Binge Drinking

A binge is a relatively short period of excessive behavior. For example, someone might go on an eating binge and consume an entire box of cookies and a whole bag of chips, or a shopping binge and buy many more items than the person can use or afford. Recently, binge drinking has become an increasing cause of concern. Dr. Henry Wechsler, the lead investigator of the Harvard School of Public Health College Alcohol Study, defined a binge episode as having five or more drinks on a single occasion for males, and four or more drinks on a single occasion for females. In this definition, a drink refers to the amount of alcohol found in a 12-ounce can or bottle of beer or wine cooler, a 4-ounce glass of wine, or a 1.25-ounce shot of liquor.

National surveys have used similar definitions to reveal patterns of drinking among adolescents and young adults in the 1990s. These surveys have revealed some troubling information about the extent of binge drinking and the negative consequences of drinking among young people. Although many people disagree with the use of the label of "binge drinking," occasional heavy drinking appears to be especially common during the period when adolescents enter adulthood.

The Patterns of Binge Drinking

Most middle and high school students and many college students drink little or no alcohol. However, some underage drinkers consume alcohol in large amounts. According to one study, the percentage of students who binge increases steadily from middle school to college. By 12th grade, nearly one-third of students report having consumed five or more drinks in a row in the last two weeks. Students who leave home to attend college drink more heavily than those who enter the workforce. Four out of ten college students (44 percent) have binged in the last two weeks. Half of this group (23 percent of the total) are frequent binge drinkers, binging three or more times in two weeks. These percentages tell only part of the story, for 19 percent of college students abstain from drinking, and another 36 percent drink lightly or moderately. Increasingly, however, students are drinking in more risky ways. Not only is the number of students who report frequent binge drinking growing, but the number who say that they drink in order to get drunk (48 percent) has also gone up in recent years.

Binge drinking is more common among certain groups of people. For example, male students are more likely to binge drink than female students, and white students binge more frequently than do African-American students. In addition, binge drinking is related to social and cultural groups. People who have a strong religious commitment have lower rates of drinking. In contrast, people who belong to fraternities or sororities (college social clubs) and are involved

in athletics appear to drink more heavily. Academic performance tends to be associated with drinking patterns—heavier drinkers tend to get poorer grades in school.

The Reasons for Drinking

Drinking alcohol has long been considered a "rite of passage" or a normal step on the way to adulthood. Experimentation with drinking is one way to explore adult behaviors. The most common reasons for drinking given by high-school students suggest that they are simply curious. Over half say that the most important reasons for drinking are to have a good time with friends, and to experiment with the effects of alcohol. Nearly as many say they drink alcohol for other positive reasons: in order to feel good or high, because it tastes good, and because it relaxes them. However, a quarter of high-school seniors indicate that they drink alcohol because they are bored, they have nothing else to do, or they are trying to get away from problems. When drinking is being used to escape or avoid something, this can be a warning sign for future problems with alcohol.

Other reasons why young people may drink heavily have to do with general influences in the world around them. Many young people perceive that social norms support underage drinking. They base this perception on the information they have available to them. For example, if social events that involve drinking by peers are publicized and talked about more often than social events that do not involve drinking, students will perceive that the social norm supports drinking.

Also, research has shown that young people tend to overestimate how much and how often their peers drink. As a result, some students binge drink not because they like drinking alcohol that much, but because they feel that it is expected of them by their peer group. They also overestimate the approval they think they will gain from peers for drinking and drunken behavior. The mistaken belief that "everybody does it" may create an environment that encourages binge drinking.

The Negative Consequences of Binge Drinking

Binge drinking causes concern because it can have negative consequences. Drinking large quantities of alcohol places both the drinker and others around him or her in danger. Heavy drinking also affects the way people behave and think. In surveys of high-school seniors and college students, the most common negative consequence mentioned by both groups is doing something you later regret (52 percent for high school, 35 percent for college). In addition, many students who drink report that drinking has interfered with their ability to think clearly and keep up with their school work, and that drinking has hurt relationships with friends and family. Over 1 in 10 college drinkers report being hurt or injured as a result of their drinking since the beginning of the school year. Drinking in binges increases the chances of an alcohol-related injury: only 4 percent of non-binge drinkers but 26 percent of frequent binge drinkers report getting hurt or injured.

Binge drinkers, and especially frequent binge drinkers, are significantly more likely to experience negative effects of drinking alcohol. Despite the fact that the majority of college students are under the legal age to drink (21 in the United States), a surprising number of students report multiple (more than one) alcohol-related problems. Although only 3.5 percent of non-binge drinkers have experienced five or more problems since the beginning of the school year, almost 17 percent of occasional binge drinkers and nearly half (48 percent) of frequent binge drinkers reported five or more problems affecting their social relationships, personal well-being, or physical health. Examples of such problems include drinking and driving, engaging in activities that resulted in damaged property, injuries, decreased attendance at classes, and falling behind in class work.

Binge drinkers are more likely than non-binge drinkers to engage in behaviors that involve risk , including the risk of death. As a result, the people around them are more likely to experience the negative consequences of those behaviors. Many high-school seniors and college students report driving after drinking (19 percent for high school, 29 percent for college), a dangerous behavior for drivers, passengers, and others sharing the road with them. Binge drinkers are more likely than non-binge drinkers to report having unplanned sex and not using protection when they had sex. These behaviors carry risks of unintended pregnancy as well as sexually transmitted diseases such as HIV. In addition, drinking games continue to be popular among heavier drinkers. Because drinking games do not allow participants to control how much they drink, these games increase all of the risks of being drunk.

