Alcohol is a big part of American culture. You see ads for it on television, in movies, in sports arenas. We have drinking games and rituals. In many settings, drinking is seen as a rite of passage and where drinking follows cultural standards, you can usually find binge drinking. As much as drinking has become a part of American culture, binging may be even more prevalent. Whether it’s a breakfast buffet or a new Netflix series, we tend to consume things in excess.
Alcohol is no exception. In fact, the U.S. Centers for Disease Control and Prevention (CDC) has compiled information on the prevalence of binge drinking in the United States, and the findings are pretty staggering. One in six adults binge drinks four times a month, and the average number of drinks per session is seven beverages. That’s a lot of alcohol, and it can cause a significant impact on your health. Still, it’s a fairly common practice.
Adults between 25- and 35-years-old are the largest age group of binge drinkers, but they’re closely followed by the college-aged demographic. Binge drinking among college students is especially dangerous. Drinking excessively can damage brains that are not finished developing by disrupting a process called myelination. Plus, heavy drinking is associated with a greater risk of experiencing accidents and car crashes, being the victim of a violent crime, and memory and learning problems.
But, you may be wondering, if so many people binge drink, why don’t one and six people struggle with alcoholism? You’d think students would be graduating with a diploma, student loans, and alcohol addiction every spring. While it can and does happen, not everyone who binge drinks develops alcoholism. So why do some heavy drinkers have a problem and others don’t?
How do you know when you need help?
When you drink alcohol, your liver will do its best to filter out the alcohol and stop it from reaching your bloodstream. If you moderate your alcohol intake, your liver will do a pretty good job, and you won’t get excessively drunk. Binge drinking floods your body and overwhelms your liver, and large amounts of alcohol will enter your bloodstream and then your brain. The more alcohol in your blood, the higher your blood-alcohol concentration (BAC) will be, which is the primary ratio that we use to determine how much alcohol is affecting a person.
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), binge drinking is defined as drinking enough to raise your BAC to 0.08 grams per decilitre. Usually, this means four drinks for women and five drinks for men in a two-hour period. Drinking at this level can lead to serious intoxication and can be dangerous for people planning to drive. Drinking like this multiple times a week can lead to serious health problems and alcohol dependence.
But what happens if you binge drink regularly once or twice a week?
Any problematic substance use can be diagnosed as some form of substance use disorder, a spectrum that was most recently officially outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is the therapists and clinical practitioners guide to diagnose mental health problems. Alcohol has its own spectrum of diseases called alcohol use disorders, or AUDs. The DSM separates these disorders into mild, moderate, and severe alcohol use disorders.
Where does binge drinking fall on the spectrum?
If you spend a night drinking and you go overboard, but episodes like that are few and far between, you may not be on the AUD spectrum at all. However, if you binge drink on a regular basis for a time, you may have a mild alcohol use disorder. A mild alcohol use disorder may be caused by peer pressure or the need to fit in socially, or it may be a form of experimentation.
A mild substance use disorder can be risky. It can increase your likelihood of experiencing some of the more serious consequences of alcohol use such as accidents, health complications, legal problems, and more severe substance use disorders. However, mild SUDs are often compartmentalized. You may be able to drink on the weekends and return to everyday life during the week. However, if you continue to binge drink, you risk developing more severe substance use disorders that can be more difficult to control, like chemical dependence.
An AUD may be getting worse if you start to feel a growing tolerance or chemical dependence. If you feel like you need to drink to avoid uncomfortable withdrawal symptoms like insomnia, tremors, or anxiety, you may have a moderate or severe alcohol use disorder.
Alcoholism is another name for alcohol addiction or a severe alcohol use disorder. It’s the last stop on the alcohol use disorder spectrum. It usually starts with chemical dependence but goes beyond the chemical imbalance that affects your nervous system. Alcoholism affects your reward center and limbic system. This is the part of the brain that controls your motivation towards certain actions or activities. For instance, the reward center takes notice of the positive feelings that are caused by a hearty meal. It logs that information away and causes cravings the next time your hungry. The reward center helps you survive by encouraging you to repeat tasks that help you survive.
Unfortunately, certain psychoactive substances like alcohol can cause some of the same chemical responses in your brain that a good meal or a warm bed does. The powerful euphoric and relaxing effects of alcohol intoxication can trick your reward center into treating drinking like one of those other life-sustaining tasks. The result is a powerful draw toward drinking. Alcoholism is characterized by compulsive alcohol use, despite serious consequences. Even if drinking has caused legal, health, financial or relational problems, an addicted person will still have trouble controlling their compulsions to drink.
Alcohol use disorders can be dangerous for various reasons. Again, they increase your likelihood of getting into an auto accident or some other type of bodily harm. Alcohol can also lower your inhibitions, which can lead to more risk-taking, like risky sexual behavior. However, if you develop a chemical dependence, withdrawal symptoms can be potentially dangerous without medical treatment. Symptoms like seizures and delirium tremens (DTs) can lead to medical complications and even death.
If you have a severe substance use disorder, you will most likely need professional treatment to overcome it. Medical detox is the safest way to get through alcohol withdrawal symptoms, and the psychotherapies and personalized treatment options that come with the full continuum of care in addiction treatment can help you achieve long-lasting sobriety.
However, you don’t need to have a severe alcohol use addiction to seek treatment. In many cases, the best way to avoid some of the most serious consequences of addiction is to address a substance use disorder early. If you or a loved one has been binge drinking a few times a week, it might be time to seek help, especially if you feel like you need to drink to feel normal. If you stop drinking and you feel symptoms of withdrawal like insomnia, shaky hands, tremors, strong cravings, a feeling that your skin is crawling, or sudden and severe confusion, speak to a medical professional immediately.
If you don’t feel any withdrawal symptoms and you’ve binged several times in the past few weeks, try taking a break. If you feel cravings, speak to your doctor or an addiction treatment specialist to learn more about treatment options for mild-to-moderate alcohol use disorders.
American Psychiatric Association. (2017, January). What Is Addiction? from https://www.psychiatry.org/patients-families/addiction/what-is-addiction
CDC. (2018, October 24). CDC – Fact Sheets-Binge Drinking – Alcohol. from https://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm
National Institute on Alcohol Abuse and Alcoholism. (n.d.). Drinking Levels Defined. from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking
Salzer, J. L. (2016, October 24). Myelination. from https://www.sciencedirect.com/science/article/pii/S0960982216308685