantity of alcohol consumed on a single occasion. The National Advisory Council of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as reaching a blood alcohol concentration (BAC) of at least 0.08 grams per deciliter (g/dL). This generally corresponds to the Substance Abuse and Mental Health Services Administration definition of binge drinking, which is to five drinks within about two hours for adult males and four drinks for adult females within a few hours.

DEMOGRAPHICS

Binge drinking is common in most parts of the world, and alcohol consumption, including binge drinking, is a major cause of death. According to the United States Centers for Disease Control and Prevention (CDC), in 2015, one in six Americans binge drank, consuming an average of seven drinks on a single occasion. Just over half these drinkers were in the 18–34 age range, while almost 18% were under age 18. College students ages 18–22 are more likely to binge drink (39.7%) than individuals of the same age who are not in college (32.6%). People with incomes above $75,000 per year were more likely to binge drink than people with lower incomes. Almost twice as many males binge drink as females, except among 12–18-year-olds, where the gender rates are almost equal.

The prevalence of binge drinking varies considerably across ethnicities, geographic regions, and individual college campuses. Binge drinking is most common among non-Hispanic whites (16%) followed by Latinos (11%), Native Americans (10%), non-Hispanic blacks (8%), and Asians (4%). Binge drinking also varies greatly from state to state, with estimates of binge drinking by adults ranging from 6.8% in Tennessee to 23.9% in Wisconsin. Binge drinkers are 14 times more likely than other drinkers to drive while alcohol impaired.

DESCRIPTION

Binge-drinking English football (soccer) fans.

(CountrySideCollection - Homer Sykes /Alamy Stock Photo)

Binge drinking is generally recognized as a harmful and potentially life-threatening practice, but there is no universally accepted definition of what constitutes binge drinking. In the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), published by the American Psychiatric Association, binge drinking falls under the category of alcohol use disorder rather than being identified as a specific disorder. In many European countries, binge drinking is defined by the consumption of significantly more than four or five drinks per occasion. There is also considerable variation in the definition of a standard drink. Furthermore, alcohol is metabolized at different rates. A person's BAC is affected by body weight, the duration of time over which alcohol is consumed, and concurrent food intake. To account for these factors; however, all definitions of binge drinking include drinking to the point of intoxication.

One standard drink is generally defined as:

· 12 fluid ounces (fl oz) of regular beer

· 8–9 fl oz of malt liquor

· 5 fl oz of table wine

· 3–4 fl oz of fortified wine, such as sherry or port

Current, Binge, and Heavy Alcohol Use among People Aged 12 to 20: Percentages, 2016 Alcohol use among people ages 12-20

SOURCE: Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health (HHS Publication No. SMA 17-5044, NSDUH Series H-52). 2017. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/ (accessed May 8, 2018).

Note: Since 2015, the threshold for determining binge alcohol use for males is consuming five or more drinks on an occasion and for females is consuming four or more drinks on an occasion.

· 2–3 fl oz of cordial, liqueur, or aperitif

· 1.5 fl oz (one jigger or shot) of brandy or 80-proof spirits (hard liquor)

The acceptability of binge drinking varies in different cultures. In some societies, binge drinking and intoxication are considered normal. In most cultures that tolerate drinking, binge drinking is more acceptable for males than for females and may even be considered a male rite of passage. Binge drinking may also be acceptable on certain occasions, such as wedding celebrations, wakes, or sports tournaments.

Binge drinking is associated with many social problems. It increases the likelihood of high-risk behaviors, such as driving under the influence; engaging in unplanned, unsafe, unprotected, or nonconsensual sex; accidents or injuries due to loss of physical coordination; and aggression or violence. People who binge drink are more likely to miss school or work and to perform less productively because of hangovers. They may engage in inappropriate interpersonal behaviors that negatively affect their relationships. Schools with high rates of binge drinking have higher rates of property damage and verbal, physical, and sexual violence.

