Tipsy Times

Literally hundreds of studies over the past decade have reported evidence that regular, moderate drinking–downing one to three drinks a day–can offer people significant health benefits by cutting their risks of heart disease and probably diabetes. What such studies usually fail to emphasize is that benefits from a little alcohol show up almost exclusively in older adults.

Indeed, the data would suggest that, there might be no health justification for drinking alcohol unless you’re already at risk of chronic degenerative conditions. That means not before about age 40, says Jürgen Rehm of the Addiction Research Institute in Zurich. Moreover, what health benefits can accrue from moderate tippling may disappear completely in people who binge to excess.

And plenty of people do, a new study finds, with the incidence of inebriation on the rise in the United States. Most disturbing, a spate of new studies shows that many of the youngest drinkers are among alcohol’s worst abusers. They include a substantial share of college students, young people who should definitely know better.

Binge drinking on the rise

To gauge adult drinking patterns, Timothy S. Naimi and his colleagues at the Centers for Disease Control and Prevention (CDC) in Atlanta analyzed telephone-survey data collected between 1993 and 2001. Some 102,000 people responded in the early years of this ongoing Behavioral Risk Factor Surveillance System study; by 2001, more than 212,000 took part.

In each year, individuals were asked whether they drank at all in the past month and, if so, on how many days per week or per month. The surveyors also asked them how many drinks they were likely to consume on a given day and how often they had consumed five or more drinks on a single occasion–the CDC team’s definition of binging.

When extrapolated to the United States as a whole, the new data indicate that slightly more than half of the nation’s 205 million adults abstained from drinking alcohol in 2001. Of those who did drink, many at least occasionally consumed excessive amounts of alcohol, the CDC scientists report in the Jan. 1 Journal of the American Medical Association. The new data indicate that collectively, U.S. adults chalked up more than 1.5 billion binging episodes in 2001–a 59 percent increase in drinking sprees compared with 6 years earlier.

As one might expect, not all segments of the population were equally likely to go on a bender. Among ethnic groups, the black population had the smallest share of bingers–about 10 percent in 2001–and the Hispanic community the largest–16.8 percent. Men were three times as likely as women to report binging. By education, adults with at least some college were the most likely to binge that year–16.2 percent. Indeed, they accounted for almost one-third of binging episodes.

Roughly half of all binging episodes occurred among people who were otherwise moderate drinkers. For instance, this could be Uncle Harry who overindulged at the wedding reception, or Mitzi in the accounting department who reached for one too many apple martinis at the holiday party.

The group that really drank to excess was the 18-to-25-year-olds. In 2001, more than 60 percent of men this age acknowledged binging–on average, a whopping 39 times a year. Only about 33 percent of women this age reported binging–and less than half as many times per year as men.

The new CDC study is the first to quantify binge drinking in the United States, although its authors argue that “our data may underestimate the true number of binge-drinking episodes.” That’s mostly because, say the researchers, the study didn’t include adolescents and it undersampled college students, a population that’s especially prone to binging.

Because of alcohol’s harmful effects on the developing fetus, Naimi’s team found especially of concern the high rate of binge drinking among women of childbearing age. In fact, new data reinforce the concern that fetal exposure to alcohol can have lasting detrimental effects on children. Nancy L. Day of the Western Psychiatric Institute and Clinic in Pittsburgh, for instance, has found that even relatively low and infrequent drinking by a pregnant woman can reduce the size, weight, and head circumference–a rough measure of brain size–of her child through at least age 14.

Collegiate indulgences

Last year, a Harvard University study reported finding that 44 percent of students reported binge drinking–a rate that has held fairly constant since 1997, say the researchers. The finding comes from a series of surveys administered since 1993 to men and women attending 119 4-year colleges.

What does seem to be changing, Henry Wechsler and his colleagues at the Harvard School of Public Health note, is a “trend toward polarization of drinking behavior.” That is, the share of students that abstains from alcohol and the share that frequently overindulges are both increasing. Interestingly, the percent of students who reported binging during high school exhibited a steady downward trend in the series of surveys, from 32 percent in 1993 to 26 percent in 2001.

The study also unveiled a growing trend among college drinkers of increasing alcohol intake since 1993. For instance, those who reported drinking on at least 10 occasions during the previous month increased by 33 percent, the share that reported getting drunk at least three times in the past month increased by 36 percent, and the proportion that reported drinking with the express purpose of getting drunk increased by 40 percent.

In another study last year, Wechsler’s group looked for factors that most influence college freshmen to start binging. Chief among them seemed to be: “very easy” access to “cheap” alcohol, socializing in environments where alcohol was being consumed, and having drunk immoderately in high school. Indeed, the Harvard researchers found, students who said they had been drinking at least once a month in their senior year of high school “were over three times more likely to pick up binge drinking in college than were students who drank less frequently.”

Binging’s fallout

The heavy overindulgence in alcohol by many students doesn’t just represent youthful high jinx, Wechsler’s group finds. Excessive alcohol consumption can have some serious impacts. For instance, a May 2002 study by the researchers found that 6 percent of college students are alcoholics and another 31 percent regularly abuse alcohol.

These rates “indicate that the drinking levels of too many students are dangerously high,” Wechsler says. Indeed, his team concludes, the seriousness of the students’ problems indicates that more than 40 percent of students leave college each year with behaviors that put them at risk of developing lifelong mental disorders that trace to alcohol.

Although bingers risk suffering a range of serious short-term impacts from their overindulgences–from auto accidents and violence to falls and rape–excessive alcohol consumption often has a less well recognized secondary fallout on nondrinkers. Last July, Wechsler’s group reported that neighbors of colleges where binging was common were 81 percent more likely than people living near low-binge institutions to suffer “secondhand” effects of those benders–from vandalism and noise to litter and assaults. Not surprisingly, the study found, these events can seriously compromise the neighbors’ quality of life.

Exacerbating the problem is the proximity of liquor stores to many colleges. “Alcohol outlets attract students with drink specials that seem to foster a binge-drinking environment,” Wechsler says.

Interventions needed

The high rates of binging in the United States warrant aggressive intervention strategies, Naimi’s group argues. One tactic might be to raise alcohol taxes, the researchers say, because studies have shown that increasing alcohol’s cost decreases binge drinking and drunk driving. Unfortunately, the CDC group notes, inflation-adjusted taxes on alcohol have in fact been falling over the past 40 years–especially for beer, “despite the fact that beer is the most common type of alcohol used by binge drinkers.”

Another problem: Many schools have developed relationships with the beverage industry that allows companies to promote alcohol through collegiate sports events. Schools should reconsider such an economic tie, Wechsler’s team argues, in light of the findings from yet another study by the Harvard group. It showed that among students, those who consider themselves sports fans are more likely to abuse alcohol.

Not only is binging more than twice as frequent at “sports schools” than at institutions where sports are downplayed, the study found, but sports fans reported higher rates of alcohol-related problem behaviors. For instance, 23 percent of sports fans who drink reported driving after binging, compared with just 15 percent of nonfans. While drinking, fans were about 50 percent more likely than nonfans to engage in each of several behaviors: getting in trouble with the police, engaging in unprotected sex, vandalizing property, and missing a class.

What would help, the CDC group argues, would be for schools and other organizations to galvanize society into stigmatizing alcohol abusers. Unfortunately, these researchers note, today “much of the general public considers alcohol intoxication to be either humorous or a rite of passage”–instead of what it really is, a serious social disease.