When Does Binge Drinking Become a Problem?

Binge drinking refers to the consumption of a significant amount of alcohol in a single setting.

The amount of alcohol one consumes in order to qualify as a binge drinking episode is considered to be significantly more than one would normally consume in a similar timeframe. The formal criteria to objectively measure binge drinking episodes as put forth by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) are:

  • The consumption of four or more alcoholic drinks on the same occasion by females at least one day during the month
  • The consumption of five or more alcoholic drinks on the same occasion by males at least one day a month
  • The consumption of alcohol in a single timeframe that raises one’s blood alcohol concentration to a level of 0.08 at least one day a month (estimated for most females and males as being the number of drinks listed above)

The notion of a single timeframe or single occasion using the above definitions is typically considered to be having these drinks within a few hours of each other. There is no formal binge drinking disorder identified by the American Psychiatric Association (APA) in the same way that binge eating disorder is classified as a mental health disorder. At the current time, binge drinking simply refers to a specific behavior that can be a risk factor for the development of issues with alcohol use.

Heavy alcohol users are considered to be individuals who binge drink five or more times during a month.

The Stages of AddictionBased on the above specifications, it is most likely safe to assume that the majority of individuals who consume alcohol have engaged in binge drinking at one time or another. Because of the potential issues with judgment that occur with moderate to heavy alcohol use, any instance of binge drinking can be problematic. For instance, an individual who is legally intoxicated is significantly more prone to issues with poor decision-making, loss of emotional control, and at a greater risk to be involved in accidents than individuals who are not legally intoxicated.

The bigger issue occurs with individuals who habitually engage in binge drinking behavior. Any individual who engages in regular binge drinking will most likely fall into the heavy drinking category. Heavy drinkers are at a significantly higher risk to develop an alcohol use disorder than individuals who drink occasionally. While binge drinking is neither a necessary nor sufficient condition for an individual to receive a diagnosis of an alcohol use disorder, habitual binge drinkers are far more likely to have an alcohol use disorder diagnosis than individuals who do not engage in binge drinking. However, there is no specified amount of alcohol consumption that is formally deemed as being necessary to be diagnosed with an alcohol use disorder. Instead, the development of an alcohol use disorder is related to the effects of one’s alcohol use on their life, how their alcohol use affects their ability to function normally, and their ability to control their use of alcohol.

Both NIAAA and SAMHSA report that low-risk drinking behavior for men consists of 14 or fewer alcoholic drinks per week (and no more than four drinks on a single occasion), whereas low-risk drinking for women is identified as no more than three drinks on a single occasion and a total of seven or fewer alcoholic drinks per week. The data indicates that a very small percentage of individuals who drink at these levels or lower actually get diagnosed with alcohol use disorders (less than 2 percent) whereas over one-quarter of individuals who drink alcohol at rates beyond these levels are diagnosed with alcohol use disorders. Thus, repeated binge drinking is a risk for the development of issues with alcohol abuse and even a formal alcohol use disorder diagnosis.

Binge drinking behaviors typically begin in late adolescence or early adulthood (often in college). Those who continue to binge drink are more likely to become heavy drinkers and to develop issues with alcohol abuse or alcohol use disorders.

Alcohol use is associated with numerous physical and emotional issues. The negative ramifications associated with alcohol use are related to the amount of alcohol that a person uses, not to the type of alcohol consumed. Thus, binge drinking on substances like wine or beer results in an increased potential for negative effects compared to the occasional use of liquor.

Because of powerful central nervous system stimulant effects and interaction with other substances, people who repeatedly binge drink are at an increased risk for:

  • Significant issues with poor performance at work, at school, or in other important activities/areas of life
  • Increased risk to be involved in accidents as a result of the effect of alcohol on physical and/or cognitive functioning
  • Relationship issues associated with being under the influence of alcohol or as a result of the effects of binge drinking in other areas of life
  • An increased risk to become involved in legal issues, risky behaviors, or to be a victim of a crime
  • Ab increased risk for the development of damage to the liver, such as cirrhosis
  • An increased risk to be diagnosed with numerous forms of cancer
  • An increased risk for renal issues
  • An increased risk for menstrual issues in women and impotence in men
  • An increased risk for cardiovascular disorders, such as high blood pressure, heart attack, stroke, etc.
  • An increased risk for the development of neurological issues, including nerve pain, movement disorders, and dementia
  • An increased probability that one will develop cognitive issues, such as problems with memory, attention, problem-solving, etc.
  • An increased risk for the development of a mental health issue, such as depression, bipolar disorder, psychotic disorders, issues with anxiety, etc.

