Binge drinking is a significant public health problem, contributing to problems such as traffic crashes, violence, sexually transmitted infections, and several types of cancer. It is a common pattern of heavy alcohol use, characterized by individuals drinking a large amount of alcohol on one occasion. One common definition of binge drinking used in surveys is consuming five or more drinks on one occasion for men and four or more drinks for women, typically in the past two weeks or in the past month (Johnston et al., 2009a; SAMHSA, 2009; Wechsler et al., 1995a). The National Institute on Alcohol Abuse and Alcoholism recently defined binge drinking as "a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 gram 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 (NIAAA, 2004)."
Binge drinking is a particular public health concern among individuals under the minimum legal drinking age of 21 and among young adults (Naimi et al., 2003). In 2008, 25% of high school seniors reported binge drinking in the past two weeks (Johnston et al., 2009a). Binge drinking rates among traditional college students aged 18-24 are considerably higher - 40% of college students report binge drinking in the past two weeks, and these rates have stayed fairly stable over the past two decades (Grucza et al., 2009; Johnston et al., 2009b; Nelson et al, 2009; Wechsler et al., 2002b). Binge drinking is a typical pattern of alcohol use among young people aged 18-24. Approximately half of those who use alcohol in this age group can be characterized as binge drinkers (Johnston et al., 2009a; 2009b; Naimi et al., 2003; Wechsler et al., 2002c). Among college students who binge drink frequently (three times or more in a two-week period), most meet the diagnostic criteria for alcohol abuse or dependence (Knight et al., 2002).
Binge drinking significantly contributes to many health and social problems and to economic costs associated with those problems. No single prevention program, treatment intervention, or policy approach is sufficient for eliminating binge drinking and its associated problems at the state, community, or institutional level. Rather, there is a critical need to combine multiple scientifically-tested strategies in order to achieve meaningful progress. Policies and systems are needed at multiple levels to create environments that discourage heavy alcohol use among the general population as well as specific populations in which binge drinking is of particular concern (e.g., underage youth and college students).
Policies are needed to identify individuals at highest risk for alcohol-related problems and provide age- and culturally-appropriate intervention and treatment programs. Such infrastructure should include screening and programs, trained staff, and economic resources to offer effective programs to those who need them. Systems for helping high-risk drinkers can be implemented at a community level or within specific institutions such as college campuses.
Appropriate systems for screening, intervention, and treatment in states, communities, and institutions such as colleges are not sufficient to reduce population-levels of alcohol-related problems. The majority of alcohol-related problems occur among individuals who drink heavily but who do not meet the criteria for alcohol abuse or dependence. Alcohol control policies can be implemented by institutions, communities, and states to limit alcohol sales (e.g., mandate responsible alcohol service training for alcohol servers and managers), reduce availability of alcohol (e.g., reduce the number of alcohol establishments), restrict marketing (e.g., restrict advertisements for alcohol promotions), and raise alcohol prices (e.g., increase excise tax on alcohol). These policies that change the environment around alcohol sales and promotion have the most potential to reduce problems related to binge drinking.