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Binge drinking, or heavy episodic drinking, is drinking alcoholic beverages intending to become intoxicated by heavy consumption of alcohol over a short period, but definitions vary considerably.
Binge drinking is a style of drinking that is popular in several countries worldwide, and overlaps somewhat with social drinking since it is often done in groups. The degree of intoxication, however, varies between and within various cultures that engage in this practice. A binge on alcohol can occur over hours, last up to several days, or, in the event of extended abuse, even weeks. Due to the long term effects of alcohol abuse, binge drinking is considered to be a major public health issue.
Binge drinking is more common in males, during adolescence and young adulthood. Heavy regular binge drinking is associated with adverse effects on neurologic, cardiac, gastrointestinal, hematologic, immune, and musculoskeletal organ systems as well as increasing the risk of alcohol induced psychiatric disorders. A US-based review of literature found that up to one-third of adolescents binge-drink, with 6% reaching the threshold of having an alcohol-related substance use disorder. Approximately one in 25 women binge-drinks during pregnancy, which can lead to fetal alcohol syndrome and fetal alcohol spectrum disorders. Binge drinking during adolescence is associated with traffic accidents and other types of accidents, violent behavior as well as suicide. The more often a child or adolescent binge drinks and the younger they are the more likely that they will develop an alcohol use disorder including alcoholism. A large number of adolescents who binge-drink also consume other psychotropic substances.
Frequent binge drinking can lead to brain damage faster and more severely than chronic drinking (alcoholism). The neurotoxic insults are due to substantial amounts of glutamate which are released and overstimulate the brain as a binge finishes. This results in excitotoxicity, a process which damages or kills neurons (brain cells). Each binge drinking episode immediately assaults the brain; repeat episodes result in accumulating harm. The developing adolescent brain is thought to be particularly susceptible to the neurotoxic effects of binge drinking, with some evidence of brain damage occurring from drinking more than 10 or 11 drinks once or twice per month. A 2020 study found that even a single episode of binge drinking can lead to atrophy of the brain's corpus callosum, from which damage was still detectable by an MRI scanner five weeks later. With prolonged abstinence neurogenesis occurs which can potentially reverse the damage from alcohol abuse.
In the United Kingdom, binge drinking is defined by one academic publication as drinking more than twice the daily limit, that is, drinking eight units or more for men or six units or more for women (roughly equivalent to five or four American standard drinks, respectively). In Australia, binge drinking is also known as risky single occasion drinking (RSOD) and can be classified by the drinking of seven or more standard drinks (by males) and five or more standard drinks (by females) within a single day. When BEACH (Bettering the Evaluation and Care of Health) conducted a study which gathered information of people over the age of 18, it defined binge drinkers as those who consumed six or more standard drinks on one occasion whether that be weekly or monthly.
In Ireland, the HSE defines binge drinking as more than six units of alcohol in one sitting for both sexes.
Researchers also classify particularly severe binge drinking, called high-intensity drinking, as consuming at least 8 to 12 drinks in a day. Although most people do not drink or do not exceed moderate levels of alcohol consumption, about half of binge drinkers engage in high-intensity drinking at least some times. High-intensity drinking is associated with unhealthful behaviors such as front-loading (trying to get drunk as fast as possible) and with harmful outcomes such as impaired driving and a higher risk of dying that day.
Other, less common definitions rely on blood alcohol concentration (BAC). For example, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines the term "binge drinking" as a pattern of drinking that brings a person's blood alcohol concentration (BAC) to 0.08 percent or above. Whatever the numerical definition used, heavy drinking or rapid consumption over a short period of time with the intention of becoming intoxicated is often implied when the term is used colloquially, since four or five drinks consumed over the course of a whole day and as an accompaniment to meals will not have the same effects as the same amount consumed over a couple of hours on an empty stomach.
An alternative colloquial term for binge drinking, "going on a bender", formerly implied a drinking spree of several days.
