Binge Drinking: Signs, Causes, & Treatments

Binge drinking is the act of consuming large amounts of alcohol in a single session.¹ At minimum, this pattern of drinking brings one’s blood alcohol concentration (BAC) to 0.08%.² Within a 2-hour period, consumption is approximately 5 drinks for adult males and 4 for females.² It contributes toward high-risk behavior, health complications, alcohol poisoning, and death.³

Binge drinking affects all age groups and genders. While about 28.8% of male adults and 20.4% of females reported binge drinking.⁵ Just over 25% of all drinkers report at least one episode of binge drinking.³ Individuals aged 26 and older account for nearly 70% of all binge drinking episodes,⁴ while about 11% of alcohol consumed by those under the age of 21 is in the form of binge drinking.¹² About 10% of seniors aged 65 and older acknowledged binge drinking at least once per month.⁵

Signs of Binge Drinking

For some, the act of binge drinking is a means of letting loose and having fun. In many social circles, this behavior is not only acceptable but glamorized. For others, binge drinking is a means of escape. This avoidant coping strategy provides temporary relief but oftentimes yields further consequences. Binge drinking is dangerous. Although most people who engage in binge drinking will never experience alcohol poisoning or kill someone while driving under the influence, there are many health and social implications that pose short- and long-term risks.

To clearly define binge drinking, the following criteria must be met:²

• Consumption brings one’s BAC to 0.08% or greater
• Within a 2-hour period, consumption is approximately 5 drinks for adult males
• Within a 2-hour period, consumption is approximately 4 drinks for adult females
• Occurs on at least one day in the past month

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines a standard drink as follows:⁶

• 12 ounces: one standard can of beer (about 5% alcohol)
• 5 ounces: one glass of wine (about 12% alcohol
• 1.5 ounces: one shot of distilled spirits (about 40% alcohol)

This is an area where some lines become blurred, as many binge drinkers consume drinks that include multiple units of alcohol. For instance, a standard Long Island Iced Tea includes vodka, tequila, rum, triple sec, and gin. One larger drink may include five units of alcohol in it, automatically raising one’s BAC above 0.08. Not all drinks are created equal, which is an important lesson for attempting to manage one’s drinking.

Health Risks of Binge Drinking

The health risks of binge drinking vary depending on several factors. The first involves individual characteristics—these may include one’s height, weight, gender, physical health, mental wellness, and whether one is taking other medications. Second, is the number of standard drink units consumed per occasion. Third, is the frequency at which one drinks. Having 3-4 drinks on a holiday and an occasional weekend is different than drinking an entire case of beer every NFL Sunday.

Short-Term Health Risks

Short-term health risks are oftentimes acute. They may occur immediately upon drinking and last for a relatively brief amount of time, but this does not mean that they cannot be serious or even fatal. Binge drinking just once could lead toward disastrous consequences if not careful. Every year there are new stories of young adults having drunk for the first time and dying of alcohol poisoning or some other alcohol-related accident.

Short-term health risks include:⁷

• Anger, frustration, hostility
• Decreased blood pressure
• Dehydration
• Depression
• Exhaustion
• Reduced attention span
• Reduced motor control and reaction times
• Slower breathing
• Birth complications including miscarriage or stillbirth in pregnant women or fetal alcohol disorders upon childbirth
• Alcohol poisoning, which may entail vomiting, seizures, coma, and/or death

Note that all of the short-term health risks aforementioned are highly preventable by abstaining from drinking or drinking responsibly.

Long-Term Health Risks

Long-term health risks are those that tend to build up over time. Continued excessive drinking exposes individuals to a variety of diagnosable medical and mental health conditions that range from high blood pressure to major depressive disorder. Warning signs are oftentimes present as the condition grows in intensity; however, these signs are oftentimes neglected.

Long-term health risks include:⁷

• Diagnosable mental health and/or substance use disorder
• Heart disease
• High blood pressure
• Increased cancer risk
• Issues sleeping
• Liver problems
• Loss of brain volume in younger individuals
• Social isolation/withdraw
• Stroke
• Weakened immune system
• Weight gain

Same as with short-term health risks, long-term ones are highly preventable by abstaining from drinking or doing so responsibly.

Causes & Triggers of Binge Drinking

The causes and triggers of binge drinking do vary but typically tend to serve in a capacity in which one is either trying to have a fun time seeking a means of escape. For some individuals there may be an intention to binge drink. For others, it may be the result of letting one’s guard down and not moderating alcohol consumption. In either case—whether intentional or not—it is still a dangerous practice.