Binge drinking is also associated with a variety of adverse health effects, including cardiovascular problems such as atrial fibrillation. Binge drinking by pregnant women can directly harm their unborn babies and cause fetal alcohol syndrome or other fetal alcohol spectrum disorders. Binge drinking is also associated with liver disease, neurological damage, sexual dysfunction, and poor control of diabetes. Finally, binge drinking can cause potentially fatal alcohol poisoning.

Risk factors

Risk factors for binge drinking include stress, sexual abuse, and mental illness. Additional risk factors for college students include having engaged in binge drinking in high school and residing in a sorority or fraternity. Low-priced, easily available alcohol is strongly correlated with binge drinking by college students. Cigarette smoking is a predictive factor for binge drinking.

CAUSES AND SYMPTOMS

The causes of binge drinking can be psychological or social. Many people binge drink to escape stress or personal problems. Other binge drinkers, especially young people, report that they engage in the practice because of peer pressure, for social status, or to fit in with a drinking culture. Bars, liquor stores, and advertising promote drinking as a fun and attractive activity.

The rise in popularity of inexpensive alcoholic energy drinks, which contain caffeine and other stimulants in addition to high alcohol levels, led to a frightening increase in binge drinking in the late 2000s, especially among college students. These products appear to be designed to support binge drinking, as the stimulants enable drinkers to stay awake and consume more alcohol rather than passing out. Numerous hospitalizations and several deaths led some colleges and states to ban the drinks, and because the safety of stimulants in combination with alcohol had not been approved by the U.S. Food and Drug Administration (FDA), the FDA required manufacturers to remove caffeine from the beverages.

Although not all binge drinkers are alcohol dependent, at least three out of five frequent binge drinkers may meet the criteria for alcohol abuse disorder. Some studies indicate that people who have three or more bingedrinking episodes within a two-week period display some symptoms of alcoholism.

Alcohol poisoning can be a potentially life-threatening consequence of binge drinking. Alcohol poisoning affects involuntary reflexes, including breathing and the gag reflex. An impaired gag reflex can cause drinkers to choke on their own vomit. Other signs of alcohol poisoning include:

· extreme confusion

· seizures

· unconsciousness

· slow or irregular breathing

· lowered body temperature

· pale or bluish skin

DIAGNOSIS

Examination

Although people usually recover from binge drinking by “sleeping it off,” alcohol poisoning is a medical emergency that requires immediate attention. The physician will check for signs and symptoms of alcohol poisoning. It is important that medical personnel be informed as to the amount and type of alcohol consumed over a specific period of time.

Tests

Blood tests are used to determine blood alcohol levels and other signs of alcohol toxicity, such as low blood sugar. A urine test may help to confirm a diagnosis of alcohol poisoning.

TREATMENT

The most important treatment for binge drinking is to stop drinking. Binge drinkers should never be allowed to drive after binging. If alcohol poisoning is suspected, it is important to stay with the person and try to keep them conscious until medical help arrives. If they are vomiting, they should be kept in a sitting position if possible, or, if lying down, have their head turned to one side to prevent choking. Patients with alcohol poisoning must be carefully monitored to prevent breathing and gagging problems. Oxygen therapy may be required, as well as intravenous fluids to prevent dehydration.

Traditional

Patients who are physically dependent on alcohol may require medical treatment for managing symptoms of alcohol withdrawal. Counseling may be required to address the underlying reasons for alcohol abuse. Groups such as Alcoholics Anonymous (AA) have a proven track record of helping people with drinking problems. Alcoholism is also treated with cognitive-behavioral therapy (CBT) or interactional group psychotherapy based on a 12-step program. Severe cases may require hospitalization or treatment in a substance-abuse rehabilitation facility.

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KEY TERMS

Alcoholic energy drink—

Caffeinated alcoholic beverages; malt liquors which, in addition to high alcohol content, have added caffeine and sometimes other stimulants.

Alcohol poisoning—

A potentially life-threatening condition caused by consuming large amounts of alcohol over a short period, negatively affecting heart rate, breathing, and the gag reflex.

Atrial fibrillation—

A condition in which the upper chamber of the heart quivers instead of pumping in an organized way.