Compare: (2011). 9781617878503, ABDO Publishing Company. ISBN 9781617878503
A 2007 survey summarised the reasons given for binge drinking by a group of 15- to 16-year-olds in Germany as including:
Other causes include feeling more grown-up and fitting in with peers, and increasing the chance of sexual encounters. Some also drink to alleviate psychological stress or anxiety. Research on interpersonal violence focused on mechanisms of victimization and perpetration (specifically stalking, harassment, sexual assault, and teen dating violence) among adolescents reported a significantly higher proportion of teenagers endorsing depressed mood and engagement in binge drinking among those subjected to victimization.
Semi-structured interviews were carried out with 64 14- to 17-year-olds who had an experience of binge drinking. These interviews found that motivations included social facilitation, which was ease in social situations, individual benefits such as getting a 'buzz', and influences of peer pressure and social norms.
Risk factors for binge drinking among adolescents include: low socioeconomic status, large amount of disposable (pocket) money, sensation and novelty seeking, low self-control, delinquency and having delinquent friends. Other risk factors include: using alcohol as a coping strategy for emotional problems (more common in adolescent girls), excessive drinking among peers, poor relationship with parents, alcohol abuse by parents. Genetic conditions combined with a background of negative environmental factors increase the harmful use of alcohol. Additionally, the risk-taking behavior associated with adolescence promotes binge drinking.
Other risk factors that influence the development of alcohol abuse or alcoholism include social and genetic factors. Several researchers have found that starting to drink before the age of 15 is associated with a fourfold increased risk for developing alcoholism compared to people who delay drinking until age 20 or later. It has been estimated by some that if the age at which people started drinking could be delayed to age 20, there would be a 50% reduction in the number of cases of alcohol use disorder. However, it is unclear whether this is a causal relationship, or a function of confounding familial (and other) factors associated with both age at first drink and propensity for alcoholism.
The main cause of death among adolescents as a result of binge drinking is road traffic accidents; a third of all fatal road traffic accidents among 15- to 20-year-olds are associated with drinking alcohol. Cyclists and pedestrians are likely to have less spatial awareness and concentration while travelling after binge drinking and, also, it is more common that adolescents who binge-drink drive drunk or are the passenger of a drunk driver. It has been found that 50% of all head injuries in adolescents in the US are associated with alcohol consumption. Violence and suicide combine to become the third-most-common cause of death associated with binge drinking among adolescents. The suicide risk in adolescents is more than four times higher among binge drinkers than non-binge drinking adolescents.
Earlier sexual activity, increased changing of sexual partners, higher rate of unwanted pregnancy, higher rate of sexually transmitted diseases, infertility, and alcohol-related damage to the fetus during pregnancy are associated with binge drinking. Female binge drinkers are three times more likely to be sexually assaulted; 50% of adolescent girls reporting sexual assault were under the influence of alcohol or another psychotropic substance at the time.
Adolescents who regularly participated in binge drinking for several years show a smaller hippocampus brain region, in particular those who began drinking in early adolescence. Heavy binge drinking is associated with neurocognitive deficits of frontal lobe processing and impaired working memory as well as delayed auditory and verbal memory deficits. Animal studies suggest that the neurodegenerative effects of alcohol abuse during adolescence can be permanent. Research in humans, which used sophisticated brain scanning technology suggests that in adolescent teenagers, drinking more than four or five drinks once or twice a month results in subtle damage to the teenagers developing brain tissue, in particular the white matter. However, this research is primarily cross-sectional and done with fairly small sample sizes, making causality less certain.
Several studies have been conducted to discover if there is a link between binge drinking in adolescent years and becoming a chronic alcohol consumer when they transition into adulthood. A particular study conducted by the National Longitudinal Survey of Youth found that harmful drinking during adolescent years was significantly associated with the continuation of dangerous levels of alcohol consumption into adulthood. Binge drinking is a way for young adolescents to rely on alcohol as a way to cope with certain stress or depression.