Though by no means all inclusive, the following are common causes and triggers of binge drinking:

• Alcohol is readily available
• Being at an event that is seemingly enhanced by drinking (i.e., ballgame, concert, party)
• Celebrating
• Finding a means of escape
• Mental health or substance use disorder.
• Needing to drink for the buzz
• Playing drinking games
• Rebelling from authority
• Relapse after a period of sobriety
• Seeing others consuming alcohol
• Socializing with friends and/or meeting new people
• Struggling with loss
• Testing one’s tolerance
• Wanting to have fun

Again, binge drinking is something that may be done by any person at any time. Individuals who struggle with a mental health or substance use disorder are particularly vulnerable, as maladaptive thinking and coping skills may direct one toward such behavior.

How & When Does Normal Alcohol Consumption Become Binge Drinking?

For many, one drink leads to another, the time is fun, and things escalate from there. Or one has a bad day and decides that the best solution in the moment is to just “drink it off.” For some, however, normal alcohol consumption may steadily progress into more frequent binge drinking episodes.

Although abstinence is healthiest, there are guidelines that suggest what is considered within the parameters of mild to moderate drinking.

Excessive drinking is considered when one is:⁸

• A woman who has more than seven drinks per week or more than three drinks per occasion
• A man who has more than 14 drinks per week or more than four drinks per occasion
• Older than 65 years and having more than seven drinks per week or more than three drinks per occasion

In consideration of these numbers, an individual is considered to have participated in binge drinking if the number of drinks on a given occasion is higher than the number indicated.

Common signs that someone may have issues with binge drinking include:⁹

• Drinking alcohol and using other drugs/medications regularly
• Drinking excessively on weekends or holidays
• Engaging in risky behaviors while under the influence of alcohol
• Frequently drinking more alcohol than intended
• Having one or more memory lapses after drinking
• Ignoring the concerns of others

When said behavior occurs with regular frequency, it is an indication of a problem. It is recommended to consult with a therapist immediately. Earlier treatment of binge drinking may help curb the behavior while preventing the onset of alcohol use disorder.

Treatment of Binge Drinking

Treatments that address the problematic behavior while concurrently exploring maladaptive beliefs and thoughts surrounding binge drinking are ideal. It is also important to work on any other problems in addition to other mental health or substance use disorders at the same time. The severity of the issue is what primarily determines the type of treatment required. Personal preference is another important factor. Common forms of treatment occur in a residential or outpatient setting.

Residential Treatment

Residential (inpatient) treatment is oftentimes the most comprehensive. Patients partaking in this form of treatment live on site throughout the duration of treatment. Individuals are monitored 24/7 while partaking in various individual and group therapy sessions, educational sessions, activities, and medication management (as appropriate).

These environments are very structured and include a team of professionals who provide the various services. Thirty-, sixty-, and ninety-day programs are common for this type of treatment. Upon discharge, ongoing outpatient therapy and support groups are recommended. For those taking medication, that will also require continued monitoring.

Outpatient Treatment

Outpatient treatment may be conducted one-on-one with a counselor, in a group setting, or as part of an intensive outpatient program (IOP). Individual sessions offer the opportunity for one to explore individual issues. The client and therapist work together toward specific goals, which oftentimes include behavioral, thought, and belief modification; psychoeducation; and resolving past grievances (as appropriate). Sessions typically last 30, 45, or 60 minutes.

Group sessions oftentimes have one or two licensed therapists as facilitators with a set number of group members. The power of group sessions is that the members ultimately begin to learn from and support one another. The experience is cathartic. IOP involves a combination of group therapy as well as psychoeducational sessions. Schedules for IOP vary, but sessions that occur 3 hours a day 5 days a week or 8 hours a day 3 days a week are relatively common. This environment is more restrictive than typical outpatient therapy but less restrictive than residential.

Common Types of Therapy for Binge Drinking

Cognitive behavior therapy (CBT) is highly recommended for treatment of binge drinking. CBT explores how one’s cognitions (thoughts) based upon personal beliefs and values impact one’s emotions to lead toward a particular behavioral outcome. For example, an individual who binge drinks may hold the belief that “I like to binge drink but am not nor ever will be an alcoholic.” The corresponding thought, then, is “I can go ahead and binge drink during the game.” The individual then begins drinking.

In this example the therapist and client would work together to adapt the belief, thought, and behavior toward a healthier outcome. Dialectical behavioral therapy (DBT) is also common. DBT is like CBT in many ways but includes an element of mindfulness. This keeps individuals focused on the present and aware of their internal and external environment.

