Binge drinking

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

File:Glass of beer Australia Day 2005.jpg

Drinking too much alcohol may qualify as binge drinking if it leads to at least two days of inebriation and the drinker neglects usual responsibilities

The British Medical Association states that "there is no consensus on the definition of binge drinking. In the past, 'binge drinking' was often used to refer to an extended period of time, usually two days or more, during which a person repeatedly drank to intoxication, giving up usual activities." The Journal of Studies on Alcohol defines binge drinking as an extended period, typically at least two days, during which time a person repeatedly becomes intoxicated and gives up usual activities and obligations in order to be intoxicated. Authors are required to restrict the use of the term to be consistent with that definition in papers it publishes. The International Center for Alcohol Policies says that diverse definitions of binge drinking exist. "Within the field of epidemiology, for example, there is disparity regarding the amount of alcohol that needs to be consumed in order to be drunk. One of the commonly used thresholds for 'binge' drinking is 5 or more drinks for men and 4 or more for women per occasion. Over some objection, this definition has gained a foothold within the social sciences literature and has influenced media reporting of drinking behavior."

The British Medical Association concludes that "in common usage, binge drinking is now usually used to refer to heavy drinking over an evening or similar time span - sometimes also referred to as heavy episodic drinking. Binge drinking is often associated with drinking with the intention of becoming intoxicated and, sometimes, with drinking in large groups." It is sometimes associated with physical or social harm.

Prevalence of binge drinking

Australia

A culture of binge drinking is prevalent among many communities, for example at high schools, universities, at parties, amongst some Aboriginal groups and in sporting clubs. Those who are able to consume large amounts of alcohol are often held in high regard by their peers. Binge drinking and getting drunk to a point of complete loss of control may not only be accepted but encouraged. Drinking to this extent often begins, in a minority of social circles, at as young as 13 and 14, and may be very widely practised and accepted by some by age 16 or 17, where teens are found to drink up a carton of beam a night for 8 days straight. This is arguably the main cause of binge drinking in Australia; it is passed off by the some of younger generation as "being Australian" and is seen as a perfectly normal cultural practice for some.

Europe

In Europe, youngsters routinely experience alcohol much earlier than in America, and often with parental approval and supervision. The drinking age in most countries is 18, and in many jurisdictions younger people can purchase certain types of alcohol in certain settings, such as in a restaurant with a parent. Parents may also choose to provide beverages such as diluted wine or beer mixed with lemonade (shandy or Lager Top) with a meal to encourage responsible consumption of alcohol. For example the legal age for drinking and buying beer in Denmark, Switzerland, Germany, Portugal, Austria, Belgium and The Netherlands is 16 years of age. It is generally perceived that binge drinking is most prevalent in the "vodka belt" and least common in the southern part of the continent, in Italy, France, and the Mediterranean. A notable exception is the Mediterranean island of Malta which has adopted the British culture of binge drinking, and where teenagers, often still in their early teens, are able to buy alcohol and drink it in the streets of the main club district, due to a lack of police enforcement of the legal drinking age of 16.

Russia

Binge drinking in Russia ("Zapoy" ("Запой") in Russian), often takes the form of two or more days of continuous drunkenness. Almost half of working-age men in Russia who die are killed by alcohol abuse.

Spain

Since the mid 1990s the botellón has been growing in popularity among young people. This can be considered a case of binge drinking since most people that attend it consume three to five drinks in less than five hours.

United Kingdom

In most European nations, binge drinking is usually seen to be less of a problem than it is in the United States. However, in the UK some areas of the media are spending a great deal of time reporting on what they see as a social ill that is becoming more prevalent as time passes. In 2003, the cost of binge drinking was estimated as £20 billion. In response, the government has introduced measures to deter disorderly behavior and sales of alcohol to people under 18, with special provisions in place during the holiday season. In January 2005, it was reported that one million admissions to UK accident and emergency units each year are alcohol-related; in many cities, Friday and Saturday nights are by far the busiest periods for ambulance services.

In 2005, the Licensing Act 2003 came into effect in the UK, partly intended to tackle binge drinking. Some observers, however, believe it will exacerbate the problem, especially with the advent of 24 hour licensing.

The culture of drinking in the UK is markedly different from that of some other European nations. In mainland Europe, alcohol tends to be consumed more slowly over the course of an evening, often accompanied by a restaurant meal. In the UK, by contrast, alcohol is generally consumed rapidly, leading much more readily to drunkenness. While being drunk in mainland Europe is widely viewed as being socially unacceptable, in the UK the reverse is true in many social circles. Particularly amongst young adults, there is often a certain degree of social pressure to get drunk during a night out. This culture is increasingly becoming viewed by politicians and the media as a serious problem that ought to be tackled, partly due to health reasons, but mostly due to its association with violence and anti-social behaviour. The impression is often given that drinking in this way automatically leads to such behaviour, which, in fairness, is not actually the case for most UK drinkers.

Binge drinking in the UK is commonly linked to football hooliganism.

The British TV channel Granada produces a program called Booze Britain, which documents the binge drinking culture by following groups of young adults.

