The term “binge drinking” has traditionally been used in reference to extreme levels of alcohol consumption over a prolonged period of time, a drinking pattern common among alcohol-dependent individuals. More recently, the term has been used to denote a pattern of “heavy episodic drinking” common in adolescents and young adults. Although this type of drinking behavior is likely to result in intoxication, it represents a level of consumption considerably lower than the original definition and generally over a limited time interval. Most commonly, binge drinking is defined as five or more drinks on a single drinking occasion for men and four or more for women. Binge drinking in its current definition has become a major public health issue over the past two decades due to the established relation between this type of drinking and the experience of significant consequences to the individual and society.
Attention to the topic was heightened with the initial publication of binge drinking rates from a national sample of college students in 1994. This study indicated that more than 40% of college students were binge drinkers and nearly 20% were frequent binge drinkers (at least three times in the past month). Despite increased prevention efforts on college campuses, rates of binge drinking have remained relatively stable over the past decade. In 1996, results of the “Monitoring the Future” surveys conducted by the National Institute on Drug Abuse reported binge drinking rates in secondary school students, finding a disturbingly high rate among high school seniors (30%) that has not changed appreciably in the past 8 years. Although rates significantly decrease after college, approximately 25% of individuals in their 30s engage in binge drinking and 14% of the U.S. adult population met this standard in a recent nationally representative sample.
The current definition of binge drinking has been criticized on several grounds. First, the 5/4 criterion does not account for a number of important variables including time over which drinking occurs, body weight, and stomach contents. The result is that nearly half of the individuals who met the binge drinking criterion in one study were not drinking to intoxication as defined by a .08 blood alcohol concentration (the legal limit in most states). Another concern is that this definition leads the public to believe that dangerous drinking is normative based on the high percentage of young people meeting this criterion. The concern is that individuals who might not otherwise drink at this level will do so in order to meet societal norms. Despite the limitations of the 5/4 standard, it has demonstrated utility from a public health perspective.
Binge drinking is associated with an increased likelihood of other behavioral risks including driving after drinking, unprotected sexual behavior, and physical and sexual aggression. For example, binge drinkers in the general population are 14 times more likely to drive while impaired by alcohol than nonbinge drinkers. As a result of increased risk behavior, binge drinkers also report an increased incidence of a variety of negative consequences including alcohol-related motor vehicle accidents, HIV and other sexually transmitted diseases, alcohol-related injuries, and legal difficulties. Wechsler and colleagues (2002) found that infrequent binge drinkers were 3 to 4 times more likely to experience a range of negative consequences relative to nonbinge drinkers and frequent binge drinkers were roughly 10 times more likely to experience these same consequences.
The term “binge drinking” has come to refer to a pattern of heavy episodic drinking common among adolescents and young adults. Although this standard may have limited clinical utility in terms of identifying individuals with alcohol use disorders, it has considerable relevance from a public health perspective. Individuals who meet or exceed this level of consumption are at increased risk for a variety of negative consequences, with frequent binge drinkers at particularly high risk.
- Johnston, D., O’Malley, P. M., & Bachman, J. G. (2002). National survey results on drug use from the Monitoring the Future Study, 1975–2001: Volume I, secondary school students (NIH Publication No. 02–5106). Bethesda, MD: National Institute on Drug Abuse.
- Naimi, T. , Brewer, R. D., Mokdad, A., Denny, C., Serdula, M. K., & Marks, J. S. (2003). Binge drinking among U.S. adults. Journal of the American Medical Association,289(1), 70–75.
- National Institute on Alcohol Abuse and (n.d.). College drinking: Changing the culture. Available from http://www.collegedrinkingprevention.gov
- Perkins, H. W., DeJong, W., & Linkenbach, J. (2001). Estimated blood alcohol levels reached by “binge” and “nonbinge” drinkers: A survey of young adults in Psychology of Addictive Behaviors, 15(4), 317–320.
- Wechsler, , Lee, J. E., Kuo, M., Seibring, M., Nelson, T. F., & Lee, H. (2002). Trends in college binge drinking during a period of increased prevention efforts. Journal of American College Health, 50(5), 203–217.