Intended Treatment Outcome & Timeline

The saying, “individual results may vary,” certainly applies to treatment outcomes and timelines. Motivation is among the top factors that contribute toward success in this respect. For those who fully immerse themselves in therapy and remain atop their recovery, outcomes may prove quite positive.

For those who do not, the road may prove more challenging. Accordingly, it is hard to put a timeline on this process. Rather, it should be measured by one’s progress. Even when one has attained an extended period of abstinence, it is important to remain intentional and consistent with one’s plan.

Medication

It is important to consult a prescribing physician (e.g., general practitioner, psychiatrist, specialist) regarding any consideration of or actual taking of medication. Not all cases of binge drinking will require medication. The ones prescribed are most commonly used in more severe cases of diagnosed alcohol use disorder.

Antabuse (disulfiram) discourages alcohol consumption by interfering with the degradation of alcohol, leaving those who drink feeling ill. Vivitrol, a monthly subcutaneous injection, is also used as a means of curbing cravings. This reduces risk of relapse. Note that with any diagnosable mental illness requiring medication, it is important to take any prescribed medications as prescribed.

Techniques to Implement at Home

Though treatment is recommended for issues with binge drinking, whether one is active in therapy or not, there are many techniques one may try at home to reduce urges and incidents of binge drinking.

At-home tactics to curb binge drinking include:

• Attending a virtual support group meeting
• Distancing from events or situations that trigger binge drinking. While at home this may include not watching certain television programs, playing certain video games, or listening to certain music.
• Eating healthier
• Engaging in healthier activities and hobbies
• Exercising
• Journaling
• Meditating or praying
• Practicing healthy distancing from those who encourage binge drinking
• Removing alcohol from one’s living space
• Removing items that trigger one to want to binge drink
• Speaking with regular support often and especially when going through a difficult time

These and other healthy activities may lead toward one living a healthier life while leaving binge drinking behind.

How to Get Help for Binge Drinking

Fortunately, there are many options for getting help. One may begin by conducting a web search, calling the local department of health, or contacting one’s managed care provider. When options are presented, it is important to then follow up with several options.

Determine whether the provider or organization is of best fit, whether there are positive treatment outcomes, the form of treatment provided, cost, et cetera. There are also many support groups both in person and virtually. Within these groups are facilitators and leaders who can answer questions and provide appropriate guidance.

How to Get Help for a Loved One

The first step toward getting help is to become informed. Becoming informed about binge drinking and available treatment options will help prepare you for the conversation, which comes next. During the conversation it is important to remain as emotionally supportive and objective as possible. Listen to what the loved one has to say. By listening and responding empathically there is a better likelihood of reaching an agreement.

This is by no means a guarantee, as resistance is likely. If one resists, still listen. From there it is important to continually remain supportive but also set and maintain boundaries. When the loved one is ready for treatment, negotiate your level of involvement. The therapist may way in from there.

How to Get Help for a Teen

With teens, it is important to follow the recommendations previously stated but also try to gather their perspective as best as possible. As a parent or guardian, it is likely that emotions are high regarding the topic. There is significant concern and perhaps even anger. To get past the point of merely responding with disciplinary measures, it is important to get to the root of the issue.

For many teens, binge drinking is often done as a means of forgetting problems, having fun, testing tolerance, and/or rebelling.⁴ In addition to the binge drinking issue, it will be important to work through these considerations as well. Know that it is important to also lead by example. Being a solid role model to a teen goes a long way. By practicing what you preach, so-to-speak, the teen knows they are not alone.

Binge Drinking Statistics

Annually, there are numerous statistics gathered about binge drinking and other substance use conditions from credible resources.

A 2019 report from the CDC that compiled results from a variety of studies on binge drinking revealed the following:¹⁰

• A sixth of US adults binge drink about four times a month, consuming around seven drinks per binge. 17 billion total binge drinks are consumed by adults every year, or 467 drinks per binge drinker.
• Younger adults aged 18–34 years are the most likely to engage in binge drinking, but more than half of the total binge drinks are consumed by those who are 35 or older.
• Men are twice as likely to binge drink as women. Four in five total binge drinks are consumed by men.
• Binge drinking is more prevalent among people with incomes of $75,000 or more per household and higher educational levels. However, binge drinkers with lower incomes and educational levels consume more binge drinks per year.
• Over 90% of U.S. adults who are excessive drinkers report binge drinking in the past 30 days.
• Many people under the age of 21 who drink alcohol report binge drinking, often consuming large amounts.

