Binge

Usage of the word “binge” has evolved in recent years.

Binge: The Dictionary Version.

Merriam-Webster defines it this way:

a drunken revel : SPREE; an unrestrained and often excessive indulgence <a buying binge>

Princeton’s WordNet 2.0 speaks of immoderate indulgence:

The noun “binge” has 2 senses in WordNet.

1. orgy, binge, splurge — (any act of immoderate indulgence; “an orgy of shopping”; “an emotional binge”; “a splurge of spending”)
2. bust, tear, binge, bout — (an occasion for excessive eating or drinking; “they went on a bust that lasted three days”)

The verb “binge” has 1 sense in WordNet.

1. gorge, ingurgitate, overindulge, glut, englut, stuff, engorge, overgorge, overeat, gormandize, gormandise, gourmandize, binge, pig out, satiate, scarf out — (overeat or eat immodestly; make a pig of oneself; “She stuffed herself at the dinner”; “The kids binged on icecream”)

Twenty-four Hours: A Short Binge?

In the substance abuse field, the longest-standing definition of “binge” refers to an episode of heavy drinking, usually lasting more than a day. In the NIAAA’s ETOH database glossary we find:

A pattern of heavy drinking that occurs in an extended period set aside for the purpose of drinking. In population surveys the period is usually defined as more than one day of drinking at a time. The activity of binge drinking also is referred to as “bout drinking” or “spree drinking.” The term “drinking bout” is used to refer to the occasion. A binge drinker or bout drinker is one who drinks predominantly in this fashion, often with intervening periods of abstinence.

My buddy Brian was a binge drinker in this sense of the word. He would buy 2-5 bottles of Scotch (and not small ones) and start drinking at while playing at the computer, and later, watching TV. A gap of a couple hours between drinks was possible when passed out, but the heavy drinking continued not too long after getting up. When we were closest, in the mid 1990s, a 24-hour binge was less common and most of them fell in a range of 36 to 72 hours. Then, as in the definition, abstinence would prevail for several weeks.

College Binge Drinking: The 5/4 Definition

In the early 1990s, studies of alcohol use on college campuses began adapting the use of “binge” to describe having 5 or more drinks “in a row”, without specifying a timeframe.

The College Alcohol Survey, which collected data from over 17,000 students on 140 campuses in 1993, led by Dr. Henry Wechsler, Ph.D. with support from the Robert Wood Johnson Foundation, split the definition to account for gender differences. Its report titled "Health and Behavioral Consequences of Binge Drinking in College" in the Journal of the American Medical Association noted:

(p. 1674, col 1) Binge drinking was defined as the consumption of five or more drinks in a row for men and four or more drinks in a row for women. …the term “binge drinker” is used to refer to students who binged at least once in the previous 2 weeks.

(p. 1673, col 2) The use of [“in a row”], without specification of a time elapsed in a drinking episode, is consistent with standard practice in recent research on alcohol use among this population.

(p.1672, col 3) [Previous] studies of college alcohol use … [have generally] used the same definition of binge drinking for men and women, without taking into account sex differences in metabolism of ethanol or in body mass.

The 5/4 definition has resonated in the media and among public health advocacy groups, but failed to win widespread acceptance among academics and researchers. The International Center for Alcohol Policies questioned it in a 1997 report:

Defining a drinking pattern solely by the number of drinks consumed … falls short of being adequate. This approach fails to take into account the context of drinking, the individual engaging in the behavior (a 250-lb male is likely to experience very different consequences from five drinks than is a 100-lb female), and the salience of alcohol within the drinking occasion. The time interval over which the drinks are consumed is a critical variable, but also one on which there is no consensus. The effects of consuming five drinks over the course of a three-hour dinner are likely to manifest themselves very differently from the effects of consuming five drinks in rapid succession over half an hour.

An October 2000 press release by the Higher Education Center for Alcohol and Other Drug Prevention noted:

Most researchers in the field are now rejecting use of the word “binge” to describe having 5/4-plus drinks over some unspecified period of time. It is true that various government reports use it, but the National Institute of Alcoholism and Alcohol Abuse (NIAAA), the federal government’s primary research institute in this area, never does, nor does the Journal of Studies on Alcohol, which is the lead journal in the field. Moreover, a special panel on alcohol prevention and treatment in higher education convened by NIAAA voted unanimously last year not to use the term “binge” in this way.

NIAAA’s 2004 Binge Definition

During its February 4-5, 2004 meeting, the National Advisory Council on Alcohol Abuse and Alcoholism (which advises the NIAAA), unanimously approved this updated definition:

A “binge” is a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to .08 grams percent or above. For the typical adult this pattern corresponds to consuming 5 or more drinks (male) or 4 or more drinks (female) in about 2 hours. Binge drinking is clearly dangerous for the drinker and for society.

• A drink is defined as half an ounce of alcohol (e.g., one 12 oz. beer, one 5 oz. glass of wine, one 1½ oz. shot of distilled spirits).
• Binge drinking is distinct from “risky” drinking (peak BAC between .05 and .08 grams percent) and “benders” (2 or more days of sustained drinking to intoxication).
• For some individuals (e.g., older people; those taking other drugs or certain medications), the number of drinks needed to reach a binge-level BAC is lower than for the “typical adult.” People with risk factors for the development of alcoholism have increased risk with any level of alcohol consumption, even that below a “risky” level.
• For pregnant women, any drinking presents risk to the fetus.
• Any drinking by persons under the age of 21 is illegal.

So, using what we know about blood alcohol content, this definition tells us that binge starts at a level of slight impairment of balance, speech, vision, reaction time, and hearing. In general terms, the binge threshold of .08 is half-way to the “sloppy drunk” characteristics of .16. BAC tables like these suggest that the binge threshold could be reached by:

• A 120-lb woman having 2½ drinks in an hour
• A 220-lb woman having 8 drinks in 5 hours
• A 160-lb man having 4 drinks in an hour
• A 240-lb man having 11 drinks in 5 hours