In college, many students will join Greek organizations that revolve heavily around social drinking. For new members, especially in fraternities, binge drinking is heavily encouraged, and underage drinking is commonplace. Over the past few decades, many schools have cracked down on Greek events with strict policies and active monitoring. However, the festivities did not stop, and many members were not only affected during their time in college but also later in life. Studies have shown that both male and female students who were associated with Greek organizations were more likely to develop Alcohol Use Disorder (AUD) in comparison to their non-Greek counterparts.
A 2023 systematic review highlights the non-addictive use of alcohol for managing developmental issues, personality traits, and psychiatric symptoms, emphasizing the need for informed, harm-controlled approaches to alcohol consumption within a personalized health policy framework.
Intoxication and recklessness with alcohol seem to play a pivotal role in the falls. Over 95% of the victims were found to have high levels of alcohol in their blood, and 37% had consumed other drugs.
The balconies have a median height of , and the people have a median age of 24 years.
Binge drinking regimes are associated with causing an imbalance between inhibitory and excitatory amino acids and changes in monoamines release in the central nervous system, which increases neurotoxicity and may result in cognitive impairments, psychological problems and in long-term heavy binge drinkers may cause irreversible brain damage in both adolescents and adults.
While several rat studies indicate that alcohol is more toxic during adolescence than adulthood, some researchers believe that it remains unclear whether this is also the case in humans. Though heavy binge drinking adolescent humans show impaired brain activity during memory tests and underdeveloped brain structures compared to adolescents who did not binge-drink, they argue that these findings are similar to adult alcoholics who did not abuse alcohol during adolescence. Extrapolation from animal studies to humans is notoriously difficult, and a review by the group Choose Responsibility concluded that alcohol's long-term damage to cognitive processes was the same regardless of whether heavy drinking commenced during adolescence or later.
Impairments in impulse control in binge drinkers, which are more prominent in female binge drinkers, are due to dysfunction of the frontal lobe. The findings in humans have been largely concordant with animal studies. Such animal studies find that heavy and regular binge drinking causes neurodegeneration in corticolimbic brain regions areas that are involved in learning and spatial memory, such as the olfactory bulb, piriform cortex, perirhinal cortex, entorhinal cortex, and the hippocampal dentate gyrus. A study in rats found that a heavy two-day drinking binge caused extensive neurodegeneration in the entorhinal cortex with resultant learning deficits. While brain damage from binge drinking is known to occur as a result of binge drinking patterns, it is unclear how long drinking sessions last and how regular binge drinking is done to cause brain damage in humans. One study found that humans who drank at least 100 drinks (male) or 80 drinks (female) per month (concentrated to 21 occasions or less per month) throughout a three-year period had impaired decision-making skills compared to non-binge drinkers. Repeated acute withdrawal from alcohol, which occurs in heavy binge drinkers, has been shown in several studies to be associated with cognitive deficits as a result of neural kindling; neural kindling due to repeated withdrawals is believed to be the mechanism of cognitive damage in both binge drinkers and alcoholics. Neuronal kindling also leads to each subsequent acute withdrawal episode being more severe than previous Drug withdrawal episodes.
Blackouts, a form of amnesia that occurs in binge drinkers may be due to suppressed hippocampus function with rebound NMDA (glutamate) activity combined with excessive glucocorticoid release induced by the stress of repeated intoxication followed by acute withdrawal/abstinence is the proposed mechanism of neural kindling leading to neurotoxicity of structures involved in learning and memory within the brain of binge drinkers. Frontal lobe processing may become impaired as a result of binge drinking, with resultant neurocognitive deficits and impaired working memory.
Alcohol suppresses brain function during intoxication; but upon withdrawal rebound effects occur in the glutamate/NMDA system and with excess glutamate activity glucocorticoid release; due to the repeated intoxication, followed by acute withdrawal, a neurotoxic effect that damages the central nervous system develops, leading to persisting impairments in verbal and nonverbal cognitive abilities as well as impairment of spatial orientation. Due to developmental processes occurring during adolescence, including myelination and restructuring of the synapses, adolescents are thought to be more vulnerable to the neurotoxic effects of alcohol.