Given the potentially severe implications of binge drinking, these numbers are significant. It is important to protect yourself and others by becoming informed and talking about the issue.

Living With Binge Drinking

Living with binge drinking will have its ups and downs. Keep in mind that this is natural. It is a normal human tendency to begin considering a vice as a coping mechanism when times get difficult. The difference once in recovery, though, is that one now has the tools and insight to recognize triggers and cravings and to react immediately. Recovery yields the most positive outcomes when one is intentional and consistent with the process.

While living with binge drinking, there may be some individuals who would prefer to drink on occasion but intend to do so moderately and safely. In such cases, it is important to bear the following in mind:

According to NIAAA, certain people should avoid alcohol completely, including those who:²

• Plan to drive or operate machinery, or participate in activities that require skill, coordination, and alertness
• Take certain over-the-counter or prescription medications
• Have certain medical conditions
• Are recovering from alcohol use disorder or are unable to control the amount that they drink
• Are younger than age 21
• Are pregnant or trying to become pregnant

For those who intend to continue drinking but prefer more of a harm reduction approach, the following strategies may help lower one’s risk:⁷

• Plan ahead. Consider the number of drinks intended to consume, who will help hold you accountable, and how you intend on getting home.
• Eat prior to and while drinking.
• Minimize consumption as much as possible, preferably no more than one or two standard drinks within a 24-hour period.
• Pace yourself and drink more slowly. Take breaks in between.
• Alternate alcoholic drinks with nonalcoholic ones, preferably water.

Aside from strategies that specifically consider consuming alcohol or not, there are many other appropriate strategies toward living a healthier life, including:

• Attending support groups
• Distancing from triggering persons, places, and things
• Eating healthier and exercising
• Engaging in healthier activities and hobbies
• Journaling or partaking in a healthy creative expression
• Meditating or praying
• Seeing a therapist
• Speaking with regular support often and especially when going through a difficult time

It ultimately comes down to the individual to make the decision to drink or not. Every time the decision is made to drink, there is risk involved.

Binge Drinking Tests, Quizzes, & Self-Assessment Tools

If there is a belief that one has or may have an issue with binge drinking, there are various tests, quizzes, and self-assessment tools available online, at one’s local medical provider, and other locations. These are a useful means of identifying whether a problem may be present and to what extent.

Tests Performed by Doctors

Tests performed by professionals are recommended, as the individuals administering them are trained and experienced. Further, they are backed by research.

One commonly used screening tool is the AUDIT-C, a three-question item that asks the following:

1. How often do you have a drink containing alcohol?
   • Never
   • Monthly or less
   • 2-4 times a month
   • 2-3 times a week
   • 4 or more times a week
2. How many standard drinks containing alcohol do you have on a typical day?
   • 1 or 2
   • 3 to 4
   • 5 to 6
   • 7 to 9
   • 10 or more
3. How often do you have six or more drinks on one occasion?
   • Daily or almost daily
   • Weekly
   • Monthly
   • Less than monthly
   • Never

Responses are then matched to the recommended alcohol consumption guidelines referred to earlier. If an issue with binge drinking is found using this screening tool or another similar one, further assessment may be conducted. From there, a treatment plan is devised and implemented.

Quizzes & Self-Assessments

It is important to use caution with quizzes and self-diagnosis tools. First, one should never self-diagnose. It oftentimes leads to problems and should always be left in the hands of a trained professional. Second, although they are useful toward suggesting a likely problem, they oftentimes do not provide a thorough assessment. Successful treatment relies on many factors. Most of these are not considered in such tools.

There is also never a guarantee that quizzes and self-diagnosis tools found online and from other resources are clinically accurate. Again, they may be useful but should be used with caution. If one does take a quiz or self-assessment that indicates a problem, it is important to seek professional help as soon as possible.

Additional Resources

The following are helpful additional resources for anyone impacted by binge drinking:

• Helpful Books About Alcoholism
• NIAAA Rethinking Drinking
• NIAAA Alcohol Treatment Navigator
• SAMHSA Behavioral Health Treatment Services Locator
• Online Therapist Directory: Sort therapists by specialty, cost, availability and more. Watch intro videos and see articles written by the therapists you’re considering working with. When you’ve found a good match, book an online therapy appointment with them directly.

Are you ready to connect with a therapist but feel a little overwhelmed by all your options? Speak with one of Choosing Therapy’s Client Navigators. Client Navigators are mental health professionals who will listen to what you’re looking for in a therapist and help pair you with the best possible fit. Getting started is free, easy, and confidential.