First, let’s clear up one big source of confusion: It is possible to have alcohol use disorder (or AUD, or alcoholism, or a drinking problem, or whichever term you prefer) without binge drinking, and it is possible to be a binge drinker without having AUD. The two are connected, but not interchangeable.
What is binge drinking, anyway?
Binge drinking is drinking behavior. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as “a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08%—or 0.08 grams of alcohol per deciliter—or more.” Since most people don’t have a clear understanding of how blood alcohol works, the Centers for Disease Control and Prevention (CDC) relate binge drinking to the amount consumed to reach these levels—having 5 or more standard drinks on one occasion for men, or 4 or more drinks on a given occasion for women. This definition refers to standard drinks, which means a 12-ounce can of beer, a 5-ounce glass of wine, or a 1.5-ounce shot of liquor.
To put this in perspective, the average wine bottle holds about five standard glasses of wine, so if you drink a bottle (or most of a bottle) of wine on an occasion, it qualifies as binge drinking for both men and women. Four normal cans or bottles of beer for a woman or five for a man also fits the description, and if you go for pints or tallboys, they add up even faster. For a lot of people, this sounds like a regular Saturday night, so it can be difficult to accept binge drinking as being a serious concern. That’s part of why it’s so common. The most recent National Survey on Drug Use and Health found that 44.5% of people who drank alcohol at all had engaged in binge drinking in the past month.
Is there a difference between being a heavy drinker and a binge drinker?
There is less consensus around the definition of heavy drinking. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines heavy alcohol use as binge drinking on 5 or more days in one month. So they take the frequency of alcohol intake into account. This is the definition they use in the national survey I mentioned above.
The NIAAA classification of heavy drinking recognizes that a person can be a heavy drinker without necessarily binge drinking. They say that heavy drinking is, “For men, consuming five or more drinks on any day or 15 or more per week. For women, consuming four or more on any day or 8 or more drinks per week.” So one binge drinking session qualifies as heavy drinking, but so does spreading the drinks out throughout the week.
What are the risks of binge drinking and heavy drinking?
I think we all know that a thing being common doesn’t make it safe or healthy. In the 1950s, 45% of Americans smoked cigarettes. In 1980, only 11% of Americans wore seat belts. Times have changed, and we are now more aware of the dangers of smoking and of driving unrestrained. But while we’re somewhat aware of the risks of drinking, alcohol use still permeates our society.
There are a lot of risks involved in binge drinking and drinking heavily. The CDC lists the following direct and indirect effects, many of which can lead to serious outcomes, including death:
- accidental injuries (driving accidents, falls, burns)
- alcohol poisoning
- memory and learning problems
- violence (fights, sexual assault, intimate partner violence, self-harm, suicide, homicide)
- negative sexual outcomes (sexually transmitted infections, unintended pregnancy)
- poor pregnancy outcomes (miscarriage, fetal alcohol spectrum disorders, stillbirth)
- increased risk of cancer
- chronic health conditions (high blood pressure, stroke, heart disease, liver disease)
These consequences often seem distant and unlikely … right up until they happen to you or someone close to you.
So what’s the bottom line?
As with other drinking behaviors, the key is to be aware of your drinking behaviors and motivations so that you can be mindful of red flags. No one can decide for you whether your binge drinking is a sign of AUD, just as no one can force you to stop. But we can (and do) recommend that you take a closer look at your drinking and practice harm reduction to keep yourself and others safer when you engage in excessive alcohol consumption.
And if you decide that you need help in reducing your heavy drinking days or in quitting alcohol entirely, we have programs that can help.