Heavy Episodic Consumption of Alcohol

Data from several national surveys indicate that about four in five college students drink and that about half of college student drinkers engage in heavy episodic consumption. Recent concerns have, therefore, often focused on the practice of binge drinking, typically defined as consuming five or more drinks in a row for men, and four or more drinks in a row for women. A shorthand description of this type of heavy episodic drinking is the "5/4 definition." Approximately two of five college students—more than 40 percent—have engaged in binge drinking at least once during the past 2 weeks, according to this definition. It should be noted, however, that colleges vary widely in their binge drinking rates—from 1 percent to more than 70 percent—and a study on one campus may not apply to others (Wechsler et al., 1994, 1998, 2000b).

The U.S. Surgeon General and the U.S. Department of Health and Human Services (USDHHS) have identified binge drinking among college students as a major public health problem. In "Healthy People 2010," which sets U.S. public health goals through the year 2010, the Federal government has singled out binge drinking among college students for a specific, targeted reduction (e.g., from 39 percent to 20 percent) by the year 2010. "Healthy People 2010" notes that: "Binge drinking is a national problem, especially among males and young adults." The report also observes that: "The perception that alcohol use is socially acceptable correlates with the fact that more than 80 percent of American youth consume alcohol before their 21st birthday, whereas the lack of social acceptance of other drugs correlates with comparatively lower rates of use. Similarly, widespread societal expectations that young persons will engage in binge drinking may encourage this highly dangerous form of alcohol consumption" (USDHHS, 2000).

There is evidence that more extreme forms of drinking by college students are escalating. In one study, frequent binge drinkers (defined as three times or more in the past 2 weeks) grew from 20 percent to 23 percent between 1993 and 1999. The number of students who reported three or more incidents of intoxication in the past month also increased (Wechsler et al., 2000b). It should be noted, however, that the number of college students who do not drink is also growing. In the same study, the percentage of abstainers increased from 15 to 19 percent.

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.