Age and genetic factors influence the risk of developing alcohol-related neurotoxicity. Adolescence, especially early adolescence (i.e. before age 15), is a critical and delicate developmental stage when specialised neuronal and Synapse systems mature. This critical developmental stage is where lifelong adult traits, e.g., talents, reasoning and complex skills mature; however, alcohol and in particular binge drinking may disrupt and interfere with this developmental process. Adolescence is also a period of development characterised by a high level of novel seeking, thrill seeking and risk-taking behaviour, and thus alcohol and other drug experimentation and abuse are common. An adolescent rat study found that a short exposure to high levels of alcohol resulted in long-lasting changes to functional brain activity with corresponding abnormalities in EEG brain waves that persisted into adulthood, including persisting disturbances in sleep EEG with a reduction in slow wave sleep. These EEG findings are similar to premature aging. According to one review of the literature, if the developmental stage of adolescence is similar to the developmental stage of the fetus with regard to sensitivity to the neurotoxic effects of alcohol, and if long-lasting or permanent damage to the brain occurs similar to what animal studies suggest, then this represents a major public health issue due to the high levels of alcohol use by adolescents. Indeed, alcohol can affect the remodeling and functional changes in synaptic plasticity and neuronal connectivity in different brain regions that occurs during adolescence ( see this related article).
For the purpose of identifying an alcohol use disorder when assessing binge drinking, using a time frame of the past 6 months eliminates false negatives. For example, it has been found that using a narrow two-week window for assessment of binge drinking habits leads to 30% of heavy regular binge drinkers wrongly being classed as not having an alcohol use disorder. However, the same researchers also note that recall bias is somewhat enhanced when longer timeframes are used.
Understanding consumer personality and how people view others is important. People were shown ads talking of the harmful effects of binge drinking. People who valued close friends as a sense of who they are were less likely to want to binge drink after seeing an ad featuring them and a close friend. People who were loners or who did not see close friends as important to their sense of who they were reacted better to ads featuring an individual. A similar pattern was shown for ads showing a person driving at dangerous speeds. This suggests ads showing potential harm to citizens from binge drinking or dangerous driving are less effective than ads highlighting a person's close friends.
In 2009, the Australian Government Department of Health and Ageing spent $53.5 million Australian Dollars on the National Binge Drinking Strategy to target young Australians. This campaign, titled "Don't Turn a Night Out Into a Nightmare," was delivered to the public over many mass media platforms to show the harms and consequences of risky single occasion drinking (RSOD), as binge drinking is defined in Australia. Evidence as to the effectiveness of these types of campaigns is mixed. Research needs to be completed to ensure that the effectiveness of the messages results in a positive shift in the behaviours of the target audience.
Adolescents who misuse alcohol can benefit from interventions aimed at risk reduction. For more severe cases, an intervention involving parents, guardians, or a psychotherapist is recommended. An effective strategy of intervention for adolescents whose binge drinking leads to admission to hospital, e.g. for alcohol poisoning or injury, is manualised brief interventions at the hospital in one to four counseling sessions each lasting 30 to 60 minutes conducted by trained staff. Evaluation of personal pattern of drinking and associated risks and an emphasis on personal responsibility in a non-condescending manner is recommended during the intervention; discussing and informing, and educating the adolescent of possible negative short-term and long-term consequences of drinking is recommended. The setting of goals and rules to achieve those goals is also recommended during intervention with problem binge drinking adolescents. Motivational enhancement therapy also shows promise as a treatment.Rhodes KV, Rodgers M, Sommers M, Hanlon A, Crits-Christoph P. The Social Health Intervention Project (SHIP): Protocol for a randomized controlled clinical trial assessing the effectiveness of a brief motivational intervention for problem drinking and intimate partner violence in an urban emergency department. BMC Emergency Medicine, 2014
Increasing public information and awareness regarding the risks of binge drinking, conducting interviews in emergency departments of young people suspected of harmful drinking patterns, and trying to persuade them to accept individual counseling in youth addiction counseling services are effective strategies for reducing the harm of binge drinking. Encouraging recreational and adventurous training activities such as climbing or driving can be used alternative "natural buzzes" to alcohol misuse. Additionally, the provision of educational content about the risks of binge drinking and a risk assessment is beneficial during intervention with young binge drinkers and a referral in the case of an alcohol use disorder for specialised help.
