What is binge drinking?
Recent data from the Office for National Statistics (ONS) indicates that for some sectors of society sensible drinking guidelines have little relevance or meaning. In 1999, the ONS for the first time issued figures for “consumption on the heaviest drinking day in the last week”. Later figures showed that in 2001:
- 21% of men and 10% of women had drunk ‘heavily’, having consumed more than 8 units and 6 units respectively, on at least one day in the previous week.
- Young people are more inclined to this pattern of behaviour, with 39% of men and 24% of women in the 16-24 age group having drunk more than 8 and 6 units respectively, on at least one day in the previous week.
- Heavy episodic drinking is a noticeable feature of people’s social lives in the United Kingdom and is sufficiently worrying for the Government to highlight it as a key issue in its forthcoming National Alcohol Harm Reduction Strategy in 2004.
- Binge drinking can be defined as drinking eight or more units for men and six or more units for on at least one day in the week
- Studies show an association between binge drinking and cardiovascular disease
- The behavioural effects of binge drinking can include: involvement in accidents and violence, poor social behaviour and unsafe sex
- For a significant proportion of young people binge drinking is not simply a youthful phase but a possible precursor of later, harmful drinking behaviour.
One difficulty faced by the DoH, researchers and others in the broader alcohol field is the lack of consensus on the definition of the term ‘binge drinking’. A 1997 report for the US based International Center for Alcohol Policies (ICAP) points to the lack of formal definitions both at international level and amongst studies undertaken within individual countries. Two recent publications define ‘binge drinking’ as ‘ten or more drinks in one session’ (based on one drink as a standardised unit of 7.9g of ethanol) or alternatively drinking over half the recommended number of units for a week in one session (based on previous Government guidelines) i.e. ten units for men and seven units for women. Neither of these publications provides a rationale for their stated definition and a review of the literature on this subject indicates that researchers tend to employ the most commonly used definition from previous works without giving an accompanying explanation. The editors of Tackling Alcohol Together assert that it is difficult to assess the risks of problems or harm arising from the volume of alcohol consumption alone as ‘numerous factors – including personality, mood, sex, level of tolerance to alcohol, and the physical, social and cultural context in which alcohol is consumed – can magnify or diminish the effects of alcohol.’
Analyses of the prevalence and character of binge drinking across the UK population are scarce. British drinkers are usually characterised, in common with those from other north European countries as ‘episodic drinkers’ but this does not necessarily imply binge drinking.
British drinkers are usually characterised as being heavy episodic drinkers in common with those from other northern European countries. This does not necessarily imply binge drinking but it is more prevalent in the UK than in other countries:
- In the UK binge drinking accounts for 40% of all drinking with 36% of men reporting and 27% of women binge drinking at least once a week
- Between 1998 and 2001 the proportion of young women binge drinking in this age group has increased from 23% to 27%.
However,
- For some people, this type of drinking continues into middle age with around one in three men, one in five women drinking twice daily limits at least once a week.
There have been few detailed studies of this type of drinking in the community. A 1993 survey of drinking patterns in nine Welsh health districts extended beyond young people and students and showed that 28.% of men and 8.2% of women reported binge drinking (over half the weekly recommended units on one occasion) at least weekly. Binge drinking was not confined to those drinking consistently at risky or harmful levels and not all those drinking at harmful levels engaged in binge drinking. The study also looked into the effect of demographic variables such as occupation, marital status and educational attainment and established a clear link between binge drinking and other types of health behaviour. For example, binge drinking was more prevalent among those who smoked regularly (33.4%) and those classified as being overweight (24%).
Published results from this type of study in UK are rare and if the DoH plans to tackle binge drinking it will need to establish a much clearer, up-to-date picture of its prevalence, what distinguishes it from common episodic drinking, e.g. during weekend socialising, and the demographic variables that influence drinking patterns.
Certain individuals are more vulnerable to the adverse effects of binge or RSOD as shown in research into the following areas:
- the effect of heavy episodic drinking on pregnant women. UK Government guidelines recommend a limit of four units of alcohol per week for pregnant women, a limit of two units on any one occasion and avoidance of intoxication. Research indicates that blood alcohol level rather than dose is ‘critical in determining effects from prenatal exposure’ on the physical and mental development of the foetus so ‘drinking five units per occasion once or twice a week probably has a greater impact than the same amount consumed over a longer period.’ Given the continuing international debate surrounding the issue of safe limits for pregnant women, the question of what constitutes a ‘binge’ for pregnant women remains unsolved. However, it is dear that intoxication is to be avoided, both for its effects on the foetus and as a potential cause of accidents.
- the link between alcohol misuse and mental illness. While it is difficult to establish causality in cases of morbidity, it is clear that there is a strong association between heavy drinking, depression and suicide. Studies in the UK show that 39% of men and 8% of women who attempted suicide were chronic problem drinkers. Alcohol had been consumed before 70% of attempted suicides by men and 40% of attempted suicides by women.
