Binge Responsibly

Are five drinks always too much?

The latest report on "binge drinking" confirms something that careful readers of such studies already knew: One man's dinner party is another man's binge—especially if the other man has a degree in public health.

According to a study published this week in The Journal of the American Medical Association "the total number of binge-drinking episodes among US adults increased from approximately 1.2 billion to 1.5 billion" between 1993 and 2001. "During this time," the researchers report, "binge-drinking episodes per person per year increased by 17 percent."

These figures are based on a telephone survey conducted by the U.S. Centers for Disease Control and Prevention (CDC). In deciding how alarming they are, it is helpful to know that the survey defines "binge drinking" as "consumption of 5 or more alcoholic beverages on 1 occasion."

Suppose you come to my house for dinner. You have a beer beforehand, a few glasses of wine during the meal, and a little bourbon afterward. According to the CDC, you have just gone on a binge.

Not surprisingly, this counterintuitive definition of the term, often used by alcohol researchers in the United States, causes confusion, and not just among laymen. It is quite different, first of all, from the traditional definition of an alcoholic binge, which involves devoting days or weeks to drunkenness.

As State University of New York sociologist David J. Hanson puts it, binge "describes an extended period of time (typically at least two days) during which time a person repeatedly becomes intoxicated and gives up his or her usual activities and obligations in order to become intoxicated. It is the combination of prolonged use and the giving up of usual activities that forms the core of the clinical definition of [a] binge."

Then, too, the CDC's notion of a binge is different from that of alcohol researchers in other countries. Hanson notes that "a recent Swedish study…defines a binge as the consumption of half a bottle of spirits or two bottles of wine on the same occasion." An Italian study viewed eight drinks a day as normal, while "in the United Kingdom, bingeing is commonly defined as consuming 11 or more drinks on an occasion."

Defenders of the five-drink benchmark note that it is strongly associated with driving under the influence—not exactly surprising, since you have to be drunk before you can drive drunk. But that does not mean having five drinks in one evening is tantamount to putting oneself or others at risk of dying in a crash. Indeed, alcohol-related traffic fatalities fell during the period when the CDC's survey found that so-called binge drinking was on the rise. Clearly, some bingers are more careful than others.