Binge drinking

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.

Stolle, Sack and Thomasius define binge drinking as episodic excessive drinking. There is currently no worldwide consensus on how many drinks constitute a "binge", but in the United States, the term has been described in academic research to mean consuming five or more standard drinks (male), or four or more drinks (female), over a two-hour period. In 2015, the US Centers for Disease Control and Prevention, citing the National Institute on Alcohol Abuse and Alcoholism, defines binge drinking as "a pattern of drinking that brings a person's blood alcohol concentration (BAC) to 0.08 percent or above. This typically happens when men consume five or more drinks, and when women consume four or more drinks, in about two hours." and estimated that about 16% of American adults met these criteria at least four times per month. One 2001 definition from the publication Psychology of Addictive Behavior states that five drinks for men and four drinks for women must be consumed on one occasion at least once in a two-week period for it to be classed as binge drinking. This is colloquially known as the "5/4 definition", and depending on the source, the timeframe can vary.

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.