A popular 'definition' of binge drinking in the UK is the consumption of 50% or more of the recommended maximum weekly number of units of alcohol in 'one session', e.g. one night out. Thus, for a male the consumption of 4 pints of 5% ABV beer/lager would constitute 'binge drinking' (11.36 units of alcohol out of a maximum weekly total of 21), and for a female the consumption of 3 large glasses of white wine (e.g. Sauvignon Blanc at 12% ABV) would again be classified as binge drinking (9 units out of 14).

New Zealand

Concerns over binge drinking by teenagers has led to a review of liquor advertising being announced by the New Zealand government in January 2006. The review will consider regulation of sport sponsorship by liquor companies, which at present is commonplace. Previously the drinking age in New Zealand was 20, then dropped to 18 a few years ago. Deemed to be a wise move at the time, due mainly to the argument that at 18 an individual can do all other adult activities. ie. Serve in war, vote, marry etc. At the time of the age-lowering, the Police were found to strictly enforce the on-license (bar, restaurant) code for underage-drinking. This led to a period of many of New Zealand's youth getting strangers to purchase high alcohol content beverages for them. eg. Cheap vodka or rum. A propensity to consume an entire bottle of spirits developed and led to an instant increase in the amount of youths under 18 being admitted to A&E hospitals. The New Zealand health service classifies Binge Drinking as anytime a person consumes 8 or more beverages in a sitting.

South Africa

In South Africa a large percentage of the population between the ages of 18 - 35 engage in binge drinking. Most recently the isiZulu word 'Phuza' (directly translated as Drink) has been adopted by many so-called binge drinkers to describe the well publicised 'Phuza Thursday'. This term was introduced by the breakfast show team of 5FM a national radio station. If suffering visibly from the after effects of binge drinking, one is said to have a 'Phuza Face. 'Phuza Face' and 'babelaas' are colloquialisms of the term 'hangover....

United States

College students are sometimes characterized as having a propensity to binge-drink (under the 5/4 definition), despite the fact that the U.S. drinking age is 21. According to the 5/4 definition, a binge drinker is a man who consumes at least five alcoholic drinks in under four hours or a woman who consumes at least four alcoholic drinks on an occasion of unspecified duration. Common stereotypical participants include athletes and fraternity/sorority members, particularly after final examinations, sporting events, during Balls-Out-Thursday, and during spring break, where there are generally no rules enforced, and men and women imbibe large amounts of alcohol, causing inebriation. College-age binge drinking is frequently not confined to the evening or nighttime hours.

One common explanation of this alleged propensity for so-called binge drinking (5/4 definition) is that many college students are living on their own for the first time, free of parental supervision, among peers, especially those of the opposite sex.

Some people argue [2] that binge drinking happens in the U.S. not in spite of the strict underage drinking laws, but rather because of it. Proponents of a lower drinking age argue that strict drinking laws drive underage drinkers underground, instead of in a licensed establishment where they will be better supervised and under less pressure to binge. Proponents of the drinking age at 21 dismiss such arguments, citing the significant drop in morbidity and mortality that followed the increased drinking age from state to state, and argue that underage drinking should be curtailed through strict enforcement of the laws against it. Others point out that morbidity and mortality also decreased among those age 21 and above and was not caused by the drop in legal purchase/possession age.

The U.S. region where binge-drinking is most prevalent is the Upper Midwest (Wisconsin,Colorado,Iowa, Minnesota, Nebraska, North Dakota, South Dakota, and Wyoming) where the 2002-2003 National Survey on Drug Use and Health http://www.oas.samhsa.gov/2k3State/ch3.htm#fig3.5 estimated that between 25--31% of residents ages 12 and older had engaged in binge drinking, using the 5/4 definition instead of the clinically-recognized definition, at least once in the last 30 days. The survey found that the lowest binge-drinking rate in the U.S. was in Utah; this is attributed in part to the large LDS (Mormon) population there and some restrictive state laws.

Research in the United States has found that "a sizable percentage of young adults…who would be labeled as 'binge drinkers'… actually do not reach estimated maximum BAC levels that public health experts associate with impairment"..

Almost 40% of college and university students are reported to be "bingers", based on the 5/4 definition. Colleges that place great emphasis on sports, especially football, have generally found larger instances of binge drinking.

Religious positions

The stigma against alcohol consumption is a relatively new phenomena mainly within the past hundred years, with exception to Muslims. As of right now, the three major religions that are against consumption of alcohol are Islam, the L.D.S. Church and, to an extent, American Protestantism. Under most Christian denominations, however, drinking the amount of alcohol that would constitute binge drinking would likely fall into a sin of gluttony, thereby implicitly, if not explicitly considered sinful. Most other religions do not take a stance on alcohol, but, like the aforementioned, do take a stance on losing control of oneself while under the influence.

Further reading

• MacLachlan, Malcolm and Smyth, Caroline (eds)Binge Drinking And Youth Culture Liffey Press (October 15, 2004) ISBN 1-90414-842-5
• Wechsler, Henry and Wuethrich, Bernice Dying to Drink: Confronting Binge Drinking on College Campuses Rodale Books (August 17, 2002) ISBN 1-57954-583-1

References

• National Institute on Alcohol Abuse and alcoholism. Alcohol Tolerance (Alcohol Alert number 31 from NIAA). Washington, DC: National Institute on Alcohol Abuse and Alcoholism, 1996.