The term binge drinking refers to the consumption of a specific amount of alcohol over a specific period of time and not necessarily to any type of substance abuse issue or substance use disorder. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) outlines binge drinking as a display of drinking that raises blood alcohol concentration to levels of 0.08 or higher.
The Substance Abuse and Mental Health Services Administration (SAMHSA) and NIAAA report that binge drinking is defined as males drinking five or more alcoholic drinks at one time, and females drinking four or more alcoholic drinks at one time, at least one day during the past month. Individuals who binge drink repeatedly, on five or more days during the month, are defined as heavy alcohol users, according to SAMHSA.
Binge Drinking, Heavy Drinking, and Alcohol Use Disorders
Individuals who repeatedly binge drink are at risk to become heavy drinkers, and heavy drinkers are at an increased risk to develop alcohol use disorders (the clinical term to describe alcohol abuse and/or an addiction to alcohol). It is certainly possible to be a heavy drinker and not have a formal diagnosis of an alcohol use disorder, and it is possible to be diagnosed with an alcohol use disorder and not be a binge drinker; however, according to the American Psychiatric Association’s (APA) diagnostic criteria for an alcohol use disorder, it is most likely very rare that an individual who qualifies as a heavy alcohol user or a repeated binge drinker would not meet criteria for at least a mild alcohol use disorder. The differentiation between having a substance use disorder and simply heavy drinking and binge drinking lies in the effects on one’s functioning and the amount of distress that drinking alcohol leads to. For most individuals, being a heavy alcohol user will result in the development of tolerance to alcohol and at least one other issue with functioning that would most likely, but not certainly, qualify them for a diagnosis of an alcohol use disorder. For the most part, the term functional alcoholic is a bit of a misnomer because individuals who are heavy alcohol users are inevitably not functioning at their optimum level.
NIAAA also reports that low-risk drinking for men is no more than four drinks on a single occasion and no more than 14 alcoholic drinks a week, whereas for women it is no more than three drinks on a single occasion and no more than seven drinks per week. Only 2 percent of people drinking at these levels are likely to develop alcohol use disorders whereas 25 percent who exceed these levels already have alcohol use disorders. Over time, APA reports that the majority of heavy drinkers will be diagnosed with an alcohol use disorder.
The Effects of Binge Drinking
Alcohol is a powerful central nervous system depressant that has global effects on the body when it is taken in large quantities. Volumes of journals and books have been compiled listing the dangers of heavy alcohol use, and young individuals of college age who engage in heavy alcohol use are not immune to these risks. Individuals who repeatedly engage in binge drinking and who qualify as heavy drinkers according to the above criteria are at risk for a number of specific dangers or issues that include:
- Negative effects on one’s career goals, educational goals, and performance in school and at work
- Negative effects on an individual’s professional and personal relationships that can often be irrevocable
- Decreased productivity at school and in other important areas
- A significantly increased potential to engage in risky behaviors, such as other illicit drug abuse, dangerous unprotected sex, or operating machinery, such as an automobile while intoxicated, that may have life-changing consequences
- Increased potential for injuries due to accidents, poor judgment, or even intentional acts while under the influence
- Developing serious legal and/or financial issues associated with behaviors that one engaged in while under the influence of alcohol
- The development of cardiovascular issues that can include high blood pressure, increased potential for heart attack, and increased potential to develop stroke
- An increased potential to damage the liver and kidneys
- An increased potential to develop gastrointestinal disorders (e.g., ulcers)
- The increased risk to develop a number of different types of cancer
- An increased risk to have children with developmental disabilities that can include fetal alcohol syndrome, learning disabilities, attention deficit hyperactivity disorder, etc.
- An increased potential to develop sexual disorders, such as impotency in men and menstrual irregularities in women
- Significantly increased chance to develop issues with the peripheral nervous system, such as neuropathies, nerve damage, etc.
- A significantly increased chance to develop issues with the central nervous system (the brain and spinal cord) that can be irreversible
- Increased potential to develop cognitive and/or emotional issues
- Increased potential to be diagnosed with some other mental health disorder that can include depression, personality disorders, anxiety disorders, etc.
- Increased potential to develop physical dependence on alcohol
Data from APA, NIAAA, and SAMHSA indicate that individuals who engage in repetitive binge drinking as young adults are far more likely to continue their heavy drinking as they get older compared to individuals who only drink lightly or moderately as young adults. This leads to an even more increased potential to develop an alcohol use disorder and/or a polysubstance use disorder.
Many young people fail to recognize the simple fact that repeated binge drinking is dangerous no matter whether one drinks beer, wine, or liquor. For example, heavy drinking is associated with an increased potential to develop lung cancer, esophageal cancers, cancer of the tongue, etc. The American Cancer Society lists the reasons for these increased risks as follows:
- Risk is related to the amount of alcohol one consumes and not the type of alcohol. The increased risk to develop diseases like cancer as a result of alcohol use is strictly related to the quantity and length of time one drinks as opposed to the type of alcohol one consumes.
- Heavy drinking and tobacco use are old bedfellows, and chronically drinking heavily and smoking cigarettes result in an increased risk to develop a number of different types of cancers over just drinking alcohol or just smoking alone. The interactions of different chemicals with alcohol in the body can produce significantly enhanced toxic effects. It does not matter if one drinks beer, wine, or liquor.
