The hidden crisis of binge drinking

According to an article entitled, Binge Drinking Common Among Adults, “about one in every six U.S. adults binges on alcohol.”

According to the article, “binge drinking — defined as at least four drinks in one sitting for women and five drinks for men — carries substantial risks and high costs. It accounts for more than half of the estimated 80,000 annual deaths and three-quarters of the $223.5 billion in economic costs tied to excessive alcohol use.”

The article goes on to point out, “and the problem is even larger than these self-reported data indicate. Previous studies have shown that, based on alcohol sales, asking people to self-report drinking behavior captures less than one-third of presumed consumption.”

Not surprisingly, the article reports, “the rate of binge drinking was highest among 18-to-24-year-olds (28.2%), as was the intensity (9.3 drinks per occasion). Both figures decreased with age.  The frequency of binge drinking, however, was highest among respondents 65 and older (5.5 episodes per month).”

My patients prefer to call binge drinking by the more PC term, “social drinking.”  As part of assessing each patients risk for disease and injury, I ask questions about alcohol, tobacco, and other substance abuse during most visits.

Mr. X is a 24 year old college grad, employed full-time as an accountant.  He lives with his roommate in Chicago and is actively dating several young women.

Me:  Mr. X, do you drink alcohol?

Mr. X: Socially, on occasion.

Me: On which occasions?

Mr. X: On most weekends and occasionally during the work week.

Me: How much do you drink on the occasions you drink?

Mr. X: You know, a few on a weekday and a few more on weekends.

Me: Can you be a little more precise?  How many is a few?

Mr. X, again avoiding the truth: Maybe 4-5 a night during the week and more on the weekend.

This young man who only drinks socially, having a “few” drinks on an “occasion,” is really a binge drinker, something he learned in college.  The problem is twofold.  Number one, he has no idea he is a binge drinker and therefore is unaware of the risks of his drinking.

The second and larger problem is that his friends are also binge drinkers and also fail to recognize the risk of binging.  These are responsible young men and women.  They do not drink and drive, arriving and leaving by taxi.  If they drive, they have a designated driver who mostly refrains from drinking.

So, what’s the harm?  According to the article, binge drinking “accounts for more than half of the estimated 80,000 annual deaths and three-quarters of the $223.5 billion in economic costs tied to excessive alcohol use.”  Just think about that.  Up to 40,000 deaths are related to binging!

In my 30 years of practice, I have been unfortunate enough to watch young souls destroy themselves with a “few” drinks on an “occasion.”  I have heard all the excuses.

“Doc, haven’t young people always partied with alcohol?  Didn’t you?”  “I make a good living and work hard.  I deserve to be able to party on the weekend.”  “We are very responsible drinkers.”

I have also seen many “wild and crazy” youths grow into responsible sober adults and raise “wild and crazy” binge drinkers of their own.  How do you know which binge drinkers will go on to become alcoholics, or worse, die.  Therein lays the conundrum.

If you or your children or friends fit the definition of a binge drinker, stop.  Since there is no way of knowing if you are destined to be one of the 40,000 fatalities, avoiding binging seems to be your only sensible choice.  Remember, the life you save may be your own.

Stewart Segal is a family physician who blogs at Livewellthy.org.

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  • Robert McIlree

    What’s the difference between a binge drinker and a functional alcoholic?  Or for that matter, an alcoholic period? What’s the medical definition and cutoff, if any? If drinking in the quantity described in this post is ‘binge’ or ‘social’, I’d like to see the definition of ‘alcoholic’.

    • http://nonmaleficence.wordpress.com Nonmaleficence

      There is no medical definition of ‘alcoholic.’ Instead, the person will fall in to the category of either alcohol abuse or alcohol dependence (the criteria for each are too much to list here, you can find them listed at this link http://wp.me/p1QzS6-1z ). A ‘binge’ drinker is more likely to fall in to the category of ‘alcohol abuse’ be cause he/she demonstrates patterns of heavy drinking mixed in with days of no drinking at all. A ‘functional alcoholic’ is more likely to fall in to the category of ‘alcohol dependence’ since he/she is more likely to drink every day, thus becoming physiologically dependent on the drug (physiological dependence, meaning he/she has tolerance to increased amounts of alcohol and has withdrawal symptoms upon stopping the drug), In May of 2013 the DSM V will replace both ‘alcohol abuse’ and ‘alcohol dependence’ with a single diagnosis, Alcohol Use Disorder.

