Basic Facts on Binge Drinking

​Binge drinking is a serious but preventable public health problem. Binge drinking is the most common, costly, and deadly pattern of excessive alcohol use in the United States. ​

Binge drinking is associated with risky behaviors, serious injuries, a number of diseases, substance misuse, and death. It is also associated with an increased risk of alcohol use disorder. 

Definition: The National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Substance Abuse and Mental Health Service Administration (SAMHSA) define binge drinking as drinking enough alcohol to have a blood alcohol concertation (BAC) equal to or above 0.08%. This translates into consuming 5 or more drinks for men or 4 or more drinks for women with a two-hour period. 

Frequency: In the US one in six adults binge drinks, with 25% consuming at least eight drinks during a binge occasion.4 Over 90% of US adults who drink excessively report binge drinking. In 2019, the National Survey on Drug Use and Health (NSDUH) reported that about 66 million, 24% of the US population (age 12 and over), reported binge drinking during the past month. Overall, 17 billion total binge drinks are consumed by adults annually, or 467 binge drinks per adult who binge drinks.

Who is at Risk? 

• Race: Whites
• Age: People younger than 21 who drink alcohol report binge drinking, often consuming large amounts. Among high school students who binge drink, 44% consumed eight or more drinks in a row. More than half of binge drinks are consumed by adults 35 and older. Frequency of binge drinking decreased with age. 10% of those 65+ bring drink once a month. 
• ​Sex: Two times more common among men than among women. Over the past decade the number of women who binge drink has been steadily increasing. 
• Education: Higher level of education is associated with more binge drinking.
• Income: Household incomes $75,000 or more is associated with more binge drinking.

Special groups at Risk:

• ​Women and girls
• Nearly 14 million women binge drink 3 times a month. 
• Women average 6 drinks when they binge drink. 20% of high school girls binge drink. 
• ​College Students
• Risk of alcohol misuse is a major concern among full-time college students. 
• This group tends to drink more than others in this age group. 
• In 2019, 53% of full-time college students drank alcohol in the past month. Of those, 33% reported binge drinking and 8% reported heavy drinking. By comparison, among same age non-college individuals, the percentages were 44%, 28%, and 6%, respectively.5 Many students may come to college with established drinking habits. 
• While substance misuse varies among fraternities and sororities across campuses, in general, membership in these groups is associated with increased rates of binge drinking and marijuana use.
• Historically, rates of drinking were higher among males compared to females. Currently, drinking among college males and females is changing. In, 2015, 59% of male college students drank alcohol in the past month, compared to 57% of females. But in 2019 data showed that the percent of males using alcohol each month was 51%, compared to 53% of females.10 However, rates of binge and heavy drinking by male students continues to exceed that of female students. In 2019, binge drinking was reported by 35% of male students and by 31% of female students. Heavy drinking was reported by 10% of males and 7% of females. From 2015 to 2019, more male students than female students ages 19 to 22 reported drinking 10 or more drinks in a row in a two-week period—19% compared to 6%, respectively. Males also reported greater rates of drinking 15 drinks in a row in a two-week period when compared to females— 4% compared to less than 1%, respectively.
• ​Teens and Preteens 
• Among 12th graders in 2019, 59% had already tried alcohol and 41% had been drunk at least once. 
• Among individuals 12–17-year-old 4.9% reported binge drinking. 
• Binge drinking during adolescence has a dramatic impact on brain development. Repeated episodes can alter brain development causing deflects in social, attention, memory, and other cognitive functions. 
• ​Older Adults (65+)
• Binge drinking is trending upward among the elderly population with over 10% reporting binged drinking. This behavior places them at increased risk due to interactions with medications and that greatly increases the risk of falls and other traumatic events. 

Risks Associated with Binge Drinking:

• Death - The Centers for Disease Control and Prevention estimates that over 50% of all deaths involving alcohol are caused by binge drinking. Over 95,000 deaths are related to alcohol with 46% associated with binge drinking. 
• Unintentional injuries - Motor vehicle accidents, falls, drowning, burns, and alcohol poisoning.
• Victim of violence - Homicide, intimate partner violence, and sexual assault.
• Self-Harm - Suicide. 
• Unsafe sexual behaviors - Unintended pregnancy and sexually transmitted disease
• Poor pregnancy outcomes - Miscarriage, stillbirth, and fetal alcohol spectrum disorders.
• Sudden infant death syndrome.
• Chronic diseases - Weight gain, high blood pressure, stroke, heart disease, and liver disease.
• Cancer - Breast (among females), liver, colon, rectum, mouth, pharynx, larynx, and esophagus.
• Memory and learning problems.
• Long term disorders-Alcohol use disorder. 
• Social isolation. 