- Heavy use of alcohol results in an individual’s system being unable to absorb nutrients, and this can lead to an increased risk for a number of diseases and disorders.
- Heavy use of alcohol is associated with different alterations in hormonal levels that can increase the risk for cancer and other disorders.
- Such use is also associated with significant damage to organs and tissues that can lead to an increased risk for the development of many different diseases and disorders.
- The positive relationship between alcohol use and obesity indicates that individuals who binge drink repeatedly are at risk for the development of diseases and disorders that are associated with obesity, such as diabetes, heart disease, stroke, cancer, etc.
What the Research Findings Mean
Findings relating alcohol use to certain diseases, disorders, and other conditions in humans involve correlational research. This means that there is a strong association between alcohol use and these conditions; however, it cannot be used to make a statement that alcohol use alone, even heavy alcohol use alone, causes> any of these conditions to occur. Alcohol use increases the risk, often vary significantly, that one will develop one or more of these issues. Animal research studies can be used to determine causal relations between heavy alcohol use and the development of certain diseases; however, as strong as animal studies are, they are not directly applicable to studies with humans due to a number of differences in the physiology of the animals used in research studies as well as behavioral differences between animals and people.
Despite the fact that only correlational studies can be performed by humans, the above relationships are real relationships. If one engages in prolonged heavy alcohol use, it is highly likely that they will suffer one or more negative ramifications physically, mentally, and socially as a result of such use compared to individuals who do not use alcohol or drugs. However, even individuals who have never smoked a single cigarette sometimes develop lung cancer. Thus, other factors interact with heavy alcohol use to increase the risk of developing any specific disorder or disease.
Heavy alcohol use is neither necessary nor is it sufficient to develop an alcohol use disorder, to develop any number of physical or mental issues associated with alcohol use, or to develop any number of social problems associated with alcohol use. However, individuals who engage in binge drinking behaviors on a repeated basis are highly more likely to develop issues than individuals who do not drink at all or who drink alcohol moderately.
Heavy alcohol use interacts with a number of other personal factors that result in specific types of outcomes. These include genetic factors, personal experiences, chance factors, and the interaction of all of these. The best way to reduce the risk that one will suffer negative factors associated with use of alcohol is to simply not consume alcohol. A person cannot control their genetic makeup, many of the things that occur in one’s life chance, or many of the events that occur in life; however, they can control how much alcohol they choose to drink, at least until an addiction has taken hold.
Finally, the best predictor of future behavior is past behavior. People who repeatedly binge drink in college are far more likely to drink alcohol heavily as they get older. However, most people can choose to try and cut down on their drinking or to get help if they need to cut down on their drinking and are unable to do so without assistance.
Signs of Binge Drinking
Many individuals fail to recognize the serious nature of repetitive binge drinking. It is very easy for most people to rationalize any behavior as being “normal for them” even though they may view it as not being normal for other people. Many times, people need to step outside of their own subjective interpretation of events and view their behavior as if they were looking at it from someone else’s perspective.
- Only drinking heavily on weekends: It is often easy to recognize that a person has a problem with alcohol when they are drinking more than five drinks a day three or more days a week. However, many individuals wrongly believe that people who have substance use disorders engage in some form of substance abuse every day, which is simply not true. A major warning sign that one is a heavy drinker is binge drinking on the weekends. College students often feel that it is their “right” to drink heavily on weekends. While occasionally partying is not harmful, consistently binge drinking on weekends is a sign that one is engaging in potentially detrimental behavior. It is important to remember that the formal definition of heavy drinking is drinking five or more drinks on one occasion five days out of the month.
- Frequently engaging in increased risk-taking behaviors or experiencing a loss of inhibitions when drinking: Those who engage in repetitive binge drinking often engage in a number of behaviors that are uncharacteristic for them when sober.
- Continually drinking more than originally planned: Many times, individuals begin drinking alcohol with the intention of only having one or two drinks, but by the end of the night, they have “closed the bar.” The repeated behavior of not being able to stick to personal limits regarding use of alcohol or drugs is also a diagnostic sign of a potential substance use disorder.
- Memory lapses associated with binge drinking: Those who experience frequent blackouts associated with binge drinking are developing severe alcohol abuse problems. Blackouts are a significant clinical sign that something is wrong; however, they are also a significant risk factor that an individual will engage in potentially dangerous or risky behaviors.
- Failing to meet certain responsibilities as a result of drinking too much: When an individual cannot attend to their normal routine as a result of a hangover or some other complication associated with drinking, they are developing a severe problem.
- Family, friends, or others commenting that alcohol is causing problems for the person: One of the common observations by individuals who are in treatment for substance use disorders is the observation that other people saw there was a problem before they realized they had one.
A surprising number of college students report binge drinking behaviors. There is a fine line between occasional binge drinking and the development of a substance use disorder. Even the ramifications of a single evening of binge drinking can be life-changing. Repetitive binge drinking leads to an increased potential for a number of serious issues that can include irreversible physical, emotional, and social effects.
To avoid issues associated with binge drinking in college, it is important to understand what binge drinking is, what heavy alcohol use is, and how both of these relate to potential alcohol abuse problems. It is always important to remain objective regarding one’s behavior and to be open and listen to others when they express concern about one’s use of alcohol or any other substance.