  • http://nonmaleficence.wordpress.com Nonmaleficence

    I think it’s great that you bring up this subject that seems to get ignored. I find that people don’t like to discuss it because it sheds light on their own drinking habits. And just like you wrote, there are a lot of people out there that ‘socially drink,’ not realizing (or denial) that they are actually binge drinking. Even people that fall in to the category of blatant alcohol dependence or alcohol abuse are in denial of the habits.

    Addiction is a nasty thing and it leads to many of the diseases that present to the doctor. Just look at the 65 y/o COPD patient that has smoked 3 pack per day for 30 years, or the type II diabetic that refuses to control their glucose. There is a whole list of diseases that are caused by one form of addiction or another.

    Anyways, it’s great to hear that you educate your patients and push them to try to change. The medical community needs more docs like you.

  • http://www.facebook.com/sewingstore Mary E Jensen

    I totally get it that “binge drinking” could lead to alcoholism, however, it could also NOT lead to alcoholism.  This is such a problem for I am guilty of having “partied” in my college years, yet rarely have an alcoholic beverage as an adult.  How do I tell my 25 year old niece to stop binge drinking because of the dangers, when in fact, I am guilty of same, and am not plagued by any of the dangers?

    • http://nonmaleficence.wordpress.com Nonmaleficence

      You’re right, and your niece probably won’t follow the path of alcoholism. For most of us, like you and I, it was just another part of growing up. Almost like a rite of passage. For others, it becomes a lifestyle that can’t be controlled and it ends up being a crutch to aid the lack of coping mechanisms.
      If you do decide to talk to her, then the most important things to remember are, honesty and education. Your niece is 25 years old and she is smart. She knows that you did the same thing, so don’t beat around the bush. Then talk to her about the dangers of alcohol and let her be honest about her drinking habits. Talking to you about it will make her cognizant of the fact that she is pushing her limits of abusing alcohol.

      You’re obviously concerned about it, otherwise you would have passed this article off. I hope it has helped in some way. Good luck!

      • http://www.facebook.com/sewingstore Mary E Jensen

        Very perceptive on your behalf, as to my concern.  Yes, the reason for my concern in the case of my niece is her family history.  Her mother is an alcoholic, putting her at a much higher risk.  We do have a very open relationship and I will feel comfortable sharing this information with her.  Thank you for your encouragement!  What concerns me is when does that “binge” drinker actually reach that point of addiction?  Does it have to be stopped completely now?  

        • http://nonmaleficence.wordpress.com Nonmaleficence

          “when does that “binge” drinker actually reach that point of addiction?”
          That’s such a hard question to answer because there are so many variables (denial, environment that she’s in, your concern that her mother drinks). If I was pushed to answer, I would say when the person isn’t able to control the habit. Simply, when they can’t say, ‘no,’ to having another drink (without peer pressure involved).
          Confronting her with the idea that it must be stopped right now will be abrasive and will push her in to denial. Just try to educate her while being non-judgmental. That’s why you already have such a great and open relationship with her, because you’re honest and non-judgmental.

          Best of luck! You sound like an amazing aunt and I hope the best for your niece.

  • Anonymous

    My thinking is “Alcohol Use Disorder” will cover a multitude of issues!!!!

    • http://nonmaleficence.wordpress.com Nonmaleficence

      I agree, missiedog1. They will all fall under ‘Substance Use Disorder,’ and the criteria will more or less fit for each drug being abused.

  • Anonymous

    The importance that I gleemed from the article, was how many questions were asked/needed prior to getting a partial answer. Please keep asking questions—-hopefully that is the first break in the patients denial. 

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