Sunday, January 13, 2013

Binge Drinking in America

And the numbers are… fuzzy.

Public health officials in the UK have been wringing their hands for some time now over perceived rates of binge drinking among the populace. In a 2010 survey of 27,000 Europeans by the official polling agency of the EU, binge drinking in the UK—defined as five or more drinks in one, er, binge—clocked in at a rate of 34%, compared to an EU average of 29%. Predictably, the highest rate of UK binge drinking was found in people between the ages of 15 and 24. This still lagged well behind the Irish (44%) and the Romanians (39%). Scant comfort, perhaps, given the historical role drinking has played in those two cultures, but still, clearly, the British and the rest of the UK are above-average drinkers.

Or are they? And what about the U.S. How do we rank? For comparative purposes, we can use the “Vital Signs” survey in the United States from 2010, performed by the Centers for Disease Control and Prevention, and published in CDC’s Morbidity and Mortality Weekly Report, results of which are pictured above. Using almost the same criteria for binge drinking—five drinks at a sitting for men, four drinks for women—the study concludes that the “overall prevalence of binge drinking was 17.1%. Among binge drinkers, the frequency of binge drinking was 4.4 episodes per month, and the intensity was 7.9 drinks on occasion.”

By the CDC’s definition, the heaviest binge drinking in America takes place in the Midwest, parts of New England, D.C., and Alaska. Survey respondents with an income in excess of $75,000 were the most serious bingers (20.2%), but those making under $25,000 binged more often and had more drinks per binge than other groups, the report says. And binge drinking is about twice as prevalent among men. Binge drinking, the survey concludes, is reported by one of every six U.S. adults.

Even so, it appears that the U.S. does not have the same level of binge drinking as the UK. However, astute readers have no doubt noticed that actual binge drinkers in the U.S. were consuming almost 8 drinks per bout, well above the official mark of four or five drinks at one time. The problem is that there is no internationally agreed upon definition of binge drinking. A 2010 fact sheet from the UK’s Institute of Alcohol Studies (IAS) maintains that “drinking surveys normally define binge drinkers as men consuming at least eight, and women at least six standard units of alcohol in a single day, that is, double the maximum recommended ‘safe limit’ for men and women respectively.”

But referring to binge drinking as “high intake of alcohol in a single drinking occasion” is misleading, says IAS. The problem is biological: “Because of individual variations in, for example, body weight and alcohol tolerance, as well as factors such as speed of consumption, there is not a simple, consistent correlation between the number of units consumed, their resulting blood alcohol level and the subjective effects on the drinker.”

Furthermore, the report charges that “researchers have criticized the term ‘binge drinking’ as unclear, politically charged and therefore, unhelpful in that many (young) people do not identify themselves as binge drinkers because, despite exceeding the number of drinks officially used to define bingeing, they drink at a slow enough pace to avoid getting seriously drunk.”

There you have it. As currently defined and measured, binge drinking is a relatively useless metric for assessing a population’s alcohol habits. “The different definitions employed need to be taken into account in understanding surveys of drinking behavior and calculations of how many binge drinkers there are in the population,” as the UK report wisely puts it. Take the above chart with a few grains of salt.

Photo Credit: CDC


Anonymous said...

hmmm... "people tend to drink more when it's cold". nice.

rachelrachel said...

People often drink more when it's cold, but that's not a good thing to do because ETOH lowers body temp while it creates a false perception of warmth.

I also have trouble with expressions such as "five drinks at a sitting." What if the drinker gets up to go to the bathroom? Then we have more than one sitting, don't we?

Also, self-reporting is unreliable. Among other difficulties, somebody who's had five drinks is probably not going to remember exactly how many drinks he's had.

And then you have the definition of "drink." One drink is not exactly the same as another drink.

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