Binge Drinking: Terminology and Patterns of Use Analyzing Internal and External Partnerships

This resource provides:

  • A brief background on the various ways that binge drinking has been defined (currently and historically)
  • A summary of binge drinking patterns in the United States

Binge drinking among adolescents and young adults—both within and outside of college settings—is of great concern given the severity of the associated consequences.

Consider the following statistics:

  • When compared to other types of drinkers, binge drinkers are more likely to experience a number of serious short- and longer-term consequences, according to both the 2004 book Reducing Underage Drinking: A Collective Responsibility, and the 2007 Surgeon General’s Call to Action to Prevent and Reduce Underage Drinking (PDF | 974 KB). These consequences may be particularly important for underage binge drinkers, a significant number of whom may continue to binge drink into adulthood—a point also noted in the 2005 Addiction article, “Adolescent Drinking Level and Adult Binge Drinking in a National Birth Cohort”.
  • Continuity of Binge and Harmful Drinking From Late Adolescence to Early Adulthood,” a 2004 longitudinal study published in Pediatrics, found that males who were binge drinkers in adolescence were twice as likely to binge drink in adulthood. It also found that females who were binge drinkers in adolescence were more than three times as likely to binge drink in adulthood.
  • Adolescent binge drinkers are three times more likely than those who do not binge drink to develop an alcohol-related disorder as an adult, according to Reducing Underage Drinking: A Collective Responsibility. The younger a person is when they begin to binge drink, the greater their risk for developing an alcohol use disorder.
  • According to the 2004 study, “Continuity of Binge and Harmful Drinking From Late Adolescence to Early Adulthood,” Youth Risk Behavior Surveillance System (YRBSS) data has also shown that underage youth who engage in binge drinking are approximately 11 times more likely than other underage drinkers to engage in additional risky behaviors such as tobacco and other drug use, physical violence, and unsafe sexual behaviors.

Binge Drinking Terminology

For the purpose of this literature review, we have used the broadest definition of binge or heavy episodic drinking. More than five drinks per drinking occasion is the most common definition, although studies did not always distinguish different amounts by gender. When different definitions were used, they are noted in the study descriptions.

The term “binge” originated as a clinical description of a pattern of problematic alcohol use that was characterized by a period of heavy use followed by a period of abstinence. In the mid-1990s, as part of the College Alcohol Study, conducted by the Harvard School of Public Health, the definition of binge drinking was modified to 5 or more drinks for men and 4 or more drinks for women on a single occasion within the past 2 weeks. The different thresholds selected for men and women were intended to reflect different alcohol metabolism rates between the sexes. They were also intended to account for the number of drinks that tend to place individuals at an increased risk for experiencing various alcohol-related social, economic, legal, and health consequences such as fights, trouble with police, and injuries.

In 2004, the National Institute of Alcohol Abuse and Alcoholism (NIAAA) proposed the following definition for binge drinking: “a pattern of drinking alcohol that brings BAC to 0.08 gram percent or above. For the typical adult, this pattern corresponds to consuming five or more drinks (male), or four or more drinks (female), in about two hours,” as the 2009 Psychological Bulletin article, Binge Drinking in Young Adults: Data, Definitions, and Determinants, reported. This definition recognizes different thresholds for men and women and defines a specific period of time in which the drinking occurs. Most recent research adheres to this definition, although researchers may assess binge drinking frequency using different time periods (such as the number of times binge drinking occurred in past two weeks, or within the past month).

The same 2009 article on binge drinking noted that researchers sometimes use the term “heavy episodic drinking” synonymously with binge drinking to characterize a pattern of heavy drinking over a defined period of time. Researchers also sometimes use “risky single occasion drinking (RSOD)” to describe this pattern of drinking. This term has been used more frequently in studies of European adolescents and adults.

Cut-off points for RSOD have varied from more than five to more than eight drinks per occasion. This is due in part to differences in standard drink amounts across countries. As a result, researchers have suggested that RSOD be defined as 60-70 grams of ethanol for men and 40-60 grams of ethanol for women per drinking occasion, as reported in “Risky Single-Occasion Drinking: Bingeing is Not Bingeing,” a 2010 study published in Addiction.

Finally, the term “risky drinking” has also been used to describe this pattern of drinking. Risky drinking has been defined as consumption of large amounts (more than than four standard drinks) of alcohol on a single occasion, as well as drinking in situations likely to result in harm for young people, according to “Changing Parental Behavior to Reduce Risky Drinking Among Adolescents: Current Evidence and Future Direction,” a 2012 study published in Alcohol and Alcoholism.

Patterns of Use

Data from SAMHSA’s National Survey on Drug Use and Health (NSDUH) from 2008-2009 reveal that rates of past-month binge drinking for underage youth (ages 12 to 20) in the northeast range from 16.7% (Maryland) to 24.6% (Vermont). In fact, nine of the 11 states in the CAPT’s northeast service area have rates of past-month underage binge drinking that are higher than the national rate of 17.7%.

Younger binge drinkers are more likely to drink with their friends and in another person’s home, according to “Social Settings and Situations of Underage Drinking,” a 1998 study published in the Journal of Studies on Alcohol. The authors of Reducing Underage Drinking: A Collective Responsibility have noted that youth binge drinking exhibits seasonal fluctuations, with increasing rates around exams and social occasions, such as homecoming, prom, and sporting events.

NSDUH data from 2008-2009 indicate that rates of binge drinking nationally are highest among those ages 18 to 25 years. Less than a quarter of individuals over the age of 26 nationally have engaged in past-month binge drinking (22.3%). While the lowest binge drinking rates are found among older adult populations, the Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System (BRFSS) data from 2009 still indicate that approximately one in ten (9.7%) older adults between the ages of 55 and 64 years have engaged in binge drinking within the past month.

When examining data among older adult populations, it is also critical to note that national surveys like the BRFSS and NSDUH may underrepresent the amount of binge drinking that occurs among older adults. Recommendations from NIAAA suggest that for older adults ages 60 years and up, binge drinking should be defined as no more than three drinks per drinking day for men, and no more than two drinks per drinking day for women. Both NSDUH and BRFSS define binge drinking using general adult population definitions (that is, five or more drinks on one occasion for NSDUH; four or more drinks on one occasion period for women, and five or more drinks on one occasion for men for BRFSS), meaning that rates of binge drinking, particularly for those ages 60 years and up, are likely underestimated.

Last Updated: 09/24/2015