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America's Binge-Drinking Problem Is Even Worse Than We Thought

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Many of us enjoy the odd glass of wine or beer, but every once in a while we like to throw down and get completely wasted. But for many Americans, these binge-drinking sessions aren’t as “every once in a while” as we’d like to believe. New research shows that nearly 20 percent of all US adults participate in binge-drinking—and when they do, they go hard.

New research published in the American Journal of Preventive Medicine shows that US adults consume more than 17 billion binge drinks each year, which boils down to about 470 binge drinks per binge drinker annually. The study, conducted by researchers at the CDC’s National Center for Chronic Disease Prevention and Health Promotion, also found that 37.4 million Americans, or one in six Americans, binge drink about once a week, and at an average of about seven drinks per binging session. That amounts to a whopping 17.5 billion total binge drinks annually.


In terms of definitions and measures, binge drinking is when men drink five or more drinks, and women four or more drinks, within a two-hour span (the difference is because men and women metabolize alcohol differently, mostly due to lower amounts of water in women’s bodies compared to men). A single drink can consist of either a shot of hard liquor, a 5-ounce glass of wine, or a 12-ounce glass of beer at 5% alcohol (plenty of craft beers now greatly exceed alcohol content, so this measure is understated in some cases).


For the study, a team led by Robert Brewer took a look at CDC data contained within its 2015 Behavioral Risk Factor Surveillance System (BRFSS), which relies on self-reported data. Importantly, study respondents are notorious for underreporting their drinking habits, so the rates of binge drinking may actually be higher than the new study reports—a possibility not lost on the researchers. This caveat aside, the CDC team used this data to calculate annual estimates of binge drinking, and to sort the findings according to age, sex, education, race/ethnicity, household income, and state.

They found that binge-drinking was most common among adults between the age of 18 and 34, but more than half of all binge drinks consumed were by adults over the age of 35 (so when the 35+ crowd binges, they really binge). Four out of five binged-drinks were consumed by men, which could mean men drink more than women when they drink (very likely), or that men are more inclined to binge than women, or a combination of the two (another possibility is that women are more inclined to underreport, either consciously or unconsciously). People reporting lower household income and lower educational levels “consumed substantially more” than those in higher income and education brackets. Arkansas, Mississippi, Kentucky, and Hawaii reported the highest number of binge drinkers, while Washington, DC, New Jersey, New York, and Washington State were ranked at the bottom.

“This study shows that binge drinkers are consuming a huge number of drinks per year, greatly increasing their chances of harming themselves and others,” said Brewer in a CDC release.

Alcohol kills about 88,000 people annually in the US, of which half can be attributed to binge drinking. Heavy drinking has been associated with cancer, heart disease, and liver failure, while binge drinking can result in alcohol-related auto accidents, violence, and risky sexual behavior.


“Binge drinking is often the hidden face of the alcohol problem—especially in young people,” Thomas G. Brown, the director and principal investigator at McGill University’s Addiction Research Program, told Gizmodo. “When people think ‘alcohol problems’ they typically think about the extreme tail of alcohol use severity, involving dependence and complete social dysfunction. But most problems, like injury, and impaired driving crashes, and so on, come from episodic heavy or binge drinking.”

Brown says most professionals screen for severe alcohol problems, missing the importance of binge and heavy drinking—and the opportunity for an early intervention.


Brian Quigley, a researcher at the University of Buffalo’s Department of Medicine, isn’t thrilled with the researchers’ use of the term “binge drinking,” which is usually bantered about in a casual way.

“Alcohol researchers should have probably used a different term, but for the moment we are stuck with it,” Quigley told Gizmodo. “I actually prefer the term ‘heavy episodic drinking.’ When the public hears the term binge drinking they think of something else, more akin to a ‘lost weekend’ involving a person drinking for days and having blackouts. That is, of course, an extreme example of a heavy drinking episode.”


Quigley says he’s used the term “binge drinking” when lecturing to college students, but when he describes it as “5 or more for men and 4 or more for women,” his class often bursts out with laughter.

“This is because my students define binge drinking colloquially and because to many college students—and others—the technical definition equals what they normally refer to as ‘pre-gaming’ before going out for the evening to do the serious drinking.”


Like Brown, Quigley says it’s important to recognize binge drinking, or heavy episodic drinking, or whatever you want to call it, because it’s predictive of the people who are likely to experience alcohol-related problems, including any number of legal, medical, and social issues.

“And remember we are talking about patterns over time,” he added. “A person engaging in a few heavy drinking episodes may not experience problems—although becoming intoxicated is always associated with risks—but the more frequently a person engages in heavy episodic drinking the more likely they are to experience alcohol-related problems.”


We asked Dr. Quigley for his suggestions on how to prevent or minimize binging episodes. His response was so good we’re going to publish it in full:

Regarding how to prevent “binge” drinking there are a number of what are called “Protective behavioral strategies.” Among these are learning to pace your drinking and staying well hydrated. A good way to accomplish both of these things it to order a non-alcoholic drink (water or soda) with your alcoholic drink or to alternate between the two types of drinks. This slows down your drinking, reduces the amount you are drinking and slows the absorption of alcohol into your system. Always ordering food when drinking also slows down the absorption rate for the alcohol.

Be aware of what a normal drink size is and keep track of how many you have consumed. Standard drink sizes as defined by the National Institute of Alcohol Abuse and Alcoholism is 12 fluid ounces of beer, 5 fluid ounces of wine, and 1.5 fluid ounces of distilled spirits. A person drinking three 16-oz pints of beer thinks they just drank three beers but based on the standard drink definition (which is how drink is defined in the binge drinking research) they actually drank four beers (48 fluid ounces).

And a warning about one thing some people believe is a protective behavioral strategy when drinking but is not, is drinking energy drinks along with or mixed with alcoholic drinks. This is not a good thing to do because, contrary to popular belief, energy drinks do not diminish the effects of alcohol on a person. The caffeine in them masks the effects of alcohol, in particular the sedative effects, by keeping the person awake and alert longer, but still just as drunk. The problem with this is that because the person stays more alert and hyped up longer they actually drink more than normal. And that puts them at greater risk for alcohol-related issues such as violence, risky sexual behavior, DWI, etc. Research has shown that when drinking alcohol mixed with energy drinks people respond more quickly to stimuli but they still do it in an uninhibited intoxicated way. So in other words, when you are drunk you do stupid things and when you are drunk and also hyped up on energy drinks you still do stupid things, you just do them more quickly. So using energy drinks when drinking is not a good way to protect oneself from the negative effects of drinking.


Got it? If you drink, have a plan, be smart, and do it responsibly.

[American Journal of Preventive Medicine]