According to the NIAAA definition of "heavy drinkers", men may be at risk for alcohol-related problems if their alcohol consumption exceeds 14 per week or four drinks per day, and women may be at risk if they have more than seven standard drinks per week or three drinks per day. Despite this risk, a 2014 report in the National Survey on Drug Use and Health found that only 10% of either "heavy drinkers" or "binge drinkers" also met the criteria for alcohol dependence, while only 1.3% of non-binge drinkers met these criteria. An inference drawn in this study is that evidence-based policy strategies and clinical preventive services may effectively reduce binge drinking without requiring addiction treatment in most cases.
Statistics published in 2013 indicated that among the Australian youth population, 31% of males and 14% of women aged 15 to 17 years engage in risky alcohol consumption.
Individuals of African descent have a lower level of binge drinking followed by those of Asian descent. In the case of Asians, their low level of binge drinking may be due to the presence of the aldehyde dehydrogenase gene (ALDH2, Chromosome 12) in many (but by no means the vast majority) that results in poor metabolism of alcohol, which leads to severe adverse effects such as facial flushing. Men are more likely to binge drink (up to 81% of alcohol binges are done by men) than women and men are also more likely to develop alcohol dependence than women. People who are homozygous for the ALDH2 gene are less likely to binge-drink due to severe adverse effects that occur even with moderate amounts of alcohol consumption.
College students are more likely to binge drink than their same-age peers who were not enrolled in college. In the US, this effect has caused serious problems with the country's legal drinking age. This effect is more prevalent in women than in men.
Other factors that have been found to correlate with higher levels of binge drinking include low religiosity, marijuana use, living with roommates, and cigarette use.
The Centers for Disease Control and Prevention (CDC) released a study in October 2011 that showed that in the United States, binge drinking costs society $223 billion a year, which amounts to $2 per drink. These costs include health care costs for alcohol-related issues, including liver cirrhosis, loss of work productivity, property damage due to drunk driving, and expenditures related to criminal acts. Overall, 11.9% of binge drinkers drove during or within two hours of their most recent binge drinking episode. Those drinking in licensed establishments (bars, clubs, and restaurants) accounted for 54.3% of these driving episodes. Significant independent risk factors for driving after binge drinking included male gender (AOR=1.75); being aged 35–54 or ≥55 years compared to 18–34 years (AOR=1.58 and 2.37, respectively); and drinking in bars or clubs compared to drinking in the respondent's home (AOR=7.81). Drivers who drank most of their alcohol in licensed establishments consumed an average of 8.1 drinks, and 25.7% of them consumed ≥10 drinks.
There is no known safe level of alcohol consumption, either when trying to get pregnant or during pregnancy. With alcohol abuse remaining highly stigmatized—particularly in the case of pregnant women—some advocate for treatment programs to focus on a non-judgmental stance, on personal empowerment, and on offering contraceptives to women engaging in sex, to prevent fetal alcohol spectrum disorder.
However, men are almost twice as likely to partake in excessive drinking than women, there being a higher rate of alcohol-related hospitalizations among males than females. Researchers from Columbia and Yale found the discrepancy could be due to the fact men release more dopamine during alcohol consumption than women. The increased neurochemical release causes a stronger association with pleasure and alcohol intoxication. "This may contribute to the initial reinforcing properties of alcohol and the risk for Habit".
The Gin Craze was a period in the first half of the 18th century when the consumption of gin increased rapidly in Great Britain, especially in London. By 1743, England was drinking 2.2 gallons (10 litres) of gin per person per year. The Sale of Spirits Act 1750 (commonly known as the Gin Act 1751) was an Act of the Parliament of Great Britain (24 Geo. 2. c. 40) which was enacted to reduce the consumption of gin and other distilled spirits, a popular pastime that was regarded as one of the primary causes of crime in London. Gin Act – Britannica Online Encyclopedia
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