Substance abuse and addiction in the US is a widespread issue. It can happen to any person, from any family, anywhere and at any time. When it comes to alcohol, problem drinking can be tough to spot because it is misunderstood. Alcohol use is legal in the US and it is a large part of social life, so often the line between casual drinking and addiction to alcohol can be a bit blurry. Binge drinking is a common practice in American culture, but it can be extremely dangerous.

What is Binge Drinking?

A standard drink in the US has 0.6 ounces of pure alcohol. Typically, this amount of alcohol is found in:

• 12-ounces of beer
• 8-ounces of malt liquor
• 5 ounces of wine
• 1.5 ounces of 80 proof distilled spirits or liquors like gin, rum, whiskey or vodka

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as a pattern of alcohol consumption that brings a person’s blood alcohol concentration to 0.08 g/dl (grams per deciliter) or higher. This usually happens when men consume five or more drinks or women consume four or more drinks in within a two-hour timeframe. The majority of people who binge drink are not alcohol dependent. According to the 2015 National Survey on Drug Use and Health, almost 27% adults in the US ages 18 or reported that they engaged in binge drinking in the previous month, while 7% reported that they engaged in heavy alcohol use in the past month. Both of these types of drinking habits are classified as “binge drinking and heavy alcohol use” by the NIAAA. The Centers for Disease Control and Prevention 2015 Youth Risk Behavior Survey and Behavioral Risk Factor Surveillance System reports the following binge drinking facts and statistics:

• One in six adults in the US binge drinks around four times each month and consumes around seven drinks per binge period. Added up, this equals 17 billion total binge drinks consumed by adults each year, or 467 binge drinks per binge drinker.
• Younger adults between the ages of 18 and 34 are the most likely to engage in binge drinking, but more than 50% of total binge drinks are consumed by people 35 and older.
• Men are more likely to binge drink than women are, with 80% of all binge drinks consumed by men.
• People with higher levels of education who have household incomes of $75,000 or more are the most likely to binge drink, but people outside of that education and income bracket consume more binge drinks per year.
• More than nine in every 10 adults who drink excessively report binge drinking in the previous 30 days.
• People younger than 21 who drink alcohol say they binge drink often, typically on multiple occasions.

Importantly, binge drinking is not the same thing as heavy drinking. NIAAA defines heavy drinking as consuming:

• 8 or more drinks per week in women
• 15 or more drinks per week in men

Why Do People Binge Drink?

As mentioned, binge drinking is a common, and often celebrated, part of American culture. Everyone else is doing it, so the pressure to partake is always there. Here are a few of the most common reason why people binge drink: Fun and entertainment. Fun is the most common reason why people binge drink. It allows them to relax, feel free and let go of inhibitions. Binge drinking is very common at parties. Peer pressure. People, especially younger people, cite peer pressure as one of the main reasons why the binge drink. Many high school and college-age people use alcohol to be social, and so it is easy to think alcohol can make you more popular or desirable – two things younger people feel they need to be. Social confidence. People who are naturally introverted or socially awkward may feel like they need to binge drink in order to let them loosen up and fit in during social situations. They say it helps them feel like they are part of the crowd. Rebellion. Younger people may feel as though binge drinking is a good way to rebel against their parents. They may use it as a threat against their parents, or they could binge drink to show how “adult” and independent they are. Feelings of superiority or dominance. Some men may binge drink in order to appear “manly.” Good examples of this behavior include drinking contests, getting into fights or any other physical altercation while drunk. Forgetting problems. People may turn to alcohol to forget about the stresses of their everyday life. This is a common occurrence, but doing it habitually is symptom of a deeper psychosocial issue. Binge drinking as a coping mechanism can ultimately lead to physical dependence In some cases, a co-occurring mental health issue could be compounding the excessive drinking issue. This is a “dual diagnosis,” and common co-occurring disorders include:

• Anxiety disorders
• Moderate to severe depression
• Personality disorders like antisocial personality disorder or borderline personality disorder
• Mood disorders
• Schizophrenia

Excessive Alcohol Abuse: Signs and Symptoms

People may interchange the terms “binge drinking” and “alcoholism” to describe their habits, but they are not the same thing. The major difference between binge drinking and alcoholism is severity of symptoms. Alcoholism is defined as a dependency on alcohol, having strong cravings for alcohol and an inability to stop drinking despite physical or social problems. These behaviors have to be repeated in order to receive a diagnosis for alcoholism. Alcohol Use Disorder (AUD) in the United States is pervasive. Data collected by NIAAA show that 6.8% of American adults, or approximately 16.3 million people, were classified as having an AUD in 2014. Going further, NIAAA reports that 2.7% of all adolescents between the ages of 12 and 17, or almost 680,000 people, had an AUD during the same year. Unfortunately, fewer than 10% of adults who needed treatment at a specialized facility for their AUD actually received that treatment, while just 55,000 adolescents classified as having an AUD received treatment for their alcoholism at a specialized facility. If you suspect someone in your life may have an AUD, you should watch for the following signs and symptoms of alcoholism:

• A marked change in mood, motivation level or overall attitude even when not drinking
• Drinking early in the morning
• Talking about alcohol cravings
• Hiding bottles or drinking in secret
• Episodes of binge drinking
• Dangerous behavior, including drinking and driving, getting into fights, having unprotected sex or putting themselves or others into risky situations
• Lack of impulse control
• Inability to quit despite trying

Certain levels of alcohol are safe for consumption, but there are people who should not be drinking any alcohol, including:

• People younger than 21
• People who are pregnant
• People who need to be driving anywhere or otherwise need to participate in any activity that requires coordination, skill or alertness
• People who take certain prescription or over-the-counter medications than can interact with alcohol, including antibiotics, antidepressants or pain medication
• Recovering alcoholics

What Are the Consequences of Binge Drinking?

The consequences of drinking extend beyond just waking up with a wicked hangover. Binge drinking produces dramatic increases in BAC, which can have physical effects. Short-term effects of binge drinking can include:

• Poor balance and coordination
• Nausea
• Dehydration
• Vomiting
• Hangover
• Shakiness
• Loss of consciousness
• Poor decision-making and excessive risk taking, such as having unprotected sex
• Memory loss

For some people, binge drinking goes beyond the party. Repeated episodes of binge drinking can cause long-term negative health consequences, including: Alcoholism. A physical dependence could form if binge drinking occurs frequently. Higher tolerance and physical dependence can occur without necessarily having an addiction, but a psychological dependence on alcohol is likely to develop. Going to be rehabilitation facility is often the best way to treat alcoholism. Brain health. Unfortunately, some people who engage in binge drinking behaviors for a prolonged period can suffer from brain damage due to structural damage. The parts of the brain responsible for learning and decision-making are especially vulnerable to this type of damage. Ultimately, this damage can work against AUD recovery in the future. Liver health. Most people know that drinking too much can affect healthy function of the liver, and binge drinking is no exception. Cardiovascular health. Having a high BAC and alcohol in the system can put stress on the heart. If binge drinking continues for an extended period, you could face an increased risk for heart attack and/or stroke.