What Binge Drinking Looks Like

People tend to rationalize their actions by looking for information that can make them exceptions to the rule or by only seeking out information that confirms what they already want to believe (known as confirmation bias). For instance, a person who binge drinks will look for potential benefits of alcohol use to rationalize drinking excessively. If an individual wants to determine whether or not they are binge drinking, whether they qualify as a heavy drinker, or whether they qualify as having an alcohol use disorder, the person needs to be objective regarding their actions.

Some of the signs that a person may be binge drinking are outlined below:

  • Ignoring the concerns of others: When other people begin to express concern regarding one’s use of alcohol, it is extremely important to be objective and to listen to them. Most often, individuals become defensive and attempt to rationalize their use of alcohol. The vast majority of individuals who eventually describe themselves as “alcoholics” often later recognize that their friends and family members had observed that they had a problem with alcohol long before they realized it themselves. Listen to the concerns of others.
  • Drinking excessively on weekends or holidays: Binge drinkers and heavy drinkers may not drink daily despite what many people believe. Instead, a major warning sign that one is a binge drinker or heavy drinker is that the individual drinks according to the above-mentioned criteria on the weekends and on specific holidays. Individuals often feel they can justify their use of alcohol during these times. When an individual says that they “only drink on weekends,” they are attempting to rationalize their behavior. Most individuals who do not have problems with their use of alcohol do not need to rationalize their use of alcohol.
  • Frequently drinking more alcohol than originally intended: This is a potential sign of binge drinking and also a sign that an individual may have an alcohol use disorder. When a person frequently begins drinking with the intention of only having one or two drinks and ends up drinking four, five, or more drinks, there may be a significant issue.
  • Engaging in risky behaviors when under the influence of alcohol: For example, the person may frequently gamble, get into physical altercations, drive a motor vehicle while under the influence, etc.
  • Not fulfilling certain obligations due to alcohol use: Individuals who are unable to go to work the day after a bingeing episode or who are unable to care for their children, keep their commitments, etc., may be displaying a significant issue with binge drinking or heavy alcohol use that can lead to an alcohol use disorder.
  • Having one or more memory lapses after drinking: Individuals who binge drink and drink heavily often have blackouts or issues with memory associated with their use of alcohol. Obviously, such a situation can result in significant problems for the person.
  • Drinking alcohol and using other drugs/medications regularly: When an individual begins to mix drugs with alcohol, this condition is a significant sign that there is a potential problem that needs to be addressed. Often, individuals who mix drugs and alcohol frequently lose track of how much alcohol they consume.

Individuals who recognize that they have a problem relatively early are better prepared to address their issues. As it turns out, a good percentage of individuals who binge drink begin as teenagers or young adults.

For some individuals who do not address the problem, these behaviors may continue into adulthood. Individuals who have a history of binge drinking early are at a significantly increased risk to develop severe alcohol use disorders that can lead to permanent physical, emotional, and social ramifications.

What to Do?

Even though there is no formal diagnosable “binge drinking disorder,” major organizations that collect data on substance abuse and are involved in the diagnosis and treatment of substance use disorders recognize that repeated binge drinking is a precursor to serious issues with alcohol. If one suspects that they are frequently binge drinking, it is extremely important to consult with a licensed mental health professional who specializes in addictive behaviors regarding their use of alcohol. A mental health professional can perform a formal assessment of the individual and then make recommendations regarding how the person should proceed.

Individuals who develop issues with problematic use of drugs and alcohol require professional assistance and support. There is no shame in asking for assistance, and seeking help from others should not be viewed as a sign of weakness; instead, it should be viewed as a sign of strength that one is willing to accept their limitations and attempt to resolve their issues.

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