Binge Drinking

Most alcohol treatment clinicians use the term binge drinking to mean a drinking spree that lasts several days—an episode known colloquially as a “bender.” Such drinking is often a diagnostic sign of alcoholism or severe alcohol dependence.

In recent years, medical and public health researchers have defined binge drinking more broadly as the consumption of five or more alcoholic drinks on a single occasion. Some researchers specify a threshold of four or more drinks for women, who typically experience alcohol-related problems at lower consumption levels.

Researchers classify a person as a binge drinker if that individual has five or more (or four or more) drinks at least once during a particular time period, typically pegged at 2 weeks or a month. Critics call this research definition too expansive, especially in light of its pejorative connotations. One problem is that the definition fails to differentiate between a true bender and lower levels of heavy alcohol use, which can lead to public misunderstanding when news headlines proclaim binge drinking rates.

In addition, the definition does not account for the drinker's body weight, the pace of alcohol consumption, or whether food is eaten at the same time. As a result, a man of 240 pounds who had one drink per hour would still be labeled a binge drinker even though his blood alcohol concentration (BAC) would remain below high-risk levels commonly associated with mental and physical impairment.

Accordingly, in 2004, the National Institute on Alcohol Abuse and Alcoholism (NIAAA), a U.S. federal agency that sponsors alcohol research, redefined a binge as a pattern of drinking alcohol that brings BAC to .08 percent (i.e., .08 gram of alcohol per 100 grams of blood) or above. This level was chosen because all 50 U.S. states have laws that define a BAC of .08 percent or higher as impaired driving. For the typical adult, a binge would result from consuming five or more drinks (male), or four or more drinks (female), in about 2 hours. NIAAA also distinguished binge drinking from both risky drinking, which involves reaching a peak BAC between .05 percent and .08 percent, and a bender, which involves 2 or more days of sustained heavy drinking.

Although the NIAAA definition is more precise, researchers have not yet embraced it, in part because of its complexity but primarily to ensure that their research can be compared with prior studies. Growing numbers of researchers no longer use the term binge drinking when describing alcohol use that merely exceeds the five-drink (or four-drink) threshold, but no alternative term has taken its place. The Journal of Studies on Alcohol, a leading periodical in the field, requires authors to use the term heavy, episodic drinking, but this is too cumbersome for everyday use. In this entry the phrase heavy drinking is used.

The Behavioral Risk Factor Surveillance System (BRFSS), a health survey organized and supported by the U.S. Centers for Disease Control and Prevention (CDC), defines heavy (binge) drinking as having five or more drinks on at least one occasion in the preceding month. The BRFSS for 2001 found that an estimated 14 percent of U.S. adults 18 years and older (22 percent of men, 7 percent of women) engaged in heavy drinking.

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