Even for students who do not binge drink, the presence of binge drinking around them can have unpleasant effects. Over half (60 percent) of college students who do not drink or who drink lightly have had their studies interrupted or lost sleep because of the drinking of other students. Nearly half (48 percent) have had to take care of a drunken student, and many (29 percent) have reported being insulted or humiliated by another student who was drunk. Considering the cases of vandalism and property damage to dormitories and physical assaults attributed to drunkenness, it is clear that binge drinking can affect the living and working environment of all students.

A Controversial Idea

The term "binge drinking" and its definition have caused a great deal of disagreement and controversy. Critics raise four major issues:

1. The term "binge drinking" has been used to describe at least two separate drinking styles. People who have worked in treatment facilities for addictions use the term "binge" to mean an extended period of excessive, alcoholic-style drinking. Many in the general population understand a binge to mean several days of out-of-control drinking, during which a person neglects responsibilities. As a result, using the same term to refer to consuming five drinks in one evening is confusing to people. In addition, some students reject being called binge drinkers because they do not feel that they drink alcohol irresponsibly.
2. Some people assume that binge drinking means drinking to the point of drunkenness, but this is incorrect. Drunkenness, or intoxication, is usually measured in terms of blood alcohol concentration (BAC) . Many factors affect BAC: how many drinks a person consumes, weight, gender, and the time taken to consume the drinks. Critics point out that it is possible for a 180-pound man to consume five drinks over several hours and never become intoxicated. In fact, studies have shown that many people who would be considered binge drinkers based on their last drinking event would not reach a BAC that indicated intoxication. Therefore, the number of drinks a person has consumed is not enough information to determine whether or not a person is intoxicated.
3. Some critics argue that binge drinking does not always have negative consequences. For example, a heavy drinker may still be on the honor roll. Although frequent binge drinkers are more likely, on the whole, to have alcohol-related problems, some individuals never do. Critics conclude that the effects of drinking for any given person must be evaluated on an individual basis.
4. Finally, defining binge drinking as five drinks in a row (four for women) has been criticized because it defines such a common behavior. If 44 percent of college students binged in the last two weeks, does that mean that nearly half of college undergraduates are problem drinkers? If binge drinking is almost normal for college students, then should it be a concern? There are two responses to these questions. First, students who binge drink do report significantly more negative experiences related to their drinking. Although not all of these problems are severe, they accumulate to reduce life satisfaction for many students. Second, heavier drinkers run risks related to higher BACs that lighter drinkers do not. While it is possible to run risks and never experience the negative outcome, it is hard to predict when a risk might turn into a real problem. Many people take risks, and only a few experience car crashes, or accidental injuries, or alcohol poisoning. However, binge drinkers do put themselves at greater risk for these outcomes.

The Dangers

Clearly, some adolescents and young adults are taking experimentation with alcohol to extremes. Almost half of drinkers in college report drinking for the purpose of getting drunk. Being drunk implies a lack of control over one's ability to make sound judgments, manage one's emotions, and maintain physical coordination. In addition, more than a quarter of college students have experienced an alcohol-induced blackout—forgetting where they were or what they did. Thus, binge drinking can result in BACs high enough to hurt the brain's ability to function. Regular drinking to intoxication increases the risks of harm to the drinker and those around him or her. Thus, binge drinking is cause for concern when it results in high BACs and intoxication. The frequency of binge drinking may be creating a climate in which heavy drinking and drunkenness are tolerated and considered acceptable.

Another danger of binge drinking is the development of tolerance . A drinker who is tolerant to alcohol must consume more drinks to achieve the positive, social, relaxing effects of alcohol. Tolerance to the many behavioral effects of alcohol develops at different rates, so that feeling unaffected by a given number of drinks does not always mean, for example, that one's reaction times or coordination are intact. Regardless of the perceived effects of alcohol, drinking higher quantities results in higher BACs, and more risk of being impaired in undesirable ways. Developing a tolerance to greater amounts of alcohol is a process that can result in physical dependence on alcohol. Once a person is dependent on alcohol, it is extremely difficult to stop drinking, even though a person may wish to quit.

In Summary

Although binge drinking does not always mean that a person is dangerously drunk or has an alcohol-abuse problem, consuming large quantities of alcoholic beverages in short periods of time is a risky behavior. In the short term, people who binge drink may feel tired and sick the next day, have conflicts with family and friends, suffer from injuries, or even die as a result of excessive drinking. In the long-term, heavy drinking may lead a person to rely on alcohol to have a good time and to develop tolerance to and physical dependence on alcohol. Despite a minimum legal drinking age of 21 in the United States, adolescents and young adults experiment with alcohol, drink enough to cause intoxication, and experience problems linked to their alcohol use. Prevention programs are needed to promote less risky drinking behavior.

see also Accidents and Injuries from Alcohol; Alcohol: Chemistry; Alcohol: Poisoning; Blood Alcohol Concentration; Diagnosis of Drug and Alcohol Abuse: an Overview.