Blood alcohol concentration or content (BAC)—

A measure of the amount of alcohol in the body; in most states, legal alcohol intoxication is defined as a BAC of at least 0.08 grams per deciliter of blood.

Cognitive-behavioral therapy (CBT)—

A type of psychotherapy in which people learn to recognize and change negative and self-defeating patterns of thinking and behavior.

Fetal alcohol spectrum disorders—

A range of birth defects, including intellectual disability, poor growth, nervous system dysfunctions, and malformations, that result from heavy maternal alcohol consumption during pregnancy.

Tolerance—

The body's adjustment to a drug such as alcohol, requiring increasingly higher quantities to produce the same effects.

Withdrawal—

The unpleasant, sometimes life-threatening, physiological changes that can occur due to the discontinuation of alcohol or drugs after prolonged regular use.

Drugs

Anxiolytic drugs are sometimes prescribed to control anxiety symptoms that accompany alcohol withdrawal. The FDA has approved three medications for the treatment of alcoholism:

· disulfiram (Antabuse) causes illness if alcohol is consumed

· naltrexone (Depade, ReVia) acts on the brain to reduce the craving for alcohol

· acamprosate (Canpral) reduces withdrawal symptoms

PROGNOSIS

Binge drinking is particularly dangerous for young people whose brains are still developing. Young people are more likely than adults to engage in risky behaviors when binge drinking, leading to automobile accidents, violence, sexually transmitted diseases, and unplanned pregnancies. Binge drinking disrupts sleep patterns, making it harder to concentrate in school, and binge drinkers are more likely to drop out of school. Studies have shown that teens who binge drink throughout high school are more likely to be overweight and have high blood pressure by the age of 24. Binge drinking can cause people to become angry or moody and socially isolated. Frequent binge drinking can induce tolerance, so that more alcohol is required to achieve a particular level of intoxication. Over time, binge drinking can cause liver disease, heart disease, and other chronic conditions, as well as stroke and certain cancers. Binge drinking by pregnant women can cause fetal alcohol spectrum disorders and other harm to their babies. Severe alcohol poisoning can lead to irreversible brain damage or death. Finally, binge drinking may be a precursor to alcohol dependence.

PREVENTION

Evidence demonstrates that parental influence and family values are very powerful determinants of drinking behavior. School- and community-based educational programs, starting in middle school if not before, teach alcohol awareness and stress the dangers of binge drinking. Many colleges and universities have alcohol awareness and prevention programs, beginning with freshman orientation. Peer-to-peer counseling and interactive programs can be particularly effective. Alcohol awareness programs can also be directed toward workplaces and promoted in the mainstream media. Health-care providers and social service workers should educate their patients and clients.

Social norms approaches teach that activities such as binge drinking are not socially acceptable. Social norming has been shown to be especially effective in reducing binge drinking among young people. For example, many young people believe that binge drinking is much more prevalent than it actually is, and correcting this misconception can discourage the practice.

One study found that in seven states that had at least four laws targeting high-volume alcohol sales, campus binge-drinking rates were lower—33% compared to 48% in states without such laws. States with other alcoholcontrol policies also had lower rates of college binge drinking. Other interventions that have been shown to help prevent binge drinking in college students include:

· increasing the cost of alcoholic beverages through taxation

· limiting the number of retail alcohol outlets within a given area

· consistently enforcing laws against underage drinking and drunk driving

· screening and counseling students for alcohol abuse

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QUESTIONS TO ASK YOUR DOCTOR

· Does my pattern of alcohol consumption qualify as binge drinking?

· What is a safe level of alcohol consumption?

· Is there a program or group that could help me control my binge drinking?

Bars and restaurants can also play a role in reducing binge drinking. Atmosphere, such as lighting and music, can affect how much and how quickly patrons drink. Serving alcohol at a slower rate, offering food and nonalcoholic drinks, and especially refusing to serve intoxicated customers and preventing them from driving and offering free nonacoholic drinks to a designated driver are business practices that help discourage binge drinking.

Resources

BOOKS

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Washington, DC: American Psychiatric Publishing, 2013.

