Heavy Episodic Consumption of Alcohol

Understanding Alcohol Consumption

The term alcohol consumption encompasses two ideas important in characterizing an individual's drinking behavior: frequency (how often a person drinks) and quantity (how much a person drinks). Frequency of consumption refers to the number of days or, sometimes, occasions that an individual has consumed alcoholic beverages during a specified interval (e.g., week, month, and year). Quantity of consumption refers to the amount ingested on a given drinking occasion.

Most typically, consumption is assessed using "standard drinks"—in the United States, these are 5 ounces of wine, 12 ounces of beer, or 1.25 ounces of distilled spirits. Because individuals do not drink the same amount at every drinking occasion, some surveys attempt to assess the frequency with which a person drinks various amounts of alcohol (e.g., one to two drinks, three to four drinks, five to six drinks) over a specified period of time. Although cumbersome, this approach probably provides a fairly accurate assessment of total volume consumed and of variability in drinking pattern.

For many purposes, however, identifying "light" or "moderate" consumption is not the issue, "heavy" consumption is. For that reason, it is common to assess heavy consumption on the basis of the frequency of consuming a number of drinks meeting or exceeding a certain threshold. When describing college drinking, heavy drinking occasions are often referred to as "binges." Based on the influential work of Henry Wechsler and colleagues—who define binge as five or more drinks in a row for men and four or more drinks for women—the prevalence of binge drinking has become a key measure in estimating the extent of alcohol problems on college campuses.

Historically, binge drinking has referred to an extended period of heavy drinking (for example, a "bender" that lasts 3 days or more) that is seen in some alcoholic patients. Some clinicians believe that using the term binge to refer to a less severe phenomenon blurs this important distinction. However, Dr. Wechsler has observed that the term binge is now commonly associated with eating and shopping and that its application to alcohol use is consistent with the term's generally accepted meaning.

Other researchers have voiced concern because the specific time period over which the five or four drinks are consumed is not specified nor is the body mass of an individual drinker. For example, after 5 drinks consumed over a fixed time span, a man of 240 pounds would have a lower blood alcohol level than a man of 140 pounds. Nor would a male or female of the same body weight achieve the same blood alcohol level following equal consumption because of gender-related differences in physiology. Dr. Wechsler believes that the phrase "in a row" implies a relatively short time frame. He also shows that individuals who consume alcohol at these levels increase their likelihood of experiencing a range of negative consequences.

Whether terms such as heavy drinking, binge drinking, or drinking to intoxication are used to describe students' behavior, it is clear that consumption of large quantities of alcohol on a single drinking occasion is important in assessing alcohol involvement. Also key in evaluating alcohol consumption are the consequences of that consumption which can include academic, personal, social, legal, and medical problems as well as dependent symptoms such as tolerance, withdrawal, and loss of control.