Cost Associated with Binge Drinking:

Excessive drinking cost the US $249 billion dollars in 2010, or $2.05 per drink. Binge drinking accounted for 77% of these costs, or $191 billion. These costs include lost work productivity, health care expenditures, criminal justice costs, and other expenses. 

How do we prevent binge drinking?

The Community Preventive Services Task Force recommends evidence-based interventions to prevent binge drinking and related harms. Recommended strategies include:

• Using pricing strategies, including increasing alcohol taxes.
• Limiting the number of retail alcohol outlets in a given area.
• Holding alcohol retailers responsible for the harms caused by illegal alcohol sales to minors or intoxicated patrons (dram shop liability).
• Restricting access to alcohol by maintaining limits on the days and hours of alcohol retail sales.
• Consistently enforcing laws against underage drinking and alcohol-impaired driving.
• Maintaining government controls on alcohol sales (avoiding privatization).
  

The Task Force also recommends screening and counseling for alcohol misuse in primary care settings.

The NIAAA website, “NIAAA Rethinking Drinking” strategies to stop binge drinking, provides the following recommendations: 

• ​Keep Track of how much you drink. 
• ​Set Goals on how many days a week you want to drink and how many drinks you'll have on those days. 
• ​Avoid Triggers associated with drinking such as activities, places, and certain people. 

Summary:

 There is a significant difference between having a beer or two and consuming enough alcohol at to be over the legal limit within 2 hours. Binge drinking places individuals at increased short-term and long-term risks for injury, death, and disease. While anyone who engages in binge drinking is as risk, certain groups like women, college students, pre-teens, and the elderly represent individuals at increased risk. Fortunately, there are a number of evidence-based intervention programs and strategies targeting individuals with issues related to binge drinking. 

References 

1. Bohm MK, Liu Y, Esser MB, Mesnick JB, Lu H, Pan Y, Greenlund KJ. Binge drinking among adults by select characteristics and state — United States, 2018. MMWR 2021;70:41. doi: http://dx.doi.org/10.15585/mmwr.mm7041a2external icon​
2. Esser MB, Clayton H, Demissie Z, Kanny D, Brewer RD. Current and binge drinking among high school students – United States, 1991–2015. MMWR 2017;66:474-476.
3. Esser MB, Hedden SL, Kanny D, Brewer RD, Gfroerer JC, Naimi TS. Prevalence of alcohol dependence among US adult drinkers, 2009–2011. Prev Chronic Dis. 2014;11:140329.
4. Iyasu S, Randall LL, Welty TK, et al. Risk factors for sudden infant death syndrome among northern plains Indiansexternal icon. 2002;288(21):2717–2723.       ​
5. Jones CM, Clayton HB, Deputy NP, et al. Prescription opioid misuse and use of alcohol and other substances among high school students — Youth Risk Behavior Survey, United States, 2019external icon. MMWR Suppl 2020;69(Suppl-1):38–46.
6. Kanny D, Naimi TS, Liu Y, Lu H, Brewer RD. Annual total binge drinks consumed by U.S. adults, 2015external icon. Am J Prev Med 2018;54:486–496.
7. Iyasu S, Randall LL, Welty TK, et al. Risk factors for sudden infant death syndrome among northern plains Indiansexternal icon. 2002;288(21):2717–2723.       
8. Naimi TS, Lipscomb LE, Brewer RD, Colley BG. Binge drinking in the preconception period and the risk of unintended pregnancy: Implications for women and their childrenexternal icon. Pediatrics 2003;11(5):1136–1141.
9. Sacks JJ, Gonzales KR, Bouchery EE, Tomedi LE, Brewer RD. 2010 national and state costs of excessive alcohol consumptionexternal icon. Am J Prev Med. 2015;49(5):e73–e79.
10. Stahre M, Roeber J, Kanny D, Brewer RD, Zhang X. Contribution of excessive alcohol consumption to deaths and years of potential life lost in the United States. Prev Chronic Dis 2014;11:130293. ​
11. World Health Organization. Global Status Report on Alcohol and Health—2018external icon. Geneva, Switzerland: World Health Organization; 2018.

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