Bow, James. Binge Drinking. New York, NY: Crabtree Pub. Co., 2015.

Gutierrez, Winston. Alcohol Consumption: Patterns, Influences and Health Effects. Hauppauge, NY: Nova Science Pubs., 2016.

Winograd, Rachel. Binge Drinking and Alcohol Misuse Among College Students and Young Adults. Boston, MA: Hogrefe, 2015.

PERIODICALS

Brancato, A. et al. “Pre-conceptional and Peri-Gestational Maternal Binge Alcohol Drinking Produces Inheritance of Mood Disturbances and Alcohol Vulnerability in the Adolescent Offspring.” Frontiers in Psychiatry 150 no. 9 (April 23,2018): eCollection. https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00150/full (accessed May 12, 2018).

Flanagan, Caitlin. “How Helicopter Parenting Can Cause Binge Drinking.” The Atlantic September 2016. https://www.theatlantic.com/magazine/archive/2016/09/how-helicopter-parents-cause-binge-drinking/492722 (accessed May 12, 2018).

Klass, Perry. “Binge Drinking Drops Among Teenagers.” New York Times, July 31, 2017. https://www.nytimes.com/2017/07/31/well/family/binge-drinking-drops-among-teenagers.html (accessed May 12, 2018).

WEBSITES

“Binge Drinking.” Alcohol Rehab Guide. https://www.alcoholrehabguide.org/alcohol/binge-drinking (accessed May 12, 2018).

“Binge Drinking” Social Issues Research Centre. http://www.sirc.org/publik/binge_drinking.shtml (accessed May 12, 2018).

“Binge Drinking: Terminology and Patterns of Use.” Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/capt/tools-learning-resources/binge-drinking-terminology-patterns (accessed May 12, 2018).

“Consequences of Binge Drinking.” Harvard T. H. Chan School of Public Health. https://www.hsph.harvard.edu/news/magazine/winter09bingingproblems (accessed May 12, 2018).

United States Centers for Disease Control and Prevention (CDC). “Fact Sheets—Binge Drinking.” https://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm (accessed May 12, 2018).

ORGANIZATIONS

National Council on Alcohol and Drug Dependence, 217 Broadway, Ste. 712, New York, NY 10007, (212) 269-7797, (800) NCA-CALL (24-hour help line), Fax: (212) 265-7510, [email protected], http://www.ncadd.org

National Institute on Alcohol Abuse and Alcoholism (NIAAA), 5635 Fishers Lane, MSC 9304, Bethesda, MD 20892-9304, (310) 443-3860, [email protected], https://www-niaaa-nih-gov.db28.linccweb.org

National Institute of Mental Health, 6001 Executive Boulevard, Room 8184, MSC 9663, Bethesda, MD 20892-9663, (301) 443-4513. TTY 301-443-8431, (866) 615-6464. TTY (866) 415-8051, Fax: (301) 443-4279, [email protected], http://www.nimh.nih.gov.db28.linccweb.org

Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD 20857, (877) SAMHSA-7 (726-4727), (800) 487-4889 (TTY), [email protected], https://www.samhsa.gov

United States Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Atlanta, GA 30329-4027, (404) 639-3534, (800) CDC-INFO (800-232-4636); TTY: 888-232-6348, http://www.cdc.gov .

Jill U. Adams Margaret Alic, PhD Revised by Tish Davidson, AM REVIEWED BY HELEN COLBY, PhD

Disclaimer: This information is not a tool for self-diagnosis or a substitute for professional care.

Full Text: COPYRIGHT 2019 Gale, a Cengage Company

Source Citation

Source Citation (MLA 8th Edition)

Adams, Jill U., et al. "Binge Drinking." The Gale Encyclopedia of Mental Health, edited by Brigham Narins, 4th ed., vol. 1, Gale, 2019, pp. 208-213. Gale Health and Wellness, https://link.gale.com/apps/doc/CX2491200069/HWRC?u=lincclin_tcc&sid=HWRC&xid=3e63e2df. Accessed 22 Nov. 2019.