Binge Drinking and Alcohol Misuse
Binge Drinking and Alcohol Misuse
Description of Young-Adult Alcohol Misuse
Alcohol misuse is common in North America and throughout much of the industrialized and developing world. In most Western countries, alcohol problems are especially pronounced in late adolescence and early adulthood - particularly during the college years - and represent a significant public health problem. In this book, we describe the nature of alcohol misuse, its epidemiology, its causes, and methods for treatment. Fundamental to this discussion is a consideration of the basic terminology of relevant alcohol-related concepts because there are many facets of alcohol misuse, and, despite some commonalities, not all of these facets can be viewed as interchangeable from a clinical or public health perspective.
1.1 Terminology and Definitions
We use the terms alcohol misuse and alcohol problems to refer to a range of phenotypic behaviors and conditions. These terms are used by clinicians, public health workers, and researchers to describe different types of consumptive behaviors and consequences.
AUD diagnostic criteria do not include measures of consumption, such as how much or how often someone drinks
Perhaps the most basic concept in characterizing alcohol involvement is alcohol consumption. At a fundamental level, though people can be classified as drinkers or abstainers, the classification of drinkers represents a large and highly diverse group that includes those who drink in moderation and those whose drinking patterns put them at risk for a range of consequences. It is important to note that current diagnostic criteria for alcohol-related disorders - alcohol use disorders (AUDs), according to the Diagnostic and Statistical Manual of Mental Disorders , 5th Edition (DSM-5; American Psychiatric Association, 2013), and alcohol dependence and hazardous use, according to the International Statistical Classification of Diseases and Related Health Problems , 10th Edition (ICD-10; World Health Organization (WHO), 2008) - both described below - fail to include direct measures of alcohol consumption despite the health-relevance of excessive alcohol consumption. Although not presenting formal diagnostic criteria, the US government has published safedrinking guidelines as part of their 2010 Dietary Guidelines for Americans  (US Departments of Agriculture and of Health and Human Services, 2010). Moderate consumption of alcohol is defined as 2 drinks a day for men and 1 drink a day for women. Drinking 15 drinks a week for men and 8 drinks a week for women, or 5 drinks in a given day for men or 3 drinks in a given day for women is considered high-risk drinking, based on epidemiological data documenting increased health-related risks that occur at those consumption levels. One study found that almost one half of men and one third of women drinkers in the United States exceed these safe-drinking levels (Dawson, Grant, & Li, 2005).
Healthy drinking limits according to the National Institutes of Health: Men: No more than 14 drinks per week or four drinks per occasion Women: No more than seven drinks per week or three drinks per occasion
NIAAA definition of binge drinking: five or more drinks (for men) or four or more drinks (for women) within a 2-hr period
In addition, there has been increasing concern in recent years over drinking patterns associated with high levels of consumption on drinking days (i.e., binge drinking). The US National Institute of Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as "a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 g/dL or above. For the typical adult, this pattern corresponds to consuming 5 or more drinks (male), or 4 or more drinks (female), in about 2 hours" (NIAAA, 2011). Such patterns represent