Binge drinking


March 2005

Defining binge drinking
Excessive alcohol consumption can have a wide range of adverse effects - medical, personal and social. These depend on both the overall amount of alcohol consumed and on the pattern of consumption [Go to reference 1].

There is no consensus on the definition of binge drinking. In the past, ‘binge drinking’ was often used to refer to an extended period of time, usually two days or more, during which a person repeatedly drank to intoxication, giving up usual activities and obligations.

In common usage, binge drinking is now usually used to refer to heavy drinking over an evening or similar time span - sometimes also referred to as heavy episodic drinking. Binge drinking is often associated with drinking with the intention of becoming intoxicated and, sometimes, with drinking in large groups [Go to reference 2].

Even within this general definition, there is no consensus as to what level of intake constitutes binge drinking.

It has been suggested that researchers tend to employ the most commonly used definition from previous work without giving an accompanying explanation for their choice of definition [Go to reference 3].

Some researchers have chosen to define binge drinking as consuming over half the government’s recommended number of units for a week in one session (thus, binge drinking would be defined as drinking, in one session, 10 units for men and 7 units for women).

In the past, Alcohol Concern have defined binge drinking as consuming more than five drinks on a single occasion. [Go to reference 4]. This is the definition used by the BMA in its 2003 report Adolescent health [Go to reference 5] and also by the European School Survey Project on Alcohol and Other Drugs (ESPAD). [Go to reference 6].

The Office for National Statistics (ONS) definition of ‘heavy’ drinking is eight or more units for men and six or more units for women on at least one day in the week. This has been used as a proxy for binge drinking in lieu of more nuanced data.

Alcohol Concern suggest that this could serve as an approximation of binge drinking, as it is in line with sensible drinking guidelines using daily benchmarks. In addition, ‘consuming this quantity of alcohol on one occasion could reasonably be expected to lead to intoxication which is a key feature of this type of drinking and places the individual at risk of harm’.[Go to reference 3] The ONS definition is also employed in the influential Prime Minister’s Strategy Unit documents on the government’s alcohol strategy. [Go to references 7 and 2

This definition of binge drinking equates to a minimum of approximately two thirds of a bottle of wine for women or four pints of beer for men. [Go to reference 7]

Ideally, a definition of binge drinking would take account of variables such as motivation, alcohol tolerance, time interval and social context. [Go to reference 3] As the Institute of Alcohol Studies notes, the problem with the type of definition outlined above is that

‘it is too broad, encompassing various patterns of consumption having very different motivations and consequences. Eight units consumed over the course of a whole day and as an accompaniment to meals will not have the same effects as eight units consumed over a couple of hours on an empty stomach’ [Go to reference 8]

A more flexible approach to defining binge drinking may prove useful in qualitative research but it is likely to be too complex for statistical purposes. In most of this document, the BMA follows the ONS definition of heavy drinking given above because it is so widely used for national statistical purposes.

Government drinking guidelines
The 1992 White Paper Health of the Nation suggested that men should consume no more than 21 and women no more than 14 units of alcohol per week. [Go to reference 9]. (A unit is 10ml of pure alcohol.) The Health Education Authority has recommended these guidelines since 1987.

In 1995, in recognition of the specific risks of excessive drinking in a single session, the sensible drinking message was changed to focus on daily guidelines. It suggests:
- a maximum intake of 2-3 units per day for women and 3-4 for men, with two alcohol-free days after heavy drinking; continued alcohol consumption at the upper level is not advised

- that intake of up to two units a day can have a moderate protective effect against heart disease for men over 40 and post-menopausal women; and

- that some groups, such as pregnant women and those engaging in potentially dangerous activities (such as operating heavy machinery), should drink less or nothing at all. [Go to reference 10]

For further information on trends please see:
Institute of Alcohol Studies (2004) Binge Drinking: Nature, Prevalence and Causes of binge drinking.
www.ias.org.uk/factsheets.html- go there now

School Health Education Unit (SHEU) Trends: Young people and alcohol 1983-2001
www.sheu.org.uk/pubs/trends/alc.htm - go there now

Office for National Statistics: Trends in the mortality of young adults aged 15 –44 in England and Wales, 1961 to 2001
www.statistics.gov.uk/CCI/article.asp?ID=504&Pos=6&ColRank=2&Rank=160 - go there now

Office for National Statistics Alcohol-related death rates, by Government Office Region in England and Wales, 2001 to 2003
http://www.statistics.gov.uk/CCI/nugget.asp?ID=1091&Pos=&ColRank=1&Rank=374

Office for National Statistics Recent trends in alcohol-related mortality, and the monitoring of these deaths in England and Wales
The rise of alcohol-related deaths in younger age groups
www.statistics.gov.uk/CCI/article.asp?ID=495&Pos=1&ColRank=2&Rank=448 - go there now

Institute of Alcohol Studies (December 2004) Alcohol - Drinking and Driving
This section contains facts and figures on drinking and driving including sections on affects on driving skills, the legal limit, who the drink drivers are, the size of the problem, who the people who die from drink driving are, counter measures, breath tests, penalties, high risk offenders and experimental programmes. www.ias.org.uk/factsheets.html - go there now

� British Medical Association 2004