Off the Couch

Thoughts about the therapeutic process, and the dynamics of client-therapist interactions.

How do you know when Binge Drinking is Really a Problem?

Who is harmed when you binge drink?

My friend’s daughter Anna* is expecting her first child in a few months. Once a heavy drinker, she stopped consuming any alcoholic beverages when she and her husband Len began trying to get pregnant. “I’ve read about how bad alcohol is for a fetus,” she said. “I want to give this baby everything I can to have a healthy and satisfying life, and I sure don’t want to start out by causing brain damage by drinking. I can do without it for as long as I need to if that’s the trade-off.”

 

Len, on the other hand, doesn’t see any reason that he should join Anna in abstaining. “Alcohol isn’t going through my body into the baby’s,” he says. But Anna worries about Len’s drinking. Although he does not get drunk every night, he does binge drink on weekends. “It gets a bit embarrassing,” she says. “He says and does things he wouldn’t say or do if he wasn’t drunk.” Anna says she can see when he’s gone over the line into drunkenness by a particular look in his eyes. She loves Len and thinks he will be a terrific dad, but she worries that the drinking will affect their child psychologically. Len thinks she’s wrong. “It’s just how I unwind,” he says.

 

For some years, I have been concerned about the problem of binge drinking among college students (my most recent article on the subject will be coming out sometime in the next year in the Journal of College Student Psychotherapy). But a number of factors, including responses to my post on Mother’s Day, concerns expressed by a number of clients, and conversations with a variety of friends, colleagues and relatives, made me start to pay attention to the issue of binge drinking in adults.

 

It turns out that, although it is a problem among college students, 70% of binge drinking episodes involve adults age 26 years and older. The Centers for Disease Control says that it is the most common pattern of excessive alcohol use in the United States.  It is a serious concern in many countries around the world. And yet it may not be considered alcoholism, since according to this same report, many people who binge drink are not alcohol dependent.

 

Just for the record, the National Institute on Alcohol Abuse and Alcoholism defines binge drinking as the consumption of enough alcoholic beverages within a 2 hour period to bring blood alcohol concentration levels to 0.08 grams per deci-liter. For women this usually means an average of four drinks, and for men an average of five, although binge drinkers are seldom very accurate about the number of drinks they consume in a two hour period, let alone in the course of an evening.

 

Alcoholism, on the other hand, is defined as including symptoms such as:

  • Craving—A strong need, or urge, to drink.
  • Loss of control—Not being able to stop drinking once drinking has begun.
  • Dependence—Withdrawal symptoms, such as nausea, sweating, shakiness, and negative emotional states such as anxiety, after stopping drinking.
  • Tolerance—The need to drink greater amounts of alcohol to feel the same effect.

 

I guess one question is, does it matter if binge drinking is alcoholism?

 

Since it turns out that even a single episode of binge drinking can be highly destructive. Here is a list of just some health problems associated with binge drinking from the Centers for Disease Control:

 

  • Unintentional injuries (e.g., car crashes, falls, burns, drowning)
  • Intentional injuries (e.g., firearm injuries, sexual assault, domestic violence)
  • Alcohol poisoning
  • Sexually transmitted diseases
  • Unintended pregnancy
  • Children born with Fetal Alcohol Spectrum Disorders
  •  High blood pressure, stroke, and other cardiovascular diseases
  •  Liver disease
  •  Neurological damage
  • Sexual dysfunction, and
  • Poor control of diabetes.

 

And just this week came a report of a new study showing that a single episode of binge drinking can cause bacteria to leak from the gut into the bloodstream with potential damage to a person’s immune system. 

So what makes people continue to binge drink despite these potential dangers? And here’s another question: Apparently, Anna’s situation is not at all unusual. The number of men who binge drink is twice the number of women. Why is this?

 

I’m just starting to research these questions. I’d love to know about your experiences and about what you think drives binge drinking. Also, if you know of studies, articles or books that try to explain why people continue to binge drink despite the obvious dangers, I’d be very grateful if you would post those as well.

 

 

 

Some Reference Articles:

 

  1. Naimi TS, Brewer RD, Mokdad A, Clark D, Serdula MK, Marks JS. Binge drinking among US adults. JAMA 2003;289(1):70–75.
  2. Centers for Disease Control Fact Sheet about binge drinking: http://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm
  3. Hibell, B., Andersson, B., Ahlström, S., Balakireva, O., Bjarnason, T., Kokkevi, A., et al. (2004). The ESPAD Report 2003: Alcohol and other drug use among students in 35 European countries. Stockholm: The Swedish Council for Information on Alcohol and Other Drugs (CAN). 

*Names and identifying information changed to protect privacy

 

Teaser image: Istock photo  26223014

 

 

 

 

 

 

F. Diane Barth, L.C.S.W., is a psychotherapist, teacher, and author